In getting ready to move, I thought I was ready for some of the challenges.  I assumed that there would be some bumps for the kids with school and that our new house would be smaller than our old one.  I was even ready for the challenge of feeding the family once we arrived in China—or so I thought.  I had no idea how much of my time and energy would be spent on a daily basis trying to figure out how and what to cook over here.  I have always prided myself on the fact that the kids are pretty good eaters.  They will usually try almost anything, and, more often than not, discover that they love the thing they had earlier been hesitant to taste.  I like exploring and figuring out how to use local ingredients.  I like seeing what the locals eat and going to the markets.  When we lived in Paris, I spent most of my afternoons deciding what to make for dinner and then shopping.  I remember those afternoons as great experiences.  Yes, I sometimes had trouble asking for what I wanted in French and I had to make substitutions when I wanted something specific form home, but France has beautiful markets (duh) and I was usually more than willing to change what I ate when something better presented itself.  I was flexible and we ate really well.  When I couldn’t find salsa, I figured out how to make it myself.  I made friends with the butcher.  I was really just learning how to cook so sometimes my creations fell flat, but other times I was surprised to find that I could make something really delicious.  We had a house full of roommates who were always willing to try the things I made and mealtimes were full and joyous.  I was expecting our time in Shanghai to feel a little like this.  Well, this is no Paris.  Not yet, anyway.

Part of the problem is my own.  I want things to get to the point where they are easy and I want that feeling now.  Shanghai is fun for exploring, but not when you need dinner on the table for 3 kids at 6:30 sharp.  I have really had difficulty with this lately.  They are not my hungry roommates from Paris, not by a long shot.  My kids have usually spent the day tasting new things at school (school lunch is saving me, by the way) and when they get home they want familiar snacks and a no surprises dinner.  I want to give that to them, but finding the ingredients here to make what used to be my go to meals is complicated.  Look, I haven’t even made it to the actual markets yet.  Right now I am navigating a maze of multiple supermarkets.  If I ever go back to work we will starve to death because my carefully crafted system of supermarket shopping will collapse around us.  The supermarkets are worthy of a post all by themselves but suffice it to say that imported things are available… for a price and right now it seems that everything we want to eat is somehow imported.  Oh, and it is never all available at one store.  I go to multiple places just to make burritos and then we are all disappointed with what ends up on the table.  When I find something that I thought we would have to learn to live without, I do a little dance of joy.  Usually, however, my dancing is interrupted because my next step is trying not to hyperventilate over the price.  This is especially painful if I have just recently thrown THE EXACT SAME ITEM in the garbage during the pantry purge in Baltimore.  Don’t worry; the next few posts will contain hard evidence of this painful experience.  I just paid 72rmb for parmesan cheese after searching everywhere for something other than the kind in the can.  Yes, $12 for a hunk of cheese.  Not even the really delicious cheese that would have been worthy of a $12 splurge!  Of course, the next day parmesan was everywhere and the exact same piece was 52rmb.  Really, it doesn’t pay to dwell on it.  The lasagna I made was passable (it is usually to die for) and only one kid refused to eat it.  It probably cost me $75 and gave me a handful of gray hair, but at least we all lived to tell about it, right?  Yeah, right.

The lost bag turned out to be a nonevent.  Once the restaurant opened my bag was sitting behind the bar. It had been there all night and everything was still in it when we picked it up.  One of the few things that really should have been a big deal but wasn’t, as opposed to all the little things here that should be easy but are enormously difficult.  Figuring out where to get things that we have become accustomed to as “necessities”, organizing deliverymen, and finding simple things that would normally take a trip to Target all become day-long ordeals for me in China.  And we aren’t even out in some remote area; we are living in a giant, thriving city.  A city where you would think pretty much anything would be available.  Not so, of course, and one of those things is emergency care.

Health care in general here operates on a different system.  Mark’s business has need for strong healthcare services, and, living in Baltimore, we have always had numerous choices not only for primary physicians, but also for hospitals and specialists.  I loved our pediatrician.  Loved, loved, loved him.  We plan on visiting Dr. Bodnar every summer when we head to Grandmom and GrandDad’s house.  The dentist, too, particularly after I got a good dose of Shanghai healthcare last week.

Now, I am no expert and we haven’t yet had to use much in the way of facilities here, but when the younger kids’ school offered a “Hospital Tour”, I was told it was vital to attend.  Normally, I wouldn’t be very interested in a tour like that.  I mean, I can figure out how to get to the doctor, right?  I have three kids- two of them frequent flyers in the emergency room.  When I jokingly mentioned this to the parent liaison at school, she signed me up right away and even handed me the printed information so that I could read it in advance.  Ha, ha, um… ha?  Actually, not funny.  Not funny at all.

