Some important notes unrelated to Zhengzhou…

  • This is my first time posting my own entry! Before this, Li-Wen has kindly been doing a lot of the manual, electronic grunge work because wordpress is not accessible for posting in China. Hence, all the fabulous formatting and design is all courtesy of Li-Wen Inc.
  • Our sincere and utmost apologies for not updating. Li-Wen and I have been crazy busy w/ life and it doesn’t look like it’s going to get any better. Both of us are heading to graduate school this fall so this blog will probably fall off a hill quite a bit.
  • So up to this point, we’ve pretty much been censoring our comments due to courtesy to our hosts. However, after many long nights and pints of sinful chocolate ice cream, we’ve decided that it’s full-disclosure from this point on as we’re writing for ourselves, not for being political correct. Expect Gossip Girl material, Chinese style! (just kidding…)

Zhengzhou, right. Okay, your natural reaction may be (rightly so) , “where the heck is Zhengzhou”? Good question. The above picture should help; the city is the capital of the Henan province (for Henan’s location — think heart of the chicken/dog). If you’re a tourist, it’s probably going to be the first stop. Henan is also currently the most populous province of China (after Chongqing was made its own region out of Sichuan).

Henan’s probably most famous for its ancient capital Kaifeng which was the national capital during four dynasties of China’s long and glorious history including the Later Han and Later Zhou Dynasties. Henan is also famous for the Shaolin Temples which we’ve reported on already… and let’s see, the region is also notorious for people selling their own blood (Henan’s reputation is that it’s poor but the economic expansion is rapidly increasing) whereby, some of the poor villages had high HIV positive incidences due to inadequate sterilization*. Besides this…I know I’m forgetting something important… Hmm…

Whatever, Zhengzhou has an ubiquitous Chinese-city-look that to my untrained eye means nothing exceptional, not even in the parks, which were very nice, full of the old dancing, poker-ing, singing-away and young people just chillin’.

Anyways, after our week in Dengfeng, we went to Zhengzhou. It was a smooth transition except for the part where Dr. X dropped us off in a random street corner with a really random friend of his who bummed along for the ride from Dengfeng to Zhengzhou. Dr. X told us that he had already booked a hotel but when we went there, for some reason that I don’t recall, it wasn’t satisfactory. We waited an hour. I called him and asked, “how are you doing?” where he said, “I’m checking out other hotels. Wait there. I’ll be back soon”. One hour later, he took us to another hotel. Fortunately, this hotel was super fabulous in that it had an internet bar connected adjacent to the hotel.

Let me stress how important internet is here – let’s take it from the viewpoint of Li-Wen. Li-Wen has the following people to interact with 1) a food and sleep-obsessed one travel partner 2) weird and not always pleasant Dr. X and 3) incomprehensible patients who speak with the heavy Henan accent. In short.

Internet => portal to the whole wide world => sanity.

To his credit, Dr. X gave us each 50 kuai/day for food expenditures for three weeks. I’m still not sure where this money is from but we were greatly appreciative of it. I also must mention here how appreciative we are of Li-Wen’s mother’s connection, this fantastic woman and her apartment where we stored our all of lugggage (for the duration of our dengfeng trip) and how my uncle carried my 40 pound suitcase up seven flights of stairs to that woman’s apartment. So this marks our beginnings in Zhengzhou…

******I remember what I forgot about Henan: the Henan roast chicken is delicious and famous!******

*thank you wiki!

Dengfeng Wrap-Up

In Dengfeng, we’ve experienced frustration, disappointment, major embarassments and not an insignificant amount of awe, which sounds about normal for a pilot trip to a new place. In truth, from a very superficial viewpoint of what I had understood of Dengfeng, by the end of the week, I was ready to leave. To cite an example: our primary sources of entertainment were visiting the local sketchy internet bar and watching bad Chinese tv singing competitions.

Now the big question: could we have done better? Yes and no. Yes, in that I think we could have had a better attitude and pushed harder to meet the Shaolin Temple monks or delved deeper into some other aspects of the Shaolin Temple. We had five days in Dengfeng; even if denied access to the Abbot, we should have asked to talk to local people or the local monks.

