China 6- last bits and pieces

On my second to last night in Hangzhou a crew from CCTV (Chinese Central TV) showed up in our hostel. They asked a friend of mine, Yuping, and I to do a small spot for them the next day as part of a cultural heritage thing they are doing for Beijing 2008. I had to skip a shift of mine at the hospital, but they took us out to this swanky place in the mountains and shot 3 small scenes of me, the foreigner, and my friend Yuping, the translator, discovering the wonders of Chinese culture--it was pretty cheesy/phony. But it was really fun. Yuping and I had to make up our own lines--I don't know if they'll actually use the audio. And they paid me 200RMB/$25. They said it is going to be broadcast internationally before the next Olympics, so we'll see!

That night, Yuping threw me a little going away party. Hanging out with some friends and the staff I'd lived with for the past couple weeks was great. But I got so sloshed my morning departure to Ningbo was none too fun.

Taking a train ride here you can not only take in a lot scenery, but you can get a pretty good glimpse at where people live and work. Train rides also afford you a sufficient sample of the land to see that buildings--apartment projects, bridges, roads, etc.--are rising from the ground like mushrooms in fall: ubiquitously and quickly. Furthermore, it seems to me that China's infrastructure is superior to that of America. From the modern roads and highways (that all have seperate lanes for bikes/slower vehicles and street signals more advanced than ours), waterways, bridges, overpasses/underpasses, to the extensive rail system, China has invested heavily in its public transportation system--at what cost to individual wealth I do not know...

(hard to capture on camera)



Spent a few nights in a city to the east of Hangzhou, called Ningbo. I quite liked it. I found a $3/night hostel and made friends with a girl who worked there. She helped me find some of the more intertesting places and plenty of back roads to keep me happy. I much prefer the backstreets to the main streets--which are the same in most cities across the world, methinks.

I'm gonna miss how they speak and use the words 'jigga' and 'nigga'-- this/this one and that/that one. They use the word nigga like we use 'um' or 'like', saying it all the time and it cracks me up: ''nigga niggaaa, nigga niggaaa....;" their verbal buffer.

Finally figured out a reliable way to get what i wanted at restaurants: I would just go to a market and buy the vegetables I wanted, bring them to a small restaurant place and say 'stir fry noodles/rice with this' (chao mien tiao er jigga). I realized this only after a friend of mine bought me a few heads of broccoli after i told her i liked it but could not find much of it in restaurants; and of course i wasn't going to cook it myself when i could get someone else to for a 75 cent meal.

I made a day trip to an island near Ningbo, called Putuo Shan, that had been recommended to me by a couple sources . What was apparently an island of religious recluse, has become a tourist site/trap more geared to commerce than communion. For 8 hours travel (taxi, bus, boat and reverse) and 300RMB/$40, I'm not sure it was worth it.



Got one more ($3) massage--that I just have to mention. It was more like acrobatics than a massage, really. This little girl, maybe 5'4 130lbs, had me in the wildest positions: contorted around her, above her, hanging off her over the side of the table. It didn't exactly feel all that relaxing by massage standards, but, then again, I was moaning and laughing half the time.

Lastly, I spent a couple nights in Shanghai. Fortunately I had a contact with whom I could crash, for Shanghai is a long ways away from the cheap China we reflexivly think of. With over 20 million people, and the traffic/buildings/noise to prove it, I, again, reaffirmed my distate for large cities.

Nevertheless, only just getting out and about, I have not been able to escape the friendliness and generosity that the Chinese people have extended me. From sharing conversation and food in small restaurants to people chatting me up and taking me with them for tea, the Chinese people have impressed me.
I've had a great time in China and could easily come back some day.

China 5--in the Hospital

Most of my time here in Hangzhou has been spent in the Zhejiang Provincial Hospital of Traditional Chinese Medicine (TCM), so I thought it worth a post of its own.
I do two 4 hour sessions a day. Mostly in the acupuncture outpatient department and specialty herbal departments, but also the Tuina (Chinese massage) department and in the inpatient wards (doing rounds in different parts of the hospital).

Acupuncture
In the acupuncture clinic there are 19 cubicle beds and 10 chairs. They are often mostly, if not completely, full for the better part of each 4 hour shift. 3-4 acupuncturists work at a time with student assistants. There are very few records kept (as far as I can tell), pretty much just the patient cards in which dates of treatment are recorded.

