45,000

45,000. That's the number of deaths that one Harvard study links to patients who lack medical insurance in the US. Could that number be hacked way down? I have my own hunches, but before getting into that dicey discussion--the cost of hospitalizations and single payer insurance and so on--I have some simple Chinese-inspired thoughts about health.

Just think how much money we might save if we just focused on food and feet.

What if we focused less on medical care and more on public health--especially what we eat and how much we walk? I look around me in western China, a less prosperous part of the country, and see people with gleaming white teeth, people who probably make very few visits to the dentist.  They don't pay a lot for dental care, but they eat good food and eat very little sugar. I see nimble-bodied people who carry all kinds of loads, who walk at all kinds of speeds, and accomplish amazing things at all ages. People are active. Don't get me wrong--I'm sure lots of people are left outside the medical system who do need care, but I also see a culture where lifestyle (and preventative practices) trumps medical care (and reactive practices).

Isn't that a sane way to save lives and money?

What if the US took the car keys from everyone and made us walk a little more a couple days a week? What if we radically shifted our healthcare discussions from reactive policies (after we're sick and in need of medical care) to preventive policies (to keep us from getting sick). We need a shift in personal lifestyle as dramatic as the shift we had when the EPA put curbs on some frightening environmental practices a generation ago. We desperately need a Rachel Carsons for personal health--someone to shake us into eating right and walking a little more.

It's not so convenient to walk? True--but what if convenience is killing us?

China, of course, doesn't have all the answers. China does support a culture with active people who tend to have vegetable rich, low-fat diets, but it also has a huge problem with air pollution and other things. China needs the equivalent of the EPA--it desperately needs regulations on air quality and on the burning of fossil fuels. But the US could pay attention to the life style of most Chinese residents--and the huge implications of that lifestyle for medical costs.

Wouldn't eating better and walking more save millions, maybe billions of dollars in the healthcare system?

But back to 45,000. Our best intentions don't necessarily keep us from getting sick. We come with whatever genes we've got, and some environmental issues are beyond our control. Stuff happens. We all get sick. I for one, would like to think I live pretty lightly on this earth, but damn! Every organ in my body has a medical story. There's that bizarre little teratoma, straight out of science fiction. Nobody knows where my giant cavernous hemangioma came from, one that almost shut down my liver. I could go on. And what about the head trauma with that bike wreck? If it weren't for medical insurance, I'd probably be hanging out in a homeless shelter somewhere.

I do believe in single-payer insurance, and think it's a basic right. I'd like to see us blast into that 45,000 number, and I think decent insurance for every human being would be a step in doing so. I don't believe in unlimited insurance for every possible procedure at every stage of life, especially near-end-of-life procedures, but I suspect that some basic, very basic, universal care is sane. I realize it won't be cheap.

So what can we do to offset the expense? If you ask me, we can pick up the other end of the stick and take seriously how much we walk and how much fat we consume.

http://www.reuters.com/article/2009/09/17/us-usa-healthcare-deaths-idUSTRE58G6W520090917

Morning run: two sides of this Beibei mountain

My running shoes are not yet laced up, but it's early enough that I can run anywhere without self-consciousness. I am, you know, a conspicuous runner in these parts, and although I’m used to being stared at, I don’t necessarily like it, especially if staring keeps people too preoccupied to step out of the way.

When I step down my four flights of concrete stairs, and up the path from my building, I can go one of two ways. Going up the hill eventually winds back behind this cluster of apartments to a mountain path that goes back about three quarters of a mile, overlooking a tributary of the Jialing River far below. The path used to push back farther along the mountainside, but now an avalanche of dirt and rubble from higher up the mountain has closed it off.

When I used to run beyond the part that's now closed, I never came upon more dwellings. And yet the very existence of the path--worn enough that somebody was walking on it, keeping the ever hungry vegetation in those parts from overtaking it-- made me suspect there must be dwellings ahead. And now, with all this rubble virtually cutting it off, I  wonder whose life has just been cut off. As it is, some of the peasants who live close to the cut off carry water to their dwellings in buckets on either end of bamboo poles over their shoulders.

This mountain path was my running route of choice if I wanted to avoid the crowd on campus or the public that's thick along Tiangsheng Road. But just yesterday I discovered an alternative route. 

If I go down my four flights of concrete stairs, and then head down the hill from my building, I find myself on a busy city street with the gates to the university on the other side. If I turn away from the university, toward the vegetable vendors, and then loop back up the other side of my mountain, I see a completely different world, one where caterpillars and bob cats are methodically dismantling it. Instead of one kind of crane swooping gracefully through the sky, rigid industrial cranes swing from atop one skyscraper after another. Sometimes ten or so can be seen at once.