Would this request have been met with success? Not necessarily — hence the ‘no’ part. In general, what generally makes or breaks an experience is the people involved, and Dr. X is no exception. I am hugely grateful to Dr. X for showing and taking us around. Still one problem that remained was the fact that he voluntarily gave us very little information, even in little cases such as where it was that we were heading at the very moment. Hence, it made access to any type of really difficult and very frustrating at times; for example, over the many meals we had with him, he consistently declined to answer what type of medicine he practiced (I think it may have been a paranoia of revealing secrets in public) but it was initially hard for us to understand this as first and he provided no explanations. When he did explain to us late at night in our hotel rooms, we didn’t understand why such information couldn’t be revealed over dinner (where nearby guests were most likely tourists) . Furthermore, his certain mannerisms such as consistently only introducing one of us and not the other made friendly overtures towards him not as easy as it could have been.

All in all, at the end of the five days in Dengfeng, we were looking forwards to Zhengzhou. Just a preview of Zhengzhou – romance! danger! and a near fatal accident!

Miracle Stories

Whenever we asked patients how they chose to see a certain TCM doctor or how good that doctor was, we were invariably met with a series of miracle stories that went somewhere along the lines of: “I knew this person who had this horrible disease X that all Western doctors said was untreatable, and he/she only had Y months left to live. Then he/she sought out this TCM doctor who prescribed Z treatment, and after N weeks the patient has completely recovered! It’s been years since and the person is still fine. All the Western doctors he/she went back to for checkups said it was a miracle.”

After one too many of these stories, Nan and I got incredibly sick of them and started counting sheep in our heads every time someone launched into one of these stories. Being the students educated in Western science that we were, we dismissed the ability of these stories to say anything about the abilities of a doctor. Now, I think it is entirely possible that the said TCM doctor may be incredibly effective, or he may be an ordinary doctor who got lucky, but short of a double blind study, I wasn’t willing to use these stories to draw any conclusions about the effectiveness of a doctor*. It’s a matter of probability, I told myself. Of the hundreds of patients the doctor has seen, the 5% of the time when a patient recovered beyond expectations (whatever the reasons) would be attributed to the doctor’s abilities, and the story would propagate like rabbits. The rest 95% of the time when the patient’s results were absolutely ordinary or even worse than expected, well, the disease was incurable anyways, so no one can blame the doctor for not being able to nurse the patient back to life.**

After hearing so many stories, I couldn’t help but wonder, what about these stories were so appealing to patients? I think the mere possibility that a disease considered incurable by WM may possibly be cured by TCM is incredibly alluring, especially for those who have received the death sentence by WM. It doesn’t have to work 100% of the time, but if there is that possibility, the patient is willing to try it. There’s not much to lose anyways. It gives them something to hang on to, some little slimmer of hope. And for a terminally ill patient, hope, or at least some kind of positive attitude, can be incredibly helpful.***

Add to this slimmer of hope a doctor’s self-confidence, and you get an even more convincing combination. Towards the end of our stay in Dengfeng, we saw Dr. X in action as he saw a patient in his hotel room. The patient was a 49-year-old peasant woman who had persistent pain in the left leg. Her left leg is thinner, shorter, and weaker than her right leg. Having seen many WM and TCM doctors to no avail, this woman was slightly skeptical and very apprehensive about the pain of acupuncture. Throughout the treatment period, Dr. X oozed self-confidence and took many opportunities to show off his skills. For example, he believes adamantly that a “good” doctor is able to tell a patient what’s wrong with them without being told (see previous entry The Enigmatic Dr. X). Thus, he prohibited the patient from describing her symptoms and proceeded to list them after a quick examination and pulse-taking. In cases where the patient disagreed, Dr. X still hung tight to his diagnosis, even if he had to convince the patient otherwise. Here’s a sample:

Dr. X, after taking a pulse: “You have had this leg problem for more than 10 years.”

The husband, a friend of Dr. X, nodded: “Yea it’s been about 10 years.”

The wife, looking a little resistant: “I remember it’s about 8…”

The husband: “No no it’s been longer than that.”

Dr. X: “It’s been more than 10, because the problem was already festering internally before it manifested physically.”