Tools:
-they use only free hand, disposable needles. Needles are sometimes disposed of in plastic disposal containers; just as often in trash cans or trash bags; and there a many needles scattered about the floor.

They use moxa rolls extensivly. the place is well ventilated when it's warm, far less so when it's cold and the windows have to be closed; in which case it is quite smoky. (I have heard that some of the former doctors here have died of lung disease--a testament to how toxic moxa smoke is.) For the moxa rolls they have this cool 8 pronged pitch fork to light and hold the rolls.

-they also have this nifty device to press out moxa cones that they then put on an herbal cake (of Bi syndrome herbs) to put on the skin.

-all of the Electro Acupuncture machines are without clips; just loose wire endings.

-they use a 'thick needle' of 80-120mm that they use to thread down the spine, often for neurological and dermatological conditions. I had it done on me just to see what it was like. I am usually not sensitive to needles, but I became faint and a little nauseous with this one.


Injections:
they do a lot of injections here.
-B12: often at ST36 to build immunity or sometimes SJ17 (in the hole behind your ear--ouch!) for paralysis, tinnitus, deafness. I even saw them do it on ST3 (on the face) for paralysis.
-Dan Shen/Salvia: locally for pain
-one's own blood: drawn from the cubital crease and injected at e.g. ST36, also for immunity and allergic diseases. I'm told it's an antiquated technique from Western Medicine.
-and others.

Techniques:
-Needle insertion: they insert very quickly free-hand, often many points in quick succession--abdomen and face especially, but you see very few winces here.
-Needling: They are also more aggressive than we tend to be--to confirm what we had always heard. I've seen them needle very deeply, lifting/thrusting GV15 (back of neck), CV23 (front of throat), and BL40 (behind the knee). Saw jinjin and yuye (under the tongue) pricked on a guy with aphasia, every GV (spinal) point needled with EA on almost every point, a 2 year needled as his father restrained him while he was crying in an opisthotonic spasm, and a lumbar puncture (by a Western doctor) that would dispel any acupuncture student's fear of needling a point on the GV meridian.
-Abdominal/turtle Acupuncture: they do a lot of abdominal acupuncture. somewhat new a style, it is a microsystem on the abdomen in the shape of a turtle. Many of them swear by it and patients often say they get better immediatly.
-Moxa- not as much direct moxa as i expected, although I've seen it done for plantar warts a few times--in which the patient comes in a just does it themselves. But they do a hell of a lot of the rolled moxa--great, but very smokey.

-Gua Sha- I have not seen it done once.
-Cupping- done a lot. Washing them is done like an afterthought--not much.
-Blood letting- haven't seen it done.
-Catgut implantations- where they insert an acupuncture needle through a hypodermic needle to implant a small piece of catgut (what is used for internal sutures) under the skin in order to stimulate a point for 4-6 days (they say). Only saw it done on the abdomen for weight loss, but could be used for anything really.

Prices: $1=7.5RMB
-needles- 20RMB
-cupping- 3RMB
-EA- 3RMB/pair
-moxa: 5RMB....etc
-total would come to about US$5
----strange scheme if you ask me. But it is pretty damn cheap. The government pays for much of the hospital expenses; for, with prices like that, more money has got to come from somewhere.

Dr. Xuan, the head of the acupuncture department, sees the most people. I have followed her as she saw about 25 people in less than 40 minutes for the first round, 15 on the second, maybe 10 scattered patients after that in a 4 hour shift. She just walks around the room, somehow knowing who is where, walks up to a patient, somehow remembers what's going on with them--for she sometimes barely says a word to them, and starts inserting needles--quickly. That she often does this very popular abdominal acupuncture helps her move so quickly. She often sees people 3times/week, so there need not be much discussion beyond the repetition of the treatment.

Dr. Xuan is what they call a national level doctor. The top level (above the provincial doctor and what more i don't know), she is paid more than other doctors but I'm not quite sure how they attain such status. She taught us a class on abdominal acupuncture, I think I might use some of it myself, in combination with what I already knew.

The acupuncture clinic is mayhem by US standards. There are up to 40-50 people in there at one time. Most people are getting treated, then there are those accompanying, the doctors and the students/assistants. A big open room with many dividers (just low enough for me to peak over) and chairs, it is like a community acupuncture sorta setting.

