Scrubs in Beijing

Even Lazier Sunday

enanareina — Sat, 19 Apr 2008 14:00:00 GMT

I was going to go to Drum Tower, Bell Tower, Lama Temple, and maybe see some hutongs today. Was, until I woke up and it was pouring rain and cold. I spent a leisurely day mostly in bed instead. I got up for breakfast, came back, slept through lunch, and woke up this afternoon. I've been organizing pictures and trying to finish some of the older stories on here. I also added titles for every other story I need to complete but haven't. There will continue to be tons of construction on here, probably until long after I've gone home, so keep coming back to check it out. Also, if you find an error, please let me know.

Funny story from today: a small group of students took a side trip to Beidahe, on the coast. They left yesterday morning by train and returned this afternoon. Late last night, our leader received a panicked phone call from one of the guys: they'd been asked for their passports, but several people didn't have them. Henry was able to read their passport numbers off his printed list, and disaster was averted.

This afternoon, the group hadn't returned by 4 like they'd said. Henry was off at the airport, picking up his friend. At some point, Laura received a phone call from the group on the train, looking for Henry, who wasn't here. She heard brief snatches of a story involving a hospital and a train passenger with an injured finger, but the connection was bad. She told those few of us at dinner what she'd heard, and then when Henry arrived she filled him in--after getting him a beer.

Finally, people from the train straggled in--soaking wet and freezing cold, and the story emerged:

One of the guys, Brian, who is fairly accident-prone, had gone to the restroom on the train. He closed the door behind himself, but it was opened by the conductor, who pulled him out and pointed to a female passenger who was holding her hand. Apparently, she'd had her hand near the door, and when he'd shut the door, her finger was smushed in some fashion. He apologized and went back to his seat.

After a few minutes, a group of train officials came to his seat, with the injured party, and began to argue with him. She kept asking him, "What are you going to do about it?", which apparently means, "Pay up". This was being translated through several different people. He kept apologizing, but she kept demanding money. One member of the group called the American Embassy for advice, but they told him it would be wise to just pay up. By that point, everyone was encouraging Brian NOT to pay her, as she was clearly extorting funds. As we are a group of doctors to be, her finger was examined and declared to probably be fine. Eventually, though, it was decided to take her to a hospital when they arrived in Beijing. At one point, an official had grabbed Brian's passport, making him really anxious, but it was returned to him in due fashion, and he wasn't arrested.

An ambulance was waiting at the train station when they arrived. This was utterly ridiculous for a minor injury to a finger, but they complied with it. The rate was 2 yuan per kilometer, making it cheaper than a cab (which is also 2 yuan per km but with a 10 yuan starting fee). They went to Tonghren Hospital, where her finger was x-rayed and declared to be fine. Brian paid the 350 yuan hospital bill, but was mostly pleased that none of the money went to the girl. He eventually came home, along with Roger, our one student who speaks Mandarin (and who went with him to translate at the hospital), and eventually got some food.

A near miss in China.

Saturday: Aggie Muster

enanareina — Sat, 19 Apr 2008 13:58:00 GMT

Saturday morning, we intended to leave very early, but we didn't quite make it. Arising by 7:45, we decided to eat group (ie, free) breakfast before leaving. Now, our breakfasts consist of fried eggs, white bread, jam, coffee, and hot milk. I've been supplying my own wheat bread instead of white, and insisting on two fried eggs, because the first couple of days I was really hungry afterward. It's getting better. I also brought some bananas (leftover from the Massive Banana Lifting at Friendship Hospital on Wednesday) in the hopes that people would share them, as they are now quite ripe (but delicious).

Finally, we were ready to head to Panjiayuan, or the weekend antique market. We caught a cab and soon arrived at a gate through a bare grey wall with tons of people and pushcarts around. We fought our way inside to find basically a massive flea market. Vendors had small stalls, cube/cage like spaces, or spots on the ground from which to hawk their wares. We looked at artwork, cheap jewelry, some not-so-cheap jewelry, furniture, rugs, porcelain plates, cloisonne Christmas decorations, and the fun part: the junk. My friend almost bought a broken piccolo, but unfortunately the vendor wanted $100 American for it. We argued and argued that it was broken, and had no case, but he stuck firm, so we did not buy the piccolo. I did play taps on his tiny cornet (which was in much better shape than the piccolo--I didn't dare ask the price). We saw empty clips for machine guns (possibly AK-47), bullets, canteens, bugles, and other army paraphernalia. Anything truly antique has either been bought or destroyed long ago in China, so most of what was there was junk. Still, it was fun to look.

