Tuesday, September 23, 2008

Up the Yin-Yang

Mysterious abdominal pain led me to a series of doctor’s visits all with remarkably similar results; each doctor puzzling over the probable cause as they palpitated my tummy. Tests were ordered and proved inconclusive. Eventually an internist recommended a colonoscopy. Anxious to discover the cause of my distress I heartily agreed. Boy, was I in for a surprise.


There are western medical clinics in China that practice standard western medical care. In fact, most of their physicians are either foreign or studied abroad. Seeing one of these doctors and obtaining a diagnosis is done just like it is back home. Where things depart from familiar territory is when an advanced procedure beyond drawing blood is necessary. While the rudiments of these procedures are the same, the context is, well, foreign.

I did not know exactly what a colonoscopy was until I got home and read the pamphlet the doctor provided. Gulp. They were going to do what? Where? In the name of medical science, and before I developed a Percocet addiction, I dutifully drank the beverage they provided that was intended to empty out my intestines. I presented myself at the Western medical clinic at the appointed time for my procedure. A hospital employee and a driver put me in a non-emergency hospital vehicle and transported me to a local Chinese hospital. The fee for the locals was probably dirt cheap, but since I had my own escort and interpreter I paid an exorbitant fee; an expat tax of sorts.

In a nation not known for the privacy of private citizens, I should not have been too surprised about what I confronted at the local hospital. I arrived at the ward where the colonoscopies were preformed. It was an assembly line process. Lined up along the wall in the hallway were people waiting their turn. Inside the room were two beds, one with the person undergoing the procedure, the other for the person coming-to from the sedation. Hospital staff milled about the two beds. I knew this in advance because, the door was open and people were standing in it watching the procedure being performed...it's not television, it's...a Chinese hospital.

Whenever I find myself in an inevitable humiliating situation, I always reassure myself by saying, “But I will never see any of these people again.” Thus, I changed into my hospital gown and took my place in the plastic chair queue. A foreigner waiting for a colonoscopy must have been a rare sight because I was now drawing more attention than the procedure room. I was doing my best to act nonchalant as I pretended to read the book I brought all the while engaging in an internal interrogation about whether or not I was a hypochondriac.

Finally, my interpreter indicated that it was now my turn. I did my best to ignore the curious onlookers and head held high, marched into the procedure room. Another difference between hospitals back home and those in China is the attire the hospital staff wears. In the U.S. most nurses and orderlies wear scrubs with ergonomic shoes. My nurse for this procedure was dressed for a night on the town with heels on and a fetching dress. An open lab coat was my signal that she was legit. The doctor, at least I think he was a doctor, looked a little more familiar with his slacks, dress shirt with tie, and lab coat. Nothing was said because my interpreter had bailed, but I was motioned toward the table. Shortly after lying down I was out and the next thing I knew I was being shuffled over to the recovery bed. Were the sheets changed between patients? Not something I wanted to dwell on.

Since I was anxious to depart and put this whole medical episode behind me I willed myself awake and moved slower than I would have liked toward the changing room.

Did the colonoscopy reveal the source of my discomfort. No. It was normal. In fact, I never discovered what was causing this pain. After a few months it was gone and never returned. Sometimes, the body just has to heal itself.

Maybe, I should have gone to a Chinese doctor practicing Traditional Chinese Medicine rather than a Chinese doctor practicing Western medicine. What is clear is that my qi was likely disrupted by too much yin. And having a tube stuck up my butt while a crowd looked on probably contributed to even more yin. Next time I have a mystery pain I think I will try meditation and massage first; definitely more yang, than yin, for the buck.

Wednesday, September 17, 2008

The Wonderful World of Disney--Hong Kong


The crowds are light, complaints the park is too small are common, and the Hong Kong government is losing money on the venture; but we really love Hong Kong Disneyland.

When we had our kids I was really dreading the day they would be old enough to go to Disneyland. My experience with Tokyo Disneyland and Magic Mountain in California were hellish; the lines were hours long for rides that lasted mere minutes. I was actually trying to find a way to make this into a "Daddy and kids activity."



I don't know what I was so worried about. We have had our annual pass for almost a year--and we love going. Granted, we do not go every weekend. We go every month or so. The annual pass for Hong Kong Disneyland is relatively inexpensive and frankly, with all the extras you get with it, like free parking, it has already paid for itself.

Since our kids are still quite young, 3 and 5 respectively, they are not really into the rides. Their favorite things to do are meet the characters and play in the water park. We bring swimsuits and towels and the kids spend most of their time playing in the water.

