Our $10.82 E.R. Visit

It was already a bad day.  Saybay broke her foot today.  Her university’s infirmary splinted it, but gave her nothing for pain, and she was in a lot of pain by 8 PM when she called me.  That’s only the beginning.  How would she get to class tomorrow, clear across campus?  How can she walk anywhere.  So, with this kind of luck . . .  Claris comes home from school with a bandage on her hand.  Of course, they would both break bones in the same day, right?  They are sisters!  That would be my luck.  I decided since the stars seemed to be lining up against me, perhaps a visit to the ER would be prudent.  Especially since Claris was already complaining that it seemed like a lot of pain in her hand. 
Claris had been playing European handball in P.E. class and jammed her pinkie finger.  No problem, except the finger kept getting more and more painful as the night went on, swollen, and then she couldn’t bend it.  About 8:30, we decide to call the doctor and ask his advice.  He didn’t really think it was an emergency, but he said if we wanted to we could get a head start on things by having it x-rayed in the emergency room and then see him in the morning to get it splinted if necessary.  He said if we ran into any difficulty in the ER, where they only speak Chinese, we could call him and he would walk us through it.  Dr. Ong is from Singapore.  Singaporeans really impress me with their knowledge of many languages.  Dr. Ong, for example, speaks several dialects of Chinese as well as English and his native Singaporean.  He says he thinks nothing of it, because in Singapore there are people of so many different nationalities who are friends that they all learn a bit of each other’s dialects.  It impresses the dickens out of me! 
Well, back to the Chinese E.R. story. 
When J broke her arm and we did the second x-ray, Dr. Ong’s bilingual nurse accompanied me to the hospital and interfaced with all the staff.  This time, we went alone, armed only with a pocket dictionary and knowledge that we could call Dr. Ong if we got into a bind.  As we left our apartment compound, the security guard wished us happy new year, and asked if we needed them to hail a taxi for us.  We explained that no, we were walking to the hospital, which is only a three minute walk from our house.   As we walked there, we rehearsed words we might need to know, like "nurse," "playing ball," and "x-ray." 
The first decision was where in the hospital to go.  Whether to go in to the emergency room or whether, as Dr. Ong’s nurse had done, go straight to the x-ray department.  Since I already had a doctor who had told me what to do, I gambled that perhaps he might have called ahead.  We went straight to the radiology department.  But, no go.  The x-ray technician said we needed a "dan," meaning, a list.  (A menu is a "cai dan" or dish list, and a bill is a "mai dan" or pay list, so we figured that a "dan" is an order.)  So, we went to the Emergency Room reception to figure out how to get an order for an x-ray. 
The first thing they asked at reception was whether we had a Chinese medical insurance card.  They seemed slightly befuddled when we couldn’t produce one, but instead instructed me to go pay 7 RMB, to create a medical chart.  When I came back with my receipt for this, the receptionist gave me a booklet to fill out which would become Clarissa’s medical record.  There was no English; fortunately Claris knew enough Chinese Characters to fill in most of the information requested, such as name, address, name of referring doctor, occupation, and phone.  She filled this in as we waited, in the row of hard plastic chairs in the hallway, to see the doctor. 
The emergency room was divided into two small receiving rooms, each manned by two doctors.  One was orthopedics and surgery, and the other was internal medicine and pediatrics.  There was a third room labeled "treatment room," with a young nurse standing expectantly in the doorway, waiting for someone to treat. 
We began to have misgivings.   This wasn’t an emergency that couldn’t wait to be seen by our regular doctor.  The issue was, that Claris didn’t want to miss school in her AP classes.  Could her regular doctor see her during lunch tomorrow?  No, that’s his lunch hour.  Okay, we’ll at least get the x-ray done tonight.  How much harm can it do.  Except, we don’t really speak Chinese.  I could see a plaster splint being applied to the man in line ahead of us.  What if they wanted to put a plaster splint on it?  What if, what if?  We decided to go ahead and see if we could be successful in getting a diagnosis.  After all, we were already there, and it’s not as if the Chinese doctors are incompetent; it’s really a matter of comfort in communication.  In worst case scenario, no harm would really be done.  In best case scenario, we would get confirmation that it wasn’t broken, peace of mind, and Claris wouldn’t have to miss any school at all.  
As we sat in our seat thinking about whether to stay or go, a girl walked by.  She was dressed in street clothing and high heels, but there was one thing that set her apart.  She had an IV line coming out of her left sleeve.  She held her right hand up high, carrying her IV bottle.  It had a neat little carrying handle attached.  How much more convenient this would have been, when I was trying to induce my most recent labor in the hospital by walking in the hallways, to just be able to carry my IV Bottle rather than have it hooked up to a trolley that I had to push around!  Still, we had a bit of a shock and slight giggle at this sight.  "Oh, let me just walk down the street with my IV."  The girl went someplace down the hall, perhaps to pay for some treatment she might receive next, and then walked back to the room she had come out of.  Other than the IV coming out of her arm, you would never think she was a patient. 
