Misadventures at a Chinese Hospital in Qingdao

Our About page says we’re “trying to live into and love — and some days just survive — China.” That last bit is just supposed to be some tongue-in-cheek hyperbole, but it recently became a little too literal.

For reasons that no doubt expose my questionable judgment, I tried to use the nearby local Chinese hospital in our un-redeveloped patch of an older outlying district of a wannabe 2nd-tier Chinese city, rather than the big downtown hospital that sometimes has Western-trained doctors in a clinic specially targeted to foreigners. I mean, how complicated could it be to get treatment for a persistent cough? What could go wrong, you know? As it turns out… a few things.

* * * * *

Why Not Choose a Local Chinese Hospital?
Of course we’ve seen the headlines and heard the stories about Chinese hospital corruption and low standards. But we’ve had two tolerable experiences at this particular hospital before: once when our two-year-old had bad pneumonia she got prescribed oral antibiotics and breathing machine meds (when we resisted hospitalization), and recently when the same kid had diarrhea she got prescribed ‘normal’ diarrhea medicine plus Chinese herbal belly button plugs (just for kicks).

I figured it’d be more convenient (wrong) and less expensive (also wrong) to visit a Chinese doctor I could walk to and pay 6元 to see rather than visit a maybe-Western-trained sort-of English-speaking Chinese doctor who costs 100元 to see plus 70元 in taxi money round-trip. And just the fact that I knew I could navigate a Chinese hospital visit on my own kind of made me want to give it a shot.

* * * * *

How to Get From the Front Doors to a Filled Prescription… in 11 Easy Steps (at least)
The Number “4” People’s Hospital is pretty average; you can find better and you can find worse (it wasn’t actually the Number “4”; I’m obscuring that detail to protect the possibly-guilty and because “4” means “die” in Chinese).

The process…

  1. from walking in the door and taking a number (<5min)
  2. to paying, getting a card, and registering to see a doctor (15min)
  3. to seeing a doctor (15min)
  4. to paying for tests (15min)
  5. to getting tests done (45min)
  6. to picking up the test results (30min for blood; 4hrs for CT printout — but the doctor has them almost instantly via the hospital’s computer network)
  7. to seeing the doctor again for a diagnosis and prescription (15min if you spend time arguing like me)
  8. to getting the skin test done to check for allergies to the prescribed meds (20min)
  9. to paying for those meds (15min)
  10. to receiving your meds (5min)
  11. to getting your IV drip prepared and inserted into your circulatory system (IV drips are a national pastime in China) (15min)

…can appear daunting at first. Each one of the points above represents a trip to a different window and/or office and/or machine, and most of them involve standing in crowded noisy lines of other sick people. (The times above are what it took for me the other day.)

Honestly, Number “4” People’s was decently navigable; at any point in the process you can ask a nurse at the booth by the main entrance and she’ll tell you what to do. To get your test results you insert your hospital card into an ATM-like machine (your name displays on a screen when they’re ready to print), but the doctor had my results on her computer before I’d made it back to her office from the testing room.

But you should probably bring a Chinese friend if:

  • You’re too sick to stand for a while in the crowded heat and yell through glass windows and run around a bit;
  • You don’t have at bare-minimum solid HSK4-level Chinese (this might not be enough). Aside from the all the medical vocabulary, it’s just noisy and hard to hear clearly.

* * * * *

How Not to Handle Your Average Local Chinese Doctor
I’d walked in at 9:30am and ping-ponged through Steps 1-6 by 11:10. Now I’m back in the doctor’s office (Step 7)… and this is when things start to go bad.

I’m not saying ‘bad’ because there’s no privacy with the door wide open and other people in the room, one of whom will eventually chime in on my consultation — that’s normal and expected. I’m saying ‘bad’ because she looks at my CT scan and says: “You need to be admitted for 7-10 days and take IV antibiotics.”

“Can’t I just take antibiotics pills? I’ve never needed an IV before. Usually we just take pills for this.”

