Learning about China’s health-care system the hard way

Students brought good food and good ccheer.

Students brought good food and good cheer.

“I did the best I could,” the surgeon said in his best English. He paused, a bit awkwardly, for a few moments then repeated, “I did the best I could.”

I really didn’t want to look. After about an hour of surgery below the right eye, nearly half of my face was covered by a gauze bandage and surgical tape that made me look something like a character in a SciFi flick, “Dr. Frankenstein’s Monster Meets the Mummy.”

Through my out-of-focus eyes, the clock seemed to say a few minutes after one in the morning. It had been six and a half hours since I fell off my bicycle on September 23 in a driving rainstorm on an invisibly slick surface on a dark campus pathway. I fell face-first onto a brick pavement, trying unsuccessfully to break my fall with both hands.

In the tenth floor surgical suite in Peking University Hospital Number 3, I felt even worse than I looked. My broken left wrist was in a newly created, hard-plastic cast. My jammed right thumb was throbbing. My left leg near the knee had been sewn up from what, at first, looked like a war wound after something (I still don’t know what) pierced my skin. My face was lacerated for about 6 centimeters where my glasses frames were thrust into my flesh. I hurt everywhere. I couldn’t see clearly, and I’m not sure if that’s because my glasses were missing or because my head was swirling.

I don’t remember much in the immediate aftermath of the crash except the blood and the pain. Three students came to my rescue and one let me borrow her mobile phone to call my office manager. Somehow, I managed to hobble about 1 kilometer to Tsinghua University’s hospital emergency room, where my experience with the Chinese health-care system began. Two hospitals. Two surgeries. A half-dozen x-rays, a CT scan and a tetanus shot. And some very dedicated, highly skilled doctors who are under constant pressure from seemingly never-ending waves of patients.

Republicans derided U.S. President Barack Obama’s 2010 health insurance law as socialized medicine. Well, this really was socialized medicine, with all of its benefits (universal care, low cost) and its liabilities (longer waits and greater bureaucracy).

®®®®®®®®®®®

I knew I had broken my wrist as I shuffled slowly westward to the hospital over the uneven pavement of Tsinghua’s beautiful lake district, which had become an instant obstacle course of puddles and tree roots. My non-professional diagnosis was quickly confirmed by a battery of x-rays. That was the easy part.

We shuttled up and down the corridors of Tsinghua’s hospital from department to department. The emergency room doctor had me take off my pants to examine the knee area. I’ll never forget the look on his face. Translated into English by my colleagues, he said: “We can’t treat injuries that serious at this hospital.”

One weekafter the injury.

One week after the injury.

It is 8 p.m., 90 minutes after the crash. The swelling is getting worse, as is the pain. And I have gotten no treatment, save the tetanus shot.

My colleagues paid the bill for hospital services in cash — under $100 — and called a taxi to go PUH3, one of the biggest — and, I was told, best — hospitals in the capital, with emergency surgeons on duty 24 hours a day.

Arriving at Peking University Hospital Number 3 at about 8:30, I was overwhelmed by the smell of cigarette smoke outside the front door, where nervous relatives of patients — and more than a few doctors — went for treatment of their nicotine addiction.

Inside the hospital, I was overwhelmed by the sea of humanity. There were lines everywhere, as relatives and friends queued up to sign up for emergency appointments or to pay their bills on the spot. In cash.

(Sidebar remark: My three colleagues used up all 2100 yuan they were carrying with them, the equivalent of about $350. I gave them my ATM card and they emptied another 400 yuan from my Bank of Beijing account so we could pay our debts before my discharge.)

The mass of humanity and the slightly aged facility reminded me of Parkland Hospital in Dallas, circa 1978, or an inner-city Washington, D.C., hospital — except that there were no gunshot injuries or knife wounds. I quickly learned that there were many more people hurting a lot more than me. In a strange way, it calmed me down as I awaited treatment.

