Teaching the nursing program

 In 1982, that was my first year of residency. I worked at the pediatric unit in the city's hospital in Nanyang, Henan province, P. R. China. I was newly married to my classmate from medical school.

For helping the nursing shortage of the hospital, the hospital decided to set up a nursing program training the nurse assistants in the hospital to become nurses. The program was well welcomed since it was not only provides more nurses for the hospital but also help the nurse assistants get better future. Even though the program is mainly for the nursing assistances within the hospital, but other hospitals could support it and get some of their nurse assistants enrolled.  Therefor we do have some people from outside of the hospital in the class.

It was the first time the hospital running this program. All the teachers were from the hospital, they basically are medical directors from every department in the hospital. The director of pediatric was Dr. Shan who was teaching the pediatric nursing.

Unfortunately, during the course, He had SVT, so he was admitted to the cardiac floor for treatment. He had to stop working and teaching. The class needs a substitute teacher. He talked about it at a morning meeting before rounding, and asked if any of us want to teach. He first asked a couple of senior pediatricians, since we were not a teaching hospital, no one wanted to teach in front of a group students. They were all fine taking followers.  And then he said, if no one can teach, he had to ask someone from other hospital to come to teach. And at the last, he asked me. For me, I did not really want to take the job because I was always afraid of speaking in public. But I could not bear the idea that we have to get a teacher from other hospital. So, I said "yes." 

Talking in public is not my specialty. In fact, when I had to talk in public, I got nervous, short of breath, and my mind went blind. Even though I was student leader since high school, but I tried to avoid any public speaking and was very successful. I would write the scripts for speaking and others would read the script when there were needs in high school. I was doing well on writing and calligraphy, so I did lots of writing as a student leader in high school by writing articles for blackboard newspaper and wall newspaper. In September 1976, after Chairman Mao passed, people all around China were making sure to let Chinaman Mao knew our firm resolution for the country. I did the writing and refused to speak In front of crowd. The other student leader read my script and made my passionate writing seem dry. In college, I again was selected as a student leader. I avoided all the talking since there was another leader who really liked to talk. One time I had to make an announcement, I went to the front and wrote the announcement on the blackboard.

So, taking the job as a teacher for the nursing program was a real challenge for me. I took it as a pride. But it took lots of work for me to overcome the fear of public speaking.

I spent lot of time to prepare my class. 

At first, I read the pediatric internal medicine, sometimes on certain topic, I even read the surgical textbook and pathophysiology and write down everything I was going to teach in the class and drawn all the diagrammatic presentations on a big paper to show in the class. 

And then, I would try to memorize everything I wrote.

And the third, I would give the lecture to my husband and took his critics, correction and suggestions since he works in the teaching hospital and already teach surgery in the local medical school.

And the last, I would record my lecture at home and listen to it and make corrections.

Despite all the preparation, at my first class, I was not able to look at the classroom full of students when I started my lecture. I looked at the window instead. Because of the thorough preparation, I was doing ok. It took me about 15 minutes; I was fine and able to look at the students. And for the subsequent class, I became the students' favorite teacher! The result was the hospital wanted me to teach the pediatric nursing for the following program! 

After students from the first nursing program graduates, the hospital started the second nursing program. I saved my preparation book and overcame my social anxiety which made it easier for the teaching later on. I did not have enough time to prepare for the class later since I had my son at that time and also working at the clinic. I took my old class preparation notebook at the clinic and read it when there was a downtime.

I taught two terms of pediatric nursing in the hospital. I have met some interesting students.

On my first class, there was a student from woman and children's hospital whose name is Xia Wang. Her dad and my dad were all in the army, and we used to live and grown up in the same family compound of the armed forces department. She was elder than me and I used to play with her little sister and later became classmates in elementary school. I used to see Xia as older and wise and admire her a lot. Xia later joined the army herself and left the retired from the army few years later. And she was in my class and I was teaching her! It was amazing seeing her as my student!

On my second term of teaching, there was a student from a factory hospital whose name is Shuting Xia. She went to middle school with me but in the different class. She was tall and beautiful and came from a family working in a factory. I left that school just after she was admitted to the school, so she did not really know me. But she was new, so I do remember her. Now she is my student as well!