“You’re pneumonia is too serious for pills. You need to be admitted. Look here…” She shows me her screen:
CT_scan_pneumonia
“…That’s your heart. That black part is your lungs. It’s supposed to be all black. See all this? This here that looks like meat? That’s the pneumonia.”

This is not what I want to hear. As if I know how to judge the seriousness of a CT scan. And sure, I know the Chinese doctor stereotypes — over-treat everything (especially with IVs and unnecessary hospitalization and surgery) just to make extra sure, and never mind a financial incentive to over-prescribe — but I mean, come on. Really?

There’s no way I’m being admitted; we leave for North America in just over two weeks, we have a newborn and two young kids at home, and I have work to do. So I’m still aiming for pills while trying not to be too rude: “I can’t be admitted; that’s impossible. Can we really not use pills in this situation?”

“I really don’t want to give you oral antibiotics,” she says while flipping through my CT images, “Not for pneumonia that’s this serious.”

I haven’t given up yet, “Well, what’s the difference between me taking pills or an IV? Is it just that pills will take longer? Because I don’t mind! I can take pills for weeks if I need to!”

“Your pneumonia is really too serious. You’ve got to be on an IV…” She will not budge. After some more back and forth — during which I wish now that I’d just flat-out refused and forced her to give me pills — I agree to come sit in the hospital’s Infusion Hall twice a day for four hours at a time for three days, after which she’ll maybe consider giving me pills depending on my progress. We also go back and forth about whether I can just do the IVs in our neighbourhood’s clinic, but she refuses. I have to come into their hospital twice a day for four hours at a time.

It’s insane; I can’t believe I’m agreeing to it but my only other option is hospitalization, and by this point I’m feeling pretty sick.

infusion_convoI want to walk out and catch a cab straight to the foreigner clinic at Qingdao Municipal or even to super-expensive Family United — anywhere a doctor will prescribe oral antibiotics. But here’s the catch: it’s the beginning of the Dragon Boat Festival national long weekend. Jessica’s already called both those other hospitals and neither has an American-trained doctor available. At Family United I’d have to go to Emergency, so with tests we’re talking 10,000元 (their nurse’s estimate!) and I’d still be seeing a locally trained Chinese doctor!

* * * * *

From the Infusion Hall to the ER… in under 10min
So that’s why I show up again at 3:30 to collect my CT printout and go on a drip for the first time in my life (though we did sell plenty of our plasma in college; I’ve got lots of experience sitting in a chair for hours with a needle in my arm).

It takes more time to get from Step 8 to Step 11 than I’d anticipated (plus I wasted about 15min standing in line at the wrong time). I send Jessica this photo at 4:28. The drip’s been in for about a minute:
POd_inthe_infusionhall
I’ve got my laptop so I can do some work, and my Chinese reading’s loaded on my phone. Neither has enough battery to last the full four hours, even used consecutively. I’ve forgotten my book. So far I’ve been polite to everyone and kept my face pleasant, but I’m in a foul mood. I can’t believe I’m going along with this. I’m about to start in on my Chinese reading when…

…huh. does my stomach feel weird? i don’t think so… maybe i’m imagining it? or does it? it’s hard to tell… … wait, no, it does feel a little weird, maybe i’m hungry… … wait, are my fingers tingling? the heck…? my fingers are tingling… … oh man i need to rest my head somewhere…

“Hey, nurse! Please come here.”

“What?”

“I feel uncomfortable.”

“Oh! Haha. I don’t know. Hold on… Hey! Older Sister! Come here!” I see her wave down a nurse who looks slightly older than this rookie, who’s in the middle of a funny conversation with a coworker. They all get off work in about 20 minutes.

…am i sweating? i’m sweating… why am i sweating…

“What’s the problem?”

“I feel really uncomfortable,” I’m slumped forward in the chair, I wonder if I’m slurring.

