Archive for May, 2009

Pain in the Wrist

Saturday, May 23rd, 2009

My earlier bout with tenosynovitis had cooled off several months, but had announced its return soon after my arrival in Wuhan.  After a month of tolerating it, I decided it was time to seek medical help. Secretly I hoped Chinese physicians might have some alternative approaches of coping with the malady — which I believe, without much supporting evidence, to be an autoimmune glitch.

In fact, Chinese medical practice is of two minds:  traditional and Western, without a lot of overlap.  Zhejiang Medical School (where I taught for a year in 2007) is decidedly Western in its M.O., with traditional studies relegated to a separate Institute.  In effect, treatment options are already settled by the time you walk in the door of a particular clinic.

Nor did I choose which door.  That was built into the mission of the Girl-Friday in the International Office commissioned to assist me.  But that’s alright, because the point of this note is not to compare traditional vs. Western outcome in the treatment of tenosynovitis, but to narrate my trip to the clinic.

I’ll begin with the forty-minute bus ride on a typically crowed, bumpy, swerving Chinese bus, which afforded standing room only.  My reasons for including this detail will become obvious later.

A short walk beyond the bus stop brings us to the outpatient clinic of a major, right-bank (of Yangtze) hospital.  Outpatient clinics are the standard mode of primary medical care; private or small-group practices are not permitted, and nobody has thought, apparently, to market HMOs to the Chinese.

Being a newcomer to this clinic, the first queue was to get a “clinic book” — my new, portable medical record.  Five yuan was the fee.  Next queue was to sign up with a particular clinic, based on your complaint.  A quick chat between my interpreter and a nurse (hanging around for the purpose?) suggested “internal medicine” was appropriate.

We find our way to the internal medicine clinic, where a nurse points out the consultation room.  The door was open, and a consultation in progress, but it soon became clear that to maintain ones place in the queue, I had to jostle my way into the room and deliver my appointment-slip to an assistant, who, awkwardly, was sitting at a table on the far side of the physician and his on-going consultation, and that in a none too spacious room. Thus, my appointment slip was put to the bottom of the assistant’s pile, with perhaps three or four above it.

An exact number is hard to ascertain, since body counts are deceptive.  At any one time, there were several people in the room — beyond the physician and his assistant — some, probably most, of whom were on-lookers.  I would surmise that a typical patient was accompanied by several family members, quite willing to add their commentary to the information flow of the consultation.  But I also deduce that there was more than one such patient-plus-entourage groups in the room at a time, for the simple reason that, as one group left, another patient took his seat in the examination chair from among those already in the room.

In fact, I waited in a chair just outside the open door, and was eventually invited in — along with my entourage, Girl Friday.  Her interpretive services really weren’t needed, for the physician spoke excellent English.  This didn’t surprise me, since, from my experience at Zhejiang University Medical School teaching medical students, I knew of the generally high level of English among these students.  Indeed, I got the feeling that he was proud-as-pink of rendering his judgements in English.

That judgement was a high-fidelity echo of the American physician’s pronouncement:  you must immobilize that wrist; it will never heal if you continue to use it.  Though, unlike my American physician, he did not prescribe or suggest a splint to help me with that unrealistic discipline.  He did, however,  scribble out two prescriptions, one for an anti-inflamatory drug, the other for an over-the-counter cortisone creme. The scribblings were mostly not Chinese, but in that quasi-Latin used to describe drugs and dosage.  I daresay any American pharmacist could have dealt with it.  The entry into my clinic-book is in Chinese.

Now dismissed from consultation, and clutching a few addition sheets of paper, we made our way back downstairs to the cashier queues.  Total charge: 55 Yuan, about $8.00, along with a receipt that enabled me to collect the prescribed remedies from the adjacent pharmacy.

The first challenge to the immobilization discipline presented itself on the bus ride home.  Packed as usual, with the inertia of erect bodies lurching in unison with the linear and centrifugal accelerations of the bus, my common-sense prescription overrode the professional one:  hold tight with both hands.  We arrived back on campus just at lunch time, and soon faced challenge #2: chopsticking with my left hand. Admittedly, chopstick action does irritate that thumb tendon. But faced with the choice of sinister starvation vs. dexterous pain, I succumbed again to practicalities — though for the subsequent month I walked around campus with a soupspoon stuck in my shirt pocket, which utensil handles Chinese cuisine reasonably well, even with the left hand.

So much for process.  What about outcomes?  Well, eventually my American physician sent me to an orthopedist, whose course of two injections of cortisone gave relief for a few months. The Chinese physician’s anti-inflamatory-plus-external-cortisone gave partial relief as long as supplies lasted.  But, now depleted, the problem is back.  Perhaps it’s time to time to seek out a back-alley acupunturist.  In any case, I just jotted down the Chinese for Ibuprofin in preparation for my next encounter with an apothecary.

As for my indignation regarding medical confidentially, I just swallowed it as I mouse-clicked to publish my medical record on the world-wide-web.

