A Small Trip to the Hospital in Guangzhou

On Saturday , Munchkin thought she broke her hand when she fell down.  Her hand never swelled, and it never turned blue, and I didn’t think it was seriously injured; but it has become more painful with each day that passes.  She has found it increasingly painful to write, so that by Wednesday it interfered with her school work.  We didn’t have appropriate bandages at our house to wrap it.  So, today after school I asked the school nurse to take a look at it and tell us if she thought we should get a doctor to look at it. 
The nurse agreed with me that it probably wasn’t broken, but she thought a wrapping might make it more comfortable, and she thought that perhaps an xray would be wise.  So, we went straight to the most convenient place where there is an x-ray machine.  Immediately after school, we went to the small hospital just around the corner from where we live. No English is spoken there, so I got the school nurse to relay Munchkin’s history to Song Ying (who was unaware of it), and Song Ying went with us so she could tell the doctor the story.  Munchkin and I walked straight to the hospital, while Song Ying took her bookbag home, returning on her bicycle to meet us at the front gate.  I imagine we arrived at about 3:30 or so. 
I’ve written about a previous trip to the hospital,* but today happened to be the performance of the school Christmas program.  Because of that, I already had my camera in my pocket.  About halfway through our hospital visit, I realized this was the perfect opportunity to take photographs to describe our adventure there.  It was the third time we’ve visited the hospital on account of a potential (or real) broken bone.  *[ I wrote about one of the earlier visits in my Blog entry titled, "Our $10.82 ER Visit," http://xanskinner.spaces.live.com/?_c11_BlogPart_BlogPart=blogview&_c=BlogPart&partqs=amonth%3D2%26ayear%3D2007 (27 Feb 2007).] 

