Last Thursday, Hope, Grace, and I went to a birthday party at The Fountains. During a game of tag, Hope took a bad fall during which she broke her tibia and her fibula. Those nearby heard the bones snap as they fractured, making it immediately obvious that the day would not go as planned. We were blessed to be surrounded by caring friends, who gathered to help us. A car was brought around, pillows to cushion her leg were located, and we were loaded up for the very long trip to the emergency room.
The drive was grueling since Hope’s bones were unstable and the bottom half of her lower leg was more or less hanging loose. Every stop and start was excruciating. Hope was not the only one in the car crying by the time we arrived!
A kind friend who worked at that hospital registered for us before we arrived, but the process was still agonizingly lengthy. From the ER we pushed her bed outside and over to the radiology building. The area was just crushed with people. This hospital sees 10,000 patients per day- if you can imagine! Just getting her bed into the elevator was a test of patience as everyone felt they needed to crowd and push in front of the little girl on the bed who was crying and screaming in pain. Ugh. Finally, Joy and I screened off entrance and told everyone to just back off and let this child get into the elevator. Two mama bears in action- for sure. I hate to be an ugly American but there are times when enough is enough and that was one of them.
In China there is some philosophy about pain that is not immediately obvious to me. Perhaps it is that doctors deal with so many people daily that they distance themselves from the pain they see. Perhaps it is a toughness in the psyche. I really don’t know what it is, but there is definitely a coldness regarding suffering that is a culture shock experience every time we go to a Chinese hospital. The x-ray room we entered and the technician we dealt with were cases in point. Hope’s screams of agony notwithstanding, the technician just manhandled her around with indifference. I left the room for a minute, thinking I might pass out just seeing my baby’s pain (her daddy stayed with her). When I came back in our friend the doctor had the technician over at the side, was down in her face, saying, “Do you or do you not speak Chinese? I don’t want to have to tell you again! Be careful with this little girl!” Had it not been so intense, I might have applauded.
Finally, with the x-rays taken, we went back outside and into the main building again where we waited for half an hour for the report. Hope’s comment was that it was nice to be able to rest for a few minutes before the next bout. The x-rays showed that the bones were badly but cleanly broken. Surgery was indicated, but first the bones had to be set to be stabilized before any further steps were taken. Fortunately, they did give local anesthesia for the setting, which somewhat deadened Hope’s discomfort, but the setting was still horrifying. Hope squeezed my hands as hard as she could, looked into my eyes, and kept asking me to quote the Bible to her or sing hymns. She knew where her comfort would come from and was intentional about focusing her eyes on Christ. I was so proud of her.
In the excitement of the moment, I had forgotten that Rebecca’s brother-in-law is head of orthopedic surgery at a different hospital, so knowing Hope had to have surgery we invited him into the loop of treatment options. At the hospital we had first gone to, surgery could not be done that night. Apparently, surgery with such a break should be done immediately OR the patient would have to wait three days or so for the swelling to go down. So the treatment at the first hospital included three days of waiting IN the hospital before surgery on Monday. Rebecca’s brother-in-law kindly agreed to perform the surgery in his hospital that night, so we piled into the car (our friend had left his car and driver with us for the day- a wonderful gift that saved us a lot of misery, time, and aggravation!) at rush hour to go to the other hospital. With Hope’s bone set, she was not as uncomfortable as previously, but this trip was no piece of cake either.
Dr. Luke met us outside and shepherded us to a room. After looking at the x-rays, he confirmed that surgery was indicated. Even though the breaks were bad, the surgery was simple and included the insertion of plates and screws. Surgery was completed around eleven that night, and Hope entered recovery phase.
Even though it was a tough day, we saw God’s grace everywhere- friends who helped us get to the hospital; doctor friends who made the path easier for us; messages and calls all day from folks who cared and wished to help; Hope’s own sweet attitude and concentration on God’s goodness… We felt loved and blessed in the midst of the suffering. Ps. 31:21 says, “Blessed be the Lord, For He has made marvelous His lovingkindness to me in a besieged city.” That is a great description of last Thursday- it was a hard day; our city was besieged; but God’s lovingkindness was, indeed, marvelous.
We’ve had a number of medical emergencies since we came to China. Hospitals are a bit different here. In America, we go to the hospital for major events, but since there are no private doctors’ offices here, the hospital is the standard for day to day medical care. Folks go for scrapes and scratches as well as for major catastrophes- thus the huge number of patients daily. And since costs must stay comparatively low, all services are not provided. Among other things, patients must provide their own supplies. So when Hope checked into the hospital, we had to “gather”. Our list included items such as: a basin, soap, washcloths, towels, toothbrush and paste, toilet paper, tissues, wipes, chucks for the bed, bowls, silverware, and bottled water. This ward was relatively clean, but in the past we’ve even brought in our own cleaning supplies to freshen things up a bit (or a lot!)
