CHINA! Tips, and other big differences from the good ole’ USA

OH China!

A List of Differences from the good ole’ USA,  and Tips I learned

1) You have to bring toilet paper with you EVERYWHERE, because no place actually has it in the stalls

2) Oh, did I mention the toilets?!

3) When crossing the street you are more likely to get hit by a person on a bike/motorcycle than a           car/bus

4) Don’t ever drink the tap water!

5) Corn on the cob…

6) Everyone that is “white/Western” is French

7) Couples match their clothes

8 ) The guy will carry the girl’s purse

9) Little old ladies dancing on the sidewalk

10) Two large bottles of beer cost ¥8, or $1.50

11) The whole bathroom becomes the shower in the dorm

12) There is no lotion

13) KFC buckets make good hats for the rain

14) Speaking of rain…bring an umbrella, it rains a lot

15) You thought America was hot? Try over 90 degree F with about 80-90% humidity

16) Bring a book of common phrases, this is very handy and you can make small talk with your cab driver!

17) Metro is very cheap and gets you to the best places

18) If you have a large group, take a taxi, it will be more likely be cheaper

19) Hand sanitizer is not common, buy sanitizing wipes

20) There are not a lot of hair products, bring your own

21) People are aggressive when it comes to food/lines

22) Slang is not taught in China, so don’t expect people to know what you are saying all the time (or at all if you are  out on the street

23) The internet is unpredictable in the dorms

24) McDonald’s is cheaper during the hours of : 1100-1400 and 1600-2000

25) Cafeteria closes after each meal time, so check the hours they are open

26) Did I mention there is no open container policy J

27) LEARN NUMBERS!

28) Girls wear high heels, even in downpours

29) If you decide to go out by yourself, don’t talk to other foreign looking people, they are trying to scam you, just pretend you don’t speak English

30) Bring cash, not travelers checks, only “Bank of China” cashes them

31) Get massages! They are cheap and you can ask for a cute guy *wink*

32) Don’t assume everyone around you only speaks Chinese, a lot of people know English, so be careful what you say

Bonus Tip: 33) Go have fun! This is a once in a lifetime opportunity! If one of your friends invites you to do something, even if it is 2AM, DO IT! You won’t regret it!

The Rest of my Trip to China! (Yes one big post)

Hey everyone, I know, I know, I did not keep up on this blog like I had wanted to.  The reason for that is, I was having way too much fun in China to sit down at night and write in my blog! I pretty much had something to do every night whether it was going out to a night club, going to the basketball court, or just hanging around in the dorm with my new friends I met.  So here are just some highlights of my trip to China, mostly non-school related.

For the past few weekends I have been going out on the weekends with new friends I have made here.  I have gone to many dance clubs and bars in Shanghai.  What I find very interesting about the night life in Shanghai is that there are not many dance clubs but there are clubs that people will sit at tables with their friends and drink all night, this is basically the bar just the Chinese version.  The music that they play at the dance clubs and bars is all American music.  I am not sure if the reason the music is American is because I was in a very large place that foreigners are or if that is the music they play because America has a lot of club music.

Steve, my neighbor across the hall

Group Picture of people I met in the international dorm!

The people I have met here are so amazing, they are the reason I do not want to go back to America.  I have met people from Nepal, Pakistan, Bolivia, Korea, and Taiwan and of course China.  When I first got here I met a boy named Ozy who is from Pakistan,

Ozy and I

and the first time I hung out with him he invited me out to his friend’s birthday gathering.  This night was one of the best nights of my life, this is when I went to eat Mexican food, yes Mexican food in China, I couldn’t believe it either.  From then on Ozy, Shailesh and I have been very good friends.

Ozy, Shailesh and I at the Stadium in Shanghai

I have gone out with them and their friends on numerous accounts and they have shown me around different places in Shanghai.  I really don’t know what I would do without these two guys.  Another important person to me has been Steve.  He lives across from me and has helped me with so much!  He is also very kind and has shown me different places in Shanghai, and he also went out with Sudan and I to different night clubs.  Steve’s friend Edward also became a good friend of mine who has become my new buddy to hang out with in the evenings, and he also invited me to go study with him in the library so we can both get some work done.