When the doctor called us in to see him, he spoke so rapidly in Mandarin that I couldn’t understand what he said.  Most people, when they see we are slow at understanding Mandarin, will slow their speech slightly and try to talk a bit more clearly.  Not this guy!  If you said "ting bu dong," (I don’t understand), he would just repeat what he said even faster.  It flashed through my mind that maybe he resented our being foreigners in his hospital.  If so, he didn’t show it in any way, except through his rapid, speech that made him very hard to communicate with.  Other than his frustration that we didn’t speak Chinese, he was kind and gentle, though expeditious and with no humor for small talk. 
Using her Mandarin, Claris was able to convey that she had been playing ball at school that day, had jammed her finger, and that the school nurse had applied ice and a bandage.  We conveyed that we were worried it might be broken.  The doctor examined the finger, asking Claris what hurt and whether she could bend it.  She was unable to bend the finger in the way the doctor wanted her to bend it.  He did not try to force it.  To my relief, he didn’t do anything that made her scream in pain.  Then the doctor asked us something else.  I didn’t understand his question.  He kept repeating it, faster and faster, until he was saying just one word over and over, very fast.  I was stymied.  I figured it was time to call the translator.  But just then, the doctor across the desk from him, the surgery doctor, looks up from her work and says, "x-ray"!  He was asking if we had brought an x-ray!  Even though we had rehearsed this word on the way in the door, it had escaped us as he said it rapidly.  That’s just the way life is sometimes, the real things sounds differently than what you are expecting.  
So, after we explain that no we don’t have an x-ray, he writes out an order for an x-ray, then sends us back to the pay desk.  I was pretty leery.  "Uh oh," I was thinking, "This is where we get taken for a ride."  Instead of our English speaking, Australian trained doctor that we are comfortable with, we are going to get charged up the wazhoo to be put into the Chinese medical system.  So, with great trepidation, I hand my pay list, ordering the x-ray, to the cashier.  I had already looked at it, and from the Chinese characters written on it, I had no idea how much money she would ask me for.  All I knew was that my entire visit to Dr. Ong last month, including x-ray, consultation, and antibiotic, plus using his driver and nurse to cart us around to the hospital, had cost 300 RMB.  I would use this as my guide in knowing whether we were being taken for a "ride" or not.  The cashier then told me, "Twenty five."  She meant twenty five Renmibi, not 25 U.S. dollars.  A huge sigh of relief.  We paid the fee, took the receipt, and then went back to the radiology technician, who of course was expecting us.  We gave him the order and the receipt.  Then, he took the x-ray picture.
When I took J for her x-ray I noticed a few things that were very different from an American hospital.  First of all, it had been a blustery, winter day, and the windows were wide open.  All the hospital staff had been wearing heavy coats and even gloves as they performed their work.  Tonight, the windows were closed.  But no one asked if anyone were pregnant, and no radiation shields were anywhere.  Though the x-ray technician stepped out of the room to push the button on the x-ray machine, he came back into the room before it had stopped running.  At the Can Am clinic in Guangzhou, the x-ray machine is a new, digital model.  Here, the x-ray machine is an old fashioned variety.  But the x-rays only took about five minutes to develop.  As the technician handed us the films, I asked him if the bone were broken.  He smiled without answering and walked back through a closed door.  As he opened the door, I could see that he was going back into a sleeping room equipped with a simple bunk bed. 
We carried the x-ray back to the orthopedic doctor.  There were two views, one of the hand straight on and the other of the pinkie turned sideways.  He studied both, then he told her it was not broken, but it needed to be splinted and then she would need to come back in three days to have it looked at again.  He went to a drawer and found a splint which he cut down to size.  The splint was made of a thin piece of wood, padded with felt on one side, and then wrapped in gauze.  After he cut off the appropriate length, he re-wrapped the end of the splint with gauze and placed the remainder back in the drawer.  He splinted Claris’s finger using this and non-adhesive, non-elastic gauze bandage.  But first, he wrapped the finger in a piece of cloth that was dipped in a fragrant tea made of Chinese herbal medicine.  I’m sure the herbal medicine is to help healing.  Then, he bandaged it nicely:  not too tight, not too loose.  When it was all done, he told us to go pay, and then come back to get her records.  He gave us another pay order.  This time I could read it clearly, 50 RMB.  I went to the desk and paid the 50 RMB.  Then, Claris went back alone to retrieve her medical record and x-ray films.  Triumphant at navigating this alone, we left the hospital and walked the short distance back to our house. 
It was, indeed, best case scenario.  To get a diagnosis that the bone was not broken, to know she need not miss school tomorrow, and even to get herbal medicine and a nice splint.  And think of the cost:  7 plus 25 plus 50 = 82 RMB.  That translates to $10.62 U.S. for our entire emergency room visit. 
When we arrived back, the security guards asked (in Chinese of course), "You’ve been to the hospital?!"  Claris shows them her hand and says, "playing ball."   They’re not much older than she is.  "Oh, jeesh," they seem to say, smiling.  Sports injury!  She seems happy.  The ibuprofen I gave her at about 8:00 has taken effect.  But I think also, it makes her feel better just to know it’s not broken, because it sure is gonna be a beauty with all that swelling! 

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