The dark side of chinese medicine
TERRY WUERZ VOLUNTEER STAFF
Perceptions of health care in Canada are often derived from our experience at home, or at most with other Western countries. With that in mind, join me in a tour of a hospital, not from your own country but of the city Shantou, in Guangdong province of China. Considered a small city (by Chinese standards) at a population of over two million in the city alone and four million in the surrounding area, Shantou is a world apart from the sparkling and sparse cities of Toronto, Calgary, or even Winnipeg.
The first impression of this hospital in Shantou is one of serenity and harmony. Approaching from the dusty, crowded street, whitewashed concrete and scuffed linoleum arise amidst the throng. Yet they do not stand in stern defiance of that from whence they came: in the entranceway, Deng Xiaopeng’s portrait pays homage to new wealth in China. One is immediately drawn to a serene park, unanticipated in this looming institution. Maroon orchids and prehistoric ferns blossom in garden courtyards splashed with pond water and traversed by curious bridges that seem ponderous enough, even, for Confucius. Unlike here in Canada, it is easy enough for physically exhausted patients or their emotionally drained family to duck away to a peaceful refuge among the throb of white-coated vampires continually poking, bleeding, predicting demise.
Scoffed at and ignored in the rest of the world, here in China, traditional Chinese medicine is accepted, at times turned to, by Western-trained physicians as a parallel yet acceptable alternative system. Patients are able to choose freely what type of doctor they prefer to tend their aches and worries. Pediatricians and orthopedic surgeons may turn to acupuncture or massage when they feel a particular Western therapy does not seem to be working; TCM doctors, in turn, are quick to run to modern blood tests or CT scans when necessary. All this, of course, is a far cry from the near denial of the very existence of alternative forms of medicine in Canada. But all is not well in this hospital of Shantou.
Down the hall from the TCM clinics, a waiting room, of sorts, is encountered. As the largest room in the hospital, rows of plastic chairs seat the many who await their number to be called. Dozens of long-faced patients sit with their families, glancing at accountants who sit in kiosks at the front, behind glass windows.
Down the hallway, the emergency department is quiet in the late afternoon. Chan is in bed, recovering from his accident. Two days ago, he smashed into another biker while riding his motorcycle. Luckily, the collision speed was low, and Chan had his helmet on. The extent of his injuries was a two-inch laceration on his chin, which has long since been mended. He is feeling strong and ready to leave the hospital. Now, he has stayed in hospital long past what would have been considered medically necessary though not yet discharged to go home.
However, there are greater things at work here than the stability of his medical condition or his itch to leave. The powers that be have decided he is willing to stay, and able to pay for the bed. So Chan stays, with no word yet as to when he will be allowed out by his doctors.
Fourth floor, neurosurgery department. Twenty-three-year-old Song Shengrou lays awake in her bed, awaiting discharge. She had been experiencing headaches and unsteadiness on her feet for a few months, prompting her to seek medical attention. She received a diagnosis of a condition known as arteriovenous malformation, or AVM, a spiderweb of sinister arteries pulsating abnormally in her brain, threatening to break down and bleed at any time. Now, she is going home.
It is not that she has been cured of her disease, or that medicine in China has done all it can for her. Rather, it seems that Song is a victim of poverty: her family will not be able to pay for the complex procedure necessary for cure. She will continue living her life, as before, with the knowledge that her lethal condition could strike at any time.
Where serenity and peace are found in the gardens, the anguish and frustration of patients unable to obtain the care needed, the care available to patients within the very same walls, become evident on the wards. Chinese physicians loathe their system, and long for the simplicity of Canadian medicine, where financial barriers to treatment are much less common.
While patients with ready resources are able to choose between traditional and Western medicines, others are forced to do without treatment. Patients can only dream of a system in which universal equality in access to medicine is a sought-after standard.
Having visited public hospitals in Brazil, Cuba, and Peru, I am no stranger to Western medicine’s poorer cousin. There is nothing consoling or idyllic about a patient who dies because his country has not the resources to treat him. Yet, there is something more sinister rooted in the country that seemingly has enough resources to pay, and will not.
No one in Canada has seriously proposed we abandon public insurance for hospitals or doctors. Nor would anyone suggest, in good faith, that physicians be forced to deny treatment for those in want of money. Nevertheless, it is undeniable that something is lost in medicine when financial income becomes an incentive for the type of treatment, or access to treatment available to patients.
Perhaps, our system is very far from perfect. In some areas, it is doing terribly, as the champions of privatization are quick to point out: wait times for access to non-essential care are up, efficiency of health-care spending needs an overhaul, and hallway medicine is a near-accepted norm. Many of these obstacles may seem insurmountable, yet I assure you they are not. Solutions exist, without adding privatization and stratifying care. Before we further distance ourselves from the ideals of universal medicare, we should take a good look at the situation in countries where they long for the system we so easily dismiss.
Terry Wuerz is a fouth-year medical student at the University of Manitoba.
