A bloody encounter

All Harbin is known for is the Ice Festival and being asked about it was one of the ice breakers when I first got here. One month later, I started receiving surprised looks that I still had not gone but I had the perfect excuse, I was waiting for my partner to arrive and with the entrance ticket going for £ 30, I was certainly not going twice. Truth is that I also was not in a hurry…the only person in China I confided that was my Chinese teacher who smiled and told me ‘ah, don’t worry…it is just for the tourists…we don’t go there’.  When I finally came around to go, I enjoyed it a lot for all the wrong reasons.  It was like looking at something that it is so tacky that one cannot help but staring in awe. Surely there is something a bit perverse about going up and down ice slides at -25 degrees with “Gangnam style’  music pumping out loud surrounded by millions of bright lights while I was silently praying the epileptic seizures would not make a come back? I much preferred the ice statues and decorations scattered around the city, so much so that when two weeks ago I finally managed to leave what I call ‘The Enclosure’ (the university campus) I felt post concert like sadness to see that they were all gone due to the rise in temperature.

However at that same ice festival I had my first encounter with a lovely fruit used in Chinese medicine. As soon as I passed the entrance gates, I immediately immersed myself in the touristy mood and decided to buy an overpriced tanghulu (糖葫芦)/ fruit skewer which are very popular in the north east of China. Nothing healthy there as the fruit is covered with sugar syrup. As I started munching away my lips must have become numb by the fruit and the temperature because the deadly frozen syrup made his way into my lip without me feeling any pain. So for a while I leisurely strolled with blood pouring out until Kerry turned around to find that Dracula has taken my place. So my most vivid memory of the wonderful Ice Festival was trying to stop the bleeding while admiring the psychedelic activities all around me. 

My favourite fruit of the piercing skewer was 山楂 shan zha/ Chinese hawthorn. Once I started paying attention, I realised that it is everywhere. In drinks, snacks and jellies …I still have to come across the fresh fruit. It usually comes in a very sugary form (no surprise there) but I prefer it in dried form which is quite sour. It brings back childhood memories of stealing the lemon slices from the adults’ drinks. As there is nothing like experiential learning and because I find memorising single herbs much harder than formulae I decided to read up more about this lovely fruit.

I am trying to avoid Chinese medicine literature in English so I went to a shop to choose a book about herbs (and also to feed my books buying addiction). As usual, I got there without my Pleco ( The Dictionary/ my best friend here) so I had to use one of my random ways of picking a title with very limited Chinese/ knowledge of who is who apart from the very obvious ones. I chose a book on the use of herbs by 孟景春 Meng Jing Chun  because the cover had his mug shot and he looked suitably old. In addition he had other two books published (which, thinking about it, doesn’t mean anything but at the time I found reassuring) and, by quickly flicking through it, I recognised another doctor's name who I was told was good by someone who knows much much more than I do. So after such an informed choice and with my wallet only £ 2 lighter, off I went to read about shan zha whilst chewing on some. 

This book includes from some general info about shan zha taken mostly from Zhang Xi Chun, brief explanations on the author's personal take on the usage of this fruit for certain conditions and two case studies. In one of them, 孟景春 uses shan zha on its own and in high dosage as translated below.

Mou, female, 65 yrs old. First visit on 04/08/1983. Had been suffering with chyluria for 19 years. Patient tried Chinese and western medicine but to no avail. In the previous month the condition had worsened. Every time she urinated there would be a great quantity of chyle which was turbid and murky like starch, worse early in the morning, but no difficulty urinating nor pain. When eating oily and greasy food she would suffer from bloating of the stomach and abdomen with a sense of oppression, sloppy stool and the urine turbidity would get worse. The face and the eyes presented with deficiency puffiness, the four limbs were limp and painful. Pale tongue, white greasy coating; pulse thin and relaxed/moderate (缓). 
Diagnosis: spleen and stomach qi stagnation, spleen not transforming essences with fat flowing downward. Treatment consisted in strengthening the spleen, move and disperse stagnation.
The prescription consisted only of shan zha ground into a powder and made into pills with honey. 90 grams/day divided into 3 doses. After half a month the chyluria was completely resolved and digestion was better as well. (Patient stopped taking the prescription). A follow up visit two years later revealed that there had been no more relapses.

Commentary: shan zha is able to dissipate stagnation of oily and greasy substances. It enters the spleen  channel. It strengthens and moves spleen qi; it opens up the middle jiao. The spleen distributes the essence into the lung which supplies it to the one hundred vessels. The lung also unblocks and regulates the water pathways. By strengthening and moving the spleen, there is any more food accumulation and stagnation and therefore the water pathways are open and the source of the downward flow of fat is cut off.

After one week at the hospital...

It has been just over a week in the department of acupuncture under Dr Zhao. She is one flamboyant character whose personality easily fills up the room; her vast array of facial expressions transfixed me for the first couple of days.

I heard quite a few stories about how different clinical practice is in China  compared to the West and this setting is no exception. If anything it is probably more run down than others because the whole hospital will be soon transferred to a brand new building and the Chinese are not very good at looking after their buildings…what gets old, gets destroyed seems to be the motto and in the meantime things fall apart (like most stuff in my room).

Patients never come on their own, in fact they have at least one family member but most often two or three which makes the room easily crowded. Like other things in China, there doesn’t seem to be many rules. Consultations are easily interrupted by other patients making sure that Dr Zhao knows they are there, people walking in bringing gifts or with business proposals or Dr Zhao herself answering private calls. Patients’ complaints and stories are shared with at least thirty people in the room and they often continue on the treatment table or after being dismissed by Dr Zhao.