“Here eat this.” She shoves a piece of candy in my mouth. I crunch it down as fast as I can. One of them pushes me back up into a sitting position.

…candy? the heck… oh man this is not getting better… i’m sweating buckets… i must be dripping on the floor… i’m dripping… ohhh black stars… white stars… am i gonna barf? …if i barf where should i barf? …not on my clothes… clear a space on the floor here…

Suddenly there are doctors — two, I think. They’re talking to the nurses. One looks straight at me and says, “What’s your name?”

“My name is Lu Tianlang.” …fuzzy black stars on the edges of my vision… and blinding bright whiteness like the washed-out parts of a photo…

His face is right in front of me, “Have you eaten? Did you have lunch?”

“At three in the afternoon I had three zongzi.”

He turns to the others, “It’s definitely not low blood sugar.”

…slumped… sweat… tingling… i can’t see clearly… a face, question…

“What is your name?” All I can see is his face and collar; all around and behind him are the bright white shining stars. I try to focus on his face.

“My name is Lu Tianlang.” …pretty sure i slurred that one…

An old man wheels a gurney up, they help me climb on — I’m oddly aware of the fact that I remember to grab my phone first — someone puts the laptop between my shins, they’re wheeling me down the hall. I think I hear them say the word in reference to whatever IV solution they used to swap out my medicine (guessing it’s this). I can feel the stars and tingling start to recede, and I tell them I’m starting to feel better. The doctors seem happy; they try out some English on me.

Chinese_ER_convoIn the neighbouring building’s ER they take blood pressure and do an EKG. I watch the doctor read the printout. He smiles, gives me a thumbs up, says I’m fine and leaves. I flag down a nurse who says I can go as soon as my drip bag is done in about 45 minutes. I’d better think of something to tell Jessica…

* * * * *

Outside the main entrance I thankfully get a cab immediately. The driver’s 60 years old. We chat. I mention what’s just happened. He takes a sideways look back in the direction of Number “4” People’s and mutters, “That place is no good. They don’t know what they’re doing in there. I don’t go there. They don’t know what they’re doing…” Then he lectures me about the importance of being healthy.

I’m feeling crappy and slightly scared. I have no medicine and tomorrow I’ll have to try another hospital. But I’ve got all kinds of warm feelings for this taxi shifu. It’s like ‘China’ decided to throw me a bone after all, even on a Bad China Day.

* * * * *

Salvation
1:30pm the next day is the soonest I can get to see a foreign-trained doctor — a “Dr. Qi” who works at the Municipal Hospital’s International Clinic. I imagine the consultation being mostly in Chinese, like the previous two times I’d seen doctors at that clinic.

But then he walks in and starts speaking *American.*

What?! …JACKPOT!!! MY NIGHTMARE IS OVER AND I’M GETTING PILLS!!! I COULD KISS THIS GUY RIGHT NOW! (Except for, you know, the pneumonia.) I wonder if the shock showed on my face.

I suspect he gets this reaction a lot. Another China long-termer in Qingdao told me later,

“I cried the first time I went in to see Dr. Chee. I couldn’t believe I was doing it in English and I just lost it right there in his office!”

I can understand that!

Turns out his name’s not even Qi (Mainland Chinese spelling for the surname ) like I’d assumed from hearing it spoken; it’s Chee (for ), as in his family probably originally immigrated from Hong Kong or somewhere (mine originally came from the Ukraine and Switzerland — hey, small world!).

This doctor visit is a full-on miracle of modern medical science. He’s better than a lot of doctors I’ve seen in North America, and I’m not just saying that because he prescribed me oral antibiotics that are literally 5x cheaper than the IV meds I’d bought the day before. If you are a sick English-speaking foreigner in Qingdao, Dr. Chee at the Qingdao Municipal Hospital’s International Clinic is your man!