Looking up from the foot of this still unpaved city street, unfinished skyscrapers loom in the distance. I still see laborers, but not ones balancing vegetable baskets or water buckets on bamboo poles. Instead, they're laying bricks and sweeping the dust of this strange new world. This young worker, clad in high heels, looks like many a college student cruising the Yonghui market area not far away.

So my dwelling is literally at this East/West crossroads:  If I go one way for just five minutes, it feel like I've set the time machine dial for 1500; if I go to the other way, for no more than five minutes, it indeed feels like we fast forwarded almost half a millennium.

From China to the Dominican Republic

The wedding was simple, all except for getting there. Barefoot and flip-flop simple. Pant-legs billowed and Ana’s dress swirled—with the small gathering of Brazilians and US-Americans squinting against blowing sand, straining to hear the thoughtfully chosen words of the marrying-man, Nick.  A groom’s forgotten line here, a bride’s wink there, a happy tear down the groom’s cheek. This was a joyous occasion. Brazilian nieces let the wind empty their baskets when they’d forgotten to drop more than a petal or two. Good food, good dancing (well, I admittedly don’t qualify as a judge, but we were all out there), good mingling of people, most from somewhere in the Americas. Here comes the sun. (Yep, Chris chose the Beatles over Mendelssohn.)

 Words fail to describe my joy reuniting with Chris, Ben, Nick and those few family members who could make this special occasion, knowing it was impossible for most to even consider it. (And, in my book, all who were there were family.) Chris, Ben, and Nick—I won’t see them again until late 2014. I wouldn’t have missed this wedding for anything, even if it wasn’t exactly simple getting there from China. 

March 30, 2013

 Getting there from China meant watching an orange moon rise in an Arctic night sky, meant experiencing the New York skyline zoom in closer and closer until it turned into an asphalt runway, and meant standing on one foot and then the other in immigration lines under the spacious thatched roof pavilions in the Punta Cana airport in the Dominican Republic.

That, of course, was the easy part. Getting there from China also meant following rules, ranging from the incredibly important to the marginally so. Absolutely supportive as my Peace Corps and university colleagues were, the paperwork for permissions started almost a year ago and dwarfed my Peace Corps medical form (something that took my doctor 63 pages and half a year to complete). Then, thanks to the brilliant idea of a school secretary, my spring schedule was altered to accommodate the wedding—with classes compressed after my return so I technically would not violate any school rules by leaving the country.

Rules. Interesting what rules are on a trip that required waiting in so many lines with so many rubber stamps pounding paper--I counted over 300 people ahead of me in a customs line at JFK; rules where, over the Pacific, a very concerned pilot reported that someone had been caught smoking in the bathroom; rules on an aircraft where, just before touching down in Chongqing, half the passengers started rummaging through the overhead bins and had to be re-seated.

Most of these rules, including the Peace Corps and university ones, concern basic safety and must be taken seriously. However, I was given occasion to have my doubts about some rules, twice in Punta Cana, first when I was seated by Gate 8 reading Dreaming in Chinese. As I read on, a name that sounded vaguely familiar occasionally punctuated my consciousness. It certainly was not my name, but after the hundredth time I heard it, I thought I’d better make sure. Oh, were the officials relieved! They indeed thought they were calling my name and they were sorry to report that there was a problem in my suitcase. One TSA in a crisp white blouse marched me past a dozen thatched-roof buildings to a shed at the far end of the runway. She was sweating and said it was hot, even by Dominican Republic standards, which is all I understood because my Spanish is worse than my Chinese, which I kept absent-mindedly using. I was seated in a folding metal chair before a metal table, a single overhead light bulb, and two other uniformed people. My suitcase was crammed full because dear ones had brought me items from the US—Ann brought next year’s winter uniform (a coat I intend to move into in about November and move out of sometime in early March), various CDs my sister-in-law brought, many bars of chocolate that Nick surprised me with, and so on. I barely got it zipped close in the first place, and I had no idea how I, usually a light traveler, was going to do so again. They rummaged and rummaged with all the non-clothes items spilling onto the floor. Ah! In a mailing package on the bottom was the mysterious object that had flummoxed the security personnel. Index cards! A friend who met me at JFK brought something I can use in my TEFL classes—index cards. Ten or so minutes later, the TSA had escorted me back to Gate 8 and we were told to march out onto the runway, where scores of us proceeded to stand waiting for another twenty minutes under the high sun while the TSA looked for something else.