Tuesday, September 16, 2008

The best things in life are...$2


Riding the 100-year-old city tram from Kennedy Town, through Central, and then hoping off at the playground in Happy Valley is one of our favorite things to do in Hong Kong. The ride takes 45 minutes to an hour and costs $2 per person. We sit on the upper deck and take in the sights and smells (dried fish street!) of the city. The old trams are not air conditioned, so all the windows are typically open--something to watch out for with little ones. Mine needed reminding to keep heads and arms inside. It also makes for a breezy ride.

Thursday, September 11, 2008

Foreign Objects


“Stepford Villas” is the moniker conferred on my neighborhood by the expatriate community of Shanghai. In this time-warped neighborhood, men work and women join clubs. I would say tend house but that is not necessarily true. The same advantageous wage structure that has denuded the American landscape of manufacturing jobs in favor of cheap Chinese labor, allows middle-class American expatriates to hire housekeepers, nannies, drivers, and masseuses that make house calls. Not having to concern themselves with the mundane tasks of domesticity, the über-housewives of my neighborhood can actually do the projects in Martha’s magazine.

In Stepford Villas, I feel every part of the interloper that I am. I was a reluctant housewife. Sure, I look the part of the new mother: de rigueur track suit with spit-up stains on the shoulders, over-stuffed diaper bag with the accoutrement of babyhood, unkempt hair, and the edgy expression of someone in a sleep deprivation experiment. But underneath it all is a baffled woman who woke up in a life she did not recognize.

My neighborhood, now within Shanghai’s first ring road and boasting the tallest building in China, was nothing but farm fields less than fifteen years ago. Some of the locals look as mystified about their new circumstances as I do about mine. The climate and air quality in this unlikely boomtown are practically pestilent most of the year, but winter shows Shanghai to an advantage. The normally turbid skies clear, the odor-laden air dissipates, and the mosquitoes die.

On an appealingly brisk December day I got my son Kendall up from his nap and we headed over to our weekly playgroup session. There I could look forward to an abundance of sagely advice offered by childrearing experts, most with exactly one child each. This week’s hostess was Sasha, a Koala-cute Aussie with a gorgeous daughter who looks like her name--Amber. Amber has done everything first in our playgroup cohort: first to feed herself, drink from a cup, and say “mama.” I expect a solution to global warming and an end to strife in the Middle East before long thanks to the miraculous Amber. Surely this indicates what an outstanding mother Sasha is--a natural. Since my little man is the last to do everything, that makes me the malingering mother of the group.

Recently, I was riveted by the plight of the poor penguins captured in that docu-drama tying to perpetuate their species. As a result, my new mantra is, “keep the egg alive.” In a rare burst of confidentiality, a father (God forbid his wife overheard him) recently admitted to me that once the “egg” becomes a teenager the mantra will change to “don’t kill the egg.”

With Christmas just a few weeks away, Sasha thoughtfully scattered Christmas ornaments on the floor along with some toys for the kids to play with. Kendall, my egg, put everything in his mouth; a habit he would continue for another nerve-racking year. I assumed his mouthing of objects was a phase he would grow out of so I did not do much to discourage it. However, failing to examine what he was putting in his mouth proved to be a tragic mistake. Kendall quickly found an ornament and began mauling it.

I was only arms length away from him when I noticed that he was gagging. I suspected the worst and sprung into CPR mode. I vaguely remembered to “clear the airway,” and I attempted a finger sweep of the mouth. Unfortunately I pushed the foreign object deeper into Kendall’s throat. I should be fired. I flipped him upside down and began swatting him on the back. He began howling at this betrayal, first the fingers in his mouth, then sharp blows to his back. All I knew was that howls were good--it meant air was getting through. But I saw nothing ejected from his mouth. What a time to discover I have no aptitude for the Heimlich maneuver.

In the mean time, the playgroup crowd stood paralyzed by this spectacle; me, more crazed-looking than usual, and Kendall crying at the rude treatment he had been made to suffer unjustly.
“Did you see anything pop out of his mouth?” I asked Kaori, a micro-Asian woman, and mother of three from Japan.
“No, but I’ll look.” She replied helpfully and got down on her hands and knees and began searching the carpet. “What did it look like?”
“I didn’t see it, I only felt something hard just before my finger-sweep shoved it down his throat,” I said.
By now a few of the other moms had joined the search for the mystery object. My son’s crying had tapered off to a wounded whimper.
“Thanks for looking--but I have to assume he swallowed it. I need to get him to a hospital in case this object tears his esophagus or blocks his intestines. Sasha, can you call me a cab?”
“Just use my driver, he’s not doing anything,” she offered, in a somewhat cavalier manner, or maybe that was just my imagination. (Surely Amber would never put something like a Christmas ornament in her mouth!)

