The hospital where I have my prenatal appointments is the best in town, and I am fortunate to be allowed to see a doctor at the international clinic (foreigners only!), where service—besides being conducted in English by bilingual Chinese people—is relatively fast, easy and warm. The price is higher than in the regular hospital, but it is still a fraction of what I would pay out-of-pocket in the States. (An ultrasound, for example, costs $22; a visit with the doctor, $30.) The service for the average person at this hospital (the average person who is Chinese, that is) is agonizingly slow and convoluted. The waiting rooms are crammed with sick people, some with bodily fluids leaking out. The floors cannot stay clean with this many people, and the paper on the patient beds is not rotated. Every service takes place in a different hall, floor, wing, or building, so people can expect to spend all day walking from waiting room to waiting room, forking over papers and cash and endless patience. I reiterate that this is the premier hospital in town, and that I am extremely fortunate to be seen at the VIP/foreigner clinic there. My experience has, overall, been good, and certainly it is leaps and bounds better than what I could expect as a Chinese person in the normal medical system. But, there have been some humorous moments in my time spent there, and I relay them to you now.
When I first arrive, they take my blood pressure and weight; both values the nurse hollers across the office to the receptionist to record in my file. There are at least ten other patients in there at the time.
Then I meet my doctor, a young Chinese woman with a gruff manner and snarly smile, who asks, “So, do you want to keep the baby?” When I answer that I do, she says, “Oh, so it is your first baby.” No, I say, I already have one child. “Ah, then your first child is a girl.” No, a boy, I reply, and she pauses for a moment and then moves on. “So you are feeling good? The baby is developing properly?” Well, I say, I feel fine, but I don’t know if the baby is developing properly. I hope so. “But you are throwing up, or no?” No, no throwing up, I say. “Really? No vomiting? Not at all?” No, none. “Oh, this is very good. Chinese women often throw up a lot.”
Then I go in for my ultrasound, which is blissfully brief: as a patient at the international clinic, I pay for the service of having a nurse escort me to the ultrasound room (on a different floor, and part of the regular hospital, not the VIP clinic) and have me cut the entire line. Yes, it’s ugly to be the only foreigner in a room of 100 Chinese people–waiting, with various ailments, to have an ultrasound–and to waltz right into a room with the guidance of a Chinese nurse. But the alternative is to wait two hours, and I swallow my guilt and get the thing over with.
I take my ultrasound print-out back to my doctor, who glances at it and says, “There is no heartbeat.” Just then, her phone rings. She picks it up and chats at length about a business matter. I am crushed and full of questions, but she’s far away from me now. Finally, she hangs up. “Yes,” she repeats, “no heartbeat.” Snarly smile. “What do you think?” I ask. “Well,” she ventures matter-of-factly, “maybe the baby is too small. I can’t say. Come back in two weeks.”
Then they draw some blood from me (and do not provide a bandage, so I bleed through my shirt afterwards) and say they’ll email me the results. I am asked to write my email address down on a piece of scrap notebook paper on the desk. This paper contains ten or fifteen other patients’ email addresses. The nurse attending to the piece of paper shuffles some papers on her desk and hands one to me. “Is this your ultrasound?” No, I say, that’s not mine. “Oh, is this one yours?” Yes, that’s mine. She has a whole mess of them loose on her desk. I write down my email address and go home.
That afternoon, I receive an email: “Dear Lawrence, the blood test confirms you are pregnant.” I write back, “Thank you. Can you please tell me if the levels of HcG are in the normal range?” She replies immediately, “The doctor says it is fine and we will see you in two weeks.”
Two weeks later, I go back. I have pre-paid for my ultrasound (oddly, this was required) and I am in and out quickly. They locate a heartbeat and I am relieved beyond measure. My doctor smiles and says, “So, there is a heartbeat. Have you had any bleeding? Vomiting? Cramping?” No, I say, none. “Really? None? No bleeding at all? No vomiting at all?” No, I’m fine. “Really? You feel okay?” Yes, I assure her, I feel okay. She seems more than a little disappointed, and extremely doubtful. “So, the baby is developing well, then?” I don’t even know how to answer, so I just shrug. She continues, “So, will we do a blood test today?” I don’t know, I say. Will we? “Only if you want to. Did you fast?” No, no one told me to fast. “Oh, well we can do it next time. It’s just to make sure that the baby doesn’t come out bad. Okay, we will see you in one month.”
And, a month later, I return, having skipped breakfast and ready to do this thing. The nurse hands me a plastic urine sample cup and a smaller tube, saying, “Here is for the urine, and here is for the stool sample.” Sorry, stool sample? “Yes, we need a stool sample. It is routine for all Chinese women.” But… Why? “Well, it is to see if you have any bleeding in your GI tract. Many Chinese women have stomach problems.” Well, I say, I don’t have stomach problems, and I don’t have to go number two right now, so. “Well, you can take this [and here she proffers the tiny tube] home with you and bring it back next time.” No, I say, I’m not bringing in a stool sample. She stares at me. “You want to…cancel…the stool sample?” Yes, please. “I will have to ask the doctor.” She disappears, and I hear her explain my situation and defiance at length to the doctor. The doctor grunts once, and the nurse reappears, smiling brightly. “The doctor says it is okay to cancel the stool sample. Just do the urine sample today.” Phew. I oblige.
Next I am told I will have an EKG. I ask why, and they again tell me, “It is routine. All pregnant women in China get an EKG. Your insurance company will pay for $600 of tests at this appointment, so we will do an EKG.” Ah, now I see why. “I don’t know if an EKG is necessary,” I offer. “I am healthy.” “Please, come this way,” the nurse smiles, and I sigh and follow. The EKG is painless, but they note that my T-waves are slightly above normal. I ask the nurse what this means, and she replies, “It means your T-waves are higher than usual. But maybe it is because we just climbed five flights of stairs.”
Oh yeah, the elevators. There are six elevators in this building, but each stops at only certain, designated floors, and somehow the whole system results in massive lines, wild overcrowding, and very frustrated patients waiting in the lobby for long periods of time. I do not even attempt to take the elevator, and neither does any able-bodied person. The stairwell is filled with people with bandages on their arms and IVs in their hands, trucking on up to the 9th floor or back down.
Anyway, after my EKG, the doctor listens for the baby’s heartbeat. It is normal. Then I have another ultrasound, this time to measure the nuchal translucency. The doctor is nervous about this one, saying, “It is a test that can tell you if your baby will maybe have Down syndrome.” During the ultrasound, I crane my neck to see the screen (the technicians routinely point the screen away from the patient). The man chuckles to the nurse in Chinese, “Ha ha, she wants to see!” I say back, in Chinese, “Yes, can I please see?” And he instantly warms up, pointing out all the different parts of the baby that we can see: “Zhege shi HEAD. Zhege shi SPINE. Spine? Yes?” I note that the baby appears to be sleeping, and he and the nurse laugh uproariously at this for some reason. Then I get my print-out and bring it to the doctor, who smiles hugely and says, “The nuchal translucency is normal!” That’s good, I say. “Well,” she frowns, “it is normal now. We will see if it changes.” By now I am accustomed to her manner and I don’t let this get me down. See you in a month!