Friday, July 20, 2007

Steep learning curve in hospitals

I had the unfortunate experience of helping a seriously sick friend here and so learned Chinese hospital protocol. My very first roommate here in Dalian had a series of stomach problems that seemed different than the common stomach problems in China. If you are eating any good food here at all, undoubtedly some microbe attacks your whole digestive track about once or twice a month here. If you avoid the street meat on sticks you can probably go longer between bouts of discomfort.

I spent a few sleepless nights in a row with my friend as her discomfort seemed to peak at about 1:00AM. We went to a couple of hospitals around town in the middle of the night. The doors were open but the whole place seemed deserted. She sat on the only chair in the lobby while I ran around knocking on windows and doors trying to roust someone. Finally a sleepy eyed nurse appeared and listened to our woes. They poked at her, took blood samples etc, and said it was an intestinal infection. Her shots and medications did not seem to help and the next few nights were more of the same. With few options left, I called my dear friend who is a doctor in Dalian. He in turn called his friend that specializes in abdominal issues. The four of us met the ER at 1:00 AM all dischelved and red eyed. My sick friend was moaned and as the poked and prodded and I stood wide eyed at all the spectacles that walked in the door.

One man came in restrained by police officers. He was wearing nothing but his underwear and handcuffs and he had been severely cut on his stomach and chest. My doctor friend leaned over to me and said, “He is a thief, but got caught!” Just then two more men, also wearing nothing but underwear, burst into the room. The larger, rather over-weight man spent the next two hours frantically pushing his friend allover the hospital on a gurney… still in nothing but black briefs. I watched but failed to come up with answers for two puzzling points: 1) why could no one lend this poor man a pair of hospital pants, and 2) what could possibly have been the circumstances necessitating them to leave with no time to put on pants or shoes?!

After an eventful night they sent my friend and I home again with drugs and a couple of shots. As she still could not even keep water down and she was obviously fading fast, the next morning another friend and I took her to yet another hospital where we shuffled her around from test to test. She got worse throughout the day and was ordered nil by mouth. However, the diagnosis was not paired with an offer for a bed and a drip. We were informed that there were no beds in this hospital. With no offers for ambulances, the three of us went by taxi to five hospitals in one evening, X-rays and CT results in hand. Everywhere we went was like reinventing the wheel. By necessity, I learned all the words for the internal organs! Finally, my friend the doctor yet again saved the day by securing a room for her at one particular hospital. We were to go there, say a specific doctor’s name, and he would take care of the rest. Again, connections are crucial here. With out them you are at whim of the default system of the masses and your current Chinese language level.

We got her into a bed and hydrated. Being the Americans that we are, at about midnight we left the hospital. We are used to strict rules limiting the amount of visitors and visiting hours in hospitals, so we opted to get out of the way. I returned early the next morning to a group of angry and befuddled nurses. They demanded to know where I was the previous night, and why didn’t I stay with my friend. Confused, I asked if there was some place for me to sleep at the hospital. She informed me that family and friends not only stay bed side night and day, but usually sleep in the same bed with the patient, or on the ground in the room or hallway. Bed side care is not the nurses’ job. As I learned, nurses change IV’s and bed sheets...when requested. As I looked around, it was indeed obvious that every patient had a family member with them, if not three!

So, for four nights another friend and I rotated shifts taking care of our patient and being her advocate. I believe that there was a file on my friend, but it was not anywhere near her bed or room, so every new nurse and doctor had to start over. This was entirely frustrating considering the language barrier. I counted three times when they tried to feed her medication or food and we had to step in and remind them that she was not to eat or drink, rather only have an IV drip. There was usually just an “ahh” of agreement and then they left again. My friend's parents came to China to help and they have all since returned to the US to get care for her there. I hear she is dong well!

The lesson I learned is that one a) not get sick; b) get to a hospital before you need an advocate; or c) keep good friends.

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