My injuries were handled one at a time, slowly but surely. First, 20 minutes of knee surgery. I don’t remember anything after my leg was pierced by several needles with anesthetics. Then came the CT scan, followed by a visit to the specialist who crafted a hard plastic cast to protect my broken wrist while leaving me with some limited mobility of the arm and fingers. I remember a brief trip outside in my antique wheelchair — which got stuck in a water-filled rut — as we navigated through the massive hospital complex in a steady drizzle. Finally, the facial surgeon. Under four layers of gauze for an hour, to protect me from infection, I had a nightmarish thought about Joan Rivers as I occasionally struggled for air. I am definitely not getting a face lift in 25 years.

At long last, I was done for the evening. We returned the well-worn wheelchair and got our deposit back. We paid all of the bills, which totaled a bit under $500. I was thinking that the single CT scan would have cost more than that back home in the U.S. of A. I consider my care a true bargain.

The doctors were young. Some seemed harried. All seemed to be quite competent. The specialists were compassionate. Maybe it was because I am a foreigner. Maybe it was because they care about more than paychecks, wrangling with insurance companies, liability lawsuits or golf tee times.

Chinese hospitals underscore the "waiting" in  "waiting room."

Chinese hospitals underscore the “waiting” in
“waiting room.”

®®®®®®®®®®®

The news over the past two weeks has been uniformly good:

  • I am healing surprisingly quickly. No eye bandage anymore. Hardly any scar. I will not be the next Boris Karloff. I can bend my damaged knee and jammed thumb. The cast could come off my arm in a few more weeks.
  • I have had an outpouring of assistance from my students. Twenty-six students volunteered for two-a-day visits for two weeks. They have helped me with meals, laundry and dish-washing. We have had enlightening and stimulating conservations on topics ranging from linguistics to American and Chinese history. If I haven’t told you before, I love the students at Tsinghua.
  • My fellow professors have supplied everything from flowers to sweets to wine. My co-director, Hang Min, even sprung me from my apartment to go to a delicious Sichuan restaurant in Zhongguancun. Other angels with cars have included Eunice Song and Jiao Jie’s family.
  • I have had time to catch up with family members via Skype. And now that I can type again, I will be able to connect more easily with the rest of my friends. I also can prepare lesson plans and PowerPoint presentations for my classes.
  • Finally, I am planning to return to the classroom tomorrow. Because of the Chinese National Day holiday, I only missed one class in both my Multimedia Journalism grad course and my U.S. Media Culture undergrad course.

This is not the kind of adventure I had in mind when I came to China last year. But we all live and learn, and this has indeed been an interesting learning experience.


An evening bike ride through Tian’anmen Square on June 3, 2014

This guest blog was written as a Facebook post by Felicia Sonmez, one of the best journalists in Beijing. Many thanks to Felicia for giving me permission to share it with you.

20140604-163200.jpg
First you get a hunch you’re being followed. Then you think you must be crazy. Why would an old man on a bike be doing a thing like that, on a leafy Beijing street, on such a pleasant spring night?

Then you slow down, and so does he. You start up again and bike faster, and so does he. Finally he gets ahead of you and stops at a corner. You hesitate for a moment, then turn right, back toward the long road to the Square. And before you know it, he’s approaching you on your left side, and suddenly, he’s crashed into you.

“Sorry!” he says.

“What are you doing?” you ask, as he stumbles off his bike.

Rather than stick around to find out the answer, you hurry to get back on your bike and pedal away as fast as you can, without looking back.

Ordinarily, you might be worried about the chance of some stranger following you back to your house. But in this case, you’re almost relieved to get home. He probably works for the government. And they already know where you live.

It’s June 3, 2014, the eve of the 25th anniversary of the Tiananmen massacre, and also a year to the day since I moved back to Beijing. The visit last month from black-clad plainclothes security agents to our bureau — as well as most every foreign news outlet in Beijing — warning us not to do any newsgathering related to the anniversary has had several weeks to sink in. So have the various warnings that have come down from the Chinese foreign ministry.

Dozens of Chinese activists, rights lawyers, artists, journalists and others with even the most tenuous of links to Tiananmen have been detained over the past few months — enough to make it clear that any reporter would be foolish to think of heading down to the Square on June 3 or 4 and expect to get any reporting done, let alone avoid getting detained.

So, after a day spent in the office, I decided on a whim to hop on my bike and just go for an evening ride around town, to see what I could see. I left my recorder and notebook and home, bringing only my pocketbook, a deactivated smartphone I use for taking photos, and a few H&M shopping bags, which I threw in the basket of my bike.