There are so many other things about China that are just so different from America that I don’t even know where to begin.  Some cute little things I have noticed is that young couples will buy shirts that match and complement each other.  I have also seen that the man also carries the woman’s purse, I find this very sweet! I have learned that in order to be in a line anywhere, you have to be very aggressive; the Chinese people will get in front of you if you are not paying attention for a split second, or even if you are.  I can’t even count the times that Sudan and I have been cut off in line. What I really like about Shanghai is there are so many people everywhere all the time.  At times this can be overwhelming such as when you are trying to get on the metro, but most other times it is great because there is so much to see and watch.  I thought that for the most part Chinese people are very friendly to me, a foreigner, but at other times I didn’t feel comfortable, however, most of the time I was totally comfortable around everyone.  What I did find surprising is that I never felt that I would be pick-pocketed.  This is something I was very worried about when I first got to China, however, I actually was very comfortable all the time and never had to worry about this.  What I found to be very tedious was cashing my travelers checks, I found out that I count only cash them at “Bank of China” and to me this was very inconvenient.

There are so many things that I love about China, especially Shanghai, that I cannot even begin to just write about all the little things.  I learned so much from my experience at Zhongshan Hospital about how different, but at the same time how similar treatment is. I think what I was most surprised about from my hospital experience is how they handle privacy differently as well as decisions of treatment.  I also enjoyed my time outside of the hospital playing in Shanghai experiencing Chinese culture first hand, such as getting massages with TCM treatments as well as gua sha.  And finally I will never ever forget all the people I met in Shanghai.  I met some of my favorite people in Shanghai and I know that I will keep in contact with all of them because I plan on coming back to Shanghai and seeing them all again.  I had the best time of my life in China and plan on visiting as soon as I can!

The rest of my Experience at Zhongshan Hospital

Wow, I have been having such a good time here in China that I have not been keeping up on my blog.

I also have very unpredictable internet that sometimes decides to work, but most of the time it doesn’t.  In this entry I am going to post the rest of my experience from Zhongshan Hospital. Here it goes:

Week 2 Reflection

June 4th-June 8th, 2012

This week I mostly spent time in the SICU (surgical intensive care unit). The first day that I spent there one of the patients had expired and I noticed that they were waiting for the family to come and take care of this patient.  I am not sure of the protocol in the United States when it comes to family members handling the body, however, when the family came they got the patient all dressed in what seemed to be the outfit she was going to be wearing at the funeral service.  I believe that in the States this would not be done right in the SICU but rather someplace more private.

Another thing that I noticed in the SICU is sometimes the handling of things that in the United States people would be wearing gloves when they would be handling that item. Not only would they wear the gloves to protect themselves but also the sample to possibly prevent contamination.  What I have noticed that I really like about this hospital is that things are always getting cleaned.  Ever since being at this hospital there is a lot of staff that is continuously cleaning surfaces as well as the patients getting cleaned by the nurses.  To me this is very reassuring that there is staff there to just clean and take care of things that are not sanitary.  What I have also noticed is that the nursing staff and the doctors seem to be very attentive when it comes to the patients, one example is them having noticed that the patient’s catheter was coming out and it was fixed right away.

A huge dynamic that I have noticed that is different from the United States is the role of the family members.  One of the patients in the SICU is bleeding to death, and the family was told that the patient needs another surgery in order to give him a chance to live, and that there are also risks to the surgery as well.  The family decided not to let the patient have the surgery, and it was the family’s decision.  In the United States people can have a “living will” that usually has what they want in times such as these.  The patient can state in there if they want treatment or not.  There is also a health care proxy that the patient could have appointed in the past.  This health care proxy is a person such as a family member or friend that they trust will make decisions the patient would want for their health care.  If neither of these is appointed I do believe it is up to the doctor’s discretion on making decisions about the patient’s health.  What I have noticed here in China is that it is always up to the family to make the decisions for the patient in times where the patient cannot make decisions for themselves.

Week 3 Zhongshan Hospital

This week I was in the IV compounding area also called PIVAS.  This is a large area where the IV’s are made for the patients on demand.  The only time they are making the IV is when there is an order for it.  This is mainly because they put many of the medications in one IV bag.  I think this is a great way to do it because I feel it is less waste of IV bags to put thinks in one bag for that patient.  I think that this is clever, but the compatibility must also be one thing that is watched out for especially when many drugs go into the same bag.  What was interesting about this part of the hospital is that the pharmacist will put the label on the bag before the bag is made. What they do it print out the labels for the orders, go to the room where all the bags are, and then pull the drugs that go into bag for that patient.