But the rules the TSA dreams up are nothing compared to those that airlines insist upon when they have to reschedule flights they really don’t want to reschedule.  Bad weather in Hong Kong led to hundreds of flights needing to be rescheduled, and I was just one of thousands of stranded passengers on Easter weekend. Personnel for Cathay Pacific and China Air played badminton with me in Hong Kong, while personnel for Cathay Pacific and JetBlue continued the game in New York City. All were constrained by various rules—and “problems” their databases had logging in this and that new flight information. Right?

I discovered, though, that stranded passengers help each other (sharing ways to recharge tech toys, extending bits of chocolate, going out of their way to show what can’t be translated); I discovered that it’s possible to endure drills grinding through airport walls all night here and loudspeakers blaring taxi information all night there; and I discovered that some “rules” that impede rescheduling can be dealt with. Among my airport heroes are the Air China woman in Hong Kong who suddenly appeared out of the shadows at 5:00 in the morning next to me when I got in line at Cathay Pacific and Coral, the Spaniard at JFK who got off work and then spent another two hours haggling with Dominique at Jet Blue. Okay, these two may have just been doing their jobs, but they seemed to be getting me to the wedding. They summarily ended squabbles about “because of this I can’t do that. . . .” Fifty-eight hours after Xiao Kairong picked me up at Ban Zhu Cun in Beibei, I saw the palm trees giving Punta Cana its name and sighted a member of the wedding.

Punta Cana, Dominican Republic

Having nothing to do with rules, there were other delights, including the handsome young Chinese couple seated next to me on the return flight to China. They listened and giggled each time one of three nearby babies burst out crying again—the man lifting his finger, seemingly orchestrating what would evolve from solo to duet to trio. He laughed each time he took it upon himself to conduct some more.  That’s the spirit—a spirit I sorely lacked at certain moments coming and going.

Like many adventures, getting to the wedding from China was part of the story, but the very best part without a doubt was being with Chris, Ana, Ben, and Nick on March 30^th and 31^st.

Students wanted Chris and Ana to have this traditional Chinese wedding image -
the phoenix and the dragon

When weeds, in wheels, shoot long and lovely and lush

Nothing is so beautiful as spring --says Gerard Manley Hopkins, and who can't agree? Beibei is alive--the high rock walls are again covered with a profusion of green, with threads of wild roses and other blossoming things mixed in. Hillside orchards lift cherry scent and rafters covering granite tables in public areas drip with wisteria. There's still plenty of dirt and pollution, but the earth's natural rhythms push spectacularly through the grime and honking horns.

It was actually the first day of spring when some students from last semester invited me to go down to the Jialing River and fly kites. As happens in spring, the skies shifted gears and threatened rain instead, but we still enjoyed a dramatic afternoon.

But spring is also alive with quickening human hearts and--it is with great joy that I will go celebrate  young love halfway around the globe and, with my beloveds, witness Chris and Ana's marriage. I will get to see Ben, Nick, and other dear ones. Not all--in fact, few of my siblings and special friends will be able to go to the Dominican Republic for this wedding, halfway between Chris's US and Ana's Brazilian home ground. Tai gui le!  I'm grateful, though, that I will be able to go--and welcome Ana to our family.

Dr. Ana Gleisner is on the right (taken in 2011).

Ana and Chris - first trip to Brazil.

We don't really need Alfred Lord Tennyson to remind us that "In the spring a young man's fancy lightly turns to thoughts of love."

Did you ever like mammograms?

In the middle ages, they tortured people by stretching them out on the rack; in the new millennium, they do the opposite, compress body parts that are still attached between plates of glass. Imagine placing your nose in a vice, and just having it squeezed until it was one flat  piece of tissue that could fit into an envelope and be mailed somewhere, or perhaps your ear. Your ear is probably already flat, but, because it's attached to your head, you'd have to tilt your head in some odd positions to accommodate having that ear squeezed between two glass plates without having your brain X-rayed. So it is with breasts when getting a mammogram.

In that hospital in Chengdu, I got to freeze as if I were a dancer in a modern ballet, with my chin thrust way behind my shoulder, a shoulder that would be curled forward in one direction, while an arm was flung out dramatically in another. And then I'd change positions into another dramatically unnatural pose and let them take  more pictures.

Now, in theory I'm a great fan of mammograms, for they have saved many a dear friend's life by detecting their cancer at an early stage, including the cancer of my Belgian buddy Inge who was tagging along with me to Chengdu (partly to check out the pandas). But in practice, I've never been thrilled to contort myself in the various positions required to get any kind of image from a woman built like me. To say that I am not big-breasted is a masterpiece of understatement.

