How to Live in China: A Brief Introduction
After seven years of living in China, you develop a set of informal rules for yourself:
1. The correct response to any unsolicited conversation is ‘ting bu dong’ or ‘I don’t understand’;
2. If in English, as above but you’re French;
3. Tell taxi drivers to fuck themselves as often as possible – it makes you feel better and the pricks might even stop;
4. Skip #3 if they actually pick you up. It just complicates matters;
5. Don’t go to hospital, ever. No, seriously. Stage four cancer is shit, don’t get me wrong, but honestly, I’d rather not know than be told by a chain-smoking doctor prescribing you a saline drip and telling you not to eat spicy foods while three other patients and their extended families listen with interest to how the funny lao wai’s pancreas is going to seize up within the month.
I do my best to follow these rules whenever possible, but it’s not always feasible. Sometimes it’s raining and the taxi drivers can’t hear me as they hurtle past dead-eyed and blank-faced, possibly on some kind of bet with their mates as to who can dodge the most fares in a single day.
Of the above rules, though, #5 is probably the most important in maintaining sanity as a not-Shanghai-or-Beijing expat. Being in those places doesn’t even really qualify you as an expat; anywhere that has a Burger King a couple of Metro stops away might as well be downtown Manhattan as far as I’m concerned.
So anyway: hospitals in Xi’an. Recently I had cause to break rule #5 owing to a fun stipulation at my place of work: if you ring in sick on a weekend day (our busiest days), you have to go in to hospital to prove you’re not faking. As a deterrent to pulling a sickie, I have to say that it’s a fucking fantastic one. I’d rather take a class of autistic six year olds through an interpretive dance workshop than have to go to hospital just to pull a sickie. On the flip side of the coin, if you’re actually ill, you have to go to the hospital. I can’t think of a more inappropriate place for a sick person than a Xi’an hospital.
So it was, a couple of Saturdays ago, that I found myself with a pain in my foot so severe that I could only manage a bit of a hobble. This meant the unthinkable: a trip to Shaanxi province’s most popular Chinese hospital on a Saturday morning. And when I mean popular, I don’t mean anything amateurish like Beatlemania or quoting Catherine Tate. I mean China popular. I’m talking about a country where a typical commuter bus makes an Auschwitz train look roomy. A government holiday here is basically a nationwide re-enactment of the LA riots.
It wasn’t with much surprise, then, that the lobby of XiJing hospital (most popular in Shaanxi) was pretty much like a bus station when we arrived. The school had sent one of the Chinese staff, a 40-kilo accountant, to help me at the hospital. I mention her weight not because I’m weird and obsessive (not for this reason, anyway) but because, given my condition, it was entirely possible that she would have to support a limping foreigner who was literally twice her weight. Luckily, that didn’t happen, as I’d perfected hobbling to an art by the time we got there.
It was from this point on that I had my memory refreshed on some of the finer points of the Chinese healthcare system.
There is Absolutely No Privacy
In the Motherland, there are certain expectations when going to your GP. You make an appointment, you turn up, and he or she sees you, listens to your problem, and prescribes some medicine based on what WebMD tells them it sounds like. I’m kidding; Wikipedia is much more reliable.
It pretty much goes without saying, but this is a private conversation. You get taken into the doctor’s office by yourself. There are some nice informative medical diagrams on the walls, a few books, maybe even one of those model vaginas that Steve Carell plays with in the 40-year-old Virgin. Your doctor is patient, softly spoken and only that one time incredulous when you tell him that that thing on your knob can’t be an STD because you’re still a virgin.
At no time does he or she invite other random members of the public to come in and have a gander, maybe even offer some of their own folk remedies for what ails you. It’s a widely recognised unspoken social contract: don’t fucking barge in on the doctor when he or she’s with a patient.
In China, it gets done differently. You get a number or whatever to wait in line (I wasn’t paying attention; I was trying to dodge people blithely crashing into my foot), but it seems to be more of a suggestion than a strict rule. There are, at any time, at least six people in the doctor’s office. Other patients are treated as a kind of slightly inconvenient fog as they thrust their patient information into the doctor’s face, often while he’s still talking to the previous patient. If they don’t do this, they’ll instead listen to your intimate medical problems like they’re watching reality TV, occasionally asking a few questions for clarity’s sake and perhaps offering some useful advice, such as cutting back on spicy foods or drinking hot water. For most Chinese people, hot water cures anything up to and including gunshot wounds and final-stage AIDS.