Afterward, we walked east on Panjiayuan to the Third Ring Road, turned north for half a block, and came to a mecca of optometrist and eyeglasses shops. My friend bought a pair of prescription sunglasses for 280 RMB, and I had a spare pair of eyeglasses made (by taking the prescription off my current glasses) for 160 RMB, or around $22 American. Our glasses were done within 45 minutes and we came home just in time for lunch.

After lunch at the dorm, we met up with another friend and did some frenzied shopping. First to Liulichang Xiejie, a small street/hutong with antique shops, artwork, and tea shops. I had my beautiful silk paintings mounted on silk paper for the journey home. Then, we caught the subway to Hongxiao Pearl Market, where I bought "Brain Age" for my Nintendo DS, pearl necklaces for our teacher's female relatives (he'd asked me to do this--he doesn't like shopping), and pearl earrings for me. Thank God I think I'm done buying pashminas--I've acquired 5 on this trip and have 2 at home. Then I took a cab home in order to shower before Muster, while the other ladies went to Silk Street to exchange some jeans.

We all met up at 6 and went with a group of 9 to Tim's Texas Barbecue in the Jianguomen Embassy District. Apparently, Texas Tim went to A&M, and then came to Beijing and opened a bbq restaurant. We were greeted at the door by a Chinese man wearing a shirt colored like a Texas flag, saying "Howdy, podner" in the most hilarious accent. I almost fell over laughing. Up the stairs and 100 RMB later, I had a large stein of Tsingtao beer in hand and was doing the old Aggie meet and greet. Most of the people there were living and working in Beijing, some in oil, some in business, others teaching English. We had a delicious barbecue dinner, complete with brisket, barbecued chicken, pork ribs, beans, cole slaw, and potato salad (made with mustard like my mother's). It was unbelievably delicious. It was a very nice reminder of home. The room we were in was decorated with Texas memorabilia and Aggie flags, as well as a Twelfth Man jersey on the wall.

Eventually the Muster began. We stood and sang the Aggie War Hymn (badly, as many of us had forgotten a few words), then listened to some poems about Muster, and had a roll call for the dead. Only one name was on the official Beijing list, so I added my grandfather's to the list. Even though he died two years ago, I'd been unable to attend his Muster, so I figured I'd make up for it here in Beijing. No one minded. Then, we concluded with another poem and singing "The Spirit of Aggieland", took group photos, drank a bunch of beer (and margaritas for some), and hung out. Some of the group went on to Sanlitun to go salsa dancing, but I headed back with 4 others toward the dorm. I was able to Skype for a little bit with my husband (although not in a good fashion, as my headset microphone is not working, so he talks and I type on IM). All in all, a good and successful day. I have big plans for tomorrow: Drum and Bell Towers, Yonghedong Lama Temple, and maybe some hutong walking.

Friday: Anzhen

enanareina — Fri, 18 Apr 2008 13:56:00 GMT

wanfujing

Thursday: Anzhen & Olympics

enanareina — Thu, 17 Apr 2008 13:54:00 GMT

Lazy Sunday

enanareina — Sun, 13 Apr 2008 13:47:00 GMT

back to silk street

Friday: Xuanwu and Great Wall

enanareina — Fri, 11 Apr 2008 13:44:00 GMT

This morning, I woke up, ate breakfast, and tried to dress for the Great Wall. I put on jeans, tennis shoes (more "Fumas" from Hongxiao), a t-shirt, and pulled my hair back with a headband and ponytail. Then I put on a warm fleece, because it's supposed to be cold at Badaling. I packed my backpack with my remaining granola bars (from the community stash of food we all brought), wallet, cell phone, digital camera, and books for the bus ride. Then, I grabbed my white coat (on loan from Xuanwu) and headed out the door.

After arrival at Xuanwu, we headed to Stepping Classroom No. 2 for the last time. Today: Medical Massage. Unfortunately, it was not as exciting as I thought it might be. We watched yet another poorly made video in Chinese (these videos always end very abruptly, as do most of the Chinese doctors' PowerPoint presentations), then watched as the teacher demonstrated on one of his students. Finally, lines of our students went to the front for massage, but I didn't get one, so I sat down to read.

