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.
