The most hilarious Chinese hospital story ever

Adventures in the Wild East — a flashback to the good old days in 2007

View from China with an Austrian School of Economics Perspective

A lightly filled hospital corridor back in the good old days

My experience with medical care in Zhuhai

This is an addendum to our guest commentary series on the good and the bad of China’s medical system. Part 1 of that series is here.

(Original source, now removed: http://zhuhai.expat9.com/blog/my-experience-with-medical-care-zhuhai. The article was published in June 2008 and is archived here.)

In the afternoon of 31 October of last year [2007], I was admitted to Zhongshan University #5 hospital. I had a dangerously high fever, and was in acute pain in my chest and back. Also, I was, from time to time, only semi-conscious. When I was admitted, I had with me some X-rays I had taken earlier in the day which showed a large mass of “something” in my chest. I was to have a CT scan and have some other tests done to diagnose the problem.

I paid a 4000RMB deposit ($KACHING$), and was sent to a semi-private room on the pulmonary floor where they looked me over (for about 5 minutes), drew some blood, and took my temperature. I had/ repeatedly told the doctors, through a translator from the HR department of my school, that I would need some medication for the pain before the scan because I could not lie down, on my back, motionless in the scanner. Even the slightest amount of pressure on my back, such as leaning back in a chair or lying down in a bed caused fits of extremely painful coughing. They said that they would give me some medication before they took me for the scan. I then waited there for the medication and my turn in the scanner.

About 20 minutes after my “examination” one of the doctors, who spoke pretty decent English, came to my room to tell me that an examination of my X-rays showed that I had a pretty severe case of pneumonia. The problem was, however, that they didn’t know what was causing it. They said that it could be “common” pneumonia, or it might be caused by something more sinister such as tuberculosis (highly contagious) or even cancer. She also said that they still wanted to do a CT scan (1000RMB $KACHING$) to have a closer look. At that point I was loaded into a wheelchair, and taken to the CT scan room. I had not yet been given any medication, and I was violently coughing and hacking the whole way to the radiology department.

When it was my turn on the scanner, they got me up out of the chair and tried to get me down on the scanner platform. As soon as my back touched the platform, I began uncontrollably coughing and hacking. They told me to “stop doing that” and to lie completely still, because the procedure would only take “a few seconds”. After a couple of more unsuccessful attempts, they realized that there was no way that they would be able to get a decent scan, and they wheeled me back to my room.

About 30 minutes later, a doctor and a nurse came to administer an injection of some pain medication. The doctor told me that the reason they had taken me for the scan earlier was that the radiology department was due to make a shift change, and I was to be the last patient on their shift, and that the on-duty staff were anxious to finish up and go home. About 2 hours later, the pain medication took effect, and I was able to lie still enough for the scan to be completed.

The following morning, the doctor came to tell me that the CT scan had been inconclusive, but that didn’t matter because they knew what my problem was, and that they wanted to perform a minor surgical procedure to extract some of the “mass” from my chest cavity and analyze it to determine the cause of my problem. That sounded reasonable enough to me. I asked her when they wanted to do this, and she told me that they would do it early that afternoon. I waited. About 4:30 in the afternoon, two doctors wheeled me down to the obstetrics department for an ultrasound examination. They pushed me past the crowd of about 35 or 40 pregnant women, all of whom, I suspect, had been waiting there for hours. Needless to say, I received a lot of dirty looks as they took me into the examination room ahead of everyone else. After that interesting experience (again, 500RMB $KACHING$), I was taken back to my room where I waited another 2 hours. I should mention at this point that, while all of this was going on, even during the trip to and from the ultrasound examination, I was plugged into an IV drip.

Around 7:00pm a team of 4 doctors came to perform the draining procedure. The procedure itself was relatively painless. They sat me, backwards, in a high-backed wooden chair in my room. I was given an injection of a local anesthetic, and a long-needled, very large-barreled syringe was inserted into my back, and about ½ liter of a very foul-smelling, amber liquid was extracted from my chest cavity.