Eventually, this was over, and the closing ceremony began. Our itinerary for Xuanwu says "Meeting VP of XuanWu Hospital"; what actually happened was some lady came in, apologized that the VP could not attend, and then sat at a table in the front with Henry, our leader, and a student from Buffalo who has taken the leadership role for their group (since they do not have a professor with them). Some speeches were given, Henry gave them the signed photograph of all of us, they gave us folders full of stamps of Xuanwu, and we turned in our white coats. Then, we filled out the universally mandated evaluation form and lined up for lunch, which the hospital provided. It ended up being very good roasted chicken, rice, some kind of green vegetable, and thick, chewy biscuits, served with bottles of water. I tried to drink sparingly and save the water for the climb.

I started worrying during lunch, as a friend told me weather.com said the forecast was rainy for the climb. I had brought nothing for rain. Also, many people had hats and gloves; I had neither. Great.

Lunch over, out to the bus and on to Badaling, about an hour and a half northwest of Beijing. We arrived to a very touristy parking lot full of buses like ours and surrounded with tourist kitsch shops. The gullible must think you can buy Coach purses everywhere you go in China. Individual vendors surrounded us as we exited the bus, trying to hawk baseball caps, straw hats, postcards, and t-shirts. One guy in our group pulled off his several years old, worn and faded American Eagle cap and tried to sell it to any vendors who approached him: "Only 100 yuan, very cheap price." They usually cracked up and left him alone.

Out of the parking lot, you start climbing a narrow street lined with more souvenir shops and a Starbucks Coffee, then through a narrow tunnel (where cars still drive through!) and into the entry square. We milled around taking pictures of the garish "One World, One Dream" Hollywood-style sign placed on the hill while our assistant from CMU, Peter, bought our tickets. You could see the Wall winding into the hills on either side of us. We chose a steeper, less crowded route. I eyed it with trepidation. I get winded climbing to the 5th floor of our dorm, even after being here 2 weeks.

And then, my ticket was in my hand, I walked through the gate, and started climbing. Up to the division where you pick a side of the Wall to climb, and then on and on up. Soon, most of the group had left me behind. The stairs were uneven, some very tall and some very shallow. In between flights of stairs, sometimes the ground was flat, but often it was sloped at a steep angle, providing no rest for weary legs or lungs. If the ground was fairly flat, it was filled with vendors of t-shirts, postcards, chiseled rock art, or other junk, and you had to push through them. I took a few breaks for photos, but tried to just keep moving--I wasn't sure I'd make it if I sat down. At one point, the stairs became extremely steep, around a 60 degree angle rise. The stairs were also tall at this point, so I was clinging to the rail with one hand and using my other to balance myself on the stairs, so in essence, I crawled up the Great Wall. Eventually, I made it to the highest point, a guard tower, and proceeded a little farther to the end of the restored wall. We took pictures of the unrestored wall stretching beyond; pictures of each other on the wall; pictures of groups of us leaping into the air; pictures of us fending off the parasitic vendors at the top. I snapped a shot of a classmate casually text-messaging from the top of the wall, looking extremely blase. I couldn't believe I'd made it; my lungs were bursting with altitude and cold and exertion, and my legs were very tired.

Eventually, it was time to go back down. Someone told me that going down was the worst part, and I thought they were lying. They were not. My lungs didn't ache as much going down, but my legs started burning badly. My quads and my calves felt like they were on fire. Eventually, my Achilles tendons felt so tight I had to change how I walked down each step. When I eventually made it down, it had gotten very cold and windy, so most of the small shops were closing up. I still managed to get my obligatory "I Climbed the Great Wall" t-shirt, even though my legs were shaking unstoppably. It's called myoclonus, and both of my calves were doing St. Vitus' Dance while I tried to walk or stand. Not terribly comfortable.

We sat around until the appointed meeting time, then trudged back toward the bus area. I popped into every shop on the way down with Lindsey, as we were looking for a Hard Rock Cafe t-shirt for her dad. We had no luck, but apparently the shops just on the other side of the street had tons. Oh well.

Back to the bus, back to my book, and eventually the bus pulled into an unfamiliar restaurant in a part of Beijing I'd never seen before. The CMU people treated us to hot pot dinner as their way of apologizing for the Tourist Restaurant (one even joked about how we would be glad we weren't eating Muslim food again), but better than the hot pot (which to me, is just boiled meat) was the dishes which came after: a fajita-like vegetable dish (I bit into the wrong pepper, spit it out on the table, and was bright red and coughing for at least 10 minutes), shrimp, and other very delicious dishes.

