Author: Ruonan Chen, a PhD Candidate at the School of Archaeology and Anthropology at the Australian National University. She is currently doing her fieldwork around hospitals and healing practices in the Tibet Autonomous Region.
Well. I am hospitalized while I am typing this, waiting to be treated for cervical vertebral disease which is causing a daily numbing sensation in both hands. The wait time in the hospital provides me with a perfect chance to do autoethnography—to observe how I, as a patient, experience the medical system. I find that waiting is one of the main themes in my hospitalizing experience. The medical system dehumanizes me by means of turning me into a bed number and I have to take concrete actions to be human again while waiting in the system.
I must admit that I have paid very little attention to my body throughout my life. I have moved around between 6 cities over 3 continents in the past 10 years after graduating from university. I abuse my body. In a sense, it is young, rough, and tough. A young and well-functioning body can do a lot of things: climb, dance, cycle, swim, jog, drink, and even regularly sit in front of a desk writing for over 10 hours (as driven by deadlines).
Yet slowly but surely, I feel the dis-ease, an endurable but ever-present uncomfortable sensation, a quasi-disease. Tension in my right shoulder, being woken up by numbness spreading to both hands in the morning, problems with my hips, knees struggling to squat. When a body part suddenly is “visible” to your senses, you know something is wrong. Chronic disease tortures me. “Kill you gently” I hear it whisper to me. Time is a bitch, asking you to pay it back eventually.
I tried modern medicine when I visited Shenzhen, a booming city in China, in 2019 and was diagnosed with peripheral neuritis.
“Take pills and change your lifestyle,” the doctors told me.
I went back to Tibet with a couple bottles of methylcobalamin (a nerve nutrition drug) and vitamin B1 in my suitcase. I tried Tibetan medicine while living in a county-level Tibetan-medicine hospital for two years during my research. Medical images showed that I had cervical vertebral issues, not severe, but causing daily discomfort. The physiotherapy department became my favorite spot. The paramedics in the department became good friends of mine. Acupuncture, external burning salt bag treatment, massage, infrared therapy—I tried them all.
The dis-ease comes and goes.
I also tried traditional Chinese medicine. I moved to Shenzhen at the beginning of this year. I visited sports physiotherapy clinics from time to time. Massage to relax muscles, Chinese medical dressings, ultrashort wave electrotherapy, electroacupuncture, Chinese steam medicine treatment—I tried all of these. I can’t tell how much these treatments worked because I just don’t know. They all relieved my dis-ease somewhat from time to time, but it didn’t last long. My body has been worn down by my misuse (I had a lot of fun during that misuse though) and by the endless flow of time .
I turned to modern medicine once again. The biggest reason is that I have started to pay for my health insurance. I should have access to the Chinese national service, but because of my precarious lifestyle, I never paid attention to how to pay for it until this year (another sign of becoming a grown-up).
I am now hospitalized in the Pain Treatment Center after visiting the Anesthesia Pain Clinic in a leading hospital in Shenzhen. I told the doctors that I only have a week to spend on my treatment, because I have an up-coming work meeting in Beijing and my small trip to West China. Indeed, I have to be a master of time management in this high-speed international metropolis.
As I expected, the time suits them well，as hospitals are trying to shorten patients’ hospitalization time. Right now China’s health sector is going through reform. Hospitals must pay attention to their patients’ average lengths of stay to make sure the national insurance fund is not abused. The government is watching what they are doing. Patients are watching too. Or in a more neo-liberal sense, customers are watching.
After I have completed the hospital admittance procedures as required by the clinic doctor and nurse, it turns out that the ward I have been directed to is already full. The nurses are not happy as they have had no prior information of my arrival, and I have to spend a night in an extra “bed” in a treating room next to the nurse station. A patient who occupies that bed is called “Bed Plus 12”, to designate them as an overflow patient for the ward. The patient would be transferred into the normal ward once a bed becomes available. Their name would then be changed to their “Bed Number”.
Well, a single room without a bathroom. Not too bad.
Doctors and nurses come and go, doing their best to give me some semblance of privacy. I have tried my best to be invisible in this space that I don’t belong to. I stay in bed reading The Soul of Care by Arthur Kleinman, an outstanding medical anthropologist at Harvard University, stating that care is not only about providing service but also about being there as “presence”.
