To pick up where I left off last Friday, I digress to describe some of my experiences with healthcare (and hypochondria) over the past week. First, in connection to my visits to one of the public hospitals in the city for some testing I had done, and second in our experience Monday morning at the dreaded “travelers clinic” where we had to get cleared in order to renew our visas. *Note: Pictures are not permitted in either place.
The Hospital: I ended up at a public hospital in the West of the city because I was having inexplicable chest pain (here is where hypochondria makes its grand entrance). Because no doctor likes to tell you to ignore pain in the vicinity of your heart, two very sweet nurses from the Global doctor’s office I go to escorted me to this public hospital, where there was a cardiologist who could see me that afternoon. They told me we’d be going to the “VIP Section;” this was funny when I first heard it, and even funnier when we got to the hospital and I saw what the “VIP Section” really was. Walking into the hospital itself felt more on par with entering Grand Central than any hospital I’ve been to. It was mobbed with people and the central “terminal” held ziz-zags of hundreds of people waiting to pay the “cashiers” or pick up from the gigantic pharmacy (an unfortunate reality of healthcare for the Chinese is that you must pay before you are given service; no matter your condition). We made our way through the maze of people, corridors, and escalators until we arrived at the promised VIP department, which was just an oversized office where “VIP’s” get to wait rather than join the herds camped out on the plastic bus-station-like seating in the waiting areas. We were in the out-patient section of the hospital, so each department had a waiting area (or two) and consultation rooms running up and down the hallways. My “VIP” status didn’t translate to my consultation – I had about 1 minute in the hot seat in front of a cardiologist, surrounded by other patients who were waiting to get her attention. She suggested some tests and with that, it was over.
There was a lot that I noticed during my walk through the hospital that alarmed and surprised me but I tried to keep in mind that this reality, like most things I see every day, is the product of a completely different system and culture and there are some habits and patterns of behavior that aren’t going to change in my 1 or 2 years here, no matter how bizarre (or gross) they seem to me sometimes. This is my nice way of saying it’s still weird to watch people spit on the ground, inside. I finally gave in to my inner-germaphobe when we got to the ultra-sound room, which we entered casually despite the fact that another patient was having his bare chest ultrasound-ed. I instinctively started backing out of the room but, no no, we were supposed to enter. The lack of privacy was disconcerting, but it was more disconcerting when the old man stood up and the doctors ushered me towards the bed, to lay down on the un-changed sheet on which undoubtedly hundreds had laid before me (it took me three years of boarding school to be okay with people laying down on my bed). Yes – I’m a little OCD, and of course I’m exposed to germs and dirtiness all the time, but this was a hospital! A place where people come when they are sick or have health problems! Change the sheet! I asked and they acquiesced to my laowai demands, completely cordially but clearly surprised. The level of cleanliness and the lack of privacy did surprise me, coming from a country where in my experience hospitals may be unnerving but they are always clean and sterile-smelling. On the other hand, I was registered at the hospital and given two heart tests for exactly $100, unheard of in my familiar American system. The doctors themselves appeared quite competent; their haste was a product of the system – there are just too many people to treat to spend 10 minutes in every consultation, or change the bed sheet, or offer actual privacy – it’s impractical.
The Clinic: Upon arrival Monday morning we knew we were in for … something; lines of at least 200 people trickled out the door and into the parking lot. I have no idea what kind of jobs here require this type of medical clearance process, but I surmised that the vast majority of those waiting on Monday were day laborers, given their darker, tanned skin and the fact that when we arrived there were virtually no women waiting in line. The clearance process was “organized” by a form issued to everyone, on which there were 7 boxes you needed to get checked off by the various nurses and doctors spread across the three floors of the clinic (eye test, vital signs, ECC, chest x-ray, stomach ultrasound, samples). Trying to accomplish this task felt like a cross between a scavenger hunt and one of those around-the-world parties we had in college (only this time there were no themed rooms or coordinating beverages). There was a slightly adjusted process for foreigners, but this was only for the physical exam portion; we were let into a “private” room, didn’t have to wait, and were seen by a doctor who spoke a little English. For all the other boxes, we were all in it together which meant that lines were ignored, and so was privacy. Unlike in the hospital where I had the chance to ask for a clean sheet for my ultrasound, there was no time for special requests – we filed through for our ultrasounds in 30 second intervals; everyone shared the same sheet, there was no sanitizing of the equipment, and my only concession was that I was able to pull most of the curtain closed so everyone in line didn’t see me with my shirt off.
When it came time for the inevitable blood sample, I did start to balk because it was basically a mob of people pushing up against a glass window behind which sat the nurses, who took a sample of your blood by having you stick your forearm through a hole in the glass. Behind the glass the process was organized; of course they used brand-new needles and changed their gloves upon request. But the bad habit in China of littering extended to this situation and the ground in front of the window was covered with discarded bloody q-tips, despite there being receptacles for medical waste all around. It was hard to be culturally sensitive in this case, it was gross. The chest x-ray experience was also interesting; in the moment Jeff commented that this was the first time he’d had an X-ray done without being given any protective shield for the rest of his body. When I got home I read an interesting article in the NYT about over-exposing premature babies to the radiation from full-body X-Rays without any protection, which was coincidental timing but made me realize this is a precaution that has been overlooked in America as well, on some of our most vulnerable citizens. The point is that there are flaws to the system, no matter the system (that being said I hope I can hold off on further hospital visits here).
The clinic was very accommodating in rushing our results and I raced back there in the afternoon in order to race to the PSB before 4 to hand over our passports. It all worked out (I think), and although the process was stressful and chaotic, it was definitely a learning experience. Unfortunately, the occasions on which you visit a hospital don’t lend themselves to patience and cultural sensitivity; when you’re nervous and don’t feel well it’s always hard to see the bigger picture. But reflecting back I’m glad I got to see what I did. As we made our way out of the hospital last week through the throngs of people into the parking lot, a moronic lady in her BMW nearly plowed us over for no reason – we were obviously exiting patients, and she didn’t need to accelerate when she did. I couldn’t hold in my frustration to my Chinese nurses any longer – “What is wrong with people?!?!” I said, my exasperation at the whole experience evident in my outburst. “Have you ever heard the word TIC?” my nurse replied with a smirk. I hadn’t. “My [American] boyfriend says it to me all the time: This Is China.”