After dinner came another surprise: the CMU people had rented us two karaoke rooms upstairs for an hour. We headed up to find very nice rooms with couches and large TV's, and we drank beer and sang until they kicked us out. Tanner did an excellent rendition of Justin Timberlake doing "Senorita", and some of the Buffalo students sang very well. I caught a brief glimpse of one of the CMU professors doing "Edelweiss" in the other room, but I was too busy fetching Anna to do "Dancing Queen" to pay much attention.

Unfortunately, the restaurant was a LONG way from the dorm, and we still had over an hour's drive to get back to bed. I just can't seem to sleep on the bus, so I stayed awake and watched the scenery as we drove home. I still felt slightly exhilarated--I'd made it to the top of the Great Wall! But I was definitely ready for bed.

Thursday: Back to Xuanwu

enanareina — Thu, 10 Apr 2008 13:40:00 GMT

Back to Xuanwu for another day. By now, we're very familiar with Stepping Classroom No. 2. Today, we divide into two groups; mine heads to General Surgery. It could be interesting, although one of my friends groans--she despises the OR. We wend our way through corridors and staircases and end up in yet another conference room.

We're quickly shown the surgical ICU, which is very modern looking--probably the most Western-looking ICU yet. Then, we go visit a few patients: an old woman with abdominal pain that turns out to be recurrent cholecystitis, a middle-aged lady with small bowel obstruction from a large sigmoid colon carcinoma, and two women with large palpable breast masses (obviously advanced breast cancer). Interestingly, the woman with colon cancer was unaware of her diagnosis. Apparently, the hospital's policy (and the cultural policy in China) is to give the family the bad news, and allow them to tell the patient or not. We asked about patients who have no family, but weren't given a clear answer. I've always heard of these situations--they come up in ethics discussions frequently in the States--but never personally encountered one. The Chinese doctors had no problems with it, but most of us in the group were very uncomfortable with this idea.

The patients with breast cancer were told about their diagnoses. When we asked why, as opposed to the colon cancer, we were told that breast disease is more obvious and harder to conceal from the patient.

The weirdest part of the morning happened after we went back to our conference room. First, we were shown CT scans of the colon carcinoma and mammograms from the breast cancers and asked to interpret these films. Several of us did a passable job of mentioning calcifications, nodules, consolidations, and densities on the mammograms, but we had to be shown the colon cancer, because it wasn't immediately obvious (at least to me). Then, the attending asked us what we thought of the situation in Tibet.

Silence fell in the room.

We have not had occasion to discuss Tibet with any native Chinese, and now was not the time (I felt) to start. We tried to demur, but he was persistent. He told us that he felt Westerners were not given much news about Tibet, or it was limited or wrong. So we asked the natural question: What was the "true" news about Tibet?

He basically answered with the Party line: that some bad elements in Tibet had started causing trouble, and the army had to protect the people, and it was such a shame that it had to happen around the Olympics and tarnish the world's memory of the Olympics. A few students made concilatory remarks at this point: Oh, we're sorry about the Olympics too, and we hope that the world doesn't associate Tibet with the rest of the Chinese people, who have been so kind to us.

It was definitely interesting. Most of the Chinese whom we've asked questions about the government have given soft but politically correct answers. One resident, when he went out to a bar with some of our students, told a different story in the bar than in the hospital. He is an interesting type, having adopted a full Western first and last name, and he subscribes to Time and The Economist.

I found it interesting that the story being given now, in Tibet, is essentially the same story used in Tianenmen in 1989. I'm sure many people here see through some of this, just as they did then, but I'm sure we're the last people they'd tell. Still, though, this doctor was so emphatic about it that I felt like he was a true believer. I was really glad to get out of that room when it was time to get on the bus.

Back to lunch, and then my group went to neurosurgery in the afternoon. It was terrible. We sat in a plush conference room and watched presentations in broken English all afternoon. I played Solitaire on my cell phone the entire time. Many students fell asleep or read books. None of us were that comfortable, though, as we'd had to dress up for dinner this evening. Tonight is the Sichuan Restaurant Blowout, if you will. Halfway through the trip (or so), we have a fancy (and pricey) dinner at a Sichuan restaurant, and we invite university officials to dine with us.

