Monday, April 24, 2017

No papers? No papers.

There is a scene in the movie Hunt for Red October that I often think about. If you’re not familiar with the film, it stars Sean Connery and Alec Baldwin movie from `990. Sean Connery plays a Soviet Submarine Captain who, along with his officers, is planning to defect to the United States. Alec Baldwin plays Jack Ryan a CIA analyst who figures out the captain’s intent.
The scene that frequently comes to mind is one where the captain and one of his officers are talking about what they are going to do in America. The officer says he wants to move to Montana and buy a pick up truck or maybe an RV. They then have the following conversation.
“… And I will go from state to state… they let you do that?”
“Oh yes.”
 “No papers?”
 “No papers.”
Now, you may be wondering why in the world I’m writing about a nearly 30 year old movie and some random scene. Well, when I was a kid I didn’t really understand the significance of this scene. I remember asking my mother what they meant about papers and she explained to me that the Soviet Union wasn’t free the United States and so you have to have papers to do things. I really still didn’t understand this and I honestly think my mother and most Americans don’t truly understand its significance. However, I am now thoroughly acquainted with the concept.
In China all Chinese people have something called a Hukou (户口). A hukou is a family registration that is tied to your hometown. If you live outside of your hometown you have to register in the city that you live. If you want to get a passport (or renew it) you have to return to the city of your hukou. I’m sure there is even more to this concept, but I don’t fully understand it and the hukou isn’t really the point of this post.
Everyone who live in Beijing (or any other city) and doesn’t have his or her hukou in Beijing must register with the local police station. As a foreigner I must also register with the local police station. Matter of fact, every foreigner who even visits Beijing  (or anywhere else in China) must register, they just don’t usually realize it because the hotels take care of it for them.  Every time I leave China and re-enter the country I must go to the local police station and complete a new registration. I must also do this every time my visa status changes or I get a new passport (I will be picking up my new passport from the U.S. embassy tomorrow. I will then have 10 days to get to the Entry Exit Bureau to get my residence permit transferred to my new passport. After that I will have to return to the police station and once again update my police registration).
Here's today's registration form (with some important information redacted)
Every police station has different requirements for what you have to bring. Every time I register I have to take my passport along with copies of the photo page, my residence permit (or visa) and my most recent entry stamp, my original lease, a copy of my lease and copies of a whole bunch of my landlord’s documents. I’ve never met my landlord. I rent my apartment through an agency, but I have a copy of his national ID card and a bunch of other documents. I have no idea what these documents even are. To me they are rather strange looking. The office at the police station where I register is only open from 9-12 and 2-5 so every time I return to the country I have to leave work to go during their limited hours.

Now I think you understand why I started with the scene from Hunt for Red October. As you can tell, I am intimately familiar with the papers that they were talking about in that scene. I am also so much more appreciative of the freedoms we have in the United States (keep in mind I have to use a VPN to post on this blog because all blog sites outside of China are blocked because the government can’t control them).

