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boschian

The fact that almost all of the commercials on Chinese TV are for some kind of medicine or another would make one think that health was first and foremost on the People’s consciousness, and yet the People spit, cough, and sneeze everywhere, with no regard whatsoever for where they are, what they may have, or who may be in their path. This minor irony did not pass through my head on Tuesday morning as I stumbled through the hallways of Harbin Medical University #2 Hospital. I was too busy mentally calculating spittle ballistics and snot trajectories, and trying not to breathe too much.


I didn’t feel great at all on Monday morning: I had a mild headache and sore throat, my neck muscles hurt, and I wanted nothing more than to ditch work and stay in bed. In this respect, it was almost exactly like any other Monday morning, and I put my body’s aches and pains down to nothing more than a physical expression of my fear and loathing of Mondays, and the first-grade classes that came with them.

Anyway, I went in and taught my first morning class, Grade 1, Class 3. 1.3 is easily the best of the first-grade classes, and usually enough to cheer me up anough to face the rest of the day in its cheerful, hyperactive, bouncing, screaming entirety.
This Monday, though, it didn’t. My head still hurt, and my throat still hurt, and my muscles still ached, and I still wanted just to die or better yet go back to bed. This got worse after Grade 4, Class 1, but 4.1 always ruined my mood. I went home after that – I had a free period, and then the lunch break after that, which was enough time for a decent nap.

The day went on – the after-lunch fifth-grade class, which was always the high point of the first half of my week, failed to make me feel better, and the next two first-grade classes made me feel even worse, and then suddenly, as my head was buried in my hands – a common occurrence with 1.1 – I noticed that my forehead felt really hot, and that, moving down from there, the lymph nodes along the side of my neck were distinctly swollen.

“Well, shit,” I thought, and went back through my memory of the last 48 hours looking for a recollection of a dry, rasping cough at any point. Finding none, I concluded that I was probably fine, and went on with the rest of the day as normal.

Then I got home, collapsed on the bed, and slept, more or less solid, until 7 the next morning, when I woke up and found that I was drenched in sweat, and my forehead was burning hot, and I felt too weak to get out of bed.


On the rare occasions that I call in sick to work, the conversation goes something like this:

“Hi, it’s Brendan. I’m really sick today – I have a fever, and I really can’t come to class. I’m terribly sorry about this.”
“OK. I hope you feel better. Have a good rest.”

On Monday, it went like this:

“Hi, Maggie. It’s Brendan.”
“Hi.”
“I have a pretty high fever and a sore throat. I’m sorry, but I can barely stand up – I really can’t teach today.”
“A fever?”
“Yeah. I don’t know how high, but it’s definitely a fever.”
“Are you coughing?”
“No – I’m pretty sure this isn’t feidian*.”
“You should go to the hospital.”
“I really don’t like going to hospitals here. If this isn’t better by tomorrow, I’ll go to the hospital, but if I can possibly avoid going, I will.”
“Oh. OK. I hope you feel better.”
“Thanks. I’m sorry I can’t come in today.”
“It doesn’t matter. Have a good rest.”
“Thanks. Bye.”


In order to get a Z-class visa for a period of longer than six months, you must get a physical.

So I got one back in the States, before I left for China. I had notarized papers certifying that I was free of ‘mental disorder’ (although anyone who has ever seen my room or even my notebook can certify that I am disordered), ‘syphilis,’ ‘brucellosis’ (by virtue of not being a cow), and many other illnesses.
And when I got to China, they told me I had to get another physical.

So this was my only experience at a Chinese hospital; my boss took me to a place in the Daoli district that was somehow affiliated with the People’s Liberation Army, and I was poked and prodded and sampled and x-rayed. It did not give me a good impression of Chinese hospitals at all, at all.

The hallways were filthy, littered with spit and cigarette butts, carpeted in grime, populated by surgeons stealing smokes. The equipment was Neolithic in nature. The doctors’ bedside manner could be charitable described as ‘brisk,’ and accurately described as ‘hostile.’ And all in all, it did not strike me in the least as a place to which I would be eager to return.


Five minutes after I called Maggie to say I couldn’t come in, I heard a knock on my door. It was Mr. Wang, the school’s driver, fixit man, and general go-to guy. Since he spoke no English, he called me ‘Bulaidan,’ the butchered transliteration of “Brendan” which the school uses instead of my English name. I hate it, and so when I opened my apartment door, wrapped in a blanket and shivering, with my head aching and my throad constricted and barely able to stand, my mood was not improved by the failure to use my Chinese name, Ou Bo’en.

“Get dressed and come downstairs,” he said. “We want to take you to the hospital to get you checked out. You’re not coughing, right?”

And in my semi-delirious state, I decided that rather than objecting, or saying that I would rather dig my eyes out with a spoon than go to a Chinese hospital, I would indeed get dressed, go downstairs, and be checked out.