On our way to the restaurant, we had an incident. Stuck in traffic on busy Qianmen, one student at the front of the bus noticed a mother sticking her bike out into the road, peering around the bus at traffic, with her small child on a seat on the back of the bike. She'd retract the bike when cars came too close, then stick it out again. He found this fascinating, so he tried to film this on his camera. As he pulled it out, though, she made it across the street, so he filmed the street around the bus for a moment. Classmates began hissing at him that the woman was staring at him through the bus window, so he turned off his camera. At that point, she came BACK across traffic (with her child) and started pounding on the bus door, gesticulating wildly and yelling in Chinese. Then, she went and stood in front of the bus as we got a green light. Our bus driver began hollering in Chinese at her, telling her to move, to relax, to get out of the way. This went on for about five minutes, until she finally gave up and left. The guy responsible kind of sank down into his seat until she was gone.

We parked in a hutong and began walking a short way to the restaurant. We were immediately besieged by vendors selling Mao watches, purses, postcards, and god only knows what else. We walked quickly and got to the restaurant.

Many dishes were served that night, and we drank 61 (750 mL) bottles of beer. Toasts were made by multiple students and many of the teachers and leaders, more as we had more beer. Eventually, the meal and the toasts were over, and we filed past the picture of Deng Xiaoping in the lobby (the restaurant was a favorite of his), back past the vendors to the bus, and home again, all the while still buzzed. The servers were well-trained, and refilled my beer glass every time it was 1/6th down, so I couldn't keep track of how much I drank.

Good night, indeed! He puts this meal at this point in the trip because most of us are kind of tired of China by this point. We've had issues with the food, though none more than the girl with anaphylactic allergy to peanuts (they fry everything in peanut oil here, so she's been subsisting largely on noodles and rice). We're homesick, or miss our significant others (except for the two couples on the trip). We're tired of each other to some extent (there's a ton of gossip and drama). So it's nice to go out and have a big fancy dinner that is NOT at the tourist restaurant.

Tomorrow is the Great Wall!

Wednesday: TCM

enanareina — Tue, 8 Apr 2008 14:05:00 GMT

Wednesday was going to be special. Today, we were finally going to see some TCM, or Traditional Chinese Medicine, which up until now most of us have only talked about with little knowledge. We arrived at Xuanwu and went back to Stepping Classroom No. 2 for instruction.

The acupuncture teacher was at the front, with Dr. H and an assistant. Standing next to her was a 15" statue of a man with the meridians and acupoints marked on it. The topic of acupuncture was introduced with a dreadful video of acupuncture needles being thrust with, I thought, unnecessary vigor, into various patients in various body parts. Then, the teacher introduced (through Dr. H's translation) a patient who would volunteer to be given acupuncture in front of us all. She demonstrated various acupoints as she placed needles in the woman's face, hands, and inner calves, then hooked electrical lines to many of them and turned on a device. Nothing really happened, visibly. The woman lay there for the duration of her treatment, then the needles were removed, she put her shoes back on (over her hose and leggings which were under her pants), said it didn't hurt when Dr. H translated the question to her, and left to applause. Afterward, so many questions were asked ("Can you use acupuncture to treat back pain? Kidney disease? Heart disease? Mental illness?") that I gave up trying to pay attention and pulled out my novel in the back of the room. Eventually, 11 am rolled around, and with it the Dr. Gone. So far, not as thrilling as I'd have liked.

After lunch, we went back to our classroom for another demonstration, this time on a volunteer from our group. A brave soul from the Buffalo med school went up and had cupping done on her back. I took a bunch of pictures because it was so grotesque looking. First, the glass cups are heated with a flaming stick, then quickly applied to the bare skin on the back. They are as quickly removed with a squelching sound, reheated, and reapplied elsewhere. Eventually, many cups are applied and left on the skin for 10 minutes; she had 9. I photographed the skin rising inside the cups, as high as bread dough, but red and mottled as a hickey. When the cups were removed, her skin was bruised and red, but she said it didn't hurt, that it was actually relaxing.

Another girl went up and had acupuncture applied on the inside of her calves; this acupoint is supposedly good for many things, including menstrual irregularity and infertility. Yet another had "moxibustion", which is a heat source placed near the skin until it reddens. The stick used for moxibustion was about 8 inches long, wrapped in paper, and is lit like a cigar, whereupon you can see the inside is an organic material. It gives off a sweetish smoke very like marijuana smoke. We joked about the smell until one brave soul asked if the leaf inside was a substance which could be smoked. We eventually determined that whatever it was might be possibly used in rope-making, and that was as close as we got to determining the mystery moxibustion substance. Several gentlemen from my class went to the front of the room where the smoke had gathered to "think deeply" and then made jokes about wanting potato chips.