For obvious reasons, avoid the urology department even harder than the rest of the Chinese hospital.
Hot Saline Action!
Chinese doctors will scoff when they hear the proles recommending such ignorant backwater folk remedies as hot water, green tea and having a rest. No; they know better. They know that to get shit cured, only one wonder drug holds the solution: an intravenously delivered dose of saline solution.
Saline-solution drips are the panacea the world’s been searching for since time immemorial. There’s nothing those little sacks of saltwater can’t get rid of. Cold? Two hours on a drip. Running a temperature? Salt kills temperature DEAD. Broken leg? It’ll probably knit on its own, but everyone knows saline speeds it up like you’re a really rubbish, uncool Wolverine.
The West is gonna be so embarrassed when it realises what it’s been missing out on.
No, but also herbs
If there’s one cliché that springs to mind when people think of Chinese medicine, it’s acupuncture. Wait, no, the other one. Herbs. Chinese herbal medicine.
Doctors here tend to give out a mixture of medicine after they’ve pumped saltwater into your bloodstream for three hours. Sometimes it’s Western stuff – pills with sexy-sounding z- and x-laden names so it makes people think it’s like Star Trek medicine – and sometimes it’s Chinese stuff. Chinese stuff is often like Western stuff, except it’s not synthesised and uses natural ingredients. This means that you have to take more of it. I don’t mean take maybe two pills a day instead of one. I mean take like thirty-four pills a day.
On the one hand, it costs a shit-tonne of money, but on the other hand, it’s an effective and relatively risk-free way of pretending to be Keith Moon for a week.
In England you DON’T Pay for Medicine?
I wasn’t exaggerating above. It really does cost a shit-tonne of money if you need anything doing. Medicine might cost between 100-500 RMB (ten to fifty quid last time I checked xe.com, which was like three years ago. Exchange rates are pretty much always the same though), while if you need an MRI or something more intensive, you’ll be looking at upwards of a grand. While this may seem a bit expensive, the Chinese have a universal health care system to fall back on: their son or, if they’re really unlucky, their son-in-law.
Don’t Go in the Middle of the Night
About three years ago, I got a pretty bad ear infection. It was bad enough that it woke me up in the middle of the night, and painful enough that I had to break rule #5. I faithfully enforced rule #3 though; despite having LITERALLY NOBODY ELSE TO PICK UP, taxi drivers will still, on occasion, ignore you in the middle of the night.
You’d think, upon initial reflections, that the middle of the night would be the ideal time to go to the hospital. Chinese people are like Mogwai: they don’t eat or drink after midnight and if they do, shit usually gets ugly. This means that the hospitals are like morgues.
It also means, however, that you’re waking a doctor up to get seen. Nobody likes being woken up on the job in China, but doctors get really arsey. Who the fuck goes to the hospital in the middle of the night? That subdural haematoma will wait until morning; whack a plaster on it and get some fucking sleep like the rest of us.
My particular attending physician was not impressed with being roused at three in the morning. I explained the problem to her – my entire ear felt like it had been dipped in honey, covered in ants and then set on fire – and using her best bedside manner, she asked me to sit, got one of those ear-checking doctor devices that looks like a sonic screwdriver, and yanked my earlobe down as hard as she could.
I would have thought she’d have been less surprised at my reaction, given my explanation, but maybe something was lost in translation. Her reaction to my spinning a full three hundred and sixty degrees in the chair and screaming like a child was one of intense annoyance. What did I think I was doing? Did I want her to check my ear? Had I just got up in the middle of the night and travelled to a hospital to play an elaborate and unfunny practical joke on her?
Suffice it to say: don’t expect any gentle treatment in China. They’ll fix your shit, but they’re not gonna hold your hand and give you a lolly afterwards – especially if you wake them up.
It’s Actually Not All Bad
If there’s one thing Chinese hospitals kick England’s arse at, it’s how fast they get stuff done. I once went in for an MRI, and it took around two hours from seeing a doctor to getting the scan done to getting the results. In England I’d either be drawing a pension before I saw anything resembling results (or the tumour would have already killed me).
Seriously, Don’t Go to the Urology Department
Just fucking trust me on this one.