The first thing I noticed when the car pulled up in front of the hospital was that the joint was jumping. Crowds of people were huddled around the entrance, and doctors sprinted into and out of the doorway in true TV-drama fashion.
The second thing I noticed was that about two thirds of the people were wearing masks.

(continued…)

The third thing I noticed was that there was an ambulance outside whose signs proclaimed it to be from Daqing, far to the north of Harbin, near the border with Russia. Daqing is a big, fairly modern city, from what I know of it, so I couldn’t help but wonder why they would need to send people down to Harbin for medical care.
I didn’t have much time to wonder, though, as Mr. Wang led me by the hand, through the doorway and into the hospital lobby.


As I have remarked before, one of my least-favourite things about China is that every group activity involves a lot of people and a lot of pushing and shoving. I am not an aggressive person, and am small and weak besides, so I almost invariably end up with my face pressed into someone’s armpit, or in similarly close quarters. This is unpleasant at the best of times, and at the worst of times – like when you’ve got a high fever and are having a hard time standing up, or when there is a fucking epidemic going on – it becomes intolerable.


Mr. Wang led me through the crowd to a masked nurse* sitting at a desk in the corner. “This is my school’s foreign teacher,” he said. (I was playing mute, and looking around as if I could see the viral clouds emitted at every sneeze, every cough, every hack and ptui that came from the people around me.) “He has a fever.”
“How high?” asked the nurse (this exchange would be repeated several more times throughout the visit, until it became a litany).
“I don’t know,” I said. “I don’t have a thermometer.”
“Oh, he speaks Chinese.” (this to Mr. Wang).
“No,” I said, “I don’t speak a single word. I just learned these phrases phonetically and have no idea whatsoever of what I’m saying.”

Fortunately, she was following the standard Chinese practise of ignoring the foreigner anyway, and making notes on a piece of paper while asking Mr. Wang about me.
“Is he coughing?”
“No, I’m not.”
“No, he’s not.”
(She wrote down that I was not.)

“Does he have any other symptoms?”
“I have a headache, a sore throat, swollen lymph nodes, and muscle pains.”
“His head hurts, and so does his neck.”
(She wrote down that my head hurt, and so did my neck.)

At this point I gave up and let Mr. Wang do the talking.


The nurse told us to go to the respiratory department, on the third floor; first, we had to shove through the crowd (someone coughed directly in my face, and someone else spat on the floor right behind me; I quickened my pace and nearly fell over) to pay for the checkup. This was done through a thick, bulletproof-looking Plexiglas window; Mr. Wang selected Option C, “Examination and Diagnosis,” and paid the 28 kuai or whatever it was by sliding the money through the slot under the window, where it was picked up by the gloved hand of another masked nurse,* who gave him his change and a receipt, and directed us to the third floor.

My mind was not at its clearest, thanks to the fever, but what intelligence it had left in it was all bent on figuring out ways to avoid breathing or touching anything. Unlike about half of the people around me, I was not enjoying the imaginary health protection of a kouzhao – face mask – and the sweater I had stretched, ninja-style, over the bottom half of my face was not easing my mind. Nor did the elevator ride to the third floor, which took place, as elevator rides are wont to do, in a small, enclosed space, and which was, as everything in China is wont to be, crowded in the extreme. And our destination, the third-floor respiratory ward, removed any lingering illusions I might have had about a comfortable hospital visit.

The hallways were full – literally full, as in wall-to-wall-front-to-back-no-room – of people pushing and shoving their way towards desks where an overworked attendant gave them a number. The waiting rooms were chock full of people waiting anxiously to have their cough listened to, and only emptied out briefly as people left to get cigarettes. (The “no smoking” rule was, for a change, being enforced.)
“One doctor, one patient,” read a sign on the wall, a rule which most people seemed to be observing. The problem was that the patient-doctor ratio was wildly imbalanced; I saw only three examining rooms, and easily two hundred patients, if not more. Mr. Wang managed, through some finagling or threatening or bribery, to get me a fairly low number from the nurse – #33; they were on #17 at the time – and left to get a cigarette or four. I nodded off; he woke me up when he came back and handed me a thick cotton face mask.
I knew perfectly well that the masks were almost as effective at warding off SARS as voodoo charms and keeping one’s fingers crossed. But having spent the past half hour or so trying to breathe as little as possible, and jumping every time someone coughed or cleared his throat, the feeling of something over my mouth and nose was calming in a way I can’t really describe. The soft cotton felt like the blanket little kids hide from monsters under – thin, but as safe and reassuring as a wall – and in a few moments I was asleep again. I slept until my number was called and Mr. Wang shook me awake, saying “they called you! It’s time!”