I was only gone for an hour, and I wasn’t sure what I’d encounter.

I biked down Dongdan North Street until I got to East Chang’an Avenue, about four big blocks away from Tiananmen Square. Central Beijing usually has a fair police presence to begin with, but tonight felt different. Every police car or van that passed was silently flashing blue and red lights, as was every police box on the street, and officers were stationed at every main intersection. I must have passed more than 100 police over the course of my bike ride.

As I approached the corner, there was suddenly a lot of yelling. I looked on as four uniformed police officers dragged a young man across the street and toward the accordion gate that was blocking part of the bike lane.

About a dozen bikers waiting for the light to change watched as the police forced the man onto his knees and yelled at him. I couldn’t make out what the man had done wrong. But a woman with him was making a phone call, and one of the bikers next to me was recording the confrontation on his smartphone. I snapped a few photos, then turned onto Chang’an Avenue and kept biking to avoid causing a scene myself.

The police presence on Chang’an Avenue has been ramping up steadily over the past few weeks, with dogs and armed officers gradually being added to the mix. But tonight was unlike anything I’ve seen. Officers and police vehicles were stationed all along the giant east-west thoroughfare, which has seven lanes of traffic on each side. A few other bikers were riding along like me, including a few guys clad in racing gear and spandex (not like me). Even among those pro-looking riders, there was a palpable tension as they sped down the road under the officers’ watchful gaze.

I approached the Square. It was unlike any time I’ve ever seen it in the eight years since I first came to China. It’s normally a pretty festive place, teeming with tourists snapping photos, as well as a fair amount of police and vendors. That’s how it was two days ago, when I came by with some friends visiting from out of town.

Tonight, it was completely empty. Not a single person was on the Square as I biked by, just a lone white police van parked in front of the Monument to the People’s Heroes, facing against traffic.

I recalled a conversation with a Beijing lawyer I met recently. Hundreds of thousands of police officers being mobilized across the city — for what? he asked. Just to ensure that a non-commemoration of a non-anniversary remains that way? He thought it was not only a waste, but a shameful one.

I thought, also, of a story the lawyer had told me about a friend of his. It was last year, and news had just broken of the arrest of venture capitalist Wang Gongquan. Wang was outspoken, but his surprising arrest was taken as a sign that the neither the wealthy nor the well-known would be spared in Beijing’s new crackdown on dissent.

Many were spooked. But perhaps that was the intention. Regardless, the day Wang’s arrest was reported, the lawyer said, was the day his friend decided to pack up and leave China.

I kept biking down Chang’an Avenue, slowing down to snap a few photos with my smartphone, and suddenly something struck me. In clearing out the Square and deploying thousands of police across the city to quell any potential disturbances, the authorities had created a spectacle — a memorial, almost — of their own. The vast emptiness at the heart of the capital was a manifestation of the void that has existed since 1989, and of which the world is reminded — though perhaps not quite so vividly — every June.

That was the thought I was planning to end my night on, until I turned north onto Nanchang Jie. I realized after a few minutes that the old man was following me, and he kept pace with me all the way up the street past the Zhongnanhai leadership compound, across the north end of the Forbidden City and to the corner of Beichizi Street.

The bizarre run-in with him, which echoed stories I’d heard from other reporters during sensitive periods in China, quickly turned my mood tonight from pensive to spooked. But perhaps that was the intention. I left before I could find out more — and before my phone, press card, or other belongings could potentially be snatched.