People come, hang about, get treated, talk with those around them, read the paper...Acupuncture, It's no big deal here.



(hard to see, but she's fanning the moxa smoke)

Herbal Medicine

The specialty clinics (internal medicine, endocrinology, rheumatology, etc) in which doctors use mostly herbal medicine (it's a TCM hospital), but also some Western medicine, are fantastic places to gain clinical experience as a student. The conditions here in which students observe doctors is extremely educational. There are many many patients presenting different variations of conditions, the doctors often stop to explain or point out something or give their diagnosis, and the students get to see what the doctor prescribes/recommends. Far better than what we have, it does not compare. Of course we have no such hospital nor do we study Western medicine as extensivly as they do; much of their time is spent figuring out the Western diagnosis--looking at lab results, medical imaging, or doing a pelvic exam, for example.

The students here seem to be very well educated--in both Chinese and Western medicine. The english vocabulary, for instance, coming out of their mouths often startled me--thymectomy, gastroptosis, lassitude....it's just their grammer and pronunciation that can sometimes leave you stumped.

I spent a lot of time with Dr. Lu, another national level doctor, seeing patients with rheumatic conditions, which he would diagnose within seconds. I learned a lot shadowing him.

In general, the doctors here, like a teacher of mine in Boston, BJ Wang, prescribe at least 12 to 15 herbs at a time, more often 15 to 20+. The vast majority is raw herbs, some patents, very little powder, and also Western Medicine. The two forms of medicine are idealy integrated in these clinics. The doctors order and assess lab work and medical images, ask questions of both forms of medicine and prescribe either as they see fit.

By the way, it was amazing how often patients would leave the doctors office with a referrel for some blood work, CT, X-ray, whatever and return within the hour for the doctor to look at it and then prescribe something. I have not done it myself, but I think such things would take days, if not weeks, to do in the US. And there are no appointments here: they just show up and get in line. How it so cheap, though, I can't figure out. An ultrasound, for example, was about US$10, a Dr. told us.

And the bike parking lot in the basement was quite a sight. I thought there were a lot of bikes in Holland!

China 4--around Hangzhou

So a bit of what I have been doing around Hangzhou.

There are blind massage guys here in China, one below, and for $5/hour... I've gone for a few. Although not as often as some Brits who I was living near--who got 2 a day!


I got foot massage today, divine. They lay you out in this ultra cozy reclining chair, soak your feet in hot water, wrap one foot in a towel like a mummy to keep it warm while they go at it on the other. With King Britt- "Deep and Sexy" set flowing through my head, i was in heaven. afterwards, i noticed they had glass suction cups and a gua sha blade, so i asked for some of both. After scraping my entire back, he slid a large fire cup up and down my paraspinal muscles--my favorite. and to top it off, he put on 10 stationary fire cups all the way up my back, so strong i thought my skin was going to be sucked off my back! Apparently he thought the same as he kept saying "oh my god! oh my god!" Good thing i knew what was going on. Strongest cupping I've ever had. The kid didn't really know what he was doing; it was too much.


I moved into a youth hostel a couple days ago, not because the YHA was cheaper ($7 vs 12) but because I didn't like the luxury of what was like a hotel room I was given by the hospital. Besides, there are more people here, mostly Chinese, to hang out with after the hospital. It's a bit out of the city, in a more quiet woodsy section of town with a little farm next door. Kinda cool.

It's funny, in China they spit (and i mean really hok loogies) everywhere (inside and out) like it's there civic duty. And the only thing cleaning up the streets are these trucks that drive around all day, everyday spraying two streams of water out the back and plyaing ad noseum an ever-lasting loop this 15 second long hyper-patriotic tune--the kind that really gets stuck in your head.

Went up to an ancient Buddhist temple in the mountains, called the Lingyin temple. It was really cool. In the surrounding mountains there are heaps of caves/rock faces in which hundreds/thousands of years ago people carved out Bhuddhist images. Both kinda spooky and really interesting.




The original temple dates back to 326AD, since updated of course. It was a really special place, I reckon--in a lush mountain side with sculptures, large statues, and pools around. I happened to have rocked up when the resident monks were chanting/drumming in the main temple. Not that we haven't all heard it before, but in person, in their element, it is something special.