So I shuffled into the examining room as quickly as I could and sat down in front of the nurse.
“Does he speak Chinese?” she asked Mr. Wang. “Very well,” he said. And so, wonder of wonders, she talked to me instead of him.* We went through the same questions as before, with the nurse at the door – how high was my fever, did I have other symptoms, was I coughing, how long had I felt like this – and then she listened to my breathing, front and back, with a stethoscope, checked my throat, complimented me on my Chinese, wrote me out a slip of paper, and sent me to go get blood taken.

Like every other part of the hospital, the ‘Blood Collection Room’ was crowded and dirty. The waiting process here was much more free-form (i.e., competitive and vicious) than it had been for examinations; first you shoved you way through a waiting room, and then you leapfrogged people sitting in front of you so that you could get to the blood-collection window, which, like the payment windows downstairs, was thick, bank-style Plexiglas. (Perhaps it would be better called the “blood-deposit window.”) There, you got stuck with a probably-clean-and-new needle, had a pen-cap’s worth of blood extracted, were given a cotton wad to hold against your arm, and told to come back in 3 hours’ time for results. I wasn’t able to sleep in the waiting room here; the process was quick enough that people shuffled seats forward every 20 seconds or so, and the competition to move ahead was so cutthroat that a momentary blink might doom you to another 5 minutes’ wait. So I stayed as alert as I could, and darted in front of as many people as I could – I have gotten good enough at this that I was only cut off twice – and had my blood taken. “Come back at 1:30,” said the nurse through the window, and I assured her that I would. Then I shuffled out of the hospital with Mr. Wang; outside, another ambulance from Daqing had come.


“I’ll call you if the results from the blood test are anything abnormal,” said Mr. Wang as the car pulled up outside my apartment building. “You don’t have to go out at 1:30 – I’ll do it.”
I thanked him as profusely as I could, and staggered upstairs to my apartment, where I had leftovers of the spicy Sichuan food and restorative ginger soup that a friend had brought over for me the night before, when she heard I was sick. I microwaved and ate them, feeling a little better, then took a couple of cold/flu pills and, seeing that it was almost 1:30, lay down next to the phone to wait for any news that might come in.
I waited a half hour, nothing came, and finally, satisfied that I was certified SARS-free, I lay down and went to sleep.

14 Comments

  1. Jim wrote:

    Brendan,

    I hope you’re feeling better. I’m worried about you. SARS is becoming the headline news here with more and more cases reported in Toronto and just today a young boy from Long Island, NY has been hospitalized for SARS. I do not know why they still are letting people travel so freely. Particularly, Canada, they are so loose with their borders. Anyway, I hope your next posting has some good news for us. Take care,

    Jd

    Sunday, April 27, 2003 at 1:03 am | Permalink
  2. meg wrote:

    wow, that’s scary, brendan. when you post the second part, please tell us you’re alright and you don’t have SARS! and i hope that going to the hospital didn’t make you worse. i know how chinese hospitals can be. if you’re in beijing, i’d recommend going to the hospital for foreigners. it’s much cleaner and shinier and bigger. after all, they want to make a good impression on the people who really matter, right? i’m being sarcastic, of course. no wonder SARS spread so quickly in china.

    i hope you’re ok… get better soon.

    Sunday, April 27, 2003 at 2:40 am | Permalink
  3. mjumbewu wrote:

    what the ….

    oh the suspense! I hope you’re well, Brendan (i figure you’re fine if you’re still posting; if you stopped i suppose THEN i’d worry).

    … anyway, i hope the next post is a happy one. and if i were a drug company and everyone out on the street was coughing in each others face then i’d push my prodcts hard too.

    take care,
    – mjumbe

    Sunday, April 27, 2003 at 3:02 am | Permalink
  4. van wrote:

    hey brendan–
    im glad you’re alright. you almost had me thinking you caught SARS. glad youre up and kicking….eh, eventually

    Monday, April 28, 2003 at 2:07 am | Permalink
  5. Tim wrote:

    If I was Brendan, I would be very scared of catching SARS as a result of that trip the hospital. Hospitals like the one he describes are frequently amplifiers for the spread of epidemics. Read Laurie Garrett’s account of the spread of Ebola from a hospital in Africa, or the stories of the spread of SARS in the well run Prince of Wales Hospital in Hong Kong before the staff realized they were dealing with an infectious disease. Reading his account also makes me pessimistic about the chances for eliminating SARS in China unless the world takes extraordinary steps to help China.

    If I were Brendan, I’d give serious consideration to getting the hell out.

    Monday, April 28, 2003 at 2:16 am | Permalink
  6. Rich wrote:

    Stay well, Brendan! Stay well!