The first step when one arrives at the hospital is to go the cashier and pay to open one’s chart.  Song Ying managed this for us.  When I had gone there by myself, I didn’t realize that there are two different fee schedules.  If you want quick service, it’s 8 RMB.  If you are willing to wait a bit longer, it’s much less (I think I recollect that it’s 3 RMB).  Paying the up front fee gets you in the queue to see a physician.  Notice this point:  no pay, no see.  So first ante up to the Registration fee payment line.  Song Ying told them we wanted quick service and she instructed me to pay the 8 RMB.  She said there were so many people, there might be a long wait.  It was the same amount as the fee I had paid the previous time. 
After we paid the 8 RMB, we went to sit and wait for one of the three doctors who was staffing the emergency room.  The nurse looked at our receipt and then went to tell the orthopedic doctor that we were there.  We sat down, and I looked around at the people in the waiting room.  Two people looked extremely ill, bent over and pallid.  They were waiting for the internal medicine doctor, who practices in the middle room.  The orthopedic doctor has the third room.  While we were sitting there waiting for the bone doctor, a staff member ran into the first room, crashing through the doors and swinging them wide.  I could see a medical team clustered around one person on a guerney.  I began to think about germs, and suddenly noticed that Munchkin was still holding and sucking on a candy cane that Santa had given to her at school.  I told Munchkin that there were germs in the hospital and it was time to either get rid of the candy cane or eat it, and thereafter to keep her hands away from her face.  She looked around at the sick people, was duly impressed, and promptly agreed.  (Then we wiped her sticky hands with one of the wet wipes that mommies learn to always carry.) 
Presently, the doctor came to get Munchkin.  Maybe all of five minutes had passed.  No one had yet come to get the people who were there in line before us.  Thoughts about triage came into my mind.  I guess the nurse we showed our receipt to functioned as a front line triage person, but I doubt if that was officially part of her job description. 
Song Ying told the doctor the story, except something was lost in translation.  She didn’t really get it right.  I had mentioned to Song Ying that it was the same arm Munchkin had broken this winter.  She thought I meant the pain was in the same place.  It was not.  Munchkin had broken her arm, but now the pain was all in the heel of her hand. 
We had to show the doctor where it hurt, but Munchkin wasn’t so much help, either.  She was too busy sucking on the remnant of the candy cane, which she had shoved in her mouth even though it was too large.  But finally the doctor did mash the spot where her hand was quite tender, making her wince and cry out loudly.  When he did, this, Song Ying chided him, fussing that he had been too rough.  In the end, just as we thought he would, he told us that he didn’t think it was broken but he needed an xray to make sure.  He wrote an order for the xrays, but before we could get them we had to once again go and pay for them. 
This is when I remembered I had a camera in my pocketbook.  Here are the photos I took as we waited to pay for the xray: 
The fee for the xray was 146 RMB.  This is in contrast to the 30 RMB or so that we paid last March when Clarissa thought she might have fractured her finger.  I can’t say why it was more expensive. 
After we paid the fee, we carried our receipt and order, along with Munchkin’s hospital ID number, and gave all the documents to the clerk in the radiology department.  As we waited in the waiting room, Munchkin saw a poster showing an MRI machine.  We talked about what MRI machines are used for and whether she had ever had one.  I suppose there is one in this hospital.  Within about five minutes, a technician came out and called us to go get the xray made.  Here are photos of the xray room.  Notice the open window.  When we were there in the middle of winter, the windows had been open at that time as well.  I’m told that houses and hospitals were all stuffy up until the advent of SARS.  Guangzhou and Hong Kong were the epicenter of the SARS breakout.  During the time when no one knew how the SARS illness was spread, a policy decision was made to open windows to get stuffy air out of buildings.  I’ve only been in hospitals in Guangzhou maybe six times, but so far in all my visits, all the windows have been wide open, even in the dead of winter.   People simply bundle up in their long underwear, gloves, and coats.  It’s no warmer or colder inside than it is outside. 
Song Ying and I were instructed to leave the room when the technician performed the xray.  But thinking about it, I now notice that I never saw a radiation shield for Munchkin’s tummy.  Gee, I wish I had thought about that while we were there!  I would have asked for one. 
After they took the xray, the technician told Song Ying that the wait for the xray to be developed was 30 minutes, since we had paid for expedited service.  If we had not paid for expedited service, she said, the wait would have been two hours.  As Song Ying told me this, she pointed me to a sign on the wall which repeated this information.  I could read the numbers and the characters for "minutes" and "hours".  Sure enough, it seemed to be a policy decision.  Song Ying told me it would be a half hour wait.  But it wasn’t. 
The staff was working in an orderly fashion.  They were taking films to the radiologist as they were developed, and he was reading them right there in front of us.  A small group of doctors was discussing the xray of a set of lungs.  Another doctor came down and picked up a film.  Shortly, the technician called us and said our films were ready to be carried back to the ER doctor.  She gave the films to Munchkin, who carried them, and we all went back to the ER waiting room to show the films to the doctor. 
The ER doctor passed us in the hallway as we were walking.  I heard him say something about supper, and he told Song Ying he would be right back.  Perhaps he was just going to order his supper, because he wasn’t gone long enough to eat.  He returned to his room in just a minute.  He sat down and held the backlit film up to the sunlight in his open window to read it.  He ascertained that the bones all looked fine.  After he did this, he typed his diagnosis and treatment into Munchkin’s computerized record, which is when I snapped this shot.  He then gave Munchkin a prescription for a bandage and a topical anti-inflammatory, Voltaren Emulgel.  He instructed us to go pay and to get the prescription filled while he wrapped the hand in a gauze bandage.  The bandage was soaked in traditional Chinese medicine.  I like the smell, but it’s something you have to get used to. 
So then, we went to the Cashier’s counter for the third time.  There were two lines and two cashiers, moving steadily along.  There were nine people in each line when we got there.  The fee for the two bandages (one that he put on and one for the next day) and anti-inflammatory was 73 RMB.  The pharmacy is across from the main reception area.  It smells like traditional Chinese medicine.  This was the longest wait of the day, and it seemed like the most tedious since we had already been twice in the cashier’s line.  After we paid, we took the receipt and order to the pharmacy to pick up the medicine and bandage.  Here is a picture of the pharmacy: 
By the time we paid and went back, Munchkin’s hand was already wrapped, she smelled like pungent traditional Chinese herbal medicine, and she was ready to go.  Song Ying coached Munchkin to say "Thank you" to the doctor, which she did ("xie xie ni"), and I told him, "xia ce jian," (see you next time).  He smiled.  We showed him the receipt, said goodbye, and left.  Here is a photo as we were leaving the ER: 
 The last thing was the bike ride home  . . . . 
Zai jian!  (Goodbye!)  We were home by 4:30. 

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