I am still sitting in Shanghai nursing my wounds. A trip through the circus-like (but cheap) Chinese medical system last Thursday and Friday left me with a week’s supply of anti-inflammatory drugs, a two-week supply of some other pills that will supposedly help to regrow my cartilage (i.e. my degenerated menisci — I’m pretty sure the pills are just glucose and crushed seashells or something) and orders to rest for at least a week. For the benefit of family and other readers in the West who may not have had any exposure to the Chinese medical system, I’ll give a little overview of the experience. If you’ve been through it yourself there’s probably not much new in this post.

A little Interwebs research leads me to the Sir Run Run Shaw Hospital in Hangzhou, to which Evan is kind enough to accompany me (we figure his own experience with knee trouble and the Chinese medical system will be useful). I should preface this explanation by saying that my trip to the SRRC Hospital is the smoothest and least frustrating of my encounters with the Chinese medical system.

The hospital is massive compared to the others I have been to in this country. The first thing I notice upon walking into the lobby is that the place is clean, and no one is smoking — a relief after visiting my sister in a Sanya hospital where she was recuperating from an attack in a bar in which she had a couple beer bottles broken over her head. The main lobby consists of an information desk (where we are immediately given some incorrect information) and a row of ladies behind glass, resembling tellers at a bank. My only complaint about the SRRS Hospital (outside the dysfunctional medical system in which it operates) is that this row of ladies at computers acts as both the registration and payment center, which means everyone has to wait together to complete either task. Other hospitals I’ve been to separate these.

A trip to a Chinese hospital (which is pretty much the only way to see a doctor as private practices are basically unheard of) begins by standing in one of the lines in front of the tellers and paying the fee to see a doctor. Actually, this is where most of one’s time is spent. Like anywhere else in China, the concept of a “line” is not sufficiently evolved, and rather than simply waiting patiently to get to the front of the line, I’m forced to take part in a sort of territorial battle to fend off a constant stream of pushers, elbowers, “I-just-have-a-quick-question-to-ask” people, and general sneakers-in who think its their right to proceed directly to Go. As I’m about to reach the front of the line, I notice a sign saying that new registrants must first complete an entry form. Hoping the woman at the computer will provide me with one of the forms I stay in the line, but I am of course turned away and told to go to the information desk. After filling out the form, I butt in at the front of the line (when in Rome…), correct the woman’s spelling of my name in the computer about ten times and pay the 5 yuan (US$0.73) fee to see a doctor. Doctors’ fees are clearly not where these institutions make their money. That comes from unnecessary tests and prescriptions. I ask to see someone in the orthopedics department and am told they are on lunch break until 1:30. It is currently only 12, so we sit on a bench outside and read for an hour and a half.

At 1:30 we return to the hospital and find the orthopedics department, which is located on one side of a large, hexagonal room, the center of which is filled with waiting benches and feels like a bus station. In my hand I hold a paper printout with my number on it. An LCD screen at the front of my section lists the next patient in line, like we’re all waiting for sliced turkey in a supermarket deli. My number is called, and I shuffle into the orthopedics department to see Dr. Zhao, who after a brief examination tells me I need X-rays of both knees and Achilles tendons and MRIs of both my knees. Dr. Zhao refuses to speak to us in Chinese and speaks in a voice so soft I can hardly understand. He prints out order forms for each of the tests, and we head back to the cash register/registration area, stand in line and eventually pay for the tests. Nothing can be done in a Chinese hospital without paying up front, even in the emergency room.

A man in his fifties rushes past me carrying his infirm father on his back. Not even Sir Run Run Shaw provides complimentary wheelchairs, I guess.

At the information desk we ask where the radiology department is and walk to Building 3, Floor 2, the department of ophthalmology, where we are told radiology is actually Building 1, Floor 2.

We give my stamped x-ray receipts to the registration ladies in radiology and sit down to wait for our deli number to pop up on the screen. SRRC Hospital is the first computerized hospital I’ve been to in China. Previous experiences have required constant vigilance and territorial skirmishes at each successive test taken or specialist visited. Eventually, my number is called and I pass through a lead doorway into the x-ray room. “Wow, what advanced pants,” the x-ray technicians exclaim as I zip off the bottom half of my pant legs so they can x-ray my knees. “So dark! So big! You must be an athlete,” they snort as a roll my shorts up above my tan line.