Before he administered some acupuncture to the woman’s legs, the woman was visibly scared and resistant because her memories of acupuncture involve a lot of pain, but Dr. X kept reassuring her strongly.

“My acupuncture is different from other doctors. Real, effective acupuncture will not hurt. Trust me, this is not going to hurt much at all. You’ll see.”

As he tapped needles about 1.5 inches into her left and right calf, the woman cringed a little. Dr. X looked up and said, “See, it doesn’t really hurt right?”

The husband also looked at her expectantly. The wife replied, “Yea, it’s not too bad…”

After he pulled out the needles, Dr. X exclaimed, “Look! The left needle has a little bit of dark blood on it, which shows it has problems. The right one doesn’t. With real acupuncture you’re able to see these results.”

Now, I have no idea really how long the woman had her leg pains or whether it really didn’t hurt, but I do know that Dr. X was incredibly self-confident, and the patient seemed more and more convinced throughout the session. And I realized that for unconventional forms of medicine that cannot be evaluated systematically, two things are important for how a patient can evaluate a doctor. 1) Anecdotal evidence from trusted sources, aka miracle stories, that prompt you to seek out a doctor in the first place. 2) How competent a doctor seems at your clinical encounter, influenced by his confidence and his ability to convince you of his skills. Dr. X certainly fulfilled both criteria.

Now, my favorite miracle/anecdotal story that I heard is this: One day there was a peasant who ran into a lion in the woods. Absolutely terrified, he raised both arms and stabbed the spear he was holding into the lion and escaped frantically. Thereafter he found that he was unable to move his arms from their raised position, and he walked around all day with his two arms above his head. No doctors could heal him. One day he met this old folk doctor who told him he could cure him. As treatment, the folk doctor gathered all the villagers around and stood the man in the center of the crowd. The folk doctor then took out a knife and slowly started cutting away the band holding the man’s trousers up. The man shouted for him to stop, the crowd jeered, but the doctor persisted. As his trousers were about to fall, the man’s arms shot down and grabbed his trousers. He yelled angrily at the doctor, but the doctor grinned at him and said, “Now you’re cured.”

*Interestingly, I learned from my health policy class that the way Americans choose what physicians to see is very similar. Most people give reasons along the lines of “My close friend/relative recommended this doctor because they had good results.” In fact, the patients’ least trusted source of information is health insurance companies. Ironically, insurance companies are actually the sources with the largest sample size and therefore most statistically reliable evaluation of a doctor’s effectiveness.

**I have no hard evidence, but from my small sample size of people I’ve talked to, popular evaluations of Western medicine (WM) seem to follow the opposite trend. The 5% of the time when a doctor messes up, the story spreads like wildfire. The times when Western medicine helped a patient, well, that what it’s supposed to do anyways.

***On a related note, WM doctors tend to give prognoses to patients that are more optimistic than what the doctor knows to be true. Why they do so and the consequences or this are another story. Yay Sociology 180 and Christakis’ Death Foretold.

For the first few days after we met Dr. X, he evaded the question when we asked him to tell us about his medical practice. Towards the end of our stay in Dengfeng, after Nan and I have bugged him enough with questions about his practice, he finally sat down for long hours at night to tell us about his practice. I thought these conversations were the jewel of our experiences in Dengfeng since they showed us the folk medicine side of health care in China, a side that is usually unacknowledged by academia but widely utilized by the populace. It turns out Dr. X is a folk healer who treats diseases that conventionally don’t have a cure (yi2 nan2 za2 zheng4). The top ten of these disease include rheumatoid arthritis, high blood pressure, stroke, diabetes, lupus, and psoriasis. Depending on how serious it is, he can cure some of these diseases, and improve the quality of life for patients with other diseases.

~Learning his trade~

He started learning TCM from his father at age 7, who also learned from his father. At age 15, he had already started practicing at the bedside. The medicine that he knows, however, has been learned from various sources, not just his father because what his father knew was limited. He constantly improves his trade by seeking out other doctors who are known to be good at treating certain illnesses and requesting lessons either by trading skills of his own or paying money. This type of learning results in some pretty unique forms of treatment, such as the use of electricity. He was very proud of his skills and said that his medicine can compete with that of any expert in any area. However, he admitted that he is only good at bedside practice and would not be able to teach theory in the classroom for the life of him. (When Nan and I later saw him try to add 7 to 16 with his fingers, we believed him.)

