Update 5: History, Hotpots and Iatrogenic Holes

February 21, 2011 - Xian, China

 Friday 18th February

Was late for the morning meeting (though was great to catch up with Connie on the phone!), so Dr Zhong got me to hide in the office until the ward round! Saw lots of flexible nasoendoscopies in clinic, and even more spitting - the nature of the clinic meant that there was even a dedicated 'spitoon' in the corner (see photo from the Shaanxi History Museum, and imagine it full). Interesting nonetheless, and followed by amazing mutton and carrot jiao ze (dumplings) - a huge plate for just Y15. Clinic in the afternoon involved more head-mirror-wrestling, and a couple of interesting vertigo patients.

Dinner was my first hotpot in China, and each place had its own hob! My pot was of "low" spicyness, and various raw meats/vegetables/tofu were provided which we dropped into the pot to cook it ourselves. I was treated by Prof Zhang (one of the ENT docs) and her husband (another doctor) and daughter, Tian. They were both charming and spoke even better English than Prof Zhang, so I had a great time.

Saturday 19th February

An early start today - met Alargo (his English name, misspelt/heard, he admits, from Aragon in Lord of the Rings!) at 8.30 to head to the Shaanxi History Museum (Xi'an in the capital of Shaanxi or Shanxi Province, not to be confused with neighbouring Shanxi Province - the tone for the first syllable is different!). It was fascinating, and took us on a journey from pre-historic China to China of 100 years ago, with beautiful exhibitions of items relating to ritual, religion, conflict and daily living, as well as interesting explanations in English. See the photos for some of the more amusing exhibits. The province has such a wealth of history, having been the capital of China for centuries, and the terminus of the Silk Road.

After lunch of another hotpot (see photos), Alargo's second favourite after noodles, we headed to the Big Goose Pagoda, a tower set in the grounds of a Buddhist monastery. The monastery was beautiful and peaceful (occasionally interrupted by various people trying to sell souvenirs), and the tower stunning from the outside. Pretty uninspiring inside, and on quite a misty day the views weren't mindblowing, but had a lovely time just wandering around, and it also has a really interesting history involving monks who brought Buddhism back to China from India, and translated lots of the Buddhist scripture into Chinese.

Sunday 20th February

Had a lie-in and met Dr Jia and Nancy (I think that was right - English name of course) for the ride to the Terracotta Warriors. We started in the largest pit, Pit 1, and it didn't disappoint. The size of a (large) aircraft hangar, we were able to walk just around the very edge, and whole centre was an excavation site filled with pottery warriors and the odd horse. It's all full size (or even slightly bigger than full size), and was built to defend the tomb of the first emperor of the Qin dynasty by about 700,000 workers. There are infantrymen, archers, cavalrymen, chariots, officers and generals, about 8,000 items in all, and they were all made by hand - it's said that each warrior has a different expression, and they have facial shapes consistent with Chinese from all over China.

Pit 2 was a bit smaller, and relatively unexcavated, but had some nicely displayed warriors alongside in glass display cabinets, and Pit 3 was very small - apparently this is the group of soldiers that were specifically tasked with defending the king. We also saw a nearby mound that is thought to be the tomb of the emperor, and had a bit of a wander through the forest before heading back for 'Chinese barbecue' in Xi'an, and my first taste of pig stomach - can't say it did much for me, very chewy.

Monday 21st February

Spent the morning in clinic with Prof Xu (the dept head). Some reasonably interesting patients, I think, but he barely spoke to me (his English is pretty poor), and I got increasingly frustrated by the crowd constantly surging into the room. There were never fewer than 4 people who were 'next up', at one point 15 were rammed into the room, and there was a constant jostle for who would go next, despite them having an allocated order - some cheeky customers in there.

Left a bit early and had a rest before heading back to watch some minor surgery under local anaesthetic. The first was an op for sinusitis, and was brutal - I found it pretty difficult, hadn't experienced such discomfort at watching a patient in pain since Uganda. It was also horrible because the surgeon was causing the pain himself, by (skip this bit if you're squeamish) forcing a centimetre-wide, not-nearly-sharp-enough instrument through the bone just under his top lip to drain the infected fluid from his maxillary sinus (he had chronic sinusitis). Pretty sure they don't do that in England, or at least not under local, but apparently the incentive for this patient may have been the cost - general is much more expensive. The second procedure was just removal of some dressings from the nose of a patient who'd had surgery 4 days previously, and was much easier to watch!

Tomorrow I will start again on Infectious Diseases - I'm leaving ENT a little early because Dr Zhong has days off, and without her there to translate I have a pretty difficult time. I've certainly learnt a lot, but am looking forward to returning to ID where a few more people speak English, and I'm very well looked after! It's been nice seeing lots of kids on the wards and in clinic, though, and it's tempting me back towards paediatrics/paediatric surgery...




robbie robson:
February 21, 2011
amazing news Tim- very much enjoying hearing about what you are up to. Maybe not the bit about the sinusitis, but just about managed to keep my rice crispies down. Keep the news/info coming!
Polly Robson:
February 21, 2011
Hi honey...the museum sounds incredible and really enjoyed the pics, though some discomfort from the thought of filled spittoons and even more from somewhat brutal sounding sinusitis ops.......just about managed to read it clutching my face while doing so! LOL Ma xx
February 21, 2011
Sounds like you had a really formative experience in your medical journey. Perhaps we should consider sending NHS patients there if the price is so good!

Loved your descriptions of medieval torture!
February 21, 2011
Fantastic pictures of the warriors TIm! And Mum, in her unbiased way, thinks you are the hansomest doc shes ever seen! So do I actually!

Love Dad
February 21, 2011
Sent that article with pics to my mum.. so HANDSOME, tim. Grrrrowl. X
February 21, 2011
Firstly, many congratulations on becoming a Doctor. Secondly, it has been wonderful sharing your experiences which are so vividly described. It most definitely appears to have a good work life balance along with some amazng pictures as a reminder of your time there. La la!
February 22, 2011
srry I made you late my dear!!!!! filled spitoons used to fill my nightmares. gross. but the food images more than make up for it. so hungry....
Carole (Allen):
February 22, 2011
Hi, Tim - sounds as though your trip is shaping up just as I would have expected. Sounds wonderful and reminds we of why I want to go back for an extended period. You're slim enough to devour all that food with relish - I just put on heaps of weight !

The photos are excellent: always issues of "the wrong light" eg pollution and the dark ! The lantern festival looks amazing and very typically Chinese.

No pictures of awful loos or diners eating with protective gloves or sucking out bones with straws yet .... A few treats left for you.

I look forward to seeing / hearing lots more.

Have fun.
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