When I attended the orientation at Lucas’ school I had gotten a bit of a feel for how serious things might be if there was an emergency for us here.  Lucas has asthma.  It doesn’t bother him much and he doesn’t need an inhaler, but it can give him a nasty cough and sometimes (like for several years in a row, always right before Christmas) give him pneumonia.  Not serious, in the hospital pneumonia, but the kind that lingers and makes you look like hell and sound even worse.  Every single time I tell someone in Shanghai that Lucas has asthma their face changes.  “Did you bring plenty of his medicine?”  they nervously ask,  “From home?”  They want to know if I have found a doctor yet.  Maybe they have heard that there might be a new one- a good one—at a particular place. The Western doctors don’t stay long, apparently, and they are often on rotations that move them in and out of the country.  You might find one you like, people warn, and then never see them again.  They might not be there when you need them like some sort of horror movie script.

Lucas needed a test for tuberculosis.  I hadn’t realized before we left the States and only found out once we were here with no trip back planned for several months.  The school needed it and wouldn’t wait very long.  All new students—no exceptions.  I asked the school nurse where I should go to get the test done and she gave me the card of a local hospital.  I say local, but it is 45 minutes from my house and on the other side of the river.  I showed the card to some of the mothers from the PTSA and everyone agreed that this was the only place they would “trust”, the only place that would have a “safe” test.

If you have ever had the chance to be tested for tb, then you know that the test requires two visits to the doctor.  The first is to get the needle prick to inject you with the test and the second is to actually look at the pinprick site to note any changes in the skin.  There was no way to head over to that hospital, especially not twice over the course of a few days, without missing school and spending the entire day in a taxi.  Surely there must be some closer place to do this, right?  Wrong.  I called a few of the places that were in my handy dandy sneak peek for the hospital tour only to learn that no one does the test.  They would do a chest X-ray, but nothing else.  It seemed extreme to have an X-ray when we already knew Lucas didn’t have any possibility of having tb.  Maybe I was misunderstanding.  Maybe this was a language mix up.  I called Mark who had his assistant call the clinics back.  Even in Mandarin the answer was the same.  There is only one place to get the test and it was going to eat up two full days making the test happen.  So I made an appointment for the X-ray.  The more complicated thing was once again somehow going to be easier.

Going on the hospital tour cleared up some of these issues.  Well, not cleared up, actually.  The hospital tour made it crystal clear that I had no idea what we were getting into when we came to Shanghai.  Yes, it is a modern city in many ways, but it is still a Chinese city with a very different system when it comes to healthcare, a system that is going to take me a while to figure out.

It turns out that the moms I met at Lucas’ school were right.  There really is only one hospital where you can get 24 hour Western medicine with English speaking doctors all in one self-contained place.  The hospital that is 45 minutes away, of course!  The focus of the tour was to acquaint us with the places that were closer to us in the event of an emergency.  Because in a real emergency 45 minutes might be too far away.  The other moms had cautioned not to go anywhere else other than the Western hospital “unless you are bleeding to death”.  There is apparently some truth to this so we were investigating the places where we would go when we needed immediate care.  We had a sit down session first before getting on the bus.

The quick takeaways:

1. Never call an ambulance unless you cannot get the person into a cab.  The ambulances here are not equipped with anything medical and are not staffed by paramedics.  When one had to come to the school, they used a bed sheet to get the patient to the elevator, laid her on the floor once they got there, and then picked her up in the sheet again to get her to a van.  They will take you to the nearest hospital by whatever route they choose and then you will need to pay them when you get out.  They might check your blood pressure but they will charge you extra for it.
2. You need to preregister at your hospital of choice because they will make you register before they will treat you.
3. You might need to pay upfront so keep a giant wad of cash (like 20,000 rmb!!) and your passports handy.
4. We need multiple emergency cards with the hospital address printed in Chinese for the taxi driver and we need to keep all the emergency information handy so that we can grab it and run out the door, hopefully with some friend or neighbor who speaks Chinese.
5. In the event of a real emergency in the middle of the night we will most likely end up in a Chinese hospital.

It was confusing, particularly since after hours many of the English speaking places did not inspire confidence.  At one, the one that seemed the most promising, the person showing us around made a point to emphasize the “imported medicine”, catered food, and the great beds from Italy.  We never met a doctor.  The guide told us that there weren’t many people there at night because there weren’t “many emergencies” and that if no one was at the desk it meant they were in the back and we should yell to get their attention.  Most telling, perhaps, was the fact that she told us at night they could handle “fevers, stomach aches, things like that”, but that if you were in a car accident then you should go to the Chinese hospital.  Most of the places are special expat parts of a regular Chinese hospital and we had to walk through them to get to the Western sections.  It was always crowded with both the very sick and the healthy all mixed together.  They were loud and people moved through the building like they do on the street, filling all the available space.  People were smoking.  Bandaged eyes and heads were on full display.  One patient lay on a gurney close to the front door.  When we got back on the bus we slathered ourselves in hand sanitizer.

I hadn’t realized that you couldn’t get any medicine over the counter.  I didn’t know you needed to pay for individual items, like a cast for a broken arm, for example, before you could have the arm set.  Even if I spoke Mandarin, the hospital would still be impossible.  Vaccines were recommended that had never occurred to me in the United States.  We talked about the need for everyone to have first aid training.  I mentioned that I had been recertified in CPR last year.  That was good, the parent liaison agreed, but then she reminded me, there isn’t any 911 here.  In China, I’m the paramedic.  That is a job I never intended to have.  Crap.