There are two rounds of medical care in China: allopathic, or western medicine, and Traditional Chinese Medicine. Which do you think I go for?
Around three months ago I was overtaken with an odd sort of illness. The symptoms were along the lines of too many different ailments to provide any clear direction towards alleviation. Some of the main candidates were mycotoxin poisoning, candida overgrowth, diabetes, allergies, various glad problems — take your pick, they all have just about the same signs and symptoms. So it was nearly impossible to pinpoint what was causing the problem, and the effects were rather debilitating — dizziness, extremely foggy headed. But going to a doctor seemed to be a ridiculous option, as I’ve learned from experience that going in with such vague symptoms that can’t be shown, felt, or heard is an invitation for a lot of tests that ultimately go nowhere. And if it doesn’t come out in a test or on an x-ray it doesn’t exist as far as alopathic medicine is concerned. I had the advantage of having a similar problem before — in 2006 in India — and therefore had strong suspicions that my problem would be scientifically unprovable — the ultimate pratfall of modern medicine.
So I tried to remedy myself the usual way: I went traveling and ignored it. I did a three week loop up from Xiamen to Shanghai, Jiangsu province, and back, I met with urban designers, authors, a family resisting forced eviction, a new city built just for medical research, and my academic adviser from my university days. The fast travel and intense work made me feel better, and I forgot about the problem. But upon returning to Xiamen the illness returned. I moved my family out of our apartment, thinking that it could have been an environmental issue (toxic mold?), and into a new place right on the coast. I started feeling a little better, but the problem would return in intermittent, thick waves. To assuage the urging of my wife, I went to a doctor.
I went to the normal public hospital in Xiamen, sat before a doctor and baited her with model diabetes symptoms — figuring I could at least check this off the list — but she didn’t flinch. Funny, diabetes is epidemic in China. I continued explaining text book symptoms of mycotoxin poisoning, thyroid dysfunction, and adrenal fatigue, but there were no glimmers of recognition on her face. Instead, without ordering a single test or examining me in any way, she informed me that my problem wasn’t as bad as I thought it was. She started writing out a prescription for dizziness medication. So I yelled at her. I was given my money back and rushed out of the hospital.
There is perhaps no understatement that can hit as low as the quality of medical care in China. It’s not really a matter of not having access to modern technology or education as it is something more onerous and frightening: general practitioners are not paid shit, and they tend to do work that’s equal to their pay. Brash mistakes and idiot errors are incredibly common, and without little red envelopes passed over to doctors like handshakes it’s difficult to get anywhere. China has good doctors, but they are not generally for the rabble. For them, there is another option: Traditional Chinese Medicine (TCM).
During the Cultural Revolution, where most vestiges of China’s ancient traditions — Old Customs, Old Culture, Old Habits, and Old Ideas — were systematically persecuted, but the one Old that not even Mao dared to touch was TCM. In fact, during this insane period of rampant culturecide, murder, and disorder, TCM, one of the oldest Chinese practices of all, flourished. This was because it works (and wasn’t replaceable at the time). So rather than destroying TCM the Chinese built it further, and some of its biggest recent developments happened during this time period when everything else in the country was getting torn apart.
A row of taxis lined up outside of the Xiamen TCM hospital. People were rushing in and out, families huddled together blocking the doorway, and posses of men dressed in urban tricolor — black, dark blue, and grey — were smoking cigarettes in circles. The hospital was large, had inpatient and outpatient wards, and appeared completely modern. It looked like a typical medical facility, no different than those anywhere else in the world. It had big, block-like, off-white buildings, big double doors at the main entrance that opened upon a crescent shaped driveway, and if you couldn’t read the characters on the sign that said “Zhong Yi Yuan” nothing would have indicated that that canon of medicine being practiced inside was over 2,000 years old.
I knew what I was in for when I entered the hospital, as I was once a TCM student at Zhejiang University. I suppose my ambition then was to be a doctor, though I could not reconcile the years of studying with the itinerant life, and, as it turned out, TCM was just an intrigue of travel, not something that would ground me. This became clear one morning when I booted up, picked up my backpack, and went to Mongolia. I never found a reason to crack open the Inner Canon of the Yellow Emperor again. Though when I find myself ill in China, I have no fear of the doctor who’s going to feel my pulse, look at my tongue, and ask me what my crap looks like.
The standard medical practice in modern China is to go to an allopathic doctor first, and if they can’t fix the problem go to the TCM hospital. This process is not to degrade the traditional style of medical care, as even its practitioners will recommend this protocol in order to ax ailments that are better treated with pills, surgery, and castes. Western medicine hits hard, it’s quick, and extremely effective for more acute forms of illness or injury, but the methodology fails short when dealing with chronic conditions that don’t necessarily show up in blood tests.
The Chinese tend to be disparagingly skeptical when it comes to their country’s medical care, and many don’t seem to have much faith in either system. Many modern Chinese are not hesitant to say that TCM doesn’t work, but they will also warn you that the medicine you get from allopathic doctors are often fake. But when they get sick, many use them both.