So, you should imagine the efforts of the Chinese technicians trying to rearrange my resistant body to place things just right on the glass plates before they came crushing down. Of course, they'd almost have me man-handled the right way and would order me to move in some little direction that--well, my Hanyu just isn't that good. Wo ting bu dong. I'd still be in the wrong position.

It was silly to be embarrassed by all this because there's no place for embarrassment in Chinese medical practices. You're about to get a mammogram? Just drop your shirt, right there. No gowns, no privacy. The door's ajar? It's so busy in the hall nobody's paying any attention. Not fussing about privacy is no doubt more efficient and--it's not like the doctors and medical staff don't see everything anyway.

(Back story: What they were doing was just routine follow-up that the excellent Peace Corps medical staff had ordered. I had some routine and not so routine health issues looked into, which required taking the train to Chengdu for an overnight and then being accompanied by a Peace Corps doctor to the hospitals--yes, plural--where the various procedures were done.)

Crowds of people waited in waiting rooms, including monks in orange and maroon robes, perhaps even more conspicuous than I was. I was actually accompanied by two doctors: my friend Inge as well as the youngest Peace Corps doctor, a beautiful woman with black hair streaming down her back, almost to her tiny blue jeans. She was most appropriately named Dr. Bing (sick) and could maneuver crowds and bureaucracy like a maverick.

Several specialists gave me undivided attention in a few subsequent exams, greatly impressing Inge.  Although I was seeing Western-trained physicians with excellent credentials, most of them either practice or are open (selectively) to Eastern traditions, too.  I will save for another time more discussion about that. I suspect we, the East and the West, have much to learn from each other's medical systems.

Girls' Day--really?

I wasn’t surprised the first time I heard someone say “Happy Women’s Day” a week ago Friday, and I wasn’t too surprised when my very charming language teacher laughed and told a small group of Koreans, Japanese, Russians, a few Americans, and a Frenchman that, in so many words, Women’s Day was the official holiday but the unofficial holiday was “Girl’s Day.” In fact, I wasn’t surprised at all. For a semester, I’d heard college students calling themselves “girls” and had witnessed little animal ears on various hats and cell phone covers.  Other things seemed “girl-ish” indeed, even though being girl-ish one minute didn’t preclude walking arm-in-arm in tight mini-skirts and stiletto heels the next. But what I had naively failed to realize was that International Women’s Day is a bona fide stay-home-from-work holiday, not only in China but in many countries—and had been an official holiday in China since the founding of the PCR in 1949. That was roughly a generation before the UN proclaimed Women’s Day for women’s rights and world peace in 1977.

 But many of the students at my college and elsewhere have been actively plotting an alternative celebration, “Girl’s Day,” something more akin to Valentine’s Day than any sort of politically grounded event. One of my students wrote to tell me that the Student Union of the School of Computer Science had announced a set of “rules” for Girl’s day. He wrote that “on the girls' day, a boy on a bicycle should take the girl who is walking beside, boys shouldn’t reject a dinner treat request from girls, boys are not allowed to retort girls even if they quarrel, boys should allow girls jumping queues, a boy shouldn’t refuse the love if a girl confess love to the boy.”  Chivalry is not dead!

  

I think I hear Susan B. Anthony groaning.

I look at those shoes and think about bound feet—what are they thinking? Who are they pleasing?

Strangely, I’ve begun to see these most a-political of acts—dressing in the most provocative and anti-feminist ways—as almost political. Not political, but rather  willful resistance to botched deliveries of the political. Thinking this way helps me understand both my Chinese students and my students at home, who also tend to be relatively a-political.   Watching Zhang’s 1994 film To Live last night led me to reflect once again on what it takes to live in a world where political movements with good intentions can go—and have gone—tragically awry. What does it mean to live anywhere—whatever the internal and external conditions are? 

The historical meaning of Women’s Day, I’m sure, is not lost on my students. And they do have a sense of irony. They, both men and women, could laugh heartily when reading “The Good Wife’s Guide,” an article (dubiously) attributed to a 1950s issue of Good Housekeeping:
*Have dinner ready. Plan ahead, even the night before, to have a delicious meal ready, and on time, for his return. This is a way of letting him know you have been thinking about him and are concerned about his needs. Most men are hungry when they come home and the prospect of a good meal (especially his favorite dish) is part of the warm welcome needed. . . .
* Arrange his pillow and offer to take off his shoes. Speak in a low, soothing and pleasant voice.
* Don't ask him questions about his actions or question his judgement, or integrity. Remember he is the master of the house, and as such will always exercise his will with fairness and truthfulness. You have no right to question him.
* A good wife always knows her place.