I am making the most of this formality free environment and so for example it felt perfectly normal this morning to literally stick  my head and rummage into one patient’s bag of herbs to check out what he had been prescribed (in fact the patient helped me to do that). I must remember that next time I give grief to someone at the supermarket for having sneaked upon me and checked the content of my basket (yes it happens often!).

Most patients come for conditions such as cerebral palsy, stroke, insomnia, numbness, depression/anxiety, tinnitus and certain types of pain. The needles used are indeed thicker and longer but I haven’t seen anything too extravagant; in fact stimulation is down to a bare minimum but I must say the number of scalp points used is quite extraordinary. 

The other day one of the Chinese students’ head was used as a pin cushion to demonstrate our needling techniques; I cannot see that happening any time soon at the University of Westminster where I trained. The chosen one was a particularly timid student, as loudly pointed out by dr Zhao, in the hope he would overcome his shyness.. She certainly got some reaction from the guy, although maybe not the desired one.

If in Chinese medicine we usually say that there four methods of diagnosis, for Dr Zhao there is a fifth; one that comes before anything else which is the MRI. Nobody walks in without one; we were told she is the expert at reading them. I believe that; she looks at the MRI before doing anything else quickly followed by neurological tests… it is such a routine that even the other foreign students who don’t speak Chinese have started chanting to themselves with the same lament like tone ‘扎这儿疼？ ‘扎这儿疼？ 一样吗？’(does touching/pricking here hurt? And here? Is it the same?).

Dr Zhao is often delighted to inform her patients about diseases we don’t see in our clinics and usually proceeds to give us a quick lecture which consists of reaching for her book and reading out some paragraph of explanations constellated with Western medical terms that sends our poor translator into a panic. At this point I can perceive the boredom spreading among my fellow students and my only consolation is to concentrate on the language aspect of things. Today she gave what seemed like the first real explanation of some patient’s condition from a Chinese medicine point of view; the sense of relief was palpable.

Although not having had any epiphany of the sort, I am learning something everyday and admittedly the placement being through scholarship and therefore free, it takes some of the pressure off; certainly that is the reason why I think most of my colleagues are putting up with translation which is rather poor and often a collective effort. Everybody who is assigned the job gets a scolding from dr Zhao for not being a good enough translator (which is true but then again the poor victim is a ‘volunteer’ student because we are scholarship students so there is no funding for a professional one). I sometimes feel like telling her that we are the ones visiting but for obvious reasons I shut up (well I don’t want to eat my dinner on my own, right?). Don’t get me wrong, my Chinese is super basic but paired with the shaky translation I feel like I have less gaps in the bigger picture. Well after all, I have put myself through a few weeks of isolation at -25 degrees and it seems to have paid off.

Beginnings

To blog or not to blog; I have been playing with the idea for at least a year. Then a few days ago looking at the big pile of flimsy flashcards generated by ‘free-style’ Chinese classes of the last seven weeks, I decided that it was about time. If anything to give something back to the virtual community out there. You see, I am an internet addict with some skills at spotting good things online. But if it wasn’t for all the people who spent time to provide feedback or stories on the net, I would have never thought twice of going to my present Chinese language school in Harbin which has little web presence.

I am also not very good at keeping in touch, so this way some people (mostly my lovely Italian relatives) will know I am still alive even if they’ll have to paste my entries into Google Translate with possibly disastrous outcomes.

Finally, I am really hoping to connect with people who share the same passion I have for Chinese medicine (I wish I could say east Asian medicine…who knows…maybe one day) and all the geeky stuff related. Sorry Facebook friends…I will bore most of you.

So… after seven weeks… here are my impressions of

Harbin : fierce, friendly, fattening city

Fierce: wintertime here does not allow much space for spontaneity; leaving the house requires careful layering with -25 outdoor and 25 degrees indoor. Fierce is the battle between you and the ice that covers most of the pavement. The secret is cultivating the penguin-like walk adopted by most locals which allows you to get to your destination in a decent amount of time but involves sacrificing looking good as it ain’t a pretty sight.

Harbin has a rough edge to it; despite being considered a second tier city, it still offers very few comforts to us Westerners. Be prepared to pay more for a decent coffee than an average Chinese meal and if one wants to add some peacefulness to the experience (which rules out all coffee chains), the choices can be counted on one hand. I could go as far as saying that Harbin is a rather boring place but I don’t want to be too harsh to this city that has so far treated me pretty well. But admittedly, the few Westerners I met came here to study hard and not for the entertainment offered. For that reason, especially in wintertime, it can also be a fiercely lonely experience.

Friendly: I have had more people smiling at me in the last seven weeks than twelve years in London. Most people are just willing to help and chat to you and for that reason, especially if you are learning Chinese, this place is worth a trip.

Fattening: shelves full of junk food, bread, cakes, … if you want a proof that sugar is the drug that runs the world…come to China. I think they are catching up with the West as the same speed they do everything else. I was served a plate of spinach last night dusted with white sugar…all those things I thought I could avoid coming to China. Gone down the drain is my dream of going home trimmer…not only that but I have such dark rings around my eyes that pandas are going to start thinking I am one of their own! However, tomorrow it is the first day of the clinical placement…so who knows…they might fix me.