The next thing that I found interesting is that the pharmacists do not actually make the IV bags for the patients, instead the nurses do this in the clean room.  This is something that I did not really agree with because I believe that the pharmacists have the proper training to do this and should be making the bag.  I think what might be mostly lacking here is the sanitary techniques that we mostly see in America.  While watching the nurses make the Iv bags they are very rushed at making them and it is just so routine for them that I am not sure that they are aware of their technique.  Since the nurses are so busy at making 4000 bags a day in this hospital it can be difficult to properly make an IV bag, however, this is something that I feel should not be shorthanded. After the bag is made by the nurse the pharmacist then check the bag and the drugs to make sure the proper drugs were put in the bag and make sure the particles are all dissolved and compatible in the bag.  They are then sorted out to the different wards and the delivery carts, and then brought to the ward for the proper time of day dosing.

Week 4:

This week I got to spend time in the Inpatient Pharmacy, this is actually a 3 story pharmacy.  On the first floor is mostly the drugs that are mostly going to be in IVs and also some TCM drugs.  The ones on the second floor are the capsules. The third floor from what I understood was mostly machines.  What I thought was interesting about the pharmacies here is that medications are arranged according to the body system.  Such as a certain shelf is antibiotics and then there are cardiac medications on a different shelf.  I think this is a very good way to arrange medications because it would be difficult to arrange Chinese in alphabetical order.  Mostly what I did that week was help to fill the orders which are done according to shelf section.  Sometimes, however, the numeric system is not correct and the medication is in a different part, this made it difficult for me, but I would just as the pharmacists for help.  When I had free time I would go and visit the SICU.  I have come to really like the SICU and all the people that are working in this unit.  I have made friends with several of the residents and one of them, Yang Li, took me to play ping pong in the school gym.  I also really like this unit because there is a patient there I go to visit.  The first day I went to the SICU something drew my attention to him.  As weird as it sounds it is as if him and I were friends in a past life, I don’t necessarily believe in reincarnation, but there was just something about this patient that made me have to pay attention to him.

Week 5:

This week I got to spend a lot of time in the Traditional Chinese Medicine unit in the outpatient area.  The woman I got to spend time with does acupuncture and cupping.  I got to watch her perform both of these on her patients.  She explained to me the meridians and how she will choose which meridian to focus on for that certain patient’s condition. I highly enjoyed learning about this practice and liked her teaching me her beliefs in this type of medicine.  I think that if I were to do any sort of TCM practice this would be it!  It seems like she really enjoys speaking with her patients and she does get to do something new every day.  There are many disease states as that she gets to help treat.

Since I spent so much time in the SICU, I became good friends with the residents, doctors and even the director of the SICU.  I really enjoyed spending my time with them and they were always so friendly to me.  Whenever I would go to the SICU the doctor or the director (whoever was there at the time) would show me around to the new patients and tell me their individual situation and tell me the action plan they were taking in order to help the patient. Here are some photos of the people I met in the SICU.

Dr. Zhu ( The SICU director) and I

Dr. Biao Zhu, and the SICU clinical pharmacistDr. Zhu (the director of the SICU) and I

Week of May 28-June 1, 2012

Week 1 at ZhongShan Hospital

The first day at the hospital Sudan and I got a tour of this hospital.  One thing that I could not get over is the size of the hospital, we were told that it has about 3,500 beds! I could not believe that when I heard it, but then again I looked around me, and I could believe it.  Just in the outpatient area it was busier than a mall on black Friday. When we took a tour of the emergency room, it was very intense! There were people everywhere, even in the hallway of the entrance there were people with their IV bags.  I could not believe how packed this hospital was.  I also got to see the TCM pharmacy.  I saw a woman that had a bag of her TCM medications to go home with and I remember learning in my CAM class that people would go home with bags of different medications, and I saw that first hand! When I went into the pharmacy the first thing I noticed was the smell, I thought it smelled great in there.  There were so many different smells I could not describe it, but it was really nice.  There were medications in bags all over. After lunch Sudan and I got a tour of a couple different floors, the one we were mainly on was the respiratory floor.  As we were getting a tour I noticed that there are many different patients (about 5) in one room.  There is also no air conditioning on in these rooms so all the windows are open, and to me it seemed a little humid in there.  Since it was humid, I was thinking this is probably not the best environment for the respiratory patients to be in.