I rushed out to the minivan in the driveway and climbed in. “Wo yao chu port o man.” I instruct the driver in my survival-purposes-only Chinese. It is likely the only thing he understood was “port o man;” Chinglish for the Portman complex that housed the only Western medical clinic in Shanghai. It was late afternoon and the traffic moved disappointingly, though not surprisingly, slow. Along the way I managed to phone my husband Mark and assure him that yes, his first-born son was still alive and breathing, but no, the foreign object he was chewing on just before he began choking had not been located. Forty-five agonizing minutes later I arrived at the clinic to find my husband and my driver looking equally distraught. We rushed into the clinic and were quickly ushered into an examination room. A young, female doctor entered just seconds behind us.
“I understand your child may have swallowed something? What did it look like?”
“Uhh, I think it was part of a Christmas ornament. Actually, I may have pushed it down his throat when I was trying to sweep it out,” I explain in a voice dripping with ineptitude.
“Let’s put him up on the table and take a look,” she said. She retrieved a tongue depressor from a jar and attempted to insert it into the egg’s mouth. He responded with firmly closed lips.
“Sorry little man, we need to look inside your mouth. Open up please.” I requested, and he parted his lips only slightly, suspiciously. It was enough of an opening for the doctor to slip in and take a quick look. The egg focused on me with a betrayed look in his eyes; it would not be the last one of the day. The doctor then placed her stethoscope on his chest for a quick listen. He squirmed as the cold instrument stung his skin.
“There does not appear to be anything obstructing his airway,” she concluded. But so had I, like an hour before. “But you say you could not find the object. That means it could be in his stomach by now. I suggest and X-Ray to be certain.”
“Okay,” Mark and I replied in unison.
“Unfortunately our X-Ray machine is down; you will need to go the foreigners’ unit at Rui Jin University,” she said, handing us a card with the address. Our hearts sank.

We were not enthusiastic about visiting a local hospital. As most parents quickly discover, once you have children your relationship with the health care system intensifies. You see more doctors, more often, than you typically do as an adult, and that is just for routine check-ups and vaccinations; never mind the inevitable accidents that occur. I knew that in the event of an accident or sudden illness I would have to rely on the medical care available in Shanghai. Frankly, I hoped that day would never come. Sure, Shanghai has the world’s first Maglev train, an ultra-modern airport, and river-spanning bridges and tunnels employing the latest in civil engineering technology. But everyone knows that their hospitals are scary; SARS anyone? In the end, we did as we were told.

Mr. Chang, our driver, was waiting with the car running. In a city as large and sprawling as Shanghai he has an incredible ability to find any address in remarkable time. He employed all his professional driver skills, and some insanity, to get us through the heaving and impossibly narrow surface streets on the way to the local hospital.

Mr. Chang pulled up to the front gate and sprang from the car with speed and agility astonishing in a portly smoker. One look at Kendall and I, and the guard pointed us in the direction of the foreigner’s unit. The reception area was confidence-inspiring with polished floors and uniformed personnel. The Western clinic had called ahead to alert them of our impending arrival, so they were expecting us. We were quickly directed to the radiology department.

Once we passed through the doors of the foreigners’ unit and into the hallway of the local hospital, dread returned. I know it is cliché to talk about the medicinal smell of hospitals, but that would have been preferable to the odor that confronted us. The tangy stench of urine assaulted our noses immediately as we passed the public toilets. The corridor was brightly lit with fluorescent lighting that showed everything to a disadvantage; the missing tiles from the floor and the dirty, stained walls. Local Chinese milled about and stared at the wai gou ren walking past them. We arrived at the radiology department and after a short wait were escorted into the X-Ray suite. Our confidence returned when we saw the big, beautiful, state-of-the-art Philips X-Ray machine. We were pleased to discover that the room temperature, normally frigid in Chinese public buildings during the winter, was kept soothingly warm. Technicians placed protective vests around Mark and me. We were instructed to hold Kendall still as the device moved over him. We did as instructed. He looked so small and vulnerable on the table with no shirt on. He was scared and crying. Mark and I were scared and trying not to cry. I felt like I had failed him.