Acts of Violence

Friday, May 22nd, 2009

Act 1.  Returning from lunch at the student cafeteria yesterday, a guy stopped my on the stairs and asked, very politely, if he could talk with me.  Nothing unusual in that; it’s nearly a daily occurrence, as students of English want to show off their skills.

I’ll call this guy Frank — because he was. Without many niceties help to titrate one another’s English, Frank got right to his issues: What were my attitudes towards gays and lesbians?  Were these — my tolerant stands — typical of America?  How did it come to be that American culture has come to be so accepting of gays (relative to Chinese culture, was his context)?  I invited Frank to walk along to the bank with me and back, realizing that this was my first conversation ever with a Chinese on the subject of homosexuality.

“Closeted” scarcely describes Frank’s situation.  He has admitted to no one at Hubei University (nor previously at this high school) his orientation; says there is no such thing as a gay-lesbian group here; fears total derision and ostracism if it became known; felt safe only talking to me since I am a foreigner.  He has had the guts to divulge his sexual awareness to his parents, who seem sympathetic — though, if my linguistic extrapolations are correct, sympathetic in the way they might be if he told them he had terminal colon cancer.

“Sometimes I felt the only option was to commit suicide.”  My alarm bells were quieted somewhat as he assured me this was his state of mind in high school.  As a student of international law, he feels more confident now, and hopes to parlay his legal education into a ticket to some more hospitable country.

We exchanged mobile numbers.  I raised the issue later with a third-year, fairly enlightened psychcology major.  She gave me contact information for a campus psychological counseling service.  God-knows what they might prescribe.  I passed the info on to Frank a day later, over lunch.  He folded the slip carefully into his wallet, expressed his gratitude, but with a tinge of skepticism.

I hurriedly assured him that I had been totally discrete.  And the conversation moved to his growing up in Urumqi with a Uighur father and Chinese mother…

Act 2.  I had worked fairly late into the evening, well past closing time for the student cafeteria, and so headed for a little cafe in the quarter across from the university campus, among whose virtues was to serve a passable cup of espresso.

By 9:30 I had returned across “Friendship Boulevard” and was sauntering along the sidewalk, parallel to the fence, towards the West Gate entrance to campus. Cries caught my attention, and I looked to see a guy dragging a girl, literally kicking and screaming, by one arm along the adjacent bicycle path towards me. Her light summer clothing surely offered no protection against abrasion by the concrete pavement.

It was not an isolated spot.  They were coming from the West Gate, whose uniformed guards (I wonder whom they guard from what) were unaware or unconcerned, though scarcely 100 feet away.  A bus stop with at least a dozen people waiting was closer at hand.  There were others, like me, strolling in the cool evening air.  If any one noticed, it was only transitorily.  Not a voice of admonition; not a gesture of intervention.  Just a wailing women being dragged by on the pavement.

I intervened. My Chinese is poor at best, and worse under duress, but “help me” must have come through.  No one stirred.  I accosted the man, startled, he let go of the girl, who ran towards the gate, as I restrained her assailant.  He wiggled loose of my grasp and pursued her, nailing her to the campus fence.  I followed, pinned him to the fence, providing a second chance for her to flee.  “Run, quick!”

I was stronger than he, but slower on my feet.  “Not your business, not your business”, he cursed at me.  I don’t suppose he understood by explanation why it was my business. He managed to struggle loose again and caught up with the girl in the middle of the boulevard, where her progress had been blocked by the median fence. I weighed the risks in braving the stream of ruthless Chinese drivers, and having a further encounter in the middle of Friendship Boulevard.  But rationalized that the risks were too great and the violence of the altercation seemed to have subsided. They walked down the median strip; I followed in parallel, then turned into the campus gate.

Everyone else just went about their business.  No cheers, no boos.  In Atlanta I probably would have been knifed or shot.

Net Bar

Wednesday, May 13th, 2009

Having ones own computer is a luxury among Hubei University students.  There are a few scattered around in the library and dormitories for general use; old PCs with slow network connections.  But if you’re out for some serious surfing, the ubiquitous net bars are the place to be.

That these establishments run all night, I came onto in a roundabout way.  It didn’t take me long to learn that we international teachers were expected to be snug in our beds by eleven, enforced by locking the gate to our apartment block.  So it was not from direct experience that I learned that the whole university campus is shut up come 11:30; no slit chain-links to crawl through.  The next question, obviously, is what happens if you miss curfew? The simple answer: you spend the night in a net bar; it’s only ten kuai, in at 11 out at 7.

But straits don’t have to be that dire. Sometimes your surfing deficit outweighs your sleep deficit,netbar01 and the only way to put yin-yang back into balance is a night at the net bar. Since I’m here to experience Chinese culture, how could I miss this opportunity?  So I tell my informant, next time she’s headed that way, give me a ring.  Seriously?  Seriously.

Next thing you know I’m on the street. past the hour of no return to my apartment, headed for the “Everyday Net Bar”, a dingy establishment, with rows and rows of PCs – I estimate five hundred.  We just managed to get two seats at 11:15; a few minutes later the house was full.  Our 15-minute tardiness is explained by our making a stop at some street vendors to stock up on junk-food and sugar-water.

