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.”


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.