THE 5-MILE STONE BRIDGE 

Ming Wang, M.D., Ph.D.

1801 West End Ave, Ste 1150, Nashville, TN, 37203

615-321-8881, drwang@wangvisioninstitute.com; drmingwang.com 

   The last time I was in mainland China was 20 years ago. Recently, I went home again with my parents during the Chinese New Year.

   I visited my grandparents in Anhai located in the southeast part of Fujian Province. On my way to China, my heart was filled with anticipation and excitement. I thought about the nice quiet little town Anhai, her small streets filled with people selling clay puppet heads. I remembered the serene 5-mile stone bridge cross a beautiful stretch of bay, linking Anhai to the continent. I recalled with nostalgia of those leisurely strolls that I took as a child at the dusk from my grandparents’ home to the edge of the town. I remembered how I climbed on a small hill where a tall stone monument stood, overlooking vast plain of farmland amidst evening breeze and pastoral peace.

   So much had changed since I was there 20 years ago. When we arrived in a small motor-powered tricycle at my grandmother’s house, I stood in front of the house in total disbelief. Where was I? Where had the grand old front door gone? I could not find the small clay street, the beautiful array of little red-roofed houses. In front of me now was a new and strange world: a broad concrete boulevard with bustling advertisements. It was not until I heard my name called and I turned around to see my grandmother and aunts coming towards us, that I finally recognized the front door of grandmother’s house. It was still there. But it looked so small now, so insignificant, as if it were trying to hide away from the bustling new world.

   One of the things that wanted to do on this trip was to visit a local hospital. When I left China 20 years ago, I was 22 years old. I did not know any medicine and not really remember what it was like in a Chinese hospital. Having graduated from a US medical school, I was curious about Chinese hospitals. My aunt, who was an internist in the local Zhong Yi Yuan”Hospital for Chinese medicine, took us there one day. The hospital was housed in a 50-year old three-story building. On the walls were pinned many pictures, mostly paintings advocating “planned parenthood”. One painting showed a happy family with a smiling and overweight baby. Presumably that was a happy family since they had one, needed only one child, a good child. I followed my aunt to her outpatient clinic. It was a room of about 10x10 ft. There was one desk and two rolls of chairs lined against the walls. About eight patients were in the room. My aunt sat at one end of desk, and two patients came forwards and sat right besides her. She felt their pulses, examined their tongues, and wrote Chinese herb prescriptions. There was no privacy. Their conversation could be heard clearly by all others in the room. Though the room was crowded and the facility simple, I must admit that the patients and the doctor seemed to get along quite well. The patients listened attentively, and were grateful to the doctor for the medical help. I couldn’t help feeling a bit of envy for the confidence that these patients had in their doctor, as I recalled my own experience in US hospitals. Though we have much better hospitals and equipment, patients often walk in and say to me, “Doc, I came for a second opinion, because I am not sure if my doctor was doing the right thing when he ask me to have a cataract operation.”    

   The part of the hospital that particularly fascinated me was the pharmacy, where because of my aunt’s connection, I was allowed to visit. It was a huge room. Floor to ceiling cabinets lined all four walls. In those cabinets stood large jars, pots and boxes filled with herb medicine. I felt a bit awed standing in the center of these as if I was surrounded by thousands of years of Chinese medical history.

   Adjacent to the pharmacy was the building window inside of which sat two female billing operators. I chatted with them and found out that the majority of the patients pay for their own health care. The government workers get their bills sent to the government and the hospital gets reimbursed later. There was no insurance company involved, no codes. I was amazed when I realized that the entire hospital billing was squarely taken care of by these two women. I thought about my US hospital –an entire floor taken up by the billing offices and the exceedingly large amount of paper work, and physical and psychological stress endured by physicians and patients. I wondered what were the secrets of this simple and effective Chinese way of doing things and what would the Clintons think about all this.

   China is undergoing a tremendous amount of change. The president of the hospital told me that the hospital was owned and paid for by the government up until last year when the hospital became financially independent. They now have to not only continue offering the best care that they can, but also seek creative ways of doing business. Because of the traditional way of social interaction and the incomplete legal system as judged by Western standards, there still are a lot of payments made under the table. To have a prominent surgeon perform an operation, one has to pass many “Hong Bao”(red bags containing cash). I don’t think that I would feel comfortable practicing medicine in China right now. In US, my practice will at least have some backing of malpractice insurance. But if I operate in China today, I am all alone. Having received so many Hong Baos and under so much personal and family pressure, I would be too nervous to perform any operation.

   Business is everywhere in China today. The whole Anhai town was vibrating with raw entrepreneurial energy. Throughout my stay, I searched in vain for any remnants of the old charming town. The serene hill where the stone monument stood was gone. In its place stood a mini theme park complete with bumper car rides. I could hardly find any more local traditional art pieces such as the clay puppet heads. Instead, the stores were filled with Mickey Mouse and stereo players.

   The night before I left Anhai, I went to the 5-mile stone bridge with my parents. I was so happy to find that the bridge was still there. There I was again, just as a child, standing at the head of the bridge looking over the bay and the Anhai town at dusk. I said to myself, “You know, China has changed, perhaps in some ways too much. But just as this enduring stone bridge, she will always be there, in her grand old form.”