Eventually, most of us lined up for various procedures. Some girls wanted their pulses taken and tongues examined to see whether they had a deficiency or excess of qi; some lined up for cupping, and others for acupuncture. I personally had my tongue examined, as I have geographic tongue and I wanted to see what they would say (the teacher gasped, and said something in rapid Chinese, which was interpreted as "your tongue is special" and "it means you have a deficiency"), and then I had acupuncture in my face and hands for allergic rhinitis and anxiety (even though on this trip I've been far more sad than anxious). My allergies weren't terrible when they put the needles in, and they weren't terrible when they pulled the needles out, but my mood did lift for a day or two. Coincidence? Who knows.

After a while, groups were taken to the TCM pharmacy area for a brief tour. When I went, I took pictures of trays of herbs being prepared for patients in the hospital. The herbs (and bugs, and lizards, etc.) are weighed carefully according to the prescription, then packaged to give to the patient, who will boil them into a "decoction" or tea which is drunk. Apparently, some are given IV in the hospital. I will admit to being far more comfortable with acupuncture and cupping than the herbs. The arguments for primarily consist of "well, it's worked for 2000 years, who cares if there's no randomized-controlled trials" and the arguments against are "there's no RCTs". This is obviously vastly over-simplified, but this is where we're starting out.

Back on the Dr. Gone, back to the dorm, and then out with a small group to check out a truly American institution, one which all Americans should be proud of its exportation to China and other countries, one which is fairly representative of American culture at its finest:

Hooters Beijing

Oh yes, friends, we went to Hooters. We took a ton of pictures of the girls, all slender with long black hair, dancing to Ciara's "One-Two Step" or singing "I'm a little teapot". Their English was surprisingly good, as they hollered "Welcome to Hooters!" on our way in. I had a grilled chicken sandwich and french fries, of which the fries were delicious. Someone else had the salad, even though the dressing was weird, simply because we are so greens-deprived right now. I've stopped eating most of the meat in the tourist restaurant because my whole system feels choked by it (and the heavy oil).

On our way to Hooters we passed the Workers' Stadium, an enormous edifice fronted by two giant soccer (football) statues, as well as an Outback Steakhouse. After leaving, we briefly visited Sanlitun Clothing Market (another giant building filled with tiny stall shops and very tough bargainers), then caught a cab towards Wanfujing to meet some other friends.

When we arrived there, our friends were not around, so we waited a bit and then decided to walk down towards Wanfujing. This is a large pedestrian-only shopping area, with "Snack Street" and the "Night Market", whose main notoriety is the availability of cooked scorpion, squid, silk worm larvae, seahorses, and cockroaches to eat. We passed a sign for "Adult Health" next to one which read "Sex Shop", a 7-Eleven, and St. Joseph's Church, an enormous cathedral. We met our friends, who'd been dropped off on the wrong side of Tian'anmen Square (while it was roped off for the evening guard change) and were thus late. Then, we went to the night market. The most exotic thing I ate was a kebob stick of strawberries and kiwi, which was DELICIOUS. I hardly eat fruit in the States, but here I feel so deprived that I'm devouring it. I also bought fruit at a street vendor earlier and have been gorging myself on strawberries, apples, and bananas in my room. I suppose I'm taking chances with traveler's diarrhea by eating raw fruit (the water might bear E. coli) but I don't care, I need the fruit. I also brought Cipro, just in case.

By the time we left the night market, most shops were closed, so we headed out to catch a cab. We noticed an interesting phenomenon: there were many cabs waiting at the edge of the street, with the cabdrivers standing there soliciting passengers. We spoke to one, but he was spooked off by a cop, which clued us in that all was not kosher here. A legit cabdriver does not stand outside his cab to get fares; if he's out of his cab he's on break and screw you if you need a ride. We headed away quickly and found a reputable-looking hotel nearby, where we caught the requisite cab and headed back to the dorm.

Just remember: when in Beijing, do not get in a cab where the driver is standing outside soliciting you. They do not use meters and will charge exorbitant fees. Often, their cabs are painted exactly the same and can blend in well.

