Monday, October 21, 2013

A Chinese Hospital Experience

**Thank you for all your emails, comments and heartfelt words in response to the news of our miscarriage.  We appreciate all your kind words and prayers on our behalf.**

One of the hardest parts of our miscarriage experience was the cultural stress that came from so many visits to the hospital.  I mentioned in my last post that the hospital visit and admission itself needed its own blog post - well, here's that post! In our city there is an “international” hospital.  Really, it’s Taiwanese, so it’s still Chinese but not as Chinese as a Chinese hospital (if that makes sense).  At the hospital, there is a VIP wing that you could compare to a clinic in the States.  All the nurses and receptionists speak English and the process to see the doctor is just like a doctor’s office in the States.  However, it seems at the VIP wing it takes about 2-3 hours for a normal appointment.  The first time we went we were there for 3 hours.  During which we saw the doctor, had an ultrasound (where we got to see the heartbeat, I was 7 weeks pregnant – pretty cool), and did a lot of waiting.  This is not how your average Chinese person sees their doctor.

For the everyday Chinese, you see your doctor at the hospital, not at an office or clinic.  In fact, there aren’t many clinics that I know of (my friend was telling me they are becoming more common where we live, but I haven’t seen one in our neighborhood).  To give you some cultural insight, here’s a quick breakdown of the hospital experience. 

When you arrive at the hospital, you go to the registration desk (where they don’t speak English), tell them which doctor you would like to see and pay the doctor’s fee.  This is the tricky part because you have to know who you need to see to get the right care.  Everything in China is specialized.  So, if you have an ear infection, you ask to go see the Ear, Nose & Throat doctor.  I am not sure what you do if you don’t really know what’s wrong with you.  Fortunately, we haven’t had to figure that out yet.  To see a doctor at the hospital, you don’t have to make an appointment, but you can.  I saw my doctor twice in the main hospital, once with an appointment and once without, but I couldn’t tell you the difference except that if you have an appointment you can skip registration.

After registration, you head to the waiting area of the doctor you are going to see.  This is where it is interesting, at the hospital they gave me an electronic card with all my information on it.  Once we got to the waiting area, my name showed up on the screen in some sort of order of when I get to see which doctor.  The screen is kind of confusing to understand, but when it’s your turn, your name comes up in big letters and they call it over the loudspeaker.  Since I’m not Chinese, they spelled my name out over the loudspeaker.  First, last and middle name.  Too funny. 

You head to your doctor's small office.  For the OBGYN doctors, they have a little room with their computer and an exam room next door.  It is private.  It was worried about this because I heard at some Chinese hospitals the gynecologist sees multiple patients, all at once, in one room with no privacy.  Yes, I know.  Sounds like something I never want to experience.  I think this is the difference between the Taiwanese hospital and other Chinese hospitals in the city, but I’m just guessing. 

If there are any tests you need done, your doctors orders them for you.  For me, because I was seeing my doctor as a follow up to a miscarriage, he ordered an ultrasound.  Instead of the nurse taking up to the ultrasound room, he swipes my card, gives it back and tells me to go back to the cashier to pay for the ultrasound, and after the ultrasound to bring him back the results. 

So, we head back towards reception and get in the cashier line; they swipe my card and I pay for the ultrasound.  After this we go upstairs where my name is now on the screen outside the ultrasound area.  They must do a hundred ultrasounds an hour.  I am not exaggerating.  I was in and out in less than five minutes and there are 7 rooms where they are performing ultrasounds.  It is crazy.  I had to go in alone, they wouldn’t let anyone come with me, and during the ultrasound they wouldn’t let me see the screen.  It was impersonal, but incredibly efficient.

After the ultrasound, I grab a printout of my results and go back to see my doctor.  This is where I really got confused because I couldn’t figure out on the screen if my name was in the queue to see him or in the “already seen the doctor” column.  So, instead I hovered by his office door to hand the nurse the results as she shuffled in and out answering questions.  Both times she pointed to the waiting area and told me to wait.  Anyways, eventually I was called back to see him.  

