lets talk about medical care 03/20/2011
Having broken a bone in 3 countries, I feel very qualified on the subject.
The first was a fractured foot in France, the result of running after a train (all of these broken bone stories are just as stupid and unexciting). I wish I could dig up a picture but the only place I know of one is on my late Facebook. EDIT: Mom found the pics!
Luckily I am tight friends with this amazing French family that I still miss so much, and they treated me like a daughter. They took me to the emergency room as soon as my train arrived. Here is where I got a taste of France's socialized medicine. (I want to point out that though imperfect, this care is completely FREE, which I think is better than going into debt or receiving no care at all.) The emergency room was chaotic Over crowded with people on beds in the hallways and doctors rushing in and out of rooms. I sat in a wheelchair unceremoniously dumped in the hallway and it was hours before someone even looked at my foot. There was a poster on the wall with a message essentially reading "don't be a dick, we are working as fast as we can." When someone finally did look at my foot, it was a very young medical student. She dipped gauze in a bucket of plaster and quickly paper mache'ed my foot. My French friends took me home with them. In the morning, the med student's ghetto plastering job became apparent as there were still soggy bits and even missing patches on the cast. Here's where having French friends proved invaluable. Yes, my ghetto emergency room story is what people in the US freak out about when they think of socialized medicine, but that's because they think for this you have to trade in your delightful family physician and all the comforts of your neighborhood clinic. Which is completely untrue it turns out. The next day my French friends called their family doctor, and he came to their house to see me. We then went to the "clinique" which is like your regular doctor's offices in America. It was very nice and clean; quiet waiting room, plenty of unharassed looking staff, fancy pants medical equipment... They immediately cut off the botched plaster job and gave me a very sturdy permanent cast, the kind that clicks when you drum your fingers on it. I got these forearm crutches which I like because they are smaller and lighter than the big armpit ones we are used to in the US. The downside is they are hard on the wrists and elbows.
France sucks for the handicapped. I lived up several flights of stairs and had to use lots of stairs in the charming old chateau-like university. Lots of cobblestone roads too. But honestly I don't remember it being so horrible. I took the bus a lot and still went on adventures with friends. After my cast came off, I had lots of physical therapy, more than I actually wanted. I felt very well cared for.
I broke my right wrist in my first and last snowboarding experience. There is a little emergency clinic right on sight there, so I got checked out right away and was given a rough splint and sling. I was at work at the time, and was supposed to drive the van of students home again, but instead we got permission from the school to let someone else drive home. German was with me, and as soon as we got home, we went straight to Emory's emergency room. It was just your average every day American emergency room experience. Waited for hours, went into different areas and exam rooms, saw different people, waited more hours... Bla bla bla. If I remember correctly, I got hooked up with a removable cloth and velcro brace and was told to see my personal bone doctor for follow up.
This is the only picture I could find of that injury. It was mostly just a long annoying process, but pretty straightforward. In the comfort of my own culture, familiar with the habits and accepted wisdom of our medical tradition, able to communicate in my native tongue to my caregivers, I felt quite secure in this heeling process.
And then there's China. OH China. Where do I begin? I broke my right foot in just as silly a manner as all my other bones have met their doom. I rolled over it wrong while walking. Apparently my bones are made of chalk. The next morning when I realized I couldn't walk, I called the FAO (Foreign Affairs Officer, the person who takes care of us foreign folk) and 4 hours later she arrived and arranged for the hospital shuttle to come pick us up. The hospital is surprisingly quiet and uncrowded. I didn't have to wait for hardly anything. Nothing is free but it is extremely cheap compared to back home. I've probably spent less than 1,000RMB on everything including crutches and X-Rays, which is a lot of money to someone here but about 150 dollars.
They rigged my foot into a kind of primitive cast... it's like an L shaped splint made of plaster tied in place with gauze. They told me to come back in 5 days to have it changed, which I thought meant this was just a temporary cast and then I would get one of those hard plaster ones like I had in France. But actually, when I went back after 5 days, they just unwrapped it, replaced the cotton lining, and rewrapped it the same way. Every week I have gone back to have this done. I guess it's kind of nice because my foot gets to be free for a moment, and in this type of cast I can wiggle my toes and stretch my ankle which was impossible in that other kind of cast... but by the end of the week-long period, this cast is tore up and just plain nasty. I've had this current one for 10 days and have 5 more to go on it, the longest stretch yet. And it is not pretty. It's stretched and frayed and about as dirty as a mop.
China is not really a place for germaphobes. This cast has been dragged around the school and touched the floors of restaurants and bars and general groundiness. Not to mention toilets. Yes, magically I have managed to use squatters with this thing. And then I climb into bed with it every night. I haven't had a proper shower in forever. I sponge bath. As for my hair, I usually wait til I can't stand how disgusting it is another second and Erik is kind enough to take me on his scooter to a barber shop where I have had some interesting hair washes.
Hygiene standards and stuff are just different from what we're used to in the west. In fact, sometimes I think we can be a little too obsessed with cleanliness back home; our fear of germs results in a lot of wasteful behaviors. But growing up with these hygienic values can make some things you encounter in China startling to your sterilized western sensibilities. I'm not saying I feel the hospital is unclean or that I fear my health is at risk, it's really fine. But for example, when they asked me to hop onto the X-Ray table, I saw there were drops of blood from the last patient. I pointed this out and my FAO is the one who got a wet rag from somewhere and wiped it up. The technicians and nurses didn't seem to think it was a big deal. Something like that would not fly in a hospital back home. Another example comes from the government hospital in Yangshuo where all the newly arrived teachers had to get health checks before being sent to their schools. People were smoking in the corridors and dropping cigarette butts wherever they like. We had to give a urine sample, basically in a labeled dixie cup, then put the cup on a cart sitting out in the corridor with no lids or anything, just a big ole cart of pee, right there in the middle of the hall.
Another difference: the privacy we are used to back home when we see our doctor is nonexistent here. Several people at once crowd into the Doctor's tiny office, and people have no problem gawking at each other's injuries and craning their necks to get a look at other people's X-Rays. Needless to say, I get stared at A LOT. I've had an old guy wander into the room I'm having my cast rewrapped in just to watch, completely unembarrassed. This kind of thing gets under my skin because it makes me feel like I'm being treated subhuman, like a spectacle. In the West, we take it for granted that our privacy is a right, something we are entitled to. But it's just not the same here. That dude believes he is entitled to have a look at something that sparks his curiosity. I know it's a cultural difference so I try not to let it bother me, but I just can't help it sometimes.
As for the last issue, China is not very handicap accessible at all. Many places have no handicap toilet (hence my squatting experiences) and elevators are extremely rare. Really, come to think of it, I have never seen a person in a wheel chair in 7 months of living here. Every now and then I see someone with a cane or crutches, but that is rare. I wonder about that. There has to be handicapped people like anywhere else in the world. Where are they? How do they manage? What about really old people with bad backs or something?
Anyway, this Friday I am finally free free free! They are cutting this nasty rag off! These last 3 weeks have gone by excruciatingly slowly, but I hope the next 5 days will fly by.
I already have plans to throw my foot a welcome back party!