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Demystifying Medicine One Week at a Time

It’s China(town), Jake

One of the more bizarre experiences I’ve had in medicine occurred on a recent trip to China.

Nicholson as Gittes: Best Movie Ever?

I’d been invited to meet with a doctor for a discussion and tour of Renmin (“People’s”) Hospital in Hubei Province. Before I went, she asked me to “give a talk.” Reasonably, she asked what  I was planning to speak on, though she indicated it would be good if I could talk about something in the category of “Functional GI Disturbances.”

Not being a subspecialist in that field (or any field, for that matter) I suggested that I’d be interested in learning about how hospitals in China are organized, or how health care is practiced, delivered, financed, and experienced. The kinds of things I think a lot about in these here United States.

We settled on “Clinical Ethics,” a topic that I could speak to, since I serve on GlassHospital’s ethics faculty and help in teaching the introductory course on medical ethics to first year students here.

I thought it would provide an interesting comparison of how health care is practiced in the two countries: would a “typical” American medical ethical dilemma translate into Chinese? What gives pause to doctors there and how do they work though clinically ambiguous situations?

I was a little nervous when the day came, never having rounded in a Chinese hospital before. I was also worried about getting lost in translation.

When I showed up, I was asked to “review the slides.” Always a good idea to mentally re-rehearse things.

I riffled though 74 slides. Not the ones I had sent. And wouldn’t you know? They were on GERD (gastroesophageal reflux disease) and NERD (yes, NERD!: non-erosive reflux disease).

The doctor who’d invited me was asking me to look over her slides, right? Maybe she wanted me to have a preview; maybe to make sure that things looked OK in English or in the medicalese.

I get it, I thought: reciprocal talks–first her on her topic, then me on mine.

“Looks great,” I told her. “Pretty detailed, in fact.”

“Excellent,” she smiled back. “Please proceed then.”

Huh?

You mean, you’re asking me to deliver a 74 slide lecture on a topic that I haven’t prepared in Chinese?

(OK, I was definitely not being asked to give it in Chinese.) But still.

I had been briefed in the pre-trip orientation about Chinese culture and the idea of avoiding shame and saving face.

And here I was, in front of 20-30 Chinese doctors and trainees, being asked to deliver clinical teaching rounds on a topic that I hadn’t prepared and in which I claim no expertise.

What would you do?

I felt the the heat on my cheeks, but to avoid causing offense, and perhaps because this was how things are done or at least interpreted, I jumped right in. I’m a bit of a ham, and I enjoy performing.

After all, the doctor who’d invited me had no doubt slogged away putting this beast of a talk together. And she’d done it for me! The least I could do was give her talk in clean, entertaining English. And let’s just say, at 74 slides, that there was a little redundancy built in.

Thank God it was on GERD, something I see every day as a practicing doctor, and not acoustic neuromas.

Oh, and NERD. I know a bit about that, too. Just never thought of it that way before.

By the way, later in the day I did get to give my talk on clinical ethics. It wasn’t nearly as fun as the one earlier in the day.

7 Comments

  1. Bravo! You did the right thing by presenting her slides and not putting up a fuss. I doubt others would have been so patient. When in Wuhan…

  2. Details, please, about GERD and NERD!

  3. Share the deck please! What a great PowerPoint karaoke story …

  4. good stuff. I wonder what they are telling their colleagues about the American . . .

  5. I, too,was hoping to find out about Gerd, which i was diagnosed with several months ago after an endoscopy. I was also told at that time that I had esophogeal ulcers. I thought that you were going to reveal some more details from your impromptu talk on the subject, including the humor. I was curious about what insight you had, Dr. JOhn, in particular on the standard treatment offered for it. Just as you wrote about the misconceptions of most people diagnosed with prostate cancer, so I thought you might have some advice about healing one’s own Gerd symptoms without resorting to the drugs which eliminate the naturally occurring acidic digestive juices of the stomach. I do believe doctors today rely too heavily on the pharmaceutical salesmen and seem very eager to dispense the drugs that these salesmen tell them will address the symptoms of Gerd. I was not willing to go that route and after 1) changing my diet and being careful not to overeat (but eating small meals throughout the day),
    2) making sure not to lie down after a meal for at least three hours,
    3) swallowing digestive fruit and vegetable enzyme capsules ( not drugs!) after a meal, 3) eating at least one apple a day and 4) sipping a mixture of apple cider vinegar and water throughout dinner, I have eliminated all pain and bloating that were the symptoms I presented with at the time of my endoscopy. I feel really fine, and fit and find it hard to fathom why medical doctors do not know about the natural way to combat Gerd that I found by reading up on alternative natural methods on Google. All medical doctors ought to know about these simple natural cures to be able to offer their patients a clear choice. Perhaps it doesn’t matter, as those of us who care enough, find out on our own, anyway!

    • glasshospital

      October 29, 2010 at 1:29 pm

      Sorry, no magic herein. But I’m glad you’ve found a way forward that seems to be helping you.

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