When you spend time living in a foreign country, as opposed to just passing through, you settle in. You find your restaurants, your grocery store, your bus routes. You have opportunities to experience the best and worst of local life and culture. Last week I had one such opportunity, and a rare one: an examination at a medical clinic in Changsha.
Despite the battery of tests my New York doctor had run to fill out the three pages of forms required for my teaching job, I was sent with the two other new foreign teachers, Paul from London and Nahoko from Kyushu, to have our health records examined and accepted in the provincial capital. It was the usual routine: no breakfast, only liquids. A driver picked us up and took us across a very smoggy gray landscape to the clinic.
Inside, our first stop was the main office, where the driver worked his way to the window with our paperwork. We were each photographed with a webcam, then given sheets of bar-coded labels and asked to verify that yes, our names were correct. The driver indicated that Paul and Nahoko should take seats while he escorted me through the process.
In America, a doctor will not so much as suggest you take an aspirin in public for fear of violating privacy laws; most procedures are done serially in the same private room. In Chinese medicine, the concept of privacy seems not to exist. Case in point: my first stop, phlebology. That means bloodwork, never my finest moment, involving as it does needles and blood. Scare stories about the Chinese using recycled needles didn’t help. AIDS prevention posters on the walls made me roll my eyes, since getting stuck with a questionable needle here could be my best shot at contracting H.I.V. Behind a window, a technician determined that, yes, I was the person in the picture, and then asked publicly in English – not that anyone else could understand – “You have period?” I waited behind a couple of patients until they vacated the low stools in front of the windows and followed the drill, sticking my left arm through the window for a swab of disinfectant my elbow. Two tubes of blood were drawn. Instead of a Band-Aid, I was given a long-stemmed Q-Tip to stanch any blood flow.
The driver motioned me down the hall to the next stop: urine samples. He handed me a lidless plastic cup and pointed me toward the women’s restroom – a single, Asian-style. Imagine being a middle-aged woman with a disc problem and balance dicey at best, using a squat toilet and trying to touch absolutely nothing in the room. Now imagine adding the cup. When I finished, I carried the cup around the corner to deliver it to the window, praying no one would bump into me – remember, it had no lid — then returned to the sink to wash my hands, thoroughly.
In the chest X-ray room, anyone waiting in line could watch through a square window. Luckily, the X-ray involved no undressing or flimsy paper robe; I was pointed to stand on two yellow footprints on the machine and told – more accurately, shown — how to position my torso, with hands on hips. The technician gave me another direction that I didn’t understand. Weren’t my hands already on my hips? Did he want me to stand closer? Finally I understood that he wanted me curve my back and touch my shoulders to the machine in front of me. A flip of the switch, and on to the next station, the electrocardiogram.
Here the assembly-line nature of the exam really kicked in. This queue of mostly men moved more slowly than the others. The curtain didn’t seem to move as male patients went in and out, but was drawn firmly when a woman went in. At two chairs at the front of the line, men removed their shoes and socks. So did I when my turn came, and from chair level I couldn’t help noticing that someone hadn’t washed his feet that day. I’ve never had to take off footwear for an EKG before, but then, I’ve never before arrived in the examining room for one fully dressed, either. When my turn came, the curtain was again drawn, and I pulled my black turtleneck over my head, lay back and thought of England as the technician clamped my arm, my chest, my ankle. Routine.
The last station was most mysterious, and the wait the most irritating. “B. type,” the sign over the door said. Did this mean another sticking? Couldn’t they figure out my blood type from the two vials already taken? Did it maybe mean body type – would I be pinched with calipers and labeled an overfed, overweight Westerner? For most of the 20 minutes I spent standing in a snaky line, I couldn’t glimpse what was happening on the other side of the wall. People emerged wiping something off their midsections, and those waiting were shooed away from watching the procedure. When I neared the front, I could see the feet of a body lying down, feet turning from center to left to right and bending as the patient changed position. Good God, could this be a rectal? But no. When I lay down, the technician – who was startled to find a foreigner in her cubicle – indicated I should pull up my sweater. She rubbed gel on my stomach and sides, then starting moving something over my skin. An ultrasound? As I rolled from right to left, I couldn’t help asking: “Do you speak English?”
“What is this test?”
She scanned her memory for the word: “Lee-ver.” When she finished, she handed me a paper towel and I, too, wiped my middle clean.
The driver, who had looked in a few times to check that I was still in line, led me back to the main hall, where he insisted on giving me a milk box and two wrapped cakes. Paul and Nahoko were waiting. “How did you both get out before me when I went first?” I asked.
“We didn’t do a thing,” Paul said. “Just sat here.”
“Only you,” Nahoko added.
It’s still not entirely clear why I was singled out, except that perhaps I’d been expected to bring my actual test results – the EKG graphs and the actual chest X-rays – to China along with the forms my doctor signed. In a land where you don’t speak the language, you don’t ask questions like that, or expect answers if you do. You do as you’re told and consider it part of the adventure.