Tuesday: Xuanwu Hospital

enanareina — Tue, 8 Apr 2008 12:59:00 GMT

Same morning routine, except I gave up on breakfast this morning in favor of trying to Skype with my husband, whom I haven't spoken to for longer than a few seconds since I left. Onto the Doctor Gone, and on to Xuanwu Hospital, a large internal medicine and TCM hospital. The first morning starts in "Stepping Classroom 2", where we are thoroughly oriented to the history of Xuanwu, and then split into various groups. I'm sent to Neurology, and I'm excited because I've heard there is an entire ward devoted to Wilson's Disease at this hospital.

Unfortunately, the neuro group was split again, and I was assigned to stroke. Dammit! I sat through a presentation on ischemic and hemorrhagic stroke, and then a case presentation of a patient with acute onset of left-sided numbness and weakness, extending to the lower half of the left face. We arrived at the diagnosis (made obvious by the glaring hemorrhage on the CT scan they showed us) and then went to see the patient. Sadly, numbness isn't a symptom that translates well through the interpretation of the resident from the patient, and her weakness has largely resolved (as she's been in the hospital for 2 weeks already). Then back to the conference room for another case presentation of TIA, and then to go see the patient. This was completely worthless, since by definition the symptoms of TIA are transient and were no longer present. So, one perfectly normal neuro exam and one nearly normal. Fascinating.

Back to the bus and home for lunch, and back to Xuanwu in the afternoon. This arrangement, though tedious, allows us to unwind a bit before returning, and allows siesta time for the residents, who are shocked that we don't all take naps in mid-day. I, too, am shocked that we don't get naps. We should seriously consider this as a culture.

The afternoon was far worse. Henry's old friend, Dr. H, treats us to an hour long lecture on how to properly perform a cardiac exam (we're fourth years, if we don't know this now it's too late), then gives us four patients to examine. I only hear murmurs in two, but they were fairly impressive mitral stenosis and regurgitation from rheumatic heart disease, as well as tricuspid regurgitation in one patient. I will always suck at hearing murmurs, but who cares, that's why I'm going into psych.

That night, after catching the Dr. Gone, a group of us went to Houhai to meet a friend of Anna's who is also studying here. We found her, and then we found a Hot Pot restaurant. Hot pot is a big pot of boiling water with herbs, into which you dip thin meats, vegetables, or noodles, allow them to cook, and then eat them with a peanut sauce. Aside from the noodles, it's not my favorite form of Chinese food, but it's fun. We then wandered around Houhai, an area around one of the large lakes which was an ancient water supply for Beijing, but is now full of bars and shops. I saw hookah bars, bars selling Budweiser, bars selling Coors Light (who knew?), and bars selling Carlsberg from Belgium. Bar workers will stand outside and call to people, inviting them inside, offering discounts on drinks. We tried to avoid them, as they often spit everywhere.

As a side note, I cannot take the spitting. Every Beijinger, it seems, loves to hawk huge loogies onto the sidewalk. While practical, as the air pollution here is unbelievable, this practice is thoroughly disgusting. I'm always hearing that terrible noise going off around me and I cringe every time, fearing the stray spitwad that might splatter me with phlegm. As paranoid as this sounds, a biker actually came very close to hitting me early in the trip, so it's justifiable paranoia. Also, I abhor phlegm.

Home again, home again, jiggety jog.

Monday: An Ding Hospital

enanareina — Mon, 7 Apr 2008 12:14:00 GMT

I woke up, took a cold shower, had blow dryer issues, walked down the street to breakfast, and back to catch the bus. An Ding is about an hour's ride in the bus, so we're going to eat lunch there. This is the only psychiatric hospital we'll visit here in Beijing--where the resident last week said, psychiatry? what's that? oh, you mean talking to patients!--so I'm curious.

We eventually arrive, wander through a dusty construction zone, and are escorted to the back of the hospital, down some stairs, and into a conference room. We are greeted by the usual Power Point presentation: welcome to An Ding Hospital, built in such and such year, cares for x patients per year, provides y services for patients. Then, finally, we split into groups and start touring.

First, we are shown one of the "rehabilitation" areas. Here, patients can read from a selection of magazines, hang out, or do crafts. One lady was knitting, but the others were working with thin golden wire, deftly twisting it into a circle, and then covering the hoop with colored pantyhose. As odd as it sounds, I took a few pictures to show that the resulting flowers (and bouquets of such flowers) were actually quite pretty. Another lady was making loop wall hangings; I also took pictures for demonstration. I shot a picture of a Remeron pen in the pocket of a resident; apparently that rep is well-traveled.

