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Chinese Hospitals Part III: Final Chapter

8/28/2018

This is the stairwell on the ICU floor. Below the "no smoking" sign is a man with a cigarette in his hand.

It might be hard to see, but in the picture above, the man on the left is holding a cigarette in his right hand. I know this because I was coming down the stairs to go back to my mom's room and spied these two conversing in the stairwell. Witnessing smoking under the "no smoking" sign is nothing new to me. In fact, I've got many pictures from China similar to the one above. It amuses me to no end. However, there is a difference between smoking in the non-smoking section of a restaurant and smoking near the ICU.

Most Americans would be incredibly upset by the fact that these gentlemen are smoking in proximity to the ICU. But they are looking through their "American lens". This is what we do when we travel. We expect things in other countries to be the same as they are in the US. We get upset when people don't speak our language. We get upset when the toilets are not like our toilets. We expect business to be conducted the American way. We expect table manners to reflect the decorum to which we are accustomed. We expect service with a smile. But it's not necessarily that way in other countries, and particularly not in China. That is what makes travel exciting, fun and a little bit scary.

Many of us Americans believe that when it comes to health, there should be some uniformity. Again, this is our ethnocentrism speaking. And frankly, we can't even agree to what healthcare means in our own country.

I was unconcerned for my mom. In her lifetime she has been exposed to a lot of second hand smoke. This was not going to kill her. I chuckled to myself and desperately hoped that they wouldn't notice me taking their picture. The scene was too good to be true. Although the picture is fuzzy, the idea is there. The ridiculousness to us Americans is clear and it highlights our ethnocentrism. As a frequent traveler to China, I must embrace these idiosyncrasies in their entirety. I must view life through the Chinese lens, even if it means I accept men smoking in ICU stairwells.

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Hospital Eccentricities Part II: The Bill

8/21/2018

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If you read last week's post, you surmised that while Chinese hospitals provide excellent care (based on my personal experiences), they do not provide much in the way of American hospital creature comforts like meals, gowns and pee pads. On a topic related to requiring the patient's family or friends to buy much of what we get as part of our stay, they also require you to pay for your hospital services on the daily. That's right, check out every day before you leave.

For local Chinese, this is normal practice and is simple as they have Chinese credit cards. Anyone who has traveled to China, however, knows that unless an establishment caters to international clientele (like hotels and government stores), foreign credit cards are not accepted. Cash is king. We brought bundles of cash every day. If I did not have a good friend and partner in China, I don't know where I would have gotten that much cash. I suppose I would have had to find a bank and had the money wired.

Caveat: Even though we did need a LOT of cash to pay for my mom's hospital procedures and stay, the total cost gives us an understanding as to why we had to pay for meals, clothes and pads. Before I write the actual number, I want to recount what we were paying for. In the US, eight nights in a hospital are approximately $80,000, but we do get food, clothes and pads. She had a private duty nurse assigned to her, 24 hours a day. In the US, I can't imagine that would be less than $10,000. I read that a heart stent in the US would be about $40,000. My mom had two stents, but it was only one procedure so let's assume $50,000 for two. She had xrays and scans and EKG's and loads of other tests. I can't imagine the cost in the US of all of that. Add in the initial ER visit and all the doctors' fees, blood tests, and cost of hospital nurses/doctors coming to check on her multiple times each day. I'm guessing $150k-$200k in the US. Drum roll please. My mom's total bill: $14,000. That's socialized medicine for you. And unlike what we might read or hear, the care is phenomenal.

Tune in next week for the last Chinese hospital installment.

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Chinese Hospitals are Quirky

8/14/2018

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A visitor in the ICU waiting room sorts his scallions.

This motley crew greets patients as they come into the ER. Not even sure any of them work there.

Never a dull moment in a Chinese hospital. Before I begin to write about the oddities one might find in a hospital, I must first state that these are my personal experiences in a variety of hospitals, but by no means does this represent every hospital in China. I also must reiterate last week's blog about my mom's experience getting two stents in her arteries. Those doctors saved her life. Every other experience I have had in Chinese hospitals over the years has been more than satisfactory, and sometimes even better than what we would get in the US.

Now onto the eccentricities. The first thing I noticed in the waiting room of the ICU were the hot plates and bags of food. Why were there hot plates and bags of food? Because loved ones camped out in the waiting room all day and cooked their meals in there. Cultural difference number one, much of which has to with not wanting to spend a lot of money buying meals. There was a cafeteria, but most visitors did not frequent it.