* * * * *

One Final Awkward
But there’s one last task to do on the way home: get that nearly 600元 worth of IV antibiotics refunded. This requires authorization from the doctor who prescribed them. So I’m going to walk into her office at Number “4” People’s with some other hospital’s blood test gauze taped to my arm and a bag of pills that she wouldn’t give me but some other doctor obviously has, and ask her to refund two huge bags of stuff she insisted I buy even though I’d said I didn’t want to, and even though submitting to her treatment had landed me in the ER. Awkward.

I walk straight up to her office just after 4pm without taking a number (she gets off at 5). I’m polite and smiley; she’s chatty, if a bit flustered and rushed. She’s assumed I’m there to return the drugs and immediately gets after it. I can’t describe the process because she personally does all the running around between floors and departments and windows for me — I just follow her and stand off to the side.

We talk all about what happened 24 hours before, and she keeps saying, “It’s really strange!” over and over. She doesn’t verbally apologize, and we don’t even come close to broaching the subject of, “So what do I do now?” Apparently it’s an unspoken understanding that I’ve found another doctor, or at least that I won’t continue with her. She’s super accommodating, and at 4:30 hands me my partial refund, says a hurried goodbye and rushes into the elevator with someone.

Was it an unspoken apology? Was she afraid I’d make trouble? Collusion between the pharmaceutical and medical industries is rampant in China, and her prescription cost 5x more than what the American doctor at a more prestigious downtown hospital prescribed. Was she afraid of being accused of something? I can’t know, but it’s all possible.

And no joke: they refunded me 444.64元 (of 581): “Die, die, die, unimpededly die.” That’s gotta be the most inauspicious Chinese hospital receipt ever.

* * * * *

That evening I thanked her on Weixin for helping me return the drugs; I just wanted to say goodbye and close things out. She replied with a written apology and a 100元 hongbao:
doctor_apology_hongbao

Not at all, I still feel apologetic. It was Bangda [a particular drug], and you did a skin test, so I thought it over, not excluding being too nervous or low blood sugar. But no, how about you first take oral antibiotics and see. I’m really embarrassed, I hope you’ll understand! Here’s a hongbao to express my apology!

I asked several different Chinese friends how to respond to that: Should I take the hongbao? Not take the hongbao? What should I say? I replied with what one of them told me to say, and tried to return a portion of the hongbao like another suggested (she didn’t take it):

It didn’t cause a health problem, so it’s fine, medical science isn’t perfect, anyone can make mistakes, let’s just consider it my contribution to the accumulating experience of medical science.

How often does that happen in China? A doctor giving a patient a hongbao? It’s usually the other way around. Here’s the anti-bribery sign from the front desk at the international clinic in the downtown hospital:

no_hongbao_please
HONEST MEDICAL TREATMENT, REFUSE TO ACCEPT HONGBAO
诚信医疗 拒收红包
Now that I think of it, I didn’t see any of these signs at Number “4” People’s. Maybe that should have been a clue! (Here’s another one from a previous medical adventure in Huangdao.)

Diagnosing & Prescribing for Pneumonia
Qingdao Number “4” People’s Hospital:

  • Consult: 6元
  • Meds + IV fees: 597元 (and pressure to accept hospitalization!)

Qingdao Municipal Hospital’s International Clinic:

  • Consult: 100元
  • Meds: 118元

I want to assume the best and give benefit of doubt, but a part of me still wonders how to interpret that 100元 hongbao apology.

In defense of brutally harsh traditional Chinese fathers

With a revamped Chinese study routine, I’m trying to consume as much Chinese content as I can. My teacher had me subscribe to a Weixin reading account, and I quickly found an article that’s valuable to foreigners, IMO, especially foreigners who have kids in China and Chinese friends.

The author defends the traditional harshness of Chinese fathers (as today’s 30-somethings might have experienced it) from a couple different angles. Describing common methods of forcing kids to study, some which would result in neighbours calling the cops in North America and which some Chinese parents say are “the obliteration of the child’s innate nature” (对孩子天性的泯灭), she takes aim at rising Chinese parenting trends associated with “respecting” and “accommodating the innate nature of children” (尊重/顺应孩子的天性), “free development/childrearing” (自由发展/养育), and “happy education” (快乐教育).