~The transmission of knowledge~

The transmission of knowledge in TCM is a tricky issue since “the Chinese are jealous” (his words) and traditionally believe only in passing on skills and knowledge to sons (since daughters are married into other families and technically become part of other families, thus divulging family secrets). As a result of this extremely selective transmission system, a lot of trade secrets (mi4 fang1) have been lost throughout the years, which is a great shame. When I asked if he has a remedy for this, or if he would himself put down his knowledge in writing, Dr. X quickly laughed off the idea. He said that he would never put down his trade in writing because that makes his trade worthless. He does, however, take students if he deems them to be “good people.” Out of the 20 something students he’s taken, however, not all turned out to be good students. Some left after they have learned some skills and claimed to be better than their teacher, defaming him. The good students, he said, are the ones who call on New Year’s to see how he’s doing.

~What defines a “good doctor”-the ability to diagnose by looking~

Dr. X doesn’t officially open a clinic since he doesn’t hang up a sign. He has a house in Guangzhou where patients come to him by word of mouth. He lives in the house with a western doctor who seems to function in a supporting role. According to Dr. X, whenever he diagnoses a disease, he will refer his patients to get a western imaging test to confirm his diagnosis, more to convince the patient whatever he says is true than to double-check his own diagnosis. He emphasized that his skill lies in “kan bing” (looking at disease), or basically diagnosis. He quoted the saying that if you can diagnose a disease correctly, then it’s already half cured. He claimed that just by looking and taking a pulse, he can tell a great deal about what illness a person has. The way you decide if someone is a good doctor is by not telling the doctor what illness you have, and letting him describe it for you. For example, he claimed that just by looking at one of our common acquaintances, he knows that he has diabetes, and Dr. X excitedly prompted us to ask said person if he indeed does. (Nan commented later that diabetes is one of the easier diseases to diagnose.)

~Selecting patients~

Without advertising or even having an official office, Dr. X already has a ready stream of patients who have heard about him by word of mouth. He said he doesn’t work at a hospital because there are too many patients, and he would feel guilty since he couldn’t possibly treat all of them. Instead, he goes by “yuan2 fen4” (a Chinese concept that has no equivalent in English). If you are able to hear about and find him, he will treat you, with the caveat that you must be a “good person.” He claims he only sees patients who are “good” and told the story of how once a rich man came in a wheelchair pushed by his Indonesian servant, and the old man treated the servant really crudely. When the man talked to Dr. X and begged him to treat him, Dr. X refused, saying he doesn’t know how to treat his disease, and he stuck to his decision no matter how much the man begged. Dr. X claimed that the payment he takes depends on how much money the patient is willing to pay. He could charge a rich man tens of thousands of dollars and a poor man next to nothing. (Previously he had also said that about 90% of his patients were business owners, CEOs, politicians, and other rich people who surely paid him a lot of money. The cynic in me thought it was strange that he doesn’t have as many poor patients who surely would come flocking to him if he does indeed treat them for next to nothing.) At the end of our encounter, he also offered his aid to us when we need it because we are “good people.”

~External qigong~
At the end of the conversation, he offered to demonstrate external qigong on Nan. Asking her to sit with her back towards him, he pulled up her shirt to demonstrate that there was nothing on her back along her spine. He then stood about 4 feet behind her and got into a leg-parted stance. Swinging his arms around firmly left and right, he went through a series of motions that seemed to take a lot of effort, since he started sweating and his face was flushed. Then he shot out his right arm with two fingers extended in a claw-like fashion about a feet away from the nape of Nan’s neck, and slowly and shakily dragged his fingers down through the air. When he finished, he lifted up the back of Nan’s shirt to reveal 2 stripes of red flushed skin about 2 to 3 inches long alongside her upper spine, right under the base of her neck. He explained that this would clear up her meridians (da3 tong1 jing1 mai4) and is good for her health. However, doing this kind of qigong is taxing on the body of the performer, since it takes away from the Original Qi (yuan qi, or zheng qi). He says he only taps into his Original Qi for treating patients about 5 times a year, or otherwise it would be bad for his own health.