As each syringe was filled, the doctor would disconnect the barrel of the syringe from the needle (which remained in my back), and squirt its contents into a 1 liter, empty, glass IV bottle which was sitting on the floor about 1 meter away from her. A couple of times they reinserted and repositioned the needle. The only problem was, however, that only about ½ the contents of each syringe found its way into the bottle. The rest wound up all over the floor around the bottle. Remember, at this time, they had no idea what this foul-smelling amber liquid might contain! When the procedure was completed (about 30 minutes), they packed up their kit, wiped off the outside of the bottle, helped me back into my bed, and told me to be careful not to step in any of the fluid on the floor. They then hurried out of the room. The puddle of unknown, foul-smelling, amber liquid remained in place on the floor until the following morning when “ayi” came in and passed a wet mop over the affected area. Incidentally, the next day, as my IV needle was being changed, about a half dozen drops of blood spilled out of me onto the floor next to my bed. They were still there when I checked myself out of the hospital six or seven days later! So much for biohazard precautions!

Later that morning the doctor returned to tell me that they had diagnosed my illness. She had with her an English medical text with a description of my disease, its causes, and its recommended treatments highlighted for me to read. Apparently, my problem was a severe case of “Emphyric Pneumonia”, better known in layman’s terms as “walking pneumonia”. This is a disease which is caused by a bacterial or viral infection. Unlike “common” pneumonia, with this disease fluid collects outside the lungs within the chest cavity.

Apparently, I had contracted the disease 4 or 5 months earlier while I was in Zhongshan, but severe symptoms didn’t manifest themselves until about 6 days before I was admitted to the hospital. The recommended treatment was a rigorous regiment of powerful antibiotics, and if that didn’t work, the insertion of a chest tube for drainage as an alternate approach.

The doctor’s initial recommendation was that I begin the antibiotic treatment and continue the daily chest draining procedure. She warned me, however, that the antibiotics were very expensive, about 800RMB per dose, and that the treatment would take about 1 week. That all sounded pretty reasonable to me, so I consented to the treatments. The antibiotic treatments ($KACHING$) began within minutes, and the ultrasound and chest draining procedures ($KACHING$ $KACHING$) continued later that afternoon.

The treatments appeared to be working quite well, because with each passing day I was feeling better and better. My temperature had returned to normal, and the vast majority of the original pain was gone. The only problem I was having was being caused by the repeated deep punctures in my back from the drainage needle. Although the procedure itself was painless, once the local anesthetic wore off, I would experience some acute, deep pain in my back and chest for several hours each day. This, however, was neither particularly alarming nor unexpected.

On the fourth or fifth day of my treatment, a doctor (the one with the decent English who had showed me the medical book) came to tell me that the antibiotic and drainage treatments were not working and that they wanted to perform major surgery on me to complete the job. When I asked her what the surgery involved, she told me that they would open me up, separate (break) 4 of my ribs close to the spine, and manually clean out my chest cavity. My first reaction was WTF!!! I was feeling 1000% better than when I checked in. All of the pain, except that caused by the drainage procedure was gone, and my temperature had stabilized back to normal. Why take such a drastic course of treatment for a condition that was obviously rapidly improving?

When I asked how much all of this was going to cost, she told me that surgery would cost about 25,000RMB (BIG TIME $KACHING$), not including the post-operative care and treatment. She also told me that the “chief surgery professor” was going to examine me later in the day and they wanted to schedule the surgery for the following morning. I told her that I wanted to think about this for a bit and while I was thinking I wanted to continue with the existing treatments. At that point she became quite exacerbated, and told me that I was being very irresponsible and that I would probably be dead within a week if I didn’t have the surgery done immediately! I wasn’t convinced. I told her that I would give her an answer after a day or two more of treatment. She then stormed out of my room, obviously angry, and muttering in Cantonese. Later that afternoon she returned with the “chief surgery professor”. He opened my shirt, thumped on my chest with his fingers for no more than 15 seconds, nodded his head and said something in Cantonese to the doctor, and left my room. That, I assume, was my 30 second “pre-op examination”. The doctor told me that “The professor says that we must do this operation right away”. I told her again that I would give her a decision after two more days. Again, more anger and Cantonese muttering.