One of my brighter former students — she’s around 30 years old now and relatively accomplished — told me, “My father has never praised me, not even once.” To better understand her kind of experience, or people who advocate for that kind of parenting, or people who have to put up with relatives who think this way, I recommend reading through this: 你越弱,越没有人宠你 (pro tip: read in your browser with the Perapera Chinese plugin installed). The author would use my former student’s case as a point in her favour, like she does with the story of the Indian wrestling champion who forced two of his daughters to become wrestling champions (movie pictured above).

This article also demonstrates the advantage of reading “real” Chinese. When you read something written by Chinese in Chinese for Chinese you get exposed to Chinese ways of speaking, composing, arguing and thinking — you can’t get much of that from reading translated content.

For more about harsh Chinese parenting, see:

When you dare take your week-old infant to the neighbourhood vegetable market in China

The days following a birth are up and down, so Jessica tells me. Some days it’s all, “I love my baby!!! I love my kids!!! I love my husband!!!” while on occasional days the smallest criticism can provoke tears. Jessica was feeling good and feisty today. She was also tired of sitting inside and so decided to brave our neighbourhood streetside vegetable market for the first time since giving birth — with our 9-day-old son in a Ergo carrier.

baby_in_the_marketShe knew it’d be pushing the buttons of every Chinese auntie and grannie in sight and generate non-stop commentary from the moment she stepped out the door (because she’s done it before), but she didn’t care. Besides, it’s not like she hasn’t already been accused of being an evil stepmother. ;)

Here’s what she was repeatedly criticized for during her fifteen minutes in the market:

  • being outside
  • bringing the baby outside
  • wearing short sleeves (it’s 20’C and sunny at the end of May)
  • buying tomatoes (they’re a “Cold” food, as in Traditional Chinese Medicine theory “Cold”; eating “Cold” things is exactly what post-partum women aren’t supposed to do)
  • being so thin and losing weight since the birth (how much weight exactly?)
  • being too active during pregnancy and not eating the right things (and that’s why he’s so small) (he was 3kg at birth)

She opted not to mention that we’d already been to Beijing and back for an embassy run. ;)

This is our third time to have an infant in China, so none of this is a big deal and it’s completely understandable. It’s certainly not our first time to draw a crowd with a foreign baby or receive well-intentioned-but-unsolicited-and-annoyingly-personal criticism (criticism often conveys concern or interest in China; it’s not usually meant to be mean). But it’s still kind of funny, especially because her sister-in-law is here from the States to help out — a ‘fresh’ foreigner encountering China for the first time.

Way back when we were preparing to bring our first infant to China, Australian friends who’d had their kid in China around the time ours was born in Canada sent us a list of everything we had to look forward to/brace ourselves for. It’s still funny (and full of valuable information)!

Links in this post:

market_flower

How to tally things up in Chinese

Found this on a partially finished structure in a work site on the east side of the last remaining piece of Qingdao’s old Licun Prison for Chinese:chinese_tallyingThis is how you tally things up in Chinese — with the character 正. Notice it has five strokes, just like Western tallying, and that the last 正 in each section is only partially finished. Go ahead and count ’em up, and see if their total of 266 is accurate!

tallywestern

1st Corinthians 13 — CSV translation (Culture Stress Version)

You know how making and serving food is an expression of love for a lot of people? I’d like to propose that, sometimes, eating it is an act of love, too.

After last night’s donkey parts dinner I’m feeling rather pious*, though I probably won’t be by the time I finish this post. So allow me to present a somewhat famous ancient passage in a fresh translation: the Donkey Parts Version (DPV). Or, if you’re of a more squeamish constitution: the Culture Stress Version (CSV), because that’s what this is really about anyway. ;)

* * * * * * * * * * * * * * *

donkeyseacucumberspecialIf I slurp down this gelatinous slab of donkey blood without making a face, but do not have love, I’m like two mass exercise dance groups of at least 100 grannies each, both in the same public square and each with its own impressive sound system.