I also went for a walk around Hangzhou's West Lake--what really distinguishes Hangzhou in China--with some Chinese friends I've made. It is quite beautiful.

Much of what would otherwise be the natural attractions of China are often helped out with man made additions. Around the Westlake are stone walkways, gardens, bridges and speakers playing relaxing music. In Wushan park just near me there are caged brids hanging from the trees/on the walls to ensure the forest is filled with the sound of birds.

On the West lake they also have a colored fountain like that of Barcelona. While it doesn't quite stack up to the "Magic fountain of Montjuc" in Barcelona, the one here is still pretty damn neat. The water jets are in sync with the music they play, moving in different patterns and pulsating so that each jet of water splashes down on itself in time with the beat... Pretty nifty. I reckon we should build one in Boston; on the Charles somewhere...I think I'll have word with Menino when I get back.

Like other third world coutries I've been too (although Hanghzhou looks far from 3rd world), I have been getting the celebrity treatment by the public, especially at tourist sites (where throngs of Chinese tourists go), where everyone says hello to me, takes a picture of me and occasionaly wants a photo with me. Kind of annoying at first, but if you just play along it can be kinda fun.

Some other memorable sights include parents squating down facing the street while they hold their babies/young chidlren's knees to chest so it can piss/s#*t into the street. Baby clothes have built in evacuation slits/holes in the crotch so that parents don't need to take any clothes off, just spread the legs and point. Better still, at the Hangzhou train station, there were no doors to the bathrooms and some of the stalls didn't have doors or people just didn't even bother to close them so that one could see right in from the hallway people's asses as they squated over the holes in the ground and did their business....sorry no pics these. :)

On a brighter note, I was walking with a chick through a park at night and we came across a little plaza/circle in the park in which there was a stereo playing hokie music to which about 60 people in their 40-60's were dancing. Neither of us could really ballroom dance, but we gave it a whirl anyway; one (older, single) lady was nice enough remind us, though, that "you guys stink".

China 3--food

On this crowded pedestrian way you can get all sorts of food, in all sorts of forms.

Most of which comes dried

or cooked...

but all of which smelled pretty heinous.

All around town are restaurants like this, my local. There all pretty much the same. $1-3/meal.

As I've said before, ordering food is no easy task. The places without pictures on the wall often have these sorta menus, where, as an illiterate foreigner, it's pick your price!

These are something of my staples...

And the 30 cent 1/2 liter beers are nice too...

At this place, where by now i've made friends, i tried to order a dish of tofu, vegetables and rice. which i know as "dofu, shutsei, er mee fan". the frist time i said it, i got the above. not bad, but i didn't get any vegetables nor was it prepared as a dish as i had hoped. the next time i got all three, still prepared seperatly. so i tried to ask for 'shutsei, shutsei, shutsei, dofu, meefan' rolling my hands over eachother trying to demonstrate that i wanted them made together. i resorted to going into the kitchen and pointing to few vegetables to prove my point, but ended up with 5 dishes--tofu, rice, and three differente vegies in different plates.... I threw i tall together and showed them that's how i wanted it--as one dish.

Not willing to put up another fight where I was basically trying to tell them what and how to cook--which I did not want to do--the last time I showed up willing to eat whatever they would give me for 10RMB. They threw all the ingredients I had the last time into a dysjointed concoction of the ingredients preperad differently and slopped together into a big bowl. It was edible, but a sign that I should try another approach...

So when I returned to the same place a couple nights later (I liked the deaf/mute guy there) I tried pointing to the food of other people eating there. I pointed to what I thought was a tofu dish, a chicken dish, and a bok choy dish. What I got was a dish of bok choy, pork (with bones of course) and a dish of intestines (not tofu skin, as i thought it was)...blah!

I love how they roll out the noodles right in front of you, stringing 'em up into small strands by hand and throwing them right through the window, outside into an awaiting boiling pot.

A little restaurant near the hospital where you choose your own soup contents... Yes those are brains on the bottom left corner. I don't think I'd dare. This is an easier option to get what I want, except that they dunk everyone's stuff in the same big pot of broth, mixin all the juices...

