How to Read “病上手に死に下手”
yamai jouzu ni shini heta
Meaning of “病上手に死に下手”
This proverb means “one is accustomed to being ill but not accustomed to dying.”
During their lifetime, people experience illness many times and recover each time, thereby acquiring methods for dealing with illness and the proper mindset. However, death is a once-in-a-lifetime experience, and since it is a first-time experience for everyone, no one knows how to face it. This proverb expresses this fundamental human condition. As for usage scenarios, it is used when understanding and showing empathy for the anxiety and confusion of someone facing death. It is also used as a philosophical expression when contemplating the end of life. Even today, with advances in medicine, the essential human experience that this saying represents remains unchanged and is accepted as a universal truth that many people can relate to.
Origin and Etymology
“Illness skilled at death unskilled” is an old proverb that has been used since the Edo period. To understand how this proverb came about, we first need to know the ancient meanings of the words “skilled” and “unskilled.” While these words express technical proficiency in modern times, in ancient times “skilled” meant “experienced” or “well-versed,” and “unskilled” meant “inexperienced” or “unfamiliar.”
The background to the birth of this proverb lies in the view of life and death held by people in the Edo period. At that time, medical technology was not advanced, and falling ill was not uncommon. Many people repeatedly experienced illness and recovery. On the other hand, death was a once-in-a-lifetime experience, and everyone was a beginner at it.
The universal human situation of “being accustomed to illness but not accustomed to dying” was expressed by people of that time using the familiar words “skilled” and “unskilled.” This proverb can be said to be a word imbued with the wisdom of our ancestors, expressing the difference in human experience during the important phases of life—illness and death—as a concise and impressive parallel phrase.
Usage Examples
- Since grandfather had been dealing with chronic illness for many years, he was illness skilled at death unskilled, showing attachment to life until the very end
- As the saying “illness skilled at death unskilled” goes, even my mother, who has repeatedly been hospitalized and discharged, is only afraid of dying
Modern Interpretation
In modern society, the meaning of this proverb has become more multifaceted. With advances in medical technology, many diseases have become treatable, and people have become even more “illness skilled” than before. The ways of dealing with illness have become remarkably sophisticated, including regular checkups, preventive medicine, and self-care.
However, at the same time, there has been a stronger tendency to treat talking about death as taboo. Due to the nuclearization of families, opportunities to experience death up close have decreased, and many people spend their lives remaining “death unskilled.” The end-of-life planning boom and active discussions about death with dignity can also be seen as responses to this modern “death unskilledness.”
On the other hand, with the spread of the internet, information about diseases has become easily accessible. Communities of patients have also been formed, making it easier to share methods for dealing with illness. However, death is still often perceived as a personal and solitary experience.
It could be said that in modern times, the situation of being “illness skilled at death unskilled” has become more extreme. While dealing with illness has improved due to medical advances, we may have become even more “unskilled” at preparing for death and developing the proper mindset than people in the Edo period.
When AI Hears This
In modern hospitals, patients can now make detailed choices about “how they want to live.” From types of pain medication to methods of nutritional support to the intensity of rehabilitation—we truly live in an era where people can design their own “relationship with illness.” Ironically, however, this advancement in medical technology has produced a massive number of people who are “poor at dying.”
According to a Ministry of Health, Labour and Welfare survey, about 70% of people say they want to “spend their final moments at home,” yet only about 13% actually die at home. In other words, while people can master medical choices during their lifetime, the overwhelming majority cannot realize their own wishes when it comes time to face death.
Behind this phenomenon lies the development of life-extending technology. Technologies like ventilators and feeding tubes have blurred the boundary between “living” and “dying.” For example, it’s not uncommon for cases to continue for months where the heart keeps beating even without consciousness.
In the Edo period, when people became ill, results came relatively quickly. But in modern times, while we’ve become skilled at managing illness, the choices regarding “death”—which lies at the end of that continuum—have become so complex that many people find themselves bewildered. The advancement of medical technology has brought the truth of this proverb into sharper focus.
Lessons for Today
This proverb teaches us about the essential difference between “familiarity” and “first experiences” in life. It shows the importance of accepting the reality that while we become proficient at many things through daily experience, there are things in life that we can never practice.
For those of us living in modern times, this teaching can be applied as “the wisdom to distinguish between what we can prepare for and what we cannot.” Preparing for illness and health management are areas where we can gain experience and improve. On the other hand, by acknowledging that perfect preparation for the end of life is impossible, we might instead find peace of mind.
This proverb also teaches us “the courage to accept imperfection.” No matter how much life experience we accumulate, we continue to be beginners at something. This is not shameful but proof of our humanity.
What’s important is to make use of wisdom from familiar areas while maintaining humility toward unknown experiences. And not forgetting empathy and compassion for people who are in similarly “unskilled” situations—this is the warm message that this proverb conveys to modern times.
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