What every tourist should know before visiting China

A panoramic view of the Forbidden City.
I plan to usher in the Year of the Horse by preparing the welcome wagon for visitors from abroad.
As a new resident of Beijing, I look forward to sharing the magic of my adopted hometown. But I warn you that you should be prepared for a few shocks, cultural and otherwise. No, you’re not in Kansas anymore. Or Houston. Or Washington.
Here is a brief primer for first-time visitors to China:
Culture and customs
  •  Check your cultural assumptions with your luggage. Life is different here. Don’t view life in China through the prism of your American or European experiences.
  • Beijing is crowded and massive. Don’t be intimidated by the volume of traffic, the human gridlock or the seeming chaos on the streets and in the subways. You’ll get used to it.
  • Don’t be afraid to jostle people. There is no sense of personal space here. Don’t take it personally if somebody elbows you or pushes you.
  • There is no “walk right, pass left” etiquette here. People walk, bike or drive every which way. Cars DO NOT stop for pedestrians. Bikes DO NOT yield to pedestrians. In fact, nobody yields to anybody.
  • Be decisive. Indecisive people get run over by bikes or cars or other pedestrians.
  • Don’t get upset when people spit on the street at any time in any place. Spit happens in China.
  • Do not expect Western-style toilets. Get used to holes in the ground. Don’t complain about it. Get used to it.
  • If there is not a price listed on an item in a market, you are expected to bargain. At tourist-oriented markets (such as the Silk Market), the original prices might be ten times what is reasonable. Don’t be afraid to walk away. Even if you are interested in buying something. Negotiate aggressively. If you don’t want to negotiate, go to a regular store.

Food and drink

Be careful of street food, despite its enticing aroma.

Be careful of street food, despite its enticing aroma.

  •  Don’t drink the water. Use bottled water, even for brushing your teeth.
  • Be smart when it comes to street food. Some of it is delicious, but some of it is cooked in oil that is, simply put, poisonous. Unless a Beijinger vouches for a vendor, think twice before trying it. I’m afraid I speak from experience (some bad “stinky tofu”).
  • Don’t be afraid to sample the rich variety of tasty regional cooking. Experiment beyond your comfort zone. Try things.
  • Don’t expect Chinese food to be the same as American Chinese food. It’s better. Most of all, it’s different.
  •  Your drinks may be warm or hot when served at restaurants. This includes water, milk and juices. Chinese meals maintain a balance. Cold drinks can throw a hot meal off-balance. If you want cold water (or beer) make sure to order it “bing.”

Getting around

  • Fewer people speak English than you might expect. It’s not like traveling in Europe. Younger people are more likely to understand English than older people. Some younger people may want to practice their English on you. Enjoy that – unless they’re trying to sell you something.
  • Stay calm. If things go wrong, it won’t do any good to raise your voice. If people don’t understand you, it won’t help you to get agitated.
  • Go to the most popular tourist attractions during the week. Earlier is better for places like the Forbidden City, the Summer Palace and the National Museum. They can get very crowded by midday, particularly on weekends or holidays.
  • Use the subway. Because of surface traffic gridlock, the subway usually is the fastest way to get from Point A to Point B in Beijing. It is clean, efficient and cheap, in addition to being crowded. Relax and enjoy it.
  • If you are taking a taxi, make sure somebody writes down your destination in advance IN CHINESE. Do not assume that you will be able to communicate with a cab driver by trying to pronounce a location in Mandarin. You’re probably mispronouncing it, or worse, saying something embarrassing that you don’t mean to say.
  • Try to find a good street map in English (or at least in Pinyin).
  • Use Google Maps online to get an idea of where you’re going and a sense of how far it is from the nearest subway stop.
  • Make sure you have your passport with you when checking in to hotels or on plane or train journeys. Carry a photocopy of your passport ID page and your visa with you at all times.

Technology

  • Get ready for slow, unreliable Internet and spotty WiFi. Do not expect that you will have working Internet 24/7. Internet and WiFi can stop working at any time.
  • If you want to use Facebook or Twitter or YouTube or other blocked sites, you will need to have working VPN service before you arrive in China. (Email me if you need information on VPNs.) You also will need a VPN to access the New York Times, Bloomberg and some other news site.
  • Bring an electrical converter or a couple of converters designed for use in China. (Not Hong Kong.)
  • Bring a multiple-USB recharger for your electronic devices such as cameras and smartphones. You will need an electrical converter for this, along with one for your laptop.
  • It may be very expensive to use your U.S. smartphone for calls and data. Check in advance before you leave the U.S. You can always disable the data and use it via WiFi. That’s what I do, which allows me to use email, social media and the Internet for free. I also use my U.S. cell phone for text messages with friends and family in the U.S. (at a cost of 50 cents per text sent and 5 cents per text received).