Much of the care is, in fact, self service. If the bed needs changing, you can go ask for sheets or even go to the linen room and get sheets to change the bed. Clean hospital clothes can also be obtained by asking. Bed pans and “pee pitchers” are available in the housekeeping room where you can go and get them. If samples of urine or feces are needed, containers are left for the caregivers use. Trash can full? You know where the bags are! Have dirty gowns or sheets? The laundry trucks are in housekeeping! Obviously, if patients are not ambulatory, are young, are old, or are otherwise incapacitated, a 24 hour caregiver is mandatory.
Other things that are different include: The hospital rents out cots for caregivers each night for 15 yuan. My husband’s pithy remark was that you could buy one for ten yuan or rent it for 15! He was probably correct in that, but it was nice to have a place to stretch out. Patient meals are not automatically provided, though they can be ordered. Most families bring in food for their loved ones during their confinement, which is what we did for Hope. Pain management is often almost non-existent so we were thankful for our supply of pain medications on hand that helped Hope handle the worst of it. I knew that headache was good for something! I imagine it would have been frowned upon to supply our own pain medications, but that detail somehow didn’t get communicated! Ah well, needs must…
Another difference is the length of stays in Chinese hospital. Hope’s roommate was having arthroscopic surgery on her knee, but she entered the hospital on Thursday for a Monday surgery. Patients often endure lengthy stays since they not only go in for a long while before a procedure but stay for a long time afterward. Since many hospitals are not as clean as this ward was, infections are easy to come by. We felt blessed that Hope was allowed to get out only three days after her surgery. Another thing we were grateful for was that though she was put into a room with three beds, only one other was occupied and that by a very kind older lady.
Climate control is also subject to culture shock. Windows are left open in almost all weather, welcoming in the pollution, the heat, the rain, or the cold. The open windows sport clothes racks so that patients can do their own laundry and hang them outside in the “fresh air” to dry!
Privacy is nonexistent. Beds have no surrounding curtains or screens. Everyone can see what is being done to you and most folks feel free to comment or offer advice! “Ice is not good for you. Drink warm water!” “Her arm hurts. Slice a potato and put up her arm where the IV enters.” “If she’s nauseated, cut a lemon and put it over her nose.” Indeed, one is amazed to see a roomful of patients whose arms are covered with sliced potatoes and who have lemon quarters on their noses.
During holidays such as the upcoming Spring Festival (called by foreigners “Chinese New Year”), mostly junior doctors are left in the hospital. Few services are available during holidays, weekends, or evenings. It does NOT pay to get sick during an off time! During one Spring Festival, the newspaper said that 82% of laboring women had Caesarean births. The doctors were definitely not into missing more of their holidays than absolutely necessary. I know it sounds weird, but we were really thankful Hope didn’t hurt her leg a week or two later or it would have been even more trying than it was.
Payment plans are “Pay as you go.” Deposits are given to bookkeeping, and whenever the care has exceeded the money down, caregivers are required to go put down more money. We have heard of many situations where patients are discharged when their ability to pay runs out, regardless of the medical needs remaining. You probably wonder what the cost of Hope’s care was- the total between the two hospitals was right at 13,000 yuan, so a bit over $2000. Though that’s a lot of money, it’s not much considering an emergency room visit, a bone setting, surgery after hours, and a three day hospital visit! The entire charge was on one bill. There will be no bills coming in from doctors, surgeons, therapists, lab work, anesthesia, and so forth. So we’re, thankfully, not waiting for the other shoe to fall. And if you were appalled by the amount of self care and provision required by Chinese hospitals, notice the difference in price tag! Yes, American hospitals are more convenient and provide more supplies and service, but the cost is SO much more that it’s a nightmare. Personally, for our pocketbooks (we have no insurance), we prefer to do more of the work ourselves and pay less. We would RATHER bring in our own basin than to pay $15 for one, or whatever the cost is these days! At this particular hospital and ward, the doctors and nurses were competent and provided necessary care. It probably helps our level of satisfaction to have been here for over ten years so that our expectations have been transformed.
Hope is now home and recovering well. Thank you for all the prayers over the past few days. In a few months, she will have another surgery to remove the plates and screws but they will use the same incision. We appreciate your continued prayers.