Medical Writing Health Economics and Market Access The Light Stuff

Volume 22, Issue 3 - Health Economics and Market Access

The Light Stuff

Decoding the Japanese

Code 1: Yes means yes, and no does not exist

At a recent dinner, my husband and I were chatting with a university professor, a Japanese fellow who has lived and worked in Europe and the US. We talked about cross-cultural differences in communication styles, and in particular the legendary habit of the Japanese of taking excessive care to avoid saying ‘No’.

He explained, ‘In general, Yes is the only affirmative answer, anything else should be taken as a No!’

He then told us an anecdote. A friend of his in Tokyo was organising a farewell party, and sent out an email in which the invitees were asked to answer the simple question, ‘Would you like to come to the party’. Two choices were given to answer this question:




Yes, but I may be busy!!!

He was not in Tokyo at this time and replied to the email, respecting the code, ‘Yes, but I am in the US’.

Please note, even the question is framed in a way that the responder can avoid saying the N-word.

Anuradha Alahari, freelance medical writer from France, currently on a short stay in Tokyo, Japan

Anuradha Alahari

Code 2: Do not let cultural differences stop us from relating as people

And while we are visiting the ‘Land of the Rising Sun’ for discussions on communication, I would like to relate a short story from several years ago when I was working with a Japanese client. As those of you who have done this know, the requisite end of the day evening dinner can be quiet difficult when trying to socialise.

Sure enough, I was at one of these dinners and somehow ended up in a corner of the table next to a particularly taciturn Japanese gentleman. Well, I may be known for being able to talk to anyone, but this was a real challenge as this particular case had fairly limited English skills and was in any case never very talkative. So we sat there studying the menu intensely and occasionally making pointless small talk.

However, I could not help but notice that the necktie he was wearing had small silhouettes of battleships on it. As a fan of neckties with small pictures on them (a great tradition from years ago that has unfortunately become much less common today), I was rather intrigued, as usually one sees ties with school crests or little animal figures or sports logos – but battleships? Still, I was not sure how to ask him, but my curiosity eventually overwhelmed me and I asked him what was on his tie. He told me it was the battleship his father had served on in WWII. Now I was even more curious, because this is not really your usual necktie decoration – especially in Japan, which has had a strong non-military policy for many years – so without really thinking, I blurted out, ‘That is interesting, would you mind if I asked you a question about your personal opinion?’. Much to my surprise and delight, he looked at me very seriously, straight in my eyes, and replied,

I would be most honored if you would ask me a question about my personal opinion.

For the rest of the evening, we had a lively discussion about militarism in modern Japan, much to the amazement of the rest of the table.

Barry Drees




Message from the President
Thirty-seventh EMWA Conference, 7–9 November 2013, Barcelona, Spain
Announcing the Geoff Hall Memorial Scholarships
Health economists and medical writers: Collaboration or collision?
Early benefit assessment of new drugs in Germany: Framework for submission of dossiers by pharmaceutical companies
NICE guidance on health technologies and the role of editors
European network for health technology assessment – EUnetHTA
Guest Editorial: Medical writing and health economics/market access: A health economist's view
Results of the 2012 EMWA salary survey
Successful document collaboration in a virtual team
Profile: An interview with Blanca Mayor Serrano on the state-of-the-art of health literacy in Spain
What can twitter do for me?
In the Bookstores
Journal Watch
The Webscout
Regulatory Writing Developments in paediatric regulation
English Grammar and Style
Medical Journalism
Medical Communications
Manuscript Writing
Out On Our Own
The Light Stuff


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Editoral Board


Raquel Billiones


Evguenia Alechine

Jonathan Pitt

Managing Editor

Victoria White

Associate Editors

Anuradha Alahari

Jennifer Bell

Nicole Bezuidenhout

Claire Chang

Barbara Grossman

Sarah Milner

John Plant

Sampoorna Rappaz

Amy Whereat

Section Editors

Daniela Kamir


Jennifer Bell


Nicole Bezuidenhout 

Digital Communication

Somsuvro Basu

EMWA News 

Ana Sofia Correia 

Gained in Translation

Ivana Turek

Getting Your Foot in the Door

Wendy Kingdom / Amy Whereat

Good Writing Practice

Alison McIntosh 

In the Bookstores

Maria Kołtowska-Häggström

Lingua Franca and Beyond

Maddy Dyer


Lisa Chamberlain-James

Medical Communications/Writing for Patients

Payal Bhatia

Medical Devices

Evguenia Alechine

My First Medical Writing

Anuradha Alahari

News from the EMA

Adriana Rocha


Tiziana von Bruchhausen


Clare ChangZuo Yen Lee 

Regulatory Matters

Sam Hamilton

Regulatory Public Disclosure

Claire Gudex

Teaching Medical Writing

Louisa Ludwig-Begall / Sarah Kabani

The Crofter: Sustainable Communications

Louisa Marcombes

Veterinary Writing

Editors Emeritus

Elise Langdon-Neuner

Phil Leventhal

Layout Designer

Chris Monk