As any American would do, I went straight to PBS Nightline, and began catching up on some netbar02good investigative reporting that I’ve missed is leaving Atlanta. But it’s Chinese culture I’m supposed to be soaking up, and, since I’m not too swift with Chinese menu-clicking, I just leaned back and gawked at my neighbors’ screens.  Video games seemed to be attraction number one. Not a video-game-critic myself, I maybe missed the fine points of the art, but “phrenetic” was the fist descriptor that came to mind.  But apparently enthralling, for the players kept bonking away for hours. Even vicariously, my neurons were scrambled in no time.

Movies were popular.  Cynical bastard that I am, I have to believe they were all pirated, though as near as I can figure out from the screenful of Chinese characters, they seem to be purveyed by household names in Chinese ISPs.  Email, Face-Book-look-alikes, photo albums with a superabundance of V’s, MP3s with animations or stills.

Lest I seem prejudicial against the tastes of Chinese youth for web offerings, I should confess that I haven’t endured the night with American college students in front of their browers.  Still, even in China, where raunchiness, political and otherwise, are filtered out, attractions like Wikipedia, the NYTimes, PBS are to be had.  But with few takers, at least not in the Everyday Net Bar.

By three or so, I was zonked out.  Frontline still blazing on the screen.  Actually, a more comfortable night than, say, on a jumbo-jet to China.  Plenty of leg-room, large chairs with lots of tilt, and thanks to earphones, pretty quiet.  Still, I haven’t complained about eleven o’clock gate closings since.

Proletarian Sensitivities

Saturday, May 9th, 2009

The premise behind my being in Wuhan is simple and sound.  My earlier sojourn was in Hangzhou — wuhan_montagewiki2a town which I really come to like.  But it is clearly not your typical Chinese city, nor is Zhejiang University your typical Chinese university.  Both are among the elite in their class.  If am I to use these post-retirement teaching stints as an opportunity to get to know China, hobnobbing with the elites won’t suffice.  I need to mix with the masses. Wuhan fills the bill better.

Wuhan is an industrial city that sits astride the mighty Chang Jiang, a few hundred kilometers downstream of the Three Gorges Dam, and at its confluence with the Han River.  Indeed, this tributary from the north originally defined three cities:  Hanyang, upstream of the Han; Hankou, downstream of it; Wuchang, on the right bank.  Altogether, a city of industry and commerce, of about nine million, sitting in the heartland of Han-China.

A city with a gritty past and a grimy present. Following China’s defeat at British hands in the infamous “Second Opium War”, Hubei Province was forced to give “concessions” in Hankou to foreign powers — British, French, Russian.  These extra-territorial areas of foreign sovereignty left not only their architectural marks on the Hankou waterfront, but indelible marks of shame in the Chinese collective consciousness.

The oppressors have not all been foreign. In the 1860’s the Taiping Rebels held sway in these parts, but the Heavenly Kingdom of Great Peace wasn’t, and the Qing Imperium exacted its retribution.  In 1911 supporters of Sun Yat-sen launched the “Wuchang Uprising”, which ultimately led to the fall of the Qing, but not before some local head-bashing. In the 20’s Guomingdang upstart Wang Jingwei set up shop here in opposition to Chiang Kai-shek, who also wreaked revenge. In 1938 the Japs did a Nanjing-Rape redux, while in 1944 the U.S. firebombed to flush out the Japs. In 1967 the Cultural Revolution unleashed the bloody “Wuhan Incident”.  And in between, God himself scourged Wuhan by way of the mighty Yangtze periodically flushing out what was left — all but that sturdy European granite.

Ah, but there have been better times, too.  Avid swimmer Mao Zedong braved the River on a few occasions, and even wrote a poem about it in 1956:

I have just drunk the waters of Changshamao_swimming1
And come to eat the fish of Wuchang.
Now I am swimming across the great Yangtze,
Looking afar to the open sky of Chu.
Let the wind blow and waves beat,
Better far than idly strolling in a courtyard.
Today I am at ease.
“It was by a stream that the Master said–
‘Thus do things flow away!’ ”
Sails move with the wind.
Tortoise and Snake are still.
Great plans are afoot:
A bridge will fly to span the north and south,
Turning a deep chasm into a thoroughfare;
Walls of stone will stand upstream to the west
To hold back Wushan’s clouds and rain
Till a smooth lake rises in the narrow gorges.
The mountain goddess if she is still there
Will marvel at a world so changed.

Those promises that “a bridge will fly” and that “walls of stone will stand” were not idle.  The “Great Bridge” here is the first to span the Yangtze and thus link northern and southern China with direct rail and road traffic.  And the Three Gorges Dam, for better or for worse, is reality.

Truly a city of steel, a Gary, a Cleveland, a Buffalo.

Given this proletarian grittiness, what is there to miss in the teahouses of Hangzhou?  In its lakeside promenades where imperial feet once trod?  In its tales of butterfly lovers and peony pavillions?  Of its fatty Dong-Po pork?  Of its lush tea plantations?  Of its silks and satins?  Of its beautiful women under their parasols?  Of its grottoes and temples?  Of its pervasive scent of camellia?