Teaching a class really helped me to overcome my social anxiety and also helped me to better understand the text and pathophysiology. Truly, teaching benefits teachers as well as students. 

After that, the classmates from my medical school organized a small reunion in our home and planned to ride our bakes out to the countryside to see our classmates there. I talked a lot and made my old classmates were surprised. They asked what I do at work. I told them that besides working as a pediatrician in the hospital and clinic, I also teach nursing program. They said: 'that is why! Good for you?" They saw the change of me.

After all, that was a good experience. I enjoyed it and loved it! Thanks to Dr. Shan for the opportunity!

And the teaching was free as I remember. My salary was ￥46.00 per month at that time.

My experience for flying back to China during the pandemic

 

Sunday, September 26, 2021  4:06:48 PM

My experience for flying back to China during the pandemic

Visa

My mom was diagnosed with esophageal tumor since last November. Mom is the primary caregiver to my dad who is bedridden for many years with Alzheimer, NG feeding, and super pelvic catheter. Apparently, they need someone to be there. My sister and brother were doing their share and I was willing to do my share.

I have a ten years vise to visit China, but because the pandemic, the ten years visa is not valid now and if there were a need, who need to apply a Humanity visa. I applied the Humanity Visa to go back to China to visit last year.  The result was disappointed. I got my passport back without visa.

Mother was very upset but has to accept it eventually.

Mother is over 80 years old and does not want to go through all the painful diagnostic examinations and do not want experience any painful treatment. She decides that just let it be.

Time goes by. Over half year past, mother’s swallow difficulty has gradually increased. From August, 2021, she even could not swallow liquid food and then even water. Apparently, without eat and drink, she could not survive. Finally, she accepts to get IV fluid. From the picture my sister sent to me, she lost lots of weight, she does not even look like my mother anymore.

I applied the humanity visa again by the end of August. Endless paper work done through email and then I was instructed to mail my passport and print out all the paper work and send to the consulate, and then wait.

To avoid disappointment, I told myself not hold my hope up. But just in case, I applied for family medical leave from work and made notes: it depends on my visa.

Life goes on. My sister and brother in law stayed with us for over a year now and they are ready to go back to China due to mother’s situation. They are Chinese citizen and they can go back without any problem. They bought the flight tickets for September 24^th and I have planned their trip accordingly.

Sep. 22 2021: 5：30 AM, get on the Amtrak from Eugene to Seattle. Arrive in Seattle at 11:50.

Sep. 22 2021 at 12:00, take the car recommended from the hotel we booked in Seattle to the hotel-Hilton garden inn. Drop off all the luggage and walk to the lab to do the Chinese government required COVID 19 tests before get on the flight to China.

Sep. 23 2021: stay in hotel and waiting for testing result and apply for health code to get on the flight.

Sep. 24 2021 12:10AM: get on the Delta 289 to fly from Seattle to Shanghai.

I would go back to Eugene by Amtrak at the 24^th after sending them off. That is why I exchanged my work schedule from 21^st to 25^th.

At 17^th of Sep. 2021 evening, my sister checked the mail. She get a express mail and handed to me while I was on the porch just started to enjoy the outdoor fresh air.

I opened the envelope and found my passport with a visa!!

I got up and hurried to upstairs and turned on my computer and bought myself a flight ticket with the same flight my sisters have. I was so lucky because there were only 4 tickets left. And then, I have to cancel my return Amtrak ticket. We booked the hotel with no refund for better price so we kept my stay in the hotel for another day and after my sister check out, three of us get in my room and rested a little till 6pm that we went to the airport.

For the hotel stay, I am fine with everything but for the ride, I have been told the ride from the hotel to airport is $70.00. When I was asking the driver: how much we own you and how do you like to be paid? He said: “$100.00, cash with tip.” For a smooth trip, I did not question. I just handed him a 100 dolor bill to get over with it. The driver who derived us from the Amtrak station to the hotel only charged us $70.00 and I asked her: how much we own you and how do you like to be paid? She said: $70.00 and anyway if you like to pay. I choose pay her cash.