Thursday, April 20, 2017

Your gallbladder was rotten

As you probably know from my blog post A rough few days, I discovered back in early March  that I had a rather large gallstone (1.8 cm). I had had a lot of rather excruciating pain, but the doctor in Beijing told me it could wait until July when I was finished working for the summer. I questioned this because this was the second really bad attack in three weeks and both had lasted days not the minutes or hours that I had read about. He assured me that it would be okay.
Nonetheless, I started speaking to my family and coworkers getting their thoughts on things in order to help me make a decision on what to do. Several people made some really good points. Among them: 1) "you don't want to wait and have it become an emergent situation and then have no choice on where you have it done." 2) "Gallbladder surgery is routine, but things do go wrong. If you're in a hospital in Beijing your family might not be able to find you" (because taxi drivers don't speak English and my family doesn't know their way around at all, but this one got me also thinking about the delay as my family tried to get an emergency visa to even enter the country). And one of the biggest deciding factors, 3) "As a Chinese [person], I would choose to have surgery in the States if I could." Thus, I decided to have surgery in the US and to have it sooner rather than later.
Having made the decision to have surgery, I now needed to figure out how to schedule surgery in a country I'm not currently in and get everything squeezed into two weeks because that was really all the time I could afford to take off from work. This is the point where I was really blessed (or used a concept the Chinese call guanxi). I have a brother-in-law who is a hospital administrator at a hospital not only close to my parents' house, but also where my Dad used to work and in-network for my health insurance (Thank you so much to my friend M who convinced me it was worth the extra cost to upgrade my insurance from worldwide excluding the US to truly worldwide - her main argument, if you need treatment for something you'll be able to go home for it). My awesome brother-in-law got  everything set-up for me. He found a surgeon who was willing to take my case with only minimal information coming out of China. The surgeon was also willing to schedule my surgery before he even met with me.
Thus, I departed Beijing on Friday evening the 7th of April (after having worked that day) and thanks to a beneficial time difference arrived at the airport closest to my parents on Friday evening (needless to say it was a LONG day). I met with the surgeon at 9 am on Monday and had my pre-op appointment at 11. My surgery was scheduled for Tuesday the 11th and my return ticket was for Thursday morning the 20th.
Of course things simply could not go that smoothly. Monday afternoon (before I'd even gotten the call telling me what time the surgery was scheduled for) I received a phone call from the financial department at the hospital telling me my preauthorization had not yet been granted. I asked her what I should do next and she said the procedure hadn't been cancelled, but I should call the office of my provider doing the procedure. Having not scheduled anything myself I wasn't sure who to call so I called my good ole brother-in-law. Super brother-in-law directed me me to a woman named Christina.
Over the next few days, Christina, a woman I've never met, practically became my best friend. To make an incredibly long story a bit shorter Christina harassed the US side of my insurance company for days, the surgery got postponed 3 times (from Tuesday to Thursday at 6:30 then Thursday at 6:30 then Thursday at 10:30 and finally to Thursday at 12:30), and I called and emailed the Shanghai office all night long Wednesday night to Thursday morning. Thursday morning at 7:30 I called the Shanghai office and was told it had been approved. Unfortunately, even when I checked in at 12:30 the hospital had not yet received the preauthorization and I had to sign a waiver. My surgery ended up not starting until about 2:45 and from something the surgeon said at my follow-up appointment it appears he did get notice it had been approved prior to starting the procedure.
Everything went really well. I woke up thinking I was in China and my first memory is someone telling me I wasn't in China and my replying, "I understand what you're saying about me not being in China, but I can't shake the feeling that there's where I am." I don't know if that conversation started with them asking me where I was or not. They asked me a bit later after several other conversations and actions had transpired where I was and I correctly identified both the hospital and the city. I suspect that is what started the previous conversation.
Several other things happened when I woke up including me having both my hands tightly clenched. They told me to unclench my hands, but I refused. They then proceeded to put the blood pressure cuff on my leg and a pulse ox monitor on my ear. Oh I did not like having that on my ear (remember my actions are all while coming out of general anesthesia)! I asked them what I had on my ear and after they explained I said, "well then if I unclench one hand will you take it off my ear?" "Yes." "Fine, which hand do you want unclenched?" They indicated the left. I unclenched it an spread my fingers wide. "There, it's unclenched."  They removed the pulse ox monitor from my ear, but didn't have to put one on my finger because there actually was already a thin disposable one there.
I declined all pain meds. I was in far less pain than many times before my surgery ( I estimated my post-op pain at 4 and at the doctor's office before my diagnosis I had estimated it at an 8.) i met my goals for release very quickly (pain control, eat with no nausea and pee). When I was in the PACU (post anesthesia care unit) one of the first things I asked was for the time. It was 4:45. By 7:45 I had eaten, gone to the bathroom twice, proven I was steady on my feet, asked for my IV removed (they hadn't done it yet) and was pacing my room in the day hospital. My nurse and the new nurse (it was shift change) came in and founding me pacing. They immediately began trying to get me discharged and by 8:03 I was dressed with discharge papers in hand waiting for my parents to return from dinner (and possibly a bit of shopping). I walked out of the hospital (having twice declined a wheelchair) on no pain meds and only wishing for a throat lozenge (the nurses said they'd find me one, but forgot) at 8:15 pm. In China they said I'd have to stay in the hospital for a week!
I got to go to church the following Sunday, which was Easter, and my sisters and their families all came over. I had an awesome time, but may have slightly overdone it, especially with the 5 inch wedges and running around the yard with the Easter egg hunt. After everyone left, I took three ibuprofen and fell asleep on the couch for about 3.5 hours before getting up and going to bed. I had to take Monday easy.
On Wednesday I saw my surgeon for my post-op follow-up. It was a couple of weeks earlier than usual, but necessary because I had a 7:25 am flight on Thursday. When I saw him he told me my gallbladder had been rotten and he couldn't believe it hadn't come out sooner (in the PACU a resident told me it had been really inflamed and that it was surprising it hadn't caused me a lot more pain). The pathology report showed in addition to cholethiasis (gallstones) I had both chronic and acute choleocystitis (inflammation of the gallbladder). I had feared I might be being a wimp pushing to have my surgery done now instead of waiting for summer, but clearly it couldn't have waited.