It is so interesting to me how this system works.  It’s impersonal, yet because it is impersonal, they are able to see a lot of patients every day.  And it’s cheap.  Really cheap.  To see my doctor in the VIP area is 300RMB (about $50) and an ultrasound in the VIP area is 300RMB.  To see the same doctor downstairs in the hospital is 32RMB ($5!!!) and the ultrasound was 160RMB (about $26).  The price difference is crazy.  In the VIP you are paying for English service, no lines, and the comfort of the environment.  Downstairs you get through much faster (even though there are more people), but because you are surrounded by people, you are also surrounded by germs, and you have to navigate the system yourself. 

Fascinating isn’t it?  It was stressful the first time I went in, but by the second time (in the same week) I had it almost figured out. 

The really fun part was when I had to be admitted to the hospital for the D&C, that was a bit different.  After I got back to my doctor with the ultrasound results, he took one look at the printout and told us that I needed a D&C.  He could do it that day, but I needed to decide right away because it was already 11:30am and he could get me into the operating room at 3:00, but I would need to be admitted now.  

So, after we agree to the procedure, he gave me some paperwork and pointed in the direction of the inpatient admission registration.  We went up to the desk and the lady directed us over to a number machine (you know, like you use at the bank or the DMV).  Our number was 190, currently they were seeing number first thought was "how long is this going to take?"  And then, after looking around at all the empty chairs, "Where are the supposedly 120 people in front of me?" There were five total other people in the waiting area.  After 45 minutes of waiting, they finally started calling lots of numbers, without waiting for 190 to show up, we went up to the desk and they checked me in.  They didn't even ask what number I was.  There are some things in China I will never figure out...

During admission, they had us pay all the money up front.  I can't remember exactly how much it was, but apparently in China you prepay for surgery and then any money you don't use gets reimbursed afterwards.  They couldn't charge my US credit card or run my debit card and the hospital didn't have an ATM, but fortunately my friend with me had her China bank card and they were able to charge that, otherwise, I would've had to go ATM hunting.  After registration, a nurse took me upstairs to prep me for surgery and get me into my room.  They put me in the maternity ward.  Does anyone else find this strange and, maybe, a bit insensitive for someone receiving a D&C?  Fortunately, several of the nurses recognized me from when my visited my friend who had her baby there a week earlier, so I felt at ease.  But I still think it's strange they put me in the maternity ward to have a procedure that was the result of losing a pregnancy. 

After the blood work and I signed all the paperwork (that I couldn't read and they couldn't translate - too many technical words, I guess), they said I needed an EKG to make sure I was healthy for surgery.  No big deal.  Except the EKG room is on the other side of the hospital.  After a 20 min excursion to the furthest wing of the hospital (ok, maybe it wasn't that far, but it felt really far), I was able to receive the 30 second test (which I passed) and then walk all the way back to my room.  Different, right? 

3:00 rolls around and they wheel me into surgery.  The operating room nurse remembered me from when my friend had her baby the week before (she ended up having a C-section), which I thought was amazing since I literally saw her for two seconds after the baby was born.  After surgery, I was back in the room by 4:15 or so.  They kept me on the IV until 6:15 when my doctor graciously broke protocol and let me go home.  Usually, women are kept overnight after a D&C.  I think all the nurses thought I was crazy for not wanting to stay overnight, but two hours on the hospital bed were enough for me!  Steven had to go back the next morning at 10:00am to officially check me out since I left after the registration desk was closed (or something like that, I didn't really understand the reason).  

So there you have it, a Chinese hospital experience!  I think mine really wasn't that bad.  I've heard firsthand accounts of others waiting four hours to get an MRI. It was stressful at times and definitely different than what we would have experienced in the States, some part goods and some parts not-so-good.  Overall, the nurses were great and very sweet and my doctor was as accommodating as he could be.  And it was so inexpensive.  When it was all said and done, the total cost for the D&C was 2,350RMB or $385.  That included the surgery and a night in the hospital (that I didn't use).  I think a room alone in the States is more than that. 

I am thankful to have this experience behind me.  And I'm thankful that I'm at a place where I can blog about this without getting upset.  God has definitely provided peace in this area - especially because it was all such an emotional and stressful experience.

On a side note, another friend of mine just had her baby last week at the same hospital (a month after my surgery).  We went to go visit her and the nurse on duty was the same one who checked me in for my D&C.  She remembered me and was excited to see me.  I feel like I know half the staff of the maternity ward between my surgery and visiting two friends who had babies recently.  Maybe next time I won't have to take a number. 

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