    Monday, April 28, 2003 at 2:40 am | Permalink
  7. blt wrote:

    Hey. I don’t know you, and you don’t know me. Wow. I would have die going through all that. One question pop out..where the hell u got the engery to write? if I was you (which i’m not), i would say screw this and sleep all day, even if that mean my death bed..haha. But glad u’re up and writing to keep ur friends alert about ur life.

    Tata. Yeah, I would love to hear wat happen. Feel better soon.

    Monday, April 28, 2003 at 3:09 am | Permalink
  8. Hank wrote:

    Hang in there Brendan. I am a veteran of the Chinese hospitals. I really enjoy your writing. Please keep it up, and there’s nothing like being sick in China.

    Monday, April 28, 2003 at 5:09 am | Permalink
  9. kevin wrote:

    Brendan,
    Finally someone that can sympathize with me. I had a similar experience at a hospital in Changchun. I don’t think I will ever adjust to the spitting, coughing, puking that goes on in the streets. Even the little kids shitting through the slits in the pants. I was actually just sent home by my company this past weekend. So don’t be jealous, but I am currently back the ole U.S.

    Tuesday, April 29, 2003 at 6:54 am | Permalink
  10. erika wrote:

    Hey, Brendan–

    After reading your latest entry, I had to call your folks to make sure that you’re ok–and I’m certainly glad you are. I think you’ve got the beginning of a good article here–a China/SARS diary that a lot of people (especially here in the States) would be interested in.

    I read Paul Theraux’s recounting of traveling by train in China and how he rode ankle-deep in spit, so I’m not surprised at the rampant spread of anything in China. Both the New York Times and NPR have written/talked about how the latest theory on the rise of SARS is that it started in the food markets of Guangzhou, being that all sorts of exotic animals are sold there (badgers, rats, etc., etc.). Is that theory getting any play in China?

    I hope you’re feeling better soon–let us know.

    Wednesday, April 30, 2003 at 3:56 am | Permalink
  11. Todd wrote:

    I’ve enjoyed reading your journal in the past, so when I saw your name on http://www.sarswatch.org a few days I had the shock of my life! I just want to send my best wishes…it would really suck if you fell ill and stopped blogging.

    Friday, May 2, 2003 at 11:09 am | Permalink
  12. Moose wrote:

    Hey Brendan,

    I really hope you stay safe. I’m particularly worried you might get stranded in the middle of an epidemic there and the government won’t let you leave, ’cause that would of course suck.

    If you’re back in philly by September or October, Fred wants you to come along with our class to an Uzbek restaurant (mmm, goat anus).

    Take care of yourself

    Sunday, May 4, 2003 at 7:02 am | Permalink
  13. hong kong people wrote:

    Hello Brendan, I will pray for you, wish you get well soon.
    *** don’t trust Beijing they sacked the 2 officials was just a political gesture, many more cases are still not surfaced by their unique measurement ( checked the info from only trusty mainlanders and HK news , NY Times, Asian Wallstreet Journel, Washington Post…..etc ) and most mainlanders nowadays in China still misled by the government with distorted fact and many of them do not know the origin of the SARS was from Guangzhou, Guangtong.

    *** One of the Shanghai high officials spoke in Mandarin to the public in last month, ” HIVs was firstly found in LA, USA, and can we say HIV’s are American’s diseases ? ” This had been a laughing subject in HK news but it’s a speech from a saint in mainland China. I had seriously agrued that with a mainlander.

    I am wondering how the expats feel if they understand Mandarin but most of the expats in Shanghai are biz guys, not English tutor.

    *** BTW, Mr. James Salisbury a American Tutor ( English teaching ) in Shenzhen contracted SARS and requested to be delivered to HK for medical help, it took 2 days for him to get the docs done from mainland to HK, unfortunately he died at the border of HK and I found this case was a invisible case. not counted in HK nor in Shenzhen.

    *** I was advised by some mainlanders that there are some other mysterious diseases like ” hot blood ” already landed in China, which could make you feel warmer, body flushed with flu sympton and progressively weaken and die in a day or two.

    We are very pessimistic about our future after 1997, 1 country 2 system is another big fat lie from China, the hangover is a bullshit. China is draining HK reserve and dragging us down by giving us 150 uneducated people every day ( immigrants that HK has no right to check their reference ) and hundred thousand legal workers acrossed the border daily to HK bringing their spiting, sneezing motion and pushing behaviours to us, we have no control to these people and the many possible virus and outbreaks coming.

    Sunday, May 4, 2003 at 12:32 pm | Permalink
  14. Arden Decena wrote:

    Brendan,

    It was pleasing to hear that you are after all not afflicted with the dreaded SARS. I can really understand what you have felt and with your experience from that hospital. No wonder, China was badly hit by this killer disease. If such hospital situation will not drastically improve, I am pessimistic if China will ever control the disease.

    Tuesday, June 3, 2003 at 6:02 am | Permalink

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