Over the morning, we toured the pottery room, the painting and calligraphy room, a game room with pool tables, ping pong, and mahjong, a karaoke room (strangely decorated for Christmas), and finally a few patient wards. The patients stay here for 2-3 months, so there's lots of time for the various crafts and occupational therapies that our psych hospitals are usually missing (although ours does have a cheap karaoke machine). The patients stay in large locked wards, and most sleep in rooms of 8-10 patients; if you "pay extra" you can get a 2-person room. One resident said that family could stay with the patients, but other residents denied this, so I'm not sure what the truth is. The English spoken by the residents and attendings at An Ding is much poorer than at Tiantan.

In one women's ward, the patients were hanging out in the common room as we walked through. A student on our trip asked me what I thought the presentation of psych illness might be like here, since these diseases are so environmentally and culturally influenced. While I was pondering this, a woman stepped out from the throng and began to sing loudly (and quite well):

"When I was young I'd listen to the radio
Waitin' for my fav'rite songs
When they played I'd sing along
It made me smile
Those were such happy times and not so long ago
How I wondered where they'd gone
But they're back again
Just like a long lost friend
All the songs I love so well

Ev'ry sha-la-la-la, ev'ry wo-ho-wo-ho still shines
Ev'ry shing-a-ling-a-ling
That they're startin' to sing so fine
When they get to the part
Where he's breaking her heart
It can really make me cry just like before
It's yesterday once more." -The Carpenters

I told him that I thought the presentation of mania wasn't really that different in China compared to the US.

Back to the conference room for lunch. The residents brought in stacks of plastic boxes labeled "Fast Food." Inside were warm containers of rice, two unidentifiable vegetables, 3 chicken wings, and whole shrimp. As the shrimp still had eyes, legs, and antennae, I didn't eat them (or the rice their antennae touched), and it was not easy to eat chicken wings with chopsticks. However, the Chinese are not too big on napkins, so I didn't pick the wings up by hand. It's a really good thing I brought a package of peanut butter crackers today.

Chatted with a psych resident during the lunch break. She said she had wanted to do cardiology, but she had been forced into psych by a professor who said her score wasn't high enough. Her English is not too good, and her self-confidence is even lower, so our conversation is very stilted. She then said that she thought we were all very beautiful, with our wide eyes and white skin. I felt pretty bad at this. It's odd how in our country, everyone wants to be tan, where here, everyone wants to be white. We sell tanning lotions, bronzers, and time in tanning beds; here, you can buy whitening face cream and hand lotions. I wanted to tell her that we try to celebrate different kinds of beauty, and that there's nothing wrong with looking Chinese, but I wasn't sure if I'd be able to communicate that.

After lunch, we split back into groups to see another ward. We toured it briefly, then headed to another "Doctor's Office" for a hard core pimp session. The attending wanted to know every drug we used: "What drug for acute psychosis? What dose? What about for mania? What dose? Do you use x drug for depression? I saw a study about Effexor at [very high dose] from US, but here we use it at [normal dose], is this common practice? (I said no, at that dose it can cause more hypertension than benefit in depression reduction [was pulling stuff out of my ass]) But it was in the study! In your country! (Oh jeez, get me out of here)" We asked how patients paid for the stay at this hospital, and the answer was "They pay, or their family pays." We asked what about patients who can't pay? "We try to find their family." Henry asked a question about indigent patients who have no family, and the answer was very confusing: "We think there is a special place for these people, a hospital, but we don't know about it."

We also asked about pregnancy: why were none of the patients pregnant? "When they come in to be admitted, we administer the hCG test, and if it is positive, they are not admitted." But what happens to them? "They can go home. Or, if she does not want the baby, she can be admitted." Bizarre. I'm not sure if this is true, but they're implying that the only way a pregnant woman can get psychiatric medication is to abort the fetus, or else suffer the mental illness without treatment. I hesitate to say this is true, though, since the English language barrier was pretty steep. Every part of this conversation had to be translated through one resident whose English was a little better than the others, but not by much.

Eventually, we left the room, left the locked ward, left the hospital, and headed back onto our bus, which we've christened "The Golden Doctor Gone" (the line is the Golden Dragon, but the A is missing). Yet MORE dinner at the accursed Tourist Restaurant. I'm starting to feel like I have scurvy from the lack of any green vegetable that isn't deep fried or sauteed in masses of oil.