Musings on health and excessive internal heat

Recently I've spent more time than I usually like to spend in hospitals, operating rooms, and in the presence of needles, iodine, IV drips, and strange medical smells. Mumu, my white cat, had surgery to remove her ovaries a month ago after a botched operation to sterilize her last year that left unborn kittens still inside her. The entire ordeal has been nothing short of harrowing for both Ray, me, and of course Mumu. Unfortunately, at the same time I myself have been going through my own mysterious medical trials that have left me at wits end, fulfilling both roles as nurse and patient. But like every aspect of daily life in Taigu, these unpleasant medical experiences have been lessons in cross-cultural understanding, whether warranted or not. Straddling newly acquired Chinese notions of health and wellness and my own pre-existing Western notions has called into question some of my most fundamental beliefs.  

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As of June 15th I hit the one year mark. In this past year have learned that everyone, regardless of age, profession, or relationship to me, seems to have an opinion about my health. And not just an opinion, but an informed opinion. Not just an informed opinion, but the supreme right to share this informed opinion with me at any time they deem appropriate. At first I didn't think much of it. My students, my boss, my friends would say, you have a cold? Wear more clothes! Eat more fruit! Drink more water! Nothing all that different from what my mother or a concerned neighbor would say at home.

But a couple months into my new life in Taigu I started to have terrible skin problems. Then suddenly, everyone began to comment... my students, my bosses, the fruit vendor, random passersby. And I found it striking that everyone seemed to say the exact same sentence, "Your face has spots, you must not be accustomed to this dry climate." At first I would agree saying yes indeed, the climate was particularly cold and dry and yes I must not be used to it. But after hearing this sentence at least one hundred times, I began to get irritated. After hours spent trying every way possible to mask my skin problems I would head to dinner with Chinese friends only to have the first words out of their mouths be... "Your face has spots, you must not be accustomed to this dry climate." For me, it became a constant reminder and symbol of my outsider status,  as if it were the physiological proof that I didn't belong here. The imaginary wall that had always existed in the US between myself and what others were thinking in their heads about me, in China, seemed to have melted away. 

Others have chosen slightly less direct ways to convey the same message. Though, unfortunately, they are no less humiliating. At the end of last semester all ninety of my grad students took me out for dinner in small groups. One group took me to hot pot. When they insisted I eat from the non-spicy side, I told them, "no no, don't worry I love to eat spicy food!" thinking they had assumed a foreigner like me couldn't take the heat. But this response was met with downward glances, mumbles, and embarrassed looks. They finally admitted that because of my bad skin they thought it would be best if I didn't eat spicy food, which they thought was an indication that I was "shanghuo" 上火, or "suffering excessive internal heat." Of course I appreciated their concern but I also felt embarrassed to have the privacy of my health condition disclosed so publicly. If no one said anything to me about my skin then maybe I could convince myself it wasn't all that bad after all. But even to this day everyone's constant commentary leaves me no choice, my face has spots, I must not be accustomed to this dry climate.

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What it comes down to ultimately is what I perceive to be one of the biggest cultural differences between living in the US and living in China: privacy. For many reasons, having a population of 1.3 billion being particularly key, the concept of privacy in China differs greatly from that in the US. This is supremely apparent even from something as simple as Chinese train compartments, in which people sleep comfortably in close quarters. While on sleeper trains I often find myself thinking about what my mom or dad will think of sleeping amongst strangers when they come to visit next year. Comparing this to Americans driving around in their private air conditioned compartments highlights this difference all the more clearly.            

It occurred to me recently that in America one's health is perhaps one of the most private aspects of one's life. Your medical information is protected under strict non-disclosure laws, doctors appointments happen one-on-on behind closed doors. But both times I've been to the doctor here I've been surrounded by doctors, patients, nurses, and others flowing in and out of the room as freely as they please, chiming in as the mood strikes them. Not to mention seeing the Chinese medicine doctor (中医), which was the first (though certainly not last) time I discussed my bowel movements in front of a room full of patient but curious onlookers.        

Having a veritable Greek chorus of commentators always at the ready can often do one of two things. Either I am left feeling well taken care of and lucky to learn firsthand about Chinese medical practices, or I am left feeling like a child who is unable to take care of myself. And they're probably right, without a CVS full of Advil, Pepto Bismal, and all manner of Western medicine, I often feel defenseless. 

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Two months ago I was invited by a friend to get a free hair treatment at a beauty salon in town. The women who worked there were lovely, as was the free treatment, and thus we began to chat about the usual topics... what country are you from, are you accustomed to eating Chinese food, etc. Of course, within five minutes she had already proclaimed the obligatory, "Your face has spots, you must not be accustomed to this dry climate."

But this time she went a step further in her line of questioning, moving swiftly onto the topic of my poop. "Do you have diarrhea? Are you regular?" she asked. The same way that I am now comfortable showering in public bathhouses, after seemingly absorbing everyone elses' blasé manner, I found myself discussing my bowel movements with a complete stranger. But what was even more surprising was my own willingness to consider her medical advise. Sadly, I have forgotten her specific advise but based on what people tell me every day it probably went something like this: wear more clothes (dress warmer), drink more hot water, don't eat street food, don't eat lamb, eat more fruits and vegetables especially bittermelon, don't let your cats on our bed, get rid of your cats, see a Chinese medicine doctor, take Chinese medicine, rub your forehead when you transition from the cold temperature outside to the warm temperature inside, and open your windows to let in more light and fresh (albeit frigid) air.     
     