Though I have spent years “deep hanging out” with doctors and nurses in my fieldwork, I don’t feel comfortable here at the very beginning. Back in “my” hospital in the field, I sided with the doctors and nurses, talking about patients as mere cases of diseases. I was an insider. Yet here, I am now in the role of the patient, wearing a patient gown, at the disposal of the same medical system, looking for help, a powerless outsider. I am “Bed Plus 12”.
I have spent one hour waiting, before my assigned doctor, Dr. Chen, approaches me and tells me to come back in the afternoon for a proper examination. Yet I have to spend another two hours in the afternoon waiting for him to turn up again.
“Dr. Chen is in surgery. He will come to you after he finishes, a nurse tells me.
But when? No one knows. Waiting. Eventually he comes and gives me a physical check.
A list of modern medical checks was prescribed: CT, DR, DX, MRI, ultrasound, blood test, urine test, fecal test. I’ve been prescribed a whole bunch of tests and have finished all but one—the CT that is scheduled for the next day.
Dr. Chen is on the night shift that evening too. The next day, Saturday, when I receive all my test reports, he is off. I spend the morning in my single room, waiting, reading, trying to be invisible.
Patients outnumber the beds, I totally understand. I am eventually moved to a regular bed after lunchtime, and my name has changed from “Bed Plus 12” to “Bed 31”.
The number is my new identity.
My diagnosis of cervical vertebral disease is the axis of my activities in the hospital, including all the checks, my chats with other people, the treatments, the medication that I take twice a day.
I have spent a wonderful afternoon visiting friends in the garden with sunshine, picnics, and laughter. Waiting is the eternal theme. But deep in my mind, I don’t know what else I should do. There are no instructions for what has been arranged for each day. I am a docile body, anxiously looking forward to a schedule to govern my behaviors in the medical system. There is no information on what to do and when. I echo with Kleinman’s sense of frustration on trying to find an answer/a diagnosis for his wife’s condition in different medical institutions. They both are well-known anthropologists with great understanding of the medical system, medical knowledge, and know-hows to navigate the systems and to talk with experts. But the time of waiting still frustrates them more than anything else.
On Sunday morning, Dr. Chen comes in briefly, telling me he would chat with me later. I spend the day waiting for a vaguely scheduled chat. Before the day shift is over, he finishes his clinical work and calls me to his office, telling me that reports show I have cervical vertebral disease and carpal tunnel syndrome. Minimally invasive surgeries can be arranged the next day.
Great! No more waiting! I have a schedule at least!
Surgery is great! I mean, at least the atmosphere is friendly. Other than that, I watch how needles pierce my palms but as I am anesthetized, I feel barely anything. I feel a transcendental detachment from my physical body and myself as a feeling person. I am starting to understand the criticism of biomedicine and its dichotomy of the body and the person.
I finally have a lengthy conversation with Dr. Chen while he performs surgery on my locally anesthetized self. I have learned that he went to high school in my hometown. He has worked in this hospital for six years after finishing his M.D. He visited Melbourne and Sydney with his wife for their honeymoon and was fined for speeding. I have also learned some medical knowledge, such as how anesthesia is for acute pain, and that the pain clinic aims to treat chronic pain.
He learns that I do medical anthropology. He also learns about how my poor reading and writing habits, my abuse of the laptop and mouse, and my participation in sports all added up as burdens on my nerves. I sell him on the idea of reading Kleinman’s book to understand his career or to understand how Kleinman sees patient care. I also tell him about a TV show that I watched the day before, Dopesick, on how the promotion by Big Pharma of opioid painkillers led to an epidemic of narcotic abuse in the US.
During that surgery, I believe Dr. Chen and I came to an understanding that we should treat each other as persons with our own stories to tell, rather than the clinically-dry roles we play as doctor and patient.
I spend another four hours in bed with a machine monitoring my pulse, blood pressure, oxygen saturation, and other vital signs while I binge-watch Dopesick. They then run another two tests in the afternoon, after which I am released from the machine and from the bed.
While I am writing this, Dr. Chen comes in to check on my body’s reactions to the surgery. Our conversation retreats to simplistic, formulaic phrases. I am still waiting for results of the recent tests. Waiting is the unchangeable theme of my hospital experience as a patient. However, we do chit chat when we bump into one another in the staircase. I now feel acknowledged as a person into the medical system represented by Dr. Chen. Also, I lent Dr. Chen Kleinman’s book and the TV show.
[Image of the hospital beds is by Adhy Savala sourced from Unsplash.]
[Image of Arthur Kleinman’s book is provided by the author.]