On the morning of what I think was my 7th day in hospital, I got a new roommate. He was an elderly (I guess early eighties) man, accompanied by his wife (a bit younger), and two of (I assume) his children. His son seemed to be the more attentive of the two; while his daughter seemed a bit annoyed by the whole hospital business, and spent most of her time there with an exasperated look on her face while she talked very loudly into her mobile phone.

Over the next thirty six hours or so there was a constant procession of visitors to the old man. I can only assume from their crude behavior that they were from somewhere “out in the villages”. Let me give you an example. One of the visitors, a “30ish” man, insisted on smoking in the room. Remember, we are on the pulmonary floor! He ignored my pleas not to do that. I would ring for the nurse. When the nurse would ask him not to smoke in the room (there was a smoking room at the end of the hall), he would angrily grind his cigarette out on the floor! He would wait for about 5 minutes after the nurse left, and then light up another one. I couldn’t leave the room because I was plugged into an IV all of this time. After repeated calls to the nurse’s station to complain, the nurses simply ignored my calls. The “smoker” was also a “spitter”. When he got the urge to spit, he would walk past my bed, open the window, and spit out of it! My room was on the 7th floor.

On the afternoon of the last full day of my hospital stay, the “smoking spitter” and his clan came into the room just in time for my daily chest drainage procedure. Apparently, Chinese hospitals have never heard of something called a “privacy screen”. I certainly never saw one through my entire stay. When the team of three doctors began the procedure, the “smoking spitter” and two or three of his clan were gawking over the doctors’ shoulders. I could hear them exclaiming “OOOOOOOOH!” “WOAAAAAAAAAAAH!” as the needle was inserted and the procedure progressed.

At about the time that the needle was fully inserted into my back, the “smoking spitter” lit up a cigarette, and the smoke made me start coughing; not exactly what one wants to do when there is a 3” needle perilously close to your lung! In response to my fit of coughing, one of the doctors told me angrily “DON’T COUGH LIKE THAT!” I then unleashed a stream of obscenities that would have curled the hair of even the saltiest of sailors. The procedure ended prematurely, and not a word was said to the “smoking spitter”.

Later that evening, my doctor came by to get my final word on the proposed surgery. I told her that, since I was feeling so much better than when I had been admitted, I had decided not to have the surgery at this time. I also told her that if I didn’t continue to improve, or if I had a relapse, that I would consider the surgery. She then told me that they had decided to lower the earlier quoted price of the surgery by about 6000 yuan. When I asked her how they were able to do that, she wasn’t very specific, but said that they would reduce the number of assigned nurses and move me from a semi-private room into a ward. Then she added, and I’m paraphrasing here, “But we can only guarantee this price if you agree to the surgery today.” That was all I needed to hear! I told her that I was not negotiating over this as I would over the price of a new kitchen appliance, and to please get my paperwork in order because I would be discharging myself from there in the morning.

In the 15 minutes or so that it took her to retrieve my X-rays, CT scan prints, and tally my bill, I received a call from my employer’s HR person who pleaded with me to consent to the surgery, especially since it was being offered at a “much better price”. When the doctor returned with my paperwork, she presented me with a release form to sign, and again repeated here warning that I would probably be dead within a week without the surgery.

At around 10:00 the following morning, as I was standing in the queue at the cashier’s desk waiting to collect the 2000 yuan or so from the positive balance of my account, I got another call from the HR person. This time she seemed to be really in a panic. She asked “Are you really going to check out of the hospital?” I replied in the affirmative. She then screamed into the phone “YOU CAN’T DO THAT! YOU CAN’T DO THAT!” I told her to calm down because I already had. This was on the morning of November 9, 2007. Six days later I was fired from my job for unspecified reasons. I’ll leave it up to you to put all of the pieces together.

If this is the “best” that Zhuhai has to offer in medical care, I would certainly hate to see what the “worst” is.