Thursday, August 9th, 2012...4:24 pm
Experiencing Surgery in China: One Great Experience, One Near Miss
When I moved to China last year with my wife, I had a huge list of things that I wanted to see and experience. I had a much shorter list of things to avoid, with one thing in particular at the top: surgery. I had heard some frightening things about healthcare in China–though perhaps not as frightening as what the Chinese hear about the American system. Many advised me to avoid hospitalization and surgery at all costs.
That healthy goal became a bit impractical after an unpleasant fall while foolishly running across a wet Shanghai street recently and hitting a slick glossy zebra stripe. The sprawling, body-slamming collision not just with the ground but with a projecting curb did more than just impart some painful bruises. I later discovered a surprise hernia that would require laparoscopic surgery. After exploring many options, I found a highly skilled Chinese surgeon that a US physician had recommended, and he helped me become comfortable with the options and the system here. Chen Bingguan is the name of the specialist and he operates at China East International Medical Clinic, a very expensive private clinic for foreigners and rich people. But he also operates at China East Hospital (Dong Fang), a public hospital that is much less expensive. And Dong Fang has a great “VIP Clinic” that caters to foreigners and Chinese VIPs (i.e., people willing to pay extra) that is still far below the cost of private hospitals.
Since my insurance here is rather limited, in spite of buying a second policy to supplement the one I have from work, I wanted to keep costs low. Fortunately, I found that I could have Dr. Chen do the surgery in the “VIP Clinic” of the public hospital for about 1/5 the cost of the private hospitals that cater to foreigners. The experience I had at Shanghai East far exceeded my expectations, with care that seemed better than what I would have expected in the U.S. I had a private room and a group of fun, responsive, and kind nurses who treated me like a celebrity. I guess they don’t get many Americans there. I also had good contact and help from my surgeon. I was on my feet right away and got excellent follow-up care with a full recovery and no pain. Fabulous. I can’t imagine how my care could have been any better.
Shortly after that, I had an MRI done at the same hospital to examine a knee that I had injured earlier. Again, I was delighted with the experience. Getting the MRI was quick, easy, and much cheaper than in the U.S., and I was able to see an knee specialist right away who quickly pointed out the problem: a torn meniscus. Knee surgery was needed to repair it. Let’s schedule it for next week. Simple minimally invasive surgery. No problem.
After the positive experience I had with the hernia repair, I was ready for round two at that hospital. I scheduled the surgery and made arrangements with my employer to miss a few days for the procedure. Would be in the hospital 4 days, then on crutches for a few weeks. And my knee trouble would be gone. Easy. And inexpensive enough that my limited insurance would cover most of it.
As surgery day neared, though, I began to feel like I was missing something. I didn’t really know what procedure was going to be used and what the odds of success were. There had been no discussion of these important details. I called and wanted to speak with the surgeon, but was told I could get all my answers when I checked in to the hospital . When I got there, I was soon greeted by a team of assistants who discussed the procedure. They would remove part or perhaps all of my meniscus, the important shock absorbing pad in the knee joint. But the surgeon has only spoken of “repair” and I assumed that mean suturing the torn section together again–why had the removal not been discussed with me? Now several negative aspects of this second brush with surgery came to my mind–the brusque manner of the surgeon, his visual difficulty in reading the MRI chart, his apparent forgetting of who I was when I saw him on my second visit following initial consultation the previous week. The emotional brain had come up with an answer before the logical brain did and was already telling me to walk away, while I still could. Part of what helped me make the decision to walk were some of the secondary issues after check-in. Instead of the lovely private room I had in my first surgery with my own air conditioning remote control unit, I would be put in a much less attractive, older room shared with a grumpy looking patient and his wife, with several other disappointments compared to my first experience. They contributed to the willingness to flee, as did the unavailability of the surgeon himself to discuss my case.
After punting on the planned surgery, I made a couple of phone calls to get more information and second opinions from other doctors. I learned from a physical therapist that in many parts of the healthcare system here, there is a tendency to turn to surgery as a first option instead of as a last resort. Just two days before we had visited a Chinese friend of ours, a vendor struggling to make a living in a little market near our home, in a local hospital. She had just delivered a baby and was sharing a tiny room with three other new mothers. She had been given a C-section. She wasn’t sure that it was necessary. Apparently C-sections are far more common here than in the United States, and there may be a general problem with unnecessary surgery of other kinds. There are remarkably skilled surgeons here and some outstanding hospitals, but it’s important to make sure that the surgery is really needed.
I took my MRI chart and went to get second opinions, first visiting a surgeon at another hospital and then a physical therapist. Both of them explained to me that my knee trouble was still minor enough that surgery would be ill-advised right now. Better to rely on exercises and other steps to strengthen and protect the knee rather than jump to surgery. This made sense and I’ve began a program with the physical therapist that appears to be restoring my range of motion. Maybe I’ll need it later, but I’m glad to explore other options first. I feel that I came within inches of surgery that may have left me in a worse condition and with high expenses, some risk, and high inconvenience. If it weren’t for some confidence shaking experiences after checking into the hospital, I could have had unnecessary surgery. I’m relieved and even elated that I avoided the knife the second time.
At the same hospital, I had two encounters with the world of surgery, one a glorious success that made me whole again and one a near miss where I’m grateful to have escaped intact rather than have an unnecessary procedure that might have damaged me. Two similar events with trained, experienced men but with different sets of facts.
I was very lucky to have such a good experience with surgery, and perhaps even luckier to walk away from what might have been an unnecessary surgery on an overly trusting patient.
Do more homework, get second opinions, and for goodness sake, be careful when you cross the street over here!