 I’m reminded, too, that translation continues to be a devilish problem. So, what is a woman? 女人  女子  妇女   妇女  妇 And what is a girl? 女孩   姑娘  的女孩  女 的姑娘  Not so easy. Is it my notion of “woman” the same thing that Chinese “girls” are resisting when they seek an alternative holiday celebrating young, pretty, unmarried women under thirty? Whew. Sometimes it’s amazing that we can communicate at all.

 

 

--> But, even if it’s true that, paradoxically, (political) resistance to botched political activity may be expressed in pointedly a-political ways, I don’t see all bygone political activity as botched and I hope that some day my students (Chinese, American, whatever) may appreciate more fully the founding of the International Women’s Day.

What's 55 + 1?

One. According to Thomas Mullaney,  the math works this way in China: 55 + 1 = 1. That is, 55 ethnic minorities plus one Han ethnic group equals one, the People's Republic of China. The Chinese language is "Hanyu"; the Chinese dominant identity is Han. Putting aside the question of the dominant "1," Mullaney asks just where did the widely accepted number "55" come from? Who decided what an ethnic group in China is and then counted them--using what criteria? Was it a unique language that defined the ethnic group? A unique culture? A period of cultural dominance? Unique foods?

Song Tao's snapshot of a Dai parsley dish

Well, it was food that was on Song Tao's mind (and mine) when we got lost looking for a particular Dai restaurant in Kunming. The moon rose in another clear Yunnan night sky, we walked and talked, and got lost. But, by the time we found the Dai restaurant, not too far from Yunnan University, the crowd was thinning and we decided the timing was perfect. So, is it true that Dai cuisine specializes in bugs? And moss? And so forth?

It's fortunate that we had heard such rave reviews about this restaurant about the size of a double car garage with the door wide open, because the menu might not have tempted us otherwise. The colorful menu listed this fare. . .

          Acid Sweet Yuanzi
          Clear Soup Pig's Knuckles
          Brain in Soy Sauce Pig's Knuckles
          Old Fried Chicken to Let Them Know
          Acanthropanax Spicy Microphones
          Water Pickles Mix Big Fire
          Cold Pigskin
          Dai Fried Cowhide
          Cold Eggplant
          Cold Gray Eggs
          Smelly Food Fried Egg
          Sauce Blasting Eggplant

Now, were the cooks wanting to pack up early and go home? Or were they serious about trying to tempt us to eat something? Somehow, we were tempted, even if not by the menu itself. We ordered pineapple rice, a phenomenal tofu dish wrapped in greens, sensational fried moss, and a Dai water parsley dish that had some of my favorite sweet and sour (lemony) flavors. The food was exquisitely memorable--and you can fill up on a lot of moss without overeating.

Song Tao's shapshot of fried river moss

The Dai are perhaps not a single ethnic people but rather several groups with different languages and cultures, some millennia old, extending through Thailand, Laos, and Cambodia. So, it might be a gross generalization to say that the Dai are a nominally Buddhist people who grow rice, sugar cane, and bananas in the fertile river basins of the Mekong and other southeast Asian rivers. It might not be true that most Dai men are tattoed with tigers and most married Dai women wear silver wristbands and wear their hair up with combs and flowers. Perhaps they don't all live in bamboo houses raised on stilts. And perhaps they (and other ethnic minorities) are not underrepresented in Chinese affairs; perhaps they are not overrepresented among people lacking sufficient food and water.

Whoever the Dai people are, I don't think their presence is the primary reason I liked  Kunming--perhaps it was just being far away from the intense commercialism and pace of the east coast; perhaps it was being in a place where diversity is the norm; perhaps it was being in a place where old women's faces crinkle with smiles instead of stiff stares. Who knows?

But two things are for sure--one, I don't really know what makes a Shaoshu Minzu or minority group, especially the Dai, (or what the differences are between and among nationality, language, culture, and ethnicity) and, two, I do know that I had an incredibly nutritious and tasty Dai dinner.

Song Tao's snapshot of Dai tofu wrapped in bamboo

* * * * *

Mullaney, Thomas S. “Introduction : 55 + 1 = 1 or the Strange Calculus of Chinese Nationhood.” China Information 2004 18: 197      http://cin.sagepub.com/content/18/2/197