Life in Dengfeng was a little difficult to adjust to, and by the end of our week in Dengfeng, Nan and I were secretly glad that we didn’t actually spend 3 months there as we originally planned. Aside from daily inconveniences like food choices being extremely limited and horrible humidity that keeps our clothes wet, here are a few scenarios explaining why.

~On being high profile guests at the hotel~

[On our third day there, Nan and I walk up the stairs of our hotel after a day out.]
Hotel employee No. 1: Oh, you live in room 42 right? We’re going to switch you to room 25 on the second floor because we need to clean the carpets of the fourth floor due to the high humidity.
Nan: Um, when are you doing this? Should we move our stuff down now?
Employee No. 1: Yea, we can help move your suitcases too.
Li-Wen: Oh it’s ok, we’ll get it ourselves.
Employee No. 1: You’ll need to get your room key updated at the front desk.
[Nan and Li-Wen go downstairs immediately to the front desk.]
Employee No. 2: Oh, are you getting your keys changed from 42 to 25?
Li-Wen: Um, yea. [thinks *how the heck does she know already?*]
Employee No. 2: Sure thing. And you’re staying until XX date right?
Li-Wen: Yea… [thinks *wtf*]

~On being conspicuously foreign while pretending not to be~

[In a small, smoke-saturated internet cafe, Li-Wen types away on her computer in Gmail and simultaneously surfs Facebook. She notices the person sitting to her left staring at her screen, very blatantly and conspicuously. This goes on for 5 minutes.]
Dude: Hey what are you looking at?
Li-Wen: [pretends not to hear and hopes he’s not talking to her]
Dude: Hello!
Li-Wen: Oh, huh, yes?
Dude: You type English so quickly. Where did you learn that?
Li-Wen: Oh I study English in college. [not entirely untrue…]
Dude: What are you typing?
Li-Wen: Oh, just emailing a friend. Practicing English, you know.
Dude: Oh.
[Li-Wen flips over to New York Times page. Turns monitor over toward Nan, who’s sitting to her right, and pretends to show her something interesting.]
[Dude scoots his chair back and over so he can see the screen better!!! @#&#$!!!]
Li-Wen: Um, can you stop staring at my screen? It makes me feel a little uncomfortable.
Dude: Oh ok. [Looks away for a bit, but continues to glance this way and finally resumes staring]
[Resigned to having a spectator, Li-Wen continues doing her thing, uploading pictures onto Facebook.]
Dude: [on seeing Li-Wen’s profile page] What’s that site? Can I see it? Can you give me the website?
Li-Wen: Umm… Why?
Dude: I want to learn English.
Li-Wen: Oh in that case this site is better. [shows him NYT] It has lots of articles in English that you can read.
Dude: Oh ok… [Looks at it for a bit] Can I get that site with the pictures too (ie. Facebook)?
[After more back and forth, eventually Li-Wen scribbles down the NYT address for him, packs up, and leaves]

A few days into our stay at the hotel, it seemed like every hotel employee knew 1) that we were Harvard students from the US, 2) guests of the mayor, 3) living in XX room, and 4) staying until XX date. While everyone was in general really helpful and nice (such as an employee who let us use their business center computer after hours), it was uncanny walking around and knowing that almost everyone knew a lot about us when we desperately wanted to keep a low profile. And while the stares we got were most certainly out of curiosity and void of malicious intent, it still made us extremely uncomfortable and suspicious (I’m not sure of what). I wonder if the strong desire for privacy is an American trait, as is the sense that any breach of that privacy is a kinda of threat.

What’s the difference between setting a big goal and a small goal? Not a lot. One of our big goal was to learn Shaolin medicine, and when we first arrived in Dengfeng, I’m sure we were both thinking, “what the #$% have we gotten ourselves into?” There were a lot of obstacles in the way, and even though it didn’t work out from one perspective, I think we learned some valuable things along the way:

1) Be prepared for everything — as YL repeatedly stressed, go with the flow. I came with a lot of set expectations, and it can prove frustrating when things don’t work out exactly that way. However, when you let go of some of your preconceptions, things get a lot better, plus you can see more clearly where you can go and sometimes more importantly, not go.