If I chew and chew and chew some more and finally choke down this unnecessarily large chunk of fried donkey penis just in time for the next toast, but do not have love, then I’m like that guy at the gym who brings his portable mp3 player — even though the spinning class music, the aerobics class music, and the house speakers are all already competing for prominence in the weight room soundscape — and sticks it right in the middle of the floor where we can more easily trip over it.

If I drink more Tsingtao than I want to so the host will have face and the guests won’t feel that I think I’m too good for them because the obnoxious and juvenile male social world is just that way, and surrender my body to a night of greasy indigestion, but do not have love, then I’m like thirty high-pitched Chinese preschoolers in a cavernous classroom of hard surfaces who won’t stop yelling Wàiguó Lǎoshī!! even though you’ve said Good Mooorniing! to them five times already.

Love is patient with the snot-faced little double-fingered nose-pickers even when the English you’re employed to teach them is beyond their developmental capacity as 3-year-olds, and love is kind even when their parents send them to school sick and they cough in your face and leave their boogers on your teaching toys. It does not envy people with long-term tourist visas. It most certainly does not boast about being a wàijiào; it is not proud.

Love is not overly rude to neighbours who honk their horn for twenty solid minutes in the middle of the night because they drove back so drunk they think someone else has parked in their parking space; it is not merely self-seeking but also seeks peace and quiet for the entire apartment complex. It is not easily angered by impossibly long strings of firecrackers at 3am on Chinese New Year’s Day, and keeps no record of wrongs, but rather considers such things merely as mildly humourous blog fodder.

Love does not rejoice in or act entitled to lǎowài privilege, but rejoices in the truth, like when Chinese friends feel close enough to burst your deluded protective bubble about how fluent your Mandarin actually isn’t, or like when you find out you’ve been saying or doing something wrong for years.

Love always protects face, always trusts that, on average, these people aren’t really any worse than the people you came from, always hopes for deep and meaningful cross-cultural relationships, and always always always always perseveres in language study.

Love never fails.

Have a happy, more gracious and more loving New Year! ;)

*(This does not happen very often.)

Links from above:

donley_penis
What a serving of donkey penis looks like. After we’ve already eaten half of it. (Gelatinous slabs of donkey blood not pictured.)

Happy Christmas Eve! Here’s your apple…

Christmas Eve, known as “Peaceful Night平安夜 (from the Chinese translation of “Silent Night”), is a big, loud, young people’s shopping/date night. There are stage shows in the pedestrian shopping streets, with a New Year’s Eve style countdown to midnight. It’s anything but peaceful, and very rènao 热闹. Churches are packed to overflowing as they try to capitalize on the attention with programs and performances for multiple nights in a row.

pinganping_santa

It doesn’t bother me that China does its own thing with Christmas. Once you know that what they call Christmas and what you call Christmas are totally different things, then you can stop trying to get the Christmas you grew up with from China. Still, being unable to make the holiday like you would in your home country, and being so far from family or anyone at all who does Christmas similar to the way you did growing up can be a little sad. But you can learn to make new traditions — some borrowed from China, some creative adaptations — to make the holiday meaningful for you and your family. At least that’s what we’re doing.

Christmas_eve_applesOne of the very Chinese things that China’s done to Christmas is associate Christmas Eve with apples. “Peaceful Night” is píngān yè 平安夜 in Chinese; “píng” is a homonym for the first syllable in apple (píngguǒ 苹果), and so people give fancy apples, either wrapped in fancy paper or with Christmas or romantic candy-heart style messages sunned into the skins.

chinese_christmas_apples

So happy Christmas Eve from China! Now go eat a pretty apple…

loveapples