Sunday, October 14, 2012

Wailing and Rending, as Though Death Had Visited

“You’re bleeding!” Summer wailed.

“Its OK, Sweetie” I tried to reassure her. “Head bumps normally bleed a lot because the skin on your head is so thin.”

She was inconsolable. She took personal responsibility for the flow of blood I now acknowledged was running down my face.

“I didn’t take good care of you! I didn’t watch out for you! It is all my fault!”

Now I am part amused and part irritated. I’ve lived nearly a half century without being looked after, especially by a young girl. I go out all the time on my own. This could have happened on any of my frequent outings and, truth to tell, with the crappy way I’d been feeling for so long I marveled that it hadn’t happened before now. Who was she to claim responsibility for my injury?

I felt no pain, just that of my heart for this poor young thing taking blame for my clumsiness. I did my best to reassure her, still not knowing the extent of the damage I’d done to myself. Meanwhile Vanessa is speed dialing Sam to find out what to do.

“Take her to the hospital” he instructs, “I’ll meet you there.”

Vanessa flags down the first passing vehicle, a delivery van. She explains to the driver that I am gravely injured, BLEEDING, and they have to get me to the hospital right away. The van driver naturally acquiesces and leans over, opening the passenger door and clearing off the front seat for me. The girls pile in the back. By now I’m a little beyond irritated. Why all the fuss over a simple fall and a little blood?

What is beyond irritated?

I tried to message Sam that I am perfectly fine and in no need of emergency medical services, but I could not text and hold a wad of tissue on my head at the same time. By the time I got most of the message typed out we were already at the hospital. The still weeping Summer shepherded me on with an arm around my waist and another on my increasingly painful elbow while Vanessa, cool and level-headed, led the way.

It being late in the evening the hospital lobby was deserted. The emergency room was a different proposition altogether.

Here, Ladies and Gentlemen I break narrative to inform you that I will relate this experience from 2 perspectives: factual and impressions. Or, if you prefer: color and play by play.

Here is my impression of the emergency room: it is a madhouse. There is no decorum, no receiving desk, no neatly uniformed nurses demanding forms be filled out and sending patients to discreet triage rooms. No waiting room filled with halt and lame, writhing in various degrees of pain and discomfort, trying to suppress vocal expressions of agony, as you would see in hospitals in America.

There are two doctors, each sitting in a hardback chair at a small wooden desk topped by a computer monitor. The CRT type monitor takes up most of the desk surface, so it is a good thing that the doctor only has a small writing pad to scribble notes on. Supplicants crowd around the doctors, shouting out their needs. The doctors barely look up as they answer question after question being shouted at them. Quite frankly, I don’t know how they function in that environment. 

Apparently the triage method employed in Chinese hospitals is by degrees: visible bone or blood gets first priority. Visible bone covered by unbroken skin comes second. Desperate parents carrying limp children are third and all else can wait, no matter what order patients arrive in.

Slight of build Vanessa bullied her way to the first doctor’s desk. He looked at me and immediately instructed her to escort me into an adjoining room. Summer did the honors, seating me on one of the two doctor’s stools, by a lone gurney with unchanged hygienic soak pads that were stained with blood and iodine solution. After extricating himself from the masses surrounding him the doctor appeared, pawed around on my head, put some gauze in my hand and left again, tersely instructing the girls. Total examination time: about ten seconds. 

Vanessa waited by my side while Summer took care of business. The doctor had written out a proposed treatment plan based on the cursory examination of my head. He handed the slip to Summer who met up with just-arrived Sam. They took off. I had no idea where to.  

Vanessa and I went to the bathroom where, unfortunately, there was a mirror. I got a good look at myself. It was not pretty. The right side of my face was streaked with gore, while my shoulder and the front of my dress were blood spattered. I still had no idea how badly I had hurt my head, but I was getting a better picture.  Just to show I am a good sport I joked that it was too bad it was not Halloween. In the condition I was in I was more than ready to scare anyone. I have to admit: I truly freaked people out, walking around that hospital looking like a hatchet had been recently removed from my head. Vanessa was not amused. I cleaned myself up as best as I could, using tissue paper and water.

Back in the hallway, and immediately back into the treatment room. The doctor glanced at the prescription form he had given over. Again he told the girls to escort me into the treatment room. The pads on the gurney still had not been changed. He instructed me to sit on the stool on the far side of the gurney and prop my chin up with my hands, like a small child praying. He even joked with Sam that I could now say my prayers. Sam duly translated, we had a nice laugh and then he left the room. That is when I learned that my staunch and stalwart friend Sam actually has a very weak stomach and gets nauseous at the sight of blood.                

With no ceremony and no warning, the doctor shaved the affected area on my head. He then proceeded to stitch my head up… with no Novocain. That hurt worse than the original injury. I counted 6 stitches before asking him how many more I could expect. He was delighted, both at the fact that I am an agreeable, cooperative, quiet patient and at the fact that I could speak Chinese. We bantered back and forth and even flirted a little bit while he stitched on. Conversation helped distract me from the agony of getting stitched up with no numbing agent. After he was done he allowed me to clean myself up in the washroom adjacent to the treatment room, and even helped a little.

What were my friends doing while the doc and I flirted? They were at the dispensary, collecting my meds. In China, the doctor writes out a proposed treatment plan on a pad similar to a prescription form. His/her notes include both medicines and treatments. The patient or the patient’s advocate pays for the treatment in advance and offers proof of payment before any treatment is received, even if there is blood or bone showing. So that’s where Summer and Sam took off to while Vanessa and I waited in the hall!

Our next stop is radiology for a CT-scan and an MRI, and then an X-ray for my rapidly swelling elbow. Sam, having taken control of things by now, presented the cashier-stamped prescription form. To my amazement there was no waiting at all. A good thing because there was no waiting room. With minimal pomp the tech arranged me on the table, after encouraging me to remove my earrings. Total time spent in radiology: about fifteen minutes. All pictures taken and films developed. With folders in hand we went back to the emergency doc who was again at the center of a ring of desperate, seeking succor. 

Two major differences between American and Chinese methods of treatment. In China, the patient is the custodian of his/her medical records, and all medicines prescribed in the course of treatment are dispensed to the patient or the patient’s advocate at once: the medications used during emergency treatment and for subsequent treatments. As a result I took home not only my medical records, X-rays and MRI/CAT films but also 2 days worth of IV bags and the solutions that would be added to the saline drips come treatment time.    

I’m bewildered. All of this is so different from what I’m used to. Walking through the mostly deserted hospital I glance through open doors, into rooms that are lighted and occupied. Here we have a room with ten beds, 8 of them occupied. No privacy curtains. The ill supine, moaning and writhing, the hale trying to calm them and hold them down. Medical staff, distinguishable only by their white coats and the fact that they traveled from bed to bed administered to their charges. Here is a room called “Transfusion Room”, with rows of comfortable looking blue chairs, mostly unoccupied at this time of night. I would become intimately familiar with that room. A few patients laying on gurneys in the hallways, seemingly abandoned.

I’ve read about hospitals in the ‘50’s and ’60’s in America, before heathcare became touchy-feely, a matter of discretion and an industry onto itself. From what I remember reading, it was a lot like this hospital.

By now it is nearly midnight. I’d been up since 6AM, because all this happened on Tuesday, the day my lone two classes are scheduled. You get some sleep. I’m going to silently record more impressions and write them down later.

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