We were asked to return to the foreigner’s unit to await the results. Shortly thereafter, a throng of lab coats appeared and began deliberating. Lots of people wear lab coats in China. So what they were is anyone’s guess. Soon we were approached by a woman who identified herself as the interpreter.
“Unfortunately, the X-Ray was inconclusive--we could not locate the object,” she rattled off crisply, with only a hint of an accent, “therefore, the doctors suggest that we put your child under anesthesia and go in and look for the object with a gastric scope.”
“Uh, could you excuse us for a moment?” I stammered back, much less articulately.
“Oh-my-God, are they crazy?” I hissed at Mark. “They want to go on a fishing expedition in Kendall’s stomach.” Before he could answer I whipped out my mobile and punched in my best friend Sue’s number. She had caller ID so she knew it was me calling.
“Helloooo, whatcha doin?”
“Sorry, no time for chit chat. I am at Rui Jin Hospital, the egg swallowed something and they are proposing a rather radical solution, do you have Dr. Leung’s number?” I hammered out like a Gatling gun. Dr. Leung was our mutual pediatrician in Hong Kong.
Sue rattled off the doctor’s number before disconnecting.
I dialed and was astonished when the doctor answered after the first ring. After I explained the situation to him, he paused momentarily before responding.
“Normally, we would wait a few days to see if the object passes before such an aggressive intervention.”
I quickly and quietly related to my husband the gist of Dr. Leung’s advice which we then relayed to the interpreter. She returned to the throng of lab coats where there was much intense deliberation. She returned, looking grim.
“If you do not wish to search for the object, and instead want to wait for it, the doctors think it best that your son remain in the hospital overnight.”
“Thanks…but I think we will be more comfortable at home.” I said.

The hospital staff was disappointed with our decision but in the end accepted it. We paid our bill and returned home. The egg seemed fine that evening and slept through the night. The following day he was constipated for the first time that I could ever remember. The interpreter from Rui Jin hospital called to check on him. I can never recall a clinic or hospital in the U.S. making a follow-up call. I was grateful, but had nothing to report. So we waited.

The next morning the egg had his regularly scheduled morning poo. After attaching a clean diaper we set him on the floor to play and set about the grisly task of examining the contents of his diaper. We both donned rubber gloves and began our inspection. I was the first casualty. Overcome by the odor I dropped out. But Mark, God love him, soldiered on. After a few minutes of meticulous scrutiny he declared the diaper free of any foreign object.

Later that morning, after Mark had gone to work, the egg had a second poo. I knew I had to screw up the courage to go it alone. This time in addition to the rubber gloves, I added wads of toilet paper up my nose and dove in. Mercifully, my gloved fingers immediately hit something hard and non-biodegradable. There it was--the little plastic piece that connects the ornament with the wire tree hanger. It was not quite an inch long with a circular piece on one end and a dagger-shaped piece on the other. I bundled up the soiled gloves inside the diaper and along with its contents happily dropped it into the Diaper Champ and went off to call Mark with the good news.
“Mark, I found the object, it passed!”
“What did it look like?”
“Scary actually. It was pointed on one end and rounded on the other. We are lucky it didn’t do any damage in there.”
“What did you do with it?”
“What do you mean, do with it? I threw it away.”
“What! Go get it. We have to save that for posterity.”

Once again, I dawned gloves and tissue wads, opened up the Diaper Champ, and retrieved the souvenir. How strange, I thought as I examined the object after thoroughly washing it in anti-bacterial soap. To think that item passed completely through Kendall’s little body.

Later that day the interpreter called again to check on our son and the status of the foreign object in his body. She seemed as relieved as we were when I relayed the good news.

Some day my son will also marvel at the object that passed through him. For now he just seems content that the constipation has passed. For a moment, I can breathe easier, the egg lives.

Wednesday, September 10, 2008

The Bold Roach


Like any moldering, somewhat tropical locale, Hong Kong has a rich and plentiful population of creepy eeewww-inspiring creatures.  Such an emissary from the bug world confronted me one evening after putting the gremlins to bed.  

Most evenings, for two glorious hours, I am able to relax with a glass of red wine and mindless television.  That night is was to be Grey's Anatomy and an Australian Shiraz-Cabernet.  I had set the glass down on the coffee table and crossed the room to the DVD player to insert the necessary disc.  

While humans are not known for the best eyesight in the animal kingdom, our eyes are good at detecting movement.  And at the moment my eyes were riveted by the movement on my wine glass.  Since there are no witnesses, I can only surmise that the look on my face combined revulsion with indignation as I watched a roach crawl up the stem of my wine glass.  

At steroid-worthy speed I shot toward the kitchen for an industrial-sized wad of paper towels. Concerned, as I was, that the perp would escape in my absence.  Evidently, I did not inspire fear in the multi-legged interloper because rather than making a run for it, he had casually sauntered farther up the wine stem--savoring the bouquet perhaps.  

Grabbing a roach off a wine-stem without breaking the glass or spilling the wine, given my heightened state of agitation, was going to be a difficult maneuver.  I determined it needed to be a two-handed operation with simultaneous execution.   Despite my hasty planning, the execution was flawless.  One roach squished beyond recognition.  

The incident cast a edge over the evening; relaxation was replaced with vigilance.   Maybe oenophile roaches are a rare breed; I tried to tell myself.  But would my English muffin be safe in the morning?