A foreign land within its own country

Oh no!
I found a cool place where you could take
your picture with drawing that looked
3-D. Unfortunately, I didn't
have anyone to take my photo so
I got a couple of the posed photos
that you had to pay for. I'm actually
in part of a fake tram...
After I left Thailand I headed to Hong Kong for six days. Hong Kong is a very interesting place because it is part of China, but it isn't part of China. Hong Kong Island was a possession of the British. Then they added Kowloon (which is Cantonese for nine dragons). Finally, the British leased the New Territories from China for 99 years. This lease of course was initiated before the founding of the People's Republic of China. In 1984 it was
Hong Kong Island has these really narrow
trams often called ding dings because of the
sound of the bell.

Here comes the tram

decided that all of Hong Kong would go back to China on July 1, 1997. Part of this agreement included that Hong Kong had to remain the same for fifty years. So far it has been 20 years and there are already a few changes (largely related to putting in a more and more pro-Beijing leadership), but Hong Kong is classified as a Special Administrative Region (SAR) and banking-wise and in a few other ways is considered a foreign country from the mainland (for example Hong Kong passport holders can attend international schools and other things only open to foreigners in China).
The tram logo
Me on the tram
This trip was my second time to Hong Kong. The first time was 14 years ago. Several things have changed. First, as an American, I don't need a visa to go to Hong Kong (never have), but last time Chinese citizens needed a visa. Now I don't believe they need a visa (although I'm not positive). Before I had to have a re-entry visa and ended up with 8 stamps in my passport! I had a stamp for exiting the mainland and then one for entering Hong Kong. One for exiting Hong Kong and then one for entering Macau (another SAR that was returned to China in 1999 by Portugal), a stamp for exiting Macau and one for entering Hong Kong again and finally a stamp for exiting Hong Kong and entering the mainland. Now. this time I arrived in Hong Kong from Thailand so it was a little bit different, but I didn't get any Hong Kong stamps at all (a little disappointing). When I arrived in Hong Kong they just gave me a little arrival card with the information that is usually in the stamp and that the papers said I needed to hold on to until I left.
While I was in Hong Kong I did most of the usual things - I took the tram up to the Peak, took a cruise through Victoria Harbour and so forth. There were two main highlights for me: a guided tour of the Hong Kong history museum and catching a Lion and Dragon Dance. The Hong Kong history museum had free tours. It was really nice. We had a tour guide who took us throughout the museum not only telling us about the history of Hong Kong, but also sharing his personal family experiences as they related to the history. The Lion and Dragon Dance was also really cool. This is a quintessential Hong Kong Chinese New Year celebration that I happened to wander across (I actually had to do quite a bit of waiting, but it was pretty cool). One thing that was unusual was that the dance I saw had purple lions in addition to the traditional yellow and red ones.
Finally, the last thing I did was also kind of interesting - I took public transportation to the China -China border at Shenzhen and crossed into the mainland on foot. I then took Shenzhen public transit to the high-speed railway station and returned to Beijing via high-speeded train (about 10 hours as opposed to 24 hours from Hong Kong by non-high speed train).
The view from the top of the peak

Another picture from the top

Me at the top - the headphones are because I
am listening to an audio tour.

A woman asked me to take her family's photo so
I asked her to take a photo of me.
This was a display in the mall at the top of the peak. These
are all candles.

The purple lions

The dragon

Go lions, go!

A night view of Victoria Harbour

I took the ding ding all the way to the other end. There I ran
across a fun market. These are common on the mainland

Meat anyone?

The midlands escalator. It's a series of escalators that take people up
the hill in the central part of Hong Kong Island.

Approaching the intra-China border