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A couple weeks ago I noticed a series of itchy red bumps all over my body. I attributed them to mosquitoes, until I woke up one morning in my own private itchy painful hell, and realized it must be something... else. I had two ideas, fleas or bed bugs, both equally daunting. After an hour of fruitless internet research and scores of traumatizing pictures, I started to get really freaked out. All the steps on every English how-to website involved American conveniences absent from my life here in Taigu, namely, a washing machine with hot or warm water, drier, and vacuum cleaner.

So after itching my way through my afternoon class I was back at the hospital with my boss for the second time this year. The doctors took a casual glance at my arms, neck, and face and decided it was probably not bugs, but an allergic reaction. A blood test done on a glass slide slipped under a chemistry-set-sized microscope confirmed this and I was immediately carted off to get an IV drip. It wasn't until the third day of my IV drip that I knew for sure what the cold liquid being fed directly into my veins was exactly. It was apparently just grape sugar (dextrose), though to this day neither I, my doctor in America, or the Chinese medicine doctor in Taigu understand why.

An IV room in the university hospital on campus

Meanwhile, the Foreign Affairs Office immediately mobilized and (just in case it was bugs) helped me clean my entire house and put all of my bedding outside to bathe in the sunlight. I learned that in lieu of hot water and a drier, direct sunlight apparently kills bugs, or at least encourages them to take a vacation. Just because I felt paralyzed and didn't know how to deal with the situation in a Chinese context didn't mean there weren't well established methods, I just had to learn them. With my house clean and my IV drip finished unfortunately I still didn't feel much better, so I decided to see a Zhongyi, or Chinese medicine doctor.

Upon entering the room, the surly but ultimately friendly Zhongyi immediately berated us for not having studied Chinese medicine, and later proceeded to explain to Dan and I why Chinese was superior to English. He had a point, the average English-speaking person wouldn't necessarily know the root meaning of even the simplest of English words, for example, time. Whereas in Chinese, 时 shi, meaning time, has a 日, or sun, making its origin and meaning immediately apparent to any Chinese speaker.

To assess your medical condition the doctor will place their index, middle, and ring fingers on the inside of your wrist. They will listen for some time, switch wrists, look at your tongue, and ask you questions to zero in on your problem. They will then write you a prescription for 中药 zhongyao, Chinese medicine. The crotchety doctor wrote out a list of about 15 items, all mysterious to me since his handwriting was unintelligible, as were the ingredients themselves. After taking the prescription to a counter a pharmacist will fill plastic bags full of all manner of dried roots, flowers, herbs, insects, and unrecognizable animal parts. If, like me, you lack the right kind of pot and know-how, you then take these ingredients to someone who can help you boil them into a thick brown bitter liquid, which you heat up and drink morning and night for two to three days. 

The first time I received my little bundles of joy I immediately identified what I thought to be the most unfortunate ingredient: cicada slough  (what cicadas leave behind when they molt). But after working with two of my students (coincidentally, Dandelion and Buffalo, remember them?) to translate the full prescription I found my medicine contained another far more Harry-Potter-potion-worthy ingredient: ox bezoar. I have here the full list of ingredients in case you are as curious as I was: turmeric, honeysuckle, dandelion, Chinese violet, China root, summer cypress, root of flowered skullcap, forsythia, cicada slough, isatis root, orange stem, bupleurum, cnidium monnieri, silkworm, and of course, ox bezoar.

The raw ingredients of my zhongyao before being boiled

The taste is something utterly indescribable. It's bitter graininess makes every dose, a full glass, an almost insurmountable challenge. From discussing the taste of Chinese medicine with my students it seems people fall into two camps, the first are those whose mothers and grandmothers have made them drink it since they were small, so that now they have already grown accustomed. The second camp are those for whom Chinese medicine is something they 喝不下去, or can't seem to get down. Right now I am stuck somewhere in the middle, barely able to get it down, but still capable of summoning the sheer willpower and desperation necessary to conquer this bizarre illness.

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The hardest situations are when I am forced to reconsider what I believed to be the most basic and effortless aspects of medical treatment, in this case, the thermometer. In the dead of winter my boss took me to the school hospital for the first time to deal with my ear infection and bronchitis. I was feeling miserable and slightly embarrassed to be in such a sorry state in front of my boss, her husband, Dan, and a few onlookers. The doctor handed me the thermometer to take my temperature.

I proceed as usual, quickly placing the thermometer under my tongue as I had done countless times before. But as soon as the thermometer entered my mouth the room suddenly filled with gasps, all around me my boss, her husband, the doctor, and the assistant, cringed and turned away in horror... The doctor ripped it out of my hands, immediately washed the thermometer and scolded me before showing me the correct position... under my armpit. I had no idea how many peoples' armpits I had just sampled, but from the horrified reaction of the doctor, she had some idea.    

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