On the second day we met up in the respiratory ward in the morning and got to listen to the different cases/patients.  We spent a good hour or two with them doing this because there were so many patients.  We were told that most of the patients are lung cancer patients, but the cases they were mostly discussing were infection and some problems they could not really figure out.

In the afternoon I got to go on the cardiovascular floor with Dr. Lee who took Sudan and I around most of the time.  He is a clinical pharmacist that spends his time on the cardiovascular floor and he took us to see all his patients.  What we were told is that most of the patients come in and they will get a PCI.  We also saw a few patients with severe heart failure.  This one patient in particular was devastating to look at because her edema was so bad in her legs and you could tell she was very thirsty since all she wanted to do was eat the Popsicle her daughter had there for her.

On Thursday Sudan and I got to do more rounds in the morning in the Cardiac ICU and see progress of a few patients.  There was one patient in particular that was interesting to me because of the severe condition they were in. I am not exactly sure what happened to the patient but I remember that they had to be resuscitated and they are currently on a respirator.  Also before lunch we got to watch the most known cardiology expert in China speak to a patient.  We also got to watch a few cases presented from this expert in both Chinese and English.

In the afternoon we spent some time on the cardiovascular floor talking with Dr. Lee, and we were discussing medications and also things that we have found different from the US.  One thing that we have noticed that is different is that some medications, in particular Warfarin, are treated differently.  In China they are not as aggressive as Americans with starting this regimen.  We were also discussing about how the pharmacist role in China is more “hands off” than in America.  The pharmacists here in China were commenting on how they wish that they could have more power in talking to the doctors about the medications the patients are on.  Here on my first week at Zhongshan Hospital I have already learned and seen so much, I am excited for what the next few weeks have in store for me.

Suzhou and Hangzhou

May 26th

Today the four of us took at tour to Suzhou!  This city said to be like the Venice of China.  We took about a two hour bus ride and got to Suzhou in the morning. The tour that we took was all in Chinese so this event was actually very difficult for me.  I usually like to be the person that knows what is exactly is going on at all times.  But one thing that I have had to learn here is China is to trust the people around me.  I have to trust Sudan a lot here because I do not speak Chinese at all, and so far things are going great.  I think that Sudan and I make a great team!  I am not really sure the names of the places that I visited in Suzhou but most of the places were temples as you can see in the pictures.

Temple in Suzhou

The four of us had a little bit of a fiasco with the hotel however, we were not told that we needed our passports with us to get the hotel room, and Stephen was the only one with proper ID on him, so we were taken to another hotel we could get into. There were so many little interesting things on this mini trip, such as the van ride and how intense the driver was, and also in that same car ride I saw a chicken get butchered on the side of the city street.  The things I see here in China are so amazing that I don’t feel like people at home will ever be able to imagine it.  However, Suzhou is a very beautiful city, and I agree, it seems like the Venice of China with all the beautiful water.

Sudan and I in Hangzhou

On Sunday we took a 3 hour drive from Suzhou to Hangzhou.  I really enjoyed Hangzhou!  It was even more beautiful than Suzhou from what I saw.  We went on a little boat ride similar to the one the previous day.  What we saw however on West Lake were the 3 stupas that are actually on the reverse side of the 1 yuan! I was so amazed at this and was very pleased I got to see this amazing scene!  We also saw a lot more temples this day and visited nice silk shops! Hangzhou was a great place to see and I know I will never forget it! Stupas in Hangzhou

Day 4/5 Research Building

May 24th and 25th Thursday/Friday in the lab Sudan and I went to the 8th floor of the research building to check out some different labs. Here is where we met a PhD. Student named Oliver. He was very nice to us and told us that he is researching oral insulin. Sudan and I were so excited, and I think that Oliver was surprised at how excited we were about his research! Oliver also gave us a great tour of the research labs and told us what each of the machines were. What I think is very interesting is that a lot of the machines they use are imported. Oliver also let us watch him do some of his research with the insulin, he was determining the particle sizes and found contaminants. While my time in this lab I met a girl who is going to be going to Harvard in August and was very interested in me and Sudan telling her about America. She was surprised at some of the differences such as tipping people in restaurants as well as public restrooms having toilet paper! It is so interesting to speak to people and talk about the differences between counties.

