Cross-cultural communication （５）　

５）Presentations at Primary Care Conferences
　After a little more than a year of examining foreigner patients, we have seen a significant number of cases. I found that the majority of these cases had a psychosomatic component, and that they improved relatively easily when treated with this in mind.

　I had joined the Japanese Society of Primary Care (now the Japanese Primary Care Association) soon after returning from the U.S. in 1983, but I had never yet presented at the conference. I decided to present this experience of treating foreigners. I was reasonably confident about the content, but I was quite unsure about the title of my presentation. This is because the impact of a title is often influenced by the impact of a presentation at a conference or the publication of a book. The title I finally decided on was “Simulation Model of Psychosomatic Disorders.“ This title expressed the fact that psychosomatic symptoms that develop in foreigners who have just arrived in Japan, a situation in which the possibility of developing psychosomatic symptoms is high, can improve quickly if appropriate medical treatment is provided that matches the language and culture of the foreigner. It is a simulation model of a typical psychosomatic disease that can be cured by following the pattern.

　The presentation went without any problems. The audience responded well and asked many questions. Among them, there was one comment that could be taken as a little malicious. It came from a veteran psychosomatic physician. It is true that these patients respond well to treatment the first time, but most of them soon relapse and come back soon. Psychosomatic illness depends on the circumstances, but it still happens to those who are predisposed to it.”

　There was a sense of satisfaction in the fact that the modest but original work I found myself doing for the first time at Osaka National Hospital was able to make it all the way to a presentation at the conference. About two months after the conference, opinions about the impressive presentations were published in the Journal of Primary Care. One small opinion piece submitted by a resident caught my eye. It was an opinion about a session I presented. “I was very interested in the presentation of a foreigner's treatment and thought I would like to be involved in the future, and there was a negative comment by a psychosomatic specialist, which I thought was out of place.” It was a frank opinion, just like a resident doctor. I also felt further satisfaction that the audience felt the same way I did.

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