Quality of mercy
Serious illness in the family is always disturbing, and when you are in a foreign country with a totally unfamiliar healthcare system, it can get downright traumatic - especially when the treatment and diagnosis seem to be based on factors other than the Hippocratic Oath of doing what is best for the patient.
Two months ago, I was called back from an overseas assignment. My father had suffered a coronary and had been hospitalized.
The journey back was a test and a race against time, but even that did not prepare me for the ordeal that was yet to come.
The hospital he was admitted to is a semi-private establishment in Beijing and my father had been placed in the special cardiac intensive care unit.
The first thing we were told to do was to make a deposit and make sure there was enough money to cover his stay.
The second thing we had to do was to employ a care-giver, someone who would sit by him and ensure his needs were met. Aren't nurses supposed to do that? Apparently not.
We were next summoned to the department head's office. With a grim face, he informed us that my dad's arteries were 90 percent blocked, and his heart and kidney functions were very weak.
He told us that open-heart surgery for a by-pass had a 50-50 chance of recovery. Even so, it may only help him live another year.
The other usual option was to put in coronary stents. But my father is 80 years old and had been diabetic for more than half his life. His vessels were fragile and that is not the best option.
After that, it seemed to us that the only choice that was not immediately life-threatening was to resort to medication.
As I waited for advice - we have about six medical specialists in the family ranging from pediatricians to pathologists - I was wracked with indecision.
The operations would be expensive. Being a non-Chinese citizen, my father would have to pay full costs. Although we would not grudge the expense, the family felt we had to consider if he would survive the surgery, given his fragile state.
And I would never forgive myself if that was his only chance of survival. I am Chinese, and filial piety is unquestionable.
A day later, his ward doctor called and tried his best to push us to opt for surgery. When I queried him about my dad's fragility, he hedged and seemed unaware that his head of department had already spoken to us.
Fortunately, he managed to recover without the surgery and any stents. A young doctor in his ward had advised us to take my father home. I bless her. She was honest and had no vested interests.
Some questions remain unanswered, and the uncertainty has eroded much of the faith I have in the local healthcare system.
My father was kept in intensive care for 20 days, long after he was well enough to complain about the food.
He was transferred to the normal ward at his own request. Every day at the ICU cost about 1,500 yuan ($236) while a bed in the normal ward cost 30.
But my own concern was not so much about expenses.
I am still wondering why two doctors in the same unit recommended such a conflicting prognosis. Was it because that the operations would have earned the hospital about 200,000 yuan in fees and earn the doctor more than brownie points?
When my dad was finally discharged, he was given more than 20 types of medication. My mother-in-law is a retired nursing officer and she told us about half of those were unnecessary or even repetitive.
Healthcare is one of the most important aspects of life and it must not be compromised in any way. Perhaps if doctors were given the proper remuneration, they would not have to turn their backs on professional ethics.
If hospitals were better managed, they would not have to resort to pushing unnecessary medication to make ends meet. China is in that uncomfortable position when its infrastructure as a developing country lags behind its reputation as a world economy.
When these are finally reconciled, perhaps then doctors can practice their profession without compromising the quality of mercy that must come with their skills.
paulined@chinadaily.com.cn