X-rays taken, we wait in line for the printouts and then head back down to orthopedics to see Dr. Zhao, who already has the digital images up on his computer (oh, technology!) There’s a bone fragment in my right heel, he says, without giving any indication as to whether that’s a problem. He wants to see the MRIs before making any diagnosis as to the condition of my knees. In the meantime, he prescribes me some expensive, external medication to put on my Achilles “and anywhere else it hurts,” which doesn’t inspire me with confidence as to its necessity. We make another trip to the cash register and then over to the pharmacy. The MRI appointment isn’t until six, so we head to a restaurant across the street to pass the time.

At six, we return to a significantly less crowded hospital and get MRIs of both my knees taken. The lone MRI technician pays me no compliments on my legs despite making me take my pants off all the way. I have a hard time keeping my legs still while the MRI machine clinks and clonks away.

The MRI images aren’t available until three the next afternoon, at which point we return, pick up the images, and wait in line to see Dr. Zhao again. Looking at the images on his computer, he asks, “Do you know what the ACL is?” I explain my understanding of it and he points it out in the images.

“Is there something wrong with it,” I ask.

“I don’t think so,” Zhao says. I wonder why we’re talking about it. “Your menisci are degenerated, your knees are inflamed, and you have fluid in your knees. I’m going to prescribe you some medication. Is that okay?”

“What medication,” I ask.

“I don’t know how to say it in English.” We try to get him to spit it out in Chinese, but he insists on fumbling around for the English. Eventually he writes “NSAID” on a piece of paper, and we guess that he means non-steroidal anti-inflammatory drugs. I start to feel like I might be missing part of the diagnosis due to the language barrier Dr. Zhao insists on imposing on the conversation. “You are young, but your knees are old,” he says by way of explanation for prescribing the expensive drugs.

“So, do I need to do anything? Will I be able to continue the bike trip? Is that bone fragment in my heel a problem?” I have about a hundred questions that I’m not getting answers for.

“I think maybe you should rest for at least a week. The bone fragment is round, so I don’t think it’s a problem.” We thank him, pay a final visit to the cashier and pharmacy and take a cab back to our hotel. The ordeal sets me back about 1,400 yuan (US$205), for which my insurance company may or may not reimburse me six months down the road.

The next day we pack all our gear onto our bikes and go to the bus station. I ride using only my right leg. I head back to Shanghai to rest for “at least a week” while Evan and Alexis continue on the trip. A friend meets me at the bus station to ride my bike into the city while I take the subway.

After trying to figure out if my insurance company will reimburse me for another hospital trip, I head to Shanghai United Family Hospital to get a second opinion on my knees, which are still not feeling up to task after a week off the bike. United Family hospitals are Western-style hospitals located in some of China’s major cities — bright, clean, friendly, English-speaking, and with a price tag to match. In contrast to my 5 yuan consultation at SRRC in Hangzhou, seeing a doctor at United Family sets me back 325 yuan (US$48). It’s almost worth it just to be treated as a customer instead of an annoyance and to be billed at the end of the stay as opposed to between every step. The doctor, a surgeon, says that my ACL is the problem and that the degenerated menisci will heal themselves. She refers me to the hospital’s sports medicine specialist. Did Dr. Zhao have something to tell me about my ACL when he pointed it out in Hangzhou? Maybe he was just trying to keep me from worrying…

My appointment with the sports medicine specialist is set for Tuesday afternoon. My one-week supply of anti-inflammatory drugs is gone just in time for a friend’s birthday this weekend. In contrast to our last rest in Shanghai, the drugs have thus far discouraged heavy drinking on my part. While the downtime is frustrating, I’m trying my best to make it at least valuable. I’ve reread Alexander Dumas’ Count of Monte Cristo and Franz Kafka’s Metamorphosis in English and Lu Xun’s (鲁迅) Diary of a Madman (狂人日记), Kong Yiji (孔乙己) and True Story of Ah Q (阿Q正传) in Chinese and learned the traditional forms of the top 1,000 most frequently used Chinese characters. Yesterday I started on the first book of Those Ming Dynasty Happenings (my translation, 明朝那些事儿). I had told myself that I would take plenty of pictures in Shanghai, and I’m sorry that hasn’t happened yet. Tomorrow’s the day, I promise.

I’ll update on progress with my knee after my appointment with the specialist on Tuesday. Hopefully Evan and Alexis will post something to get us up to date in the meantime. I’m about as in the dark as everyone else!