So as I mentioned in my last entry, I went to the Beijing University Eye Center at 8 am on Friday morning. Clinic lasted until about 1:15 pm. We saw 41 patients in those 5.25 hours and could have easily seen more, but Dr. Wu said that since the weather had turned worse (it was windy and cold), many patients didn't come (same as in the US!). Out of those 41, 14 or so had a history of acute angle closure glaucoma! Crazy! It is definitely much more common over here, which makes me that much more interested in the research project I'm working on over at home on why more Chinese get PACG than other ethnicities.
I noticed many unique qualities of the ophtho clinic here during that morning, and I'll talk about them in no particular order (the order that I wrote them down during the day. First, Dr. Wu used the direct ophthalmoscope to examine the patients' fundus and optic nerve head! I have seen exactly zero ophthalmologists in the US use a direct ophthalmoscope...they all have their own lenses to look in the back of the eye at the slit-lamp. Second, doctors' visits are super-cheap...around 6-10 yuan for the exam. That's around $1. Third, the professor had a set-up in the exam room in which she sat at a desk facing the door, with the slit-lamp to the side. A medical student sat at the desk opposite the professor, with a computer. As patients came in, the student handled their forms and patient cards, and also inputted data into the computer. She also printed out receipts for the patients to take to the cashier. It made the whole process so much more efficient than in the US, although the student definitely seemed like a cashier at times rather than a student learning about ophthalmology. The patients' hospital cards have some computer chip inside, so that when it's placed on an electronic sensor, the patients' info (name, age, DOB, etc) automatically pops up in the database! You don't have to waste time typing it in, etc. The way that patients get "appointments" is that they have to line up early in the morning to get numbers to see certain doctors, and when the numbers run out for a professor for that day, then the patients in the back of the line don't get to see that particular doctor. In a way, I like this system, because it really equalizes people, in the sense that even the poorest person can see a renowned doctor, but at the same time, someone who came from a faraway province might not be able to get a number that day and would have to come back the next day or the next and have to spend money to stay in the Beijing to wait for an appointment slot. This issue also forces doctors to schedule surgeries or laser procedures very soon, for example, the next week. It also forces the patients to make decisions on their medical care very soon. It cost 3000 yuan for an operation and 160 yuan for a laser (the exchange rate is about 7.5 yuan to the dollar, so you do the math). Another difference is that patients are ultimately responsible for their medical records, imaging, test results, etc. They carry their medical record, which was essentially a small booklet, around with them, and they can have different booklets for different specialties. They also had their visual field results, UBM images, etc for the doctor to look at. One last important issue for the doctors to think about is that there are large differences in the prices of medicines. Although this is often the case in the US, insurance plans will often cover the price, whereas there is no such system here. For instance, prostaglandin analogs, which are first-line therapy for glaucoma, cost 200-300 yuan (closer to 300) per bottle, while timolol, a beta-blocker, is not as effective (it's second-line therapy), but it costs 5 yuan per bottle. Unless the patient is relatively well-off (i.e. has a job, etc), they obviously choose the timolol. All very fascinating to observe. Here's the eye center...it's really big...the second floor is clinics, third and fourth floors are inpatient wards, the fifth floor is for ENT and stomatology, the sixth floor has offices, and the other floors have research labs and lecture halls:
Ok, so now to the fun part of the weekend. Friday night, I went with my classmates to 南锣鼓巷 (NanLuoGuXiang), or South Bell and Drum Lane, which is a hutong with a bunch of small stores and pubs along the sides. We did some browsing in some of the shops, found two massage places to go back to later, and eventually settled on a smoky bar to hang out in, although as most of you know, I don't drink EtOH. I thought it was a little ironic that their beers cost 10 yuan, while my cold "milk chocolate" was 30. It was pretty nasty. They served it with ice in it, so it was super-dilute and didn't taste like chocolate at all. There were tiny flakes of chocolate throughout the drink, which makes me think that they just tried to mix those chocolate flakes in with cold milk and then iced it even more. And of course, tons of people were smoking, and my lungs and throat couldn't handle it. My nasal passages and throat were congested and scratchy all day Saturday, too. I had to shower when I got back because I smelled like cigarettes. The only saving grace was that the waitress girl was kind of cute, but not even that could make up for the fact that my life expectancy dropped by a few days, and my cancer risk went up a bit after that night.
On Saturday, my friend Wang Fengdan, who is a student from PUMC who went to UCSF last year, invited us UCSFers, along with the other PUMC-->UCSF exchange students from last year, to her apartment (in which she lives with her husband) for lunch. It was really fun...we ate hot pot and then played some Mafia afterwards. They have a really nice place and it was fun to be around my PUMC friends again. Here's a pic from hotpot:
The night was pretty fun, too. We went out to a club that had mostly Chinese students, but also a lot of (tall!!) Europeans/Americans. The UCSF/Harvard students went, as well as a few PUMC students. The music was typical American club music. It was SUPER-loud, but I finally remembered to take earplugs to a club! My ears were very happy afterward. I experienced neither tinnitus nor muffled hearing s/p (status-post) clubbing, for the first time. The cover was 'only' 50 yuan. Here's a picture of me and Susan (from Harvard) showing off our "bling" (our coat check bracelets):
And this is me with Fan Cong, a 7th-year PUMC student (who is also interested in ophtho!). Her English name is Cletty, which she made up. It's a mix of "clever" and "pretty," which seems to be a good name! Almost as creative as my friend from Guangzhou, who originally named himself "Roham," a mixture of "Ronaldo" and "Beckham," his two favorite football players! Hehe. This picture shows just how smoky it was inside (though not as bad as the bar the previous night):
Sunday, I met up with my friend Wang Yao, who was our calligraphy teacher at Beijing University nearly four years ago and is now a graduate student in Chinese at Beijing University. It started out badly, as I wasn't able to find her in the huge subway station. I eventually found her at the entrance to the mall, outside the subway station, after 20 minutes and four phone calls. We went to a restaurant called 外婆家 (Grandma's Kitchen) that serves food from the Yangtze River area; it was pretty good...we ordered a ton of food for just us two. Here's a picture, with a list of the food, from left to right, below the picture:
Stinky tofu, sauteed greens, an awesome chicken dish with super-tender chicken, Dongpo pork, sesame buns, fried shrimp, preserved egg and fish soup. I managed to carry a conversation (for the most part) in Chinese for three hours, although I flubbed a lot of my words and pronounciation 2/2 nervousness. She was also nice enough to take me to buy some shoelaces to replace the ones that had split in half on my dress shoes, before she went to meet up with her boyfriend.
The subway ride on my way back to my dorm was PACKED, but it wasn't even the worst I had seen (last Sunday was 10 times worse). This picture doesn't come close to capturing how crowded it was in the station and on the trains:
On the way back to my dorm, I stopped in the record store, FAB, where I saw a mass of people by the CD's. It turns out that some singer was there signing records for his adoring fans. I just looked him up, and his name is 乔任梁. His English name is "Kimi." Um. I have nothing to say. This is what he looks like from 30 feet away (his face is half-covered and he's earing a green shirt...behind that blue roll in the front):
I just looked him up, and he looks like a girl, so I guess his English name is appropriate....?
And walking back on Sunday at 4:30 pm, this was the line that was already starting to form to get a number to see the doctors in clinic on Monday....
All in all, a pretty fun and eventful weekend. This week will also be eventful, as 1 am Friday local time is match time for my peers! We will be crossing our fingers on Thursday night (and going out to pre-celebrate, hehe).
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