Something I have noticed lately is the construction that is happening all over Shanghai! Here are a few pictures that I caught as I was taking the bus to the Research building in the morning. Not only is the construction in Shanghai, but it was also all over in Beijing.

Construction in Shanghai

Thursday evening Sudan and I decided to take a little evening stroll and look more around Shanghai! Even though it was pouring down rain we decided to go out shopping, and we ended up at the Bund! It was soooo beautiful that I didn’t want to leave, and even though it was pouring out…there were soooo many people there! I can’t imagine what it is like when the weather is better. Friday evening the four of us took out the students hosting us as well as the student in the lab Zhou, who has been so very helpful! We went to the Sushi Express in this really beautiful mall. We all had a great time and decided to walk around Shanghai some more since the evening was so perfect.

Inside the mall

Day 3; TCM museum

Wednesday May 23, 2012

TCM museum sign!

I went to the TCM museum this morning and there were so many interesting things! I really liked the third floor where they actually had examples of the medicine and herbs, and also animal products people would use! What I learned that was really interesting was that TCM would use mercury to help people live longer, which I found quite ironic!  While we were at the museum there were school children also there, they were so adorable I couldn’t help but to take a picture of them as well.

In the afternoon after we had lunch we had a little discussion with some students and faculty.  One of the students at Fudan presented about their school and the classes they take, most of which are different types of chemistry.  The four of us then presented about ACPHS.  The students seemed very interested in America and had a lot of questions. One thing they thought was neat was parking lots. I have not really seen any parking lots and we showed them how large parking lots can be and they were very interested. Today was a great day that had a lot of interaction, the students here are very friendly!

Inside the museum

Cute little kids!

Day 2; May 22, 2012

Tuesday May 22, 2012

At the research building today I observed one of the Fudan students while they were transferring lung cancer cells. I was told that they were doing research to see the efficacy of the lung cancer drug. I also got to see the cells under the microscope.

Some other things I have noticed around town is that men here have very long fingernails which I find to be interesting.  I have also noticed that people care for the elderly much more here. On the subway I have noticed that people will hold on to the arm of their elderly parents and make sure that they are safe, I find this to be very comforting!  Going along with that however, I don’t see many building being handicap accessible, probably due to the buildings being rather old.

YuZheng, Stephen, and Sudan at sushi express!

After the day at Fudan I ate dinner at a sushi place that you pick what you want as it comes around. This was so much fun! I really enjoyed this style of service, also I got to watch the sushi be prepared!

Day 1 of rotation completed! 5/21/2012

Today is my first day of rotations here at Fudan University and I have already learned so much!  When I got there we went to the research building where the students and faculty conduct their research.

Front of the Research Building at Fudan

Sign in the Clinical Pharmacy hallway

What I have really learned is that the pharmacy field here in China is more research based rather than clinically based. The students here are mostly in the labs doing research as opposed to learning what the drugs do. There are also fewer students in the clinical pharmacy program, I was told right now there are about 10 students in the program.  When Dr. Cai gave the presentation today he mostly talked about how genes are affecting the way the drugs work in the body! I think this research that he and his colleagues are doing is very important for the future and will help further our understanding of medications!

Dr. Cai presenting on pharmacogenetics

What I was also interested in seeing was one of the students doing this research right in front of me.  He was studying Plavix and how certain markers can affect the dosing of this medication. While he was doing this he was using a PCR and electrophoresis for is research, which he showed me how to use.

                There are also many cultural things that I have learned so far since being in China.  One major thing that I have noticed is that there is never any toilet paper in any bathroom, also that the toilets are squatting toilets.  I have also seen that there are many people that ride bicycles and scooters around town a lot, I think I am more likely to get hit by one of those than an actual car.

In Beijing, people riding bicycles and scooters

I also found that eating corn on the cob is a very common street snack than many people enjoy, as well as sweet potatoes.  One thing however, that is really bothering me in China is that I see a lot of poorer people on the streets that seem almost helpless. I feel really bad for these people and you can tell that a lot of them work hard but just barely make money to take care of themselves, to me this is very tragic. I am excited to keep seeing what this rotation holds for me educationally, as well as culturally!