2) Have a trustworthy and patient partner to bounce ideas off — it doesn’t necessarily have to be your travel buddy although Li-Wen was invaluable as an asset to this. Talking to family and friends about what was happening and bouncing things off them as a sounding board made things much more contextualized and easy to visualize in practice

3) When you don’t get answers the first time, ask again (politely) — for some reason, we had some problems getting Dr. X to talk about his Shaolin background; he was very reluctant to talk about it. We kept asking and when it was the right moment, he was suddenly very willing to explain. This also applied to when we were in Zhengzhou and Beijing; some of our academic and life questions didn’t get answered the first time around but if you keep trying, it works.

4) Have a Plan B if steps 1-3 don’t work out — in our case, we did have a Plan B and Plan B worked out surprisingly well!

This is not to say, of course, that small goals don’t matter. They do! One of mine out of pure necessity was to learn to wash clothes. Hey, it sounds like a simple application of biochemistry — apply water and soap, rub, and the dirt falls off, rinse then hang to dry right? No. For one thing, clothes get more easily dirtied in China because there’s just a lot more soap-resistant crap floating around. For another, puny muscles mean no dry clothes. In Dengfeng, it was really humid so our clothes took several days to dry. Mine took a week to dry until I realized the full potential of Li-Wen’s uber muscles. It was really sad; I would wring out my clothes as best as I could; then hand it to Li-Wen, who would wring it and a whole bucket of water would come out again >_<. As a result, our upper body strength became nicely toned for the entire duration of our time in China. So yeah, I guess the main lesson of this one is; if you can’t do it, get someone else to!

So one of my bigger regrets (and they are few and far in between) about this trip was that neither Li-Wen nor I took pictures of the hospitals that we visited. We visited the local Traditional Chinese Medicine (TCM) hospital in Dengfeng, and much to my shame, it was much cleaner and larger than I had expected. We’ll compare it to the other hospitals that we encountered in later posts. Given we only had a couple of days there, I was only able to make the following observations:

* relatively small; if memory serves correctly, the hospital only had four wings, all within close proximity to each other.

* only two rooms for screening tests; doesn’t seem to be much equipment for medical analysis stuff like x-ray, CT, etc., but the very presence of Western medicine diagnostic tools in a TCM hospital surprised us greatly. More of that later.

* much more of a rural population, as evident by the clothing style and thick Henan accent

* insurance swipey things – surprising to see that China has some form of insurance (only government workers and some of the big companies employees receive insurance), although while we there, I didn’t see any patients who used it.

One of the joys of the trip was of course, meeting the people! In particular, there was a nice doctor we met there who patiently answered our many questions, and he let us look at all the material on their desks and was in general, very kind to us. However, this was not always the case, and so that brings me to my next topic, social propriety.

In the case of introductions, at the Dengfeng hospital, when we met the hospital administrators, our contact would only introduced one of us, which we thought was odd. The handshakes exchanged then were also really “sad” as Li-Wen puts it; I get the sense that in China’s backwaters, the customs aren’t very Westernized yet. To be fair, I think we came in with the possibly unfair standards of shaking hands and other Western customs like that, and when they weren’t met, we were very surprised. On the other hand, I have just learned in my Fudan Oral Chinese class today that when Chinese people meet in today’s society, they are suppose to shake hands. Funny that.

This was just a small example of differences in social propriety we encountered along the way and at times, it can prove to be really trying and frustrating. Luckily, Li-Wen and I talked it out, and we were able to come up with creative solutions. For example, in the case of our contact introducing only one of us, we talked to him directly asking him for the sake of our Western customs that he introduce us both; this not only corrected the solution but also saved his face, which is important in Chinese society The important thing, I think, is to keep in mind the other person’s perspective. Other than in Dengfeng, the social etiquette was fine, so it’d be really easy for me to say it’s a large-city versus small-city kind of thing, but I suspect the issue is a bit more complicated than that and biased by our individual circumstances.