The second curiosity with respect to food is that unlike hospitals in the US, Chinese hospitals do not provide meals for patients. We complain about hospital food, but who are we to complain? We are served meals as part of our stay! That's also why families are cooking meals on hot plates in the waiting room. They are cooking for their loved ones who are patients there. When my mom was in the hospital in Harbin, I did not have a hot plate, nor the patience to cook. My American privilege allowed me to go to the cafeteria to buy my mom's meals.

In the same vein as not providing meals, they also do not provide hospital gowns. That's right, you stay in your street clothes. In my mom's case, my dad and I bought her some snazzy new underwear, sweatpants and sweatshirt so that she could change out of the clothes she came in. She was there for eight nights!

Due to my mom's instability and their concern that her heart would explode if she moved too much, the nurses required her to go to the bathroom in her room. To answer your question: No, there was no actual bathroom in her room. So they would have her sit over a commode and pee into a pee pad. At first they provided the pee pads for her. You know where this is going. They were embarrassed to ask us to provide our own, but also were not supposed to be supplying them. Luckily I picked up on this, both due to my ability to speak Chinese and my deductive reasoning skills, based on the fact that they did not provide meals or hospital gowns. Yes, you must provide your own pee pads. They had a store that sold pee pads, underwear and the like, right in the hospital basement. Convenient!

That's all for this week. Tune in next week for some more hospital quirks!

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What if I get sick?

8/7/2018

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My mom's guardian angels at the hospital

Every experience I have had in a Chinese hospital has been remarkable, in the positive sense of the word. Whether it be an ear infection or kidney stones, a smashed toe or a sore throat, the speed with which we are seen by a doctor, the accuracy with which we are diagnosed and the excellence in treatment are consistently impressive.

In addition to my anxiety and concern, I am always a little bit excited about Chinese hospital visits. They are a test of my language skills. They are rare cultural and educational experiences. However, in October 2015, my mom was admitted to a hospital with symptoms of a heart attack. That visit lasted eight days. We were in Harbin, in northeastern China, between North Korea and Russia. Although Harbin is the capital of Heilongjiang Province, it is hardly Beijing or Shanghai.

I should mention that this was my mom's first trip to China. My dad has joined me on many China journeys over the past thirty years. My mom, however, is irrationally (her word) afraid to fly. But she wanted to join me on a trip at least once in her life. 2015 was the year.

It was the walk toward the Great Wall that should have given us a clue that my mom was ill. As we walked up a hill, she panted."I don't think I've ever been in worse shape in my life!" Neither of us realized that her exhaustion was not due to jet-lag, but to a few seriously clogged arteries, one of which was the "widow-maker".

We flew to Harbin, another flight and another stressor for my mom. That first evening in Harbin, she went to our hotel room early, feeling a little dizzy and tired, symptoms that had been diagnosed as panic attacks in the US. She had not told me why she was going up early, just that she was tired. About an hour later, my mother came back downstairs, white as a ghost. We got in a taxi to the nearest hospital.

The EKG did not show anything. The doctors were thorough, however, and took some blood to rule out heart issues. The rest is history. My mom's largest artery was almost completely clogged, as was another smaller artery. She needed two stents. The hospital called in the best cardiologist with the best English skills, trained in Australia and the US. We were given his personal cell number. My mom had round-the-clock nurse in her private room.

The nurse is the young woman in glasses in the top picture. The security guard in the picture became a good friend of my mom's during her ordeal. At first, he and the other guards and nurses would walk by my mom's room and stare at her as if she were a cute animal in a zoo. They would point and smile at her, but would not engage. Each day they would get bolder and bolder. Some would wave or say "Hi" and run away laughing at their attempts to speak English. This was amusement for my mom who could not leave her bed and had no books, television or any other form of entertainment. Eventually, her guard came in and they did their own form of sign language. They communicated in their own way and became the most unlikely of friends.

I attribute my mother's life to that hospital in Harbin, due to the excellent care that she received. But I also know that if my mom had been in the US, she would have been complacent. She would have felt unusually tired and dizzy, but would have tried to sleep it off. She would not have gone to a hospital and she might not be here today. Although our China trip was far from what we expected, ultimately being halfway around the world saved my mom's life.

So the answer to the question, "What if I get sick in China?" is easy. You go to the hospital and you are given the best care possible and are treated with respect and reverence. It probably seems odd to the average American, but to me, the medical experiences are indeed different, but no less excellent than in the US.

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Chinese Hospitals Part III: Final Chapter

Hospital Eccentricities Part II: The Bill

Chinese Hospitals are Quirky

What if I get sick?

Lauren Drazen

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