What to pack

  • Dress in layers. Be ready for wind gusts.
  • Bring disposable 3M anti-pollution masks. They aren’t very expensive and they can make your life more enjoyable on dangerously polluted days. Don’t be self-conscious about using masks. It’s for your own health.
  • Bring toilet paper, napkins, tissues and hand sanitizer. You often will not find these products in public places.
  • Make sure you have plenty of prescription medicine and vitamins. It will be hard to find, if you need it, and it may be expensive and questionable in quality.
  • Make sure you bring extra medication to combat stomach ailments and flu-liked symptoms such as Pepto Bismol, cold medicine, DayQuil and NyQuil.
  • Check in with your credit card companies and banks before you leave to let them know you will be making purchases in China.

Feel free to offer suggestions to make this guide more useful. I will update it with your ideas.

Enjoy China!


What’s in and what’s out in 2014

Image

Moonrise over the ancient city wall, Xi’an.

Just a few things have changed in my life this year.

New job. New city. New country. New life.

Teaching journalism in China. It’s almost as much of a challenge as practicing journalism in America.

Here are some of the things that are “in” in my new life at Tsinghua University — and some of the old, familiar things I’ve left behind.

OUT: Texas on the Potomac
IN: Yankee on Tiananmen Square

OUT: Hikes on the National Mall
IN: Hikes on the Great Wall

OUT: Bike helmets
IN: Anti-pollution masks

OUT: Turn signals
IN: Chaos on the road

OUT: The second most congested commute in America
IN: The second most congested commute in the world

OUT: Considering something three days old as new
IN: Considering something three centuries old as new

OUT: Finnish saunas
IN: Chinese massages

OUT: American Chinese food
IN: Real Chinese food

OUT: DC Metro
IN: A subway system with trains every two minutes, polite employees and escalators that actually work

OUT: Dysfunctional democracy
IN: Democracy?

OUT: Taking your shoes off at airports
IN: VPNs to access Facebook, Twitter, YouTube and WordPress

OUT: Rush Limbaugh’s rants against Barack Obama
IN: Chinese media rants against Japanese Prime Minister Abe

OUT: The New York Times
IN: People’s Daily

OUT: The Abraham Lincoln statue at the Lincoln Memorial
IN: The terracotta warriors of Xi’an

OUT: Delicious Chesapeake crab cakes
IN: Delicious Chinese dumplings

OUT: Lobster rolls from food trucks
IN: Stinky tofu from street vendors

OUT: Scrapple
IN: Chicken feet, fish lips and duck brains

OUT: The Washington Redskins
IN: Mao’s little red book

OUT: Obscenely expensive Internet service
IN: Unreliable Internet, spotty WiFi and the Great Firewall of China

OUT: Obamacare
IN: Truly socialized medicine

OUT: Soccer moms
IN: Ping pong dads

OUT: 24/7 deadlines
IN: Monthlong breaks between semesters (We call them “district work periods”)

OUT: Suits and ties
IN: Casual Friday every day

The dress code is a lot more casual -- even for a China Radio International appearance.

The dress code is a lot more casual — even for a China Radio International appearance.


My local Beijing Walmart isn’t like any you’ve ever visited in the USA

You are leaving the Beijing subway and nearing the entrance to Walmart. It's not like the suburban mall you have in mind.

You are leaving the Beijing subway and nearing the entrance to Walmart.

I had this vision in my mind of what the Beijing Walmart would look like.

Elderly person at the front door welcoming you to the store. Wide aisles. Bright lighting. A little bit of Middle America in the middle of China’s capital.

Definitely not on sale in U.S. Walmarts: Scarlett Caterpillar Fungus.

Definitely not on sale in U.S. Walmarts: Scarlet Caterpillar Fungus.

But no…

My local Haidan district Walmart, just one subway stop south of Tsinghua University’s Wudaokou subway station, is a strange sort of American-Chinese hybrid. The Egg Foo Young of Chinese retailing.

First of all, there is no greeter. There isn’t even a front door, just those semi-transparent plastic flaps that substitute for doors all over China.

The store itself doesn’t resemble any Walmart in the USA. It looks more like your local dollar store. On steroids. Three floors of crowded bargains, from washing machines and treadmills to live turtles (not to bring home as pets).