I rode my bike and crossed over the Qiantangjiang bridge to the other side of the Hangzhou. Saw some of the barges moving the hoards of materials they use to carry out the immense amount of construction going on here. The barges were so full of materials they were submerged so that water was almost pouring in. I would have taken a photo, but, on a bike, I had to ride on the side walk part of the bridge where there were crowds of people on bikes and scooters, so I couldn't stop lest I have everyone behind crash into me. On the otherside, where new buildings are growing like flowers in spring, I visited a translator/friend of mine at the Zhejiang University. Here in the cafteria,

I had a hard time getting down my first taste of prawns. They don't exactly clean up 'em for ya like I've seen in the west. Head, legs, tail and all, creepy little things.

The local fruit shop.

Notice that all the bulbs are long life flourscents. They are the norm, as is energy efficiency everywhere. All the glitzy lights on buildings and pagodas are turned off after 10 or so. While there are many people and they certainly do consume a lot of energy, I think they are more conscious of their consumption than we in the states.

A fruit whose name I don't know and which I wouldn't care to try again--more looks than taste, this one.

This is the big shopping place nearby-- the Walmartization of China.


With everything from eletronics to sporting goods to food, it looks a lot like a store you'd see in America--but a bit different:
Fish and other meats in some petrified form.

Thankfully I haven't yet gotten sick. The food is pretty good. Hard to get anything without meat in it--one reason I have conceded my vegetarianism for the trip. Vegetable and even tofu dishes come with meat. Especially because I've eaten little meat in my life, I often don't know what meat I'm eating--often pork, I think, hopefully no non-farm animals....

p.s.- I've finally been able to get the video i wanted of a guy playing the 'hong' in barcelona, check out that blog to have a look/listen.

China 2

My first week in Hangzhou went quite well.
In the hospital,

we do 2 rotations a day, observing in one of the departments around the hospital: e.g. the outpatient acupuncture clinic, the inpatient acupuncture clinic, and herbal clinics in which doctors see people under specialties--Bi syndrome, respiratory, diabetes, endocrine, etc.
The treatment conditions here are very different to say the least. The outpatient clinic makes a joke of OSHA and the privacy many take for granted in our medical system. People line up at the door before it opens and then flood in looking to get one of the beds.

Acupuncture is no big deal. People sit around in chairs with needles in, moxa rolls going, heat lamps ablaize, talking to each other or reading the paper. People listen in on and observe others' treatment all the time.

It is so nonchalant that one time an older guy who was obviously a regular walks over to a doc doing a treatment and says something to the effect of--'come on treat me now', to which the dr. replies 'OH go sit down, I'll get to you soon enough!', as though no big deal.
Treatments can be real fast. I shadowed the head of the dept. who saw easily 20 people in 30 minutes, then did 2 more rounds of that before the shift was through. They do a lot of what they call abdominal acupuncture or turtle acupuncture here. What is said to be a microsystem on the abdomen that can treat diseases of the whole body. They say they get great results with it.
So far paralysis is quite common--maybe %50. To confirm what we hear in the states, they do quite aggressive needling, all free hand, mostly tolerated well by patients--although they definitely do wince at times. (pics to come later)
For herbal clinic, I've been following who is supposed to be a famous, national level herbal Dr. He specializes in rheumatic diseases, although people come to him for other stuff too. During the 8-12pm shift, there is pretty much constantly a crowd of people pushed up next to his desk, waiting in line, listening in and watching what's going on. They are so very much there that one time when the doc was repeating to a patient that he must take his insulin, an onlooker yells something to the effect of "listen to the Dr, take your insulin, let's go!".


A translator I had for Bi syndrome/rhuematology herbal clinic took a few of us to the mountains of Hangzhou. quite nice. They do real well to keep things up here in Hangzhou--one of the more tourist friendly places in china.
West lake tea terraces

A sculpture depicting the story of the two tigers who brought the monk to the spring. Now a site for sacred water called the 'tiger spring'.

Went to the TCM Museum here in Hangzhou. Was mostly herbal focused, with a room of a thousand samples, recounting the origin and development of herbal medicine in china. Interesting, but I was hoping for something on acupuncture.
In the herbal dispensary/shop at the front of the museum was this 200,000RMB (apx 23,000$US) ginseng. Far more expensive than any potential therapeutic value I reckon.

Be forewarned!

Some grinders for making powder. Looks like they could have doubled as a prostration device.