I followed the nurse in the pink gown and pointy cornered pink hat up an escalator, down a low lit corridor, and around a corner to the front of a little enclosed booth that was set up off to the side of the hallway. There were indications that this was a place where patients are routinely stonewalled with long waits — a procession of petty vandals had completely gratified the outside of the booth as far as the string attaching the complimentary pen to the window would allow them to stretch. But I knew that I would not need such patience: I’m a foreigner, and people like me are rushed through Chinese hospitals as fast as possible. I’m unsure if this is a complimentary service for us foreign guests or if they think we’re bumblers who would get confused and cog up their tightly running system if left to our own devices. I don’t play the proud role of the old China hand here, as I know that the Chinese quagmire is never more labyrinthine than in bureaucratic institutions like hospitals. So I stumble in like Joe Dumbass, and hang out around the information desk until some young nurse appears to guide me through the mire.
My liaison to the Ximen TCM hospital was named Jing Jin, and she spoke less English that I do Chinese, but language barriers are the least of a patient’s difficulties when navigating through these places. When seen from the ground, Chinese hospitals appear chaotic, but when you tick back the resolution you can see an order within the entropy that’s not unlike looking at a cross section of a bee colony. Everything in Chinese hospitals has an order . . . for those who understand it.
Everything at this TCM hospital was electronic. You write your name and phone number on a form and you are entered into the computer system, and are given a card with a microchip that you will used for everything from that moment on out. Jing Jin handed me my card and led me over to a machine that looked like an ATM. I fed in my card, told her what my ailments where, and she selected what department I needed to see a doctor in. She then told me to feed 100 RMB into the machine, which was credited to my account, and a receipt telling us what ward and what doctor to go to was printed out.
I was then lead in to see a doctor. He took my card and fed it into a reader that was connected to his desktop, and payment was automatically deducted for the consultation. I told him what was wrong, and he immediately said, “Diabetes” and sent me to go get blood work. I scurried behind the rapidly walking Jing Jin back to the payment machine. She fed in my card, selected the type of bloodwork I needed, and the cost was automatically deducted. Again, a receipt was printed out telling us where to go for the test.
The results were provided immediately after having my finger pricked. Normal. So we returned to the doctor. My card was again fed into his computer, and we began the examination. He looked at my tongue, felt my pulse, talked about my crap — the TCM norm. I knew the terrain here, I even came equipped with a photo of my morning’s bowel movement out of fear that I may not quite know how to deliver an adequate description in Chinese, which the doctor enthusiastically inspected. Then I was knocked off the boat:
“Is your urine hot?” he asked me.
I looked at Jing Jin. She thought I misunderstood, so she typed the question into the translator app on her phone. She turned the screen to me, it said, “Is your urine hot?”
“I don’t know,” I responded, not quite understanding what would constitute hot urine. Not good enough.
The doctor then tried to clarify his question. “Is your urine very hot?”
Responding that I’d never taken its temperature before obviously wouldn’t work here, so I replied off the cuff, “Yes, sure, it’s very hot.”
He nodded, then began typing out a prescription on his computer. I watched as he put strings of characters for various herbs followed by numeric values in grams into a two row spreadsheet. After a few moments he pushed a button and the information was automatically sent to my card.
Jing Jin then scampered off with me struggling to keep pace to the pharmacy, where I loaded my card into a similar ATM style machine and sent over my order, the cost, of course, being electronically deducted. 10 minutes later I was given six big bags that were crammed full of bark pieces, roots, twigs, white crystalline minerals, nuts, seeds, cocoons, husks, and dried leaves, and told to mix and boil the contents of each bag and drink the soup twice daily. Jing Jin then dropped me off at the door, said goodbye, and scampered off.
I was rushed through this hospital so quickly that there was no time for poking around, chatting, or figuring out what was really going on. Though it was clear that the people receiving treatment were the same social mix that you would find at any other plebeian hospital throughout the country. Makeup caked young women in tight fitting pleather skirts and ruffled bright blue sweaters were vying for places in front of the doctors with migrant workers with uncombed hair, dust gunk caked pants, and torn jackets. Old women in puffy quilted jackets and matching trousers sat next to shopping mall-attired mothers with babies. There was no discernible demographic that dominated, chosing TCM over Western medicine; the people there were not all elderly or rustic or underclass — it was just the normal mix of modern China.
TCM isn’t an example of some intangible relic on display in China’s cultural zoo (like it’s “colorful” minorities) but a practice that is almost as normal now as it was a thousand years ago. TCM is old, but it’s not archaic or outdated — it’s an ancient practice presented in a modern context. Even in eastern cities like Shanghai, Hangzhou, and Xiamen — China’s cutting edge of urbanization — there are many TCM hospitals, not to mention herb shops and traditional pharmacies. Allopathic and traditional medicine are not adversaries or competitors in China, as they are in the West, but are simply two wings of a medical system that performs for a culture which is accustom to the ancient and the modern functioning seamlessly side by side. Though I have to admit that it’s slightly temporally disorienting to go into a modern and technologically sophisticated medical facility and be proscribed bags of sticks and roots — but that’s the story of modern China.
Yes, the herbs worked.