What’s completely different is the product selection. You can buy Crest and Colgate and Laughing Cow cheese, but not much else that you’d buy in the American big  box.

When’s the last time you saw the Walmart “Great Value” brand bag of Scarlet Caterpillar Fungus in the USA? Or Marinated Duck Gizzard? Or Prickly Ash Powder? Or Purple Sweet Potato snacks? Or Pineapple-flavored Beer? Or Apple Vinegar Drink?

The list goes on — check it out in my slide show.

This slideshow requires JavaScript.

I ended up on a shopping spree that cost me more than $40 in yuan. Doesn’t sound like much, does it? Well, think of it this way: That’s the cost of about 25 meals on campus. Or three months of cell phone service. I think I’ve stocked my apartment for a month with everything from loose Chinese tea and two kinds of tofu to, yes, purple sweet potato snacking pieces.

My most expensive purchase was a living room rug for the equivalent of $13. The second most costly purchases was imported almonds (for hiking, of course), at about $4.

My shopping journey took four hours, most of it pure entertainment. After all, how many of you can say that you carried a rug in a backpack while you rode a bicycle home from the subway while balancing two bags of groceries?


Ten ways appearing on TV in China is different than the United States

The logo of CCTV English's current affairs program

The logo of CCTV English’s current affairs program

I’ve just completed my debut on Chinese TV before what was probably the biggest audience in my 35-year journalism career.

I was a guest on the nightly news show called “Dialogue” on CCTV (China Central TV). It’s a half-hour program where policy experts sit down and debate — freely, in my case — important international issues. No yelling. No screaming.

That alone is a big change from my appearances on — and viewing of — American TV news.

Here are some other differences between being a guest on Chinese TV and American TV:

1. No limo to pick you up.

2. No make-up artist.

3. No green room.

4. All of the anchors know what they’re talking about.

5. All of the anchors speak perfect English.

6. In-depth discussion of international issues.

7. Thirty minutes. No commercial interruptions.

8. No interruptions at all — the host and other panelist let me finish each answer before responding themselves.

9. No limo to drive you home.

10. I rode my bike home from the East Gate of Peking University subway stop after finishing the show.


Adjusting to life in China: Little by little, I’m at home in Beijing

It's easy to adjust to the serenity and natural beauty of the Tsinghua University campus.

It’s easy to adjust to the serenity and natural beauty of the Tsinghua University campus.

Little by little, there are signs that I’m adjusting to life in China. I still speak terrible Chinese, but I’m making (slow) progress. Some other signs point to a shorter-than-expected period of adjustment in my new country. A few examples:

  • At my apartment, I’m eating more meals  with chopsticks than with forks, knives or spoons.
  • I take the subway and wander the streets of Beijing without fear of getting lost.
  • I venture off campus on my bicycle into the chaotic swirl of Chinese traffic.
  • I add money to my subway fare card without the help of my Teaching Assistant.

    I can take subway line #2 clockwise or counterclockwise and not get lost.

    I can take subway line #10 clockwise or counterclockwise and not get lost.

  • I price things in yuan and don’t convert to dollars anymore.
  • I leave my passport at home when I go out.
  • I don’t get upset when the Internet connection is really slooooooooooooooooooow. Like the Texas weather, just wait an hour and it’ll change.
  • I don’t get upset when a car is driving down the wrong side of the road and appears to be heading straight for my bike.
  • I’m posting on Weibo as often as on Twitter.
  • I’m beginning to understand the difference between the four Chinese speech tones.
  • I’m beginning to understand a few street signs. In Chinese.
  • I’m starting to get the hang of sign language. Or maybe charades.
  • I’m starting to think it’s normal to ride your bike after dark without any lights.
  • I’m starting to say “ni hao” to people rather than “hello.” (With Caroline Ward, it’s still “ni howdy!”)
  • I can introduce myself as “DOO-NUH REE-KUH” rather than “RICK DUNHAM.” (I’ll pass along my real Chinese name when my colleagues show me the spelling.)
  • I don’t check the Internet every day to see what’s happened to the Phillies … or Nats … or Eagles … or Redskins.
  • I come home every night and turn on CCTV in English to discover what good deeds President Xi has done today. And what’s new in Turkmenistan.
  • I thank my lucky stars that I took this job.