The COVID 19 tests:

We made an appointment at the Anytests lab at 13:30. We used this lab because it is the recommended by the Chinese consulate per other flying group members. We booked the hotel just because that is a walking distance to the testing lab.

When we arrived the lab, it was only 13:00. The lab employee hurried to take us to get the sample collected. So they can perform the test on time.

We have to open our passport information page and hold in our hand while they were taking samples and the other lab worker will take our cell phone and take our pictures at the same time. One nasal swab, one pharyngeal swab and one blood draw.

And there were paper works: letter of commitment on COVID 19 vaccine; consent for testing, patient intake. Luckily, I got most the paper work online and fill them out before come. That saved some time. And then, we take pictures with the paper work and passport together. And we need to take another picture with holding our passport in front of the Lab facility. And then scan the barcode to join the DL289 weichat group to get result and communications. My weichat phone does not have phone card, I had to use their free wi-fi to get to weichat for that.

Everything is done. We went back to hotel to check in.                

We took food with us, so we do not go out to eat. After ate, took a hot shower and lying down in bed and wait. We have been told that the results will be in our email box around mid-night. Since we have been getting up so early to get on the train and we can just rest and trying to make my mind in order. It is good to have some time alone.

Trying to get some rest. Fall in and out sleep many times. When I was checking on the clock, there was about 1 hour each time when I wake up to check my email. The flying group members are all nerves and keeping posts it kept me awake more. Start at the midnight, some people getting their results and I was the later one get them. Checked it and all are normal. So I started to get in the system to submit all the needed result and paper work to the system in order to get the health code to get on the flight. The system is different for non-Chinese citizens. I tried to use phone to do so, it is not easy that I missed upload lots of pictures and papers. After my sister get hers and her husband’s done and left my room. I started to turn on my computer and do it on computer. It is much easier and I completed it by 2:30 AM and submitted to the San Francisco Chinese consulate. Finally, I can rest.

Wake up at 7 AM, check my health code, the color was orange (under verification). Continue to try to sleep. And wake up in an hour, checked the code, still orange. In and out sleep till 10:00AM, I decide to get up and start my coffee. At 10:30AM, my code changed color: green and shinning! I have passed the requirement！ I can get on the flight to go back to my parents!

The flight:

The flight is DL289. We arrived the airport4 hour early so we do not need to be hurry.

Since I was planning to stay in 90 days. I almost took all my necessary stuff with me. So as my sisters, they realized that lots of winter cloth they took to my home are not needed but were needed in China. So they tool lots of luggage as well. We are the first one to come to the check in counter. They were not ready to work yet. They were just setting up the station. We waited a while and they started to check us in. luggage is too heavy, they tried to let us took out some and then put in some, very patiently to adjust the weight and not cost up more money. We do appreciate it very much!

Through security check, we came to the gate and peacefully waiting. That was a good feeling. Just before on board, we were checked temperature and they put a brown sticker on back of out passport. And then raw by raw has been called to board. I was the last one to get on board because I sit the last raw, seat 56B. There is no one seat at 56A.

I was so lucky that the food service is acceptable to me. I ordered pasta which is happening to be vegetarian. And then later on, I was at sleep when they serve food. They put the food on my table and when I wake up, there is still vegetarian. I was going to book food as vegetarians, but did get chance. There were too much to do before we leave.

And I, myself sit on two seat the way flight to Shanghai, China!

The quarantine:

The policy is: direct flight from America to China, passengers need to be quarantined at the city of the flight destination for 14 days. After that, the passenger could go back to their final destination and quarantine following local policy. At the moment, in my home province, it is 14+7+7. I asked my nephew what the policy of Nan yang, he answered: 7 days at home quarantine. I hope this will not change.

When we arrived in Shanghai, we have been told that staying in the seat and wait for custom to check. Someone came and talked with few passengers and then lead them left. And then we were told can pick up our personal belongs and get off the flight.

Following the flow, we were at the custom. Step by step, checked our passport, scanned our custom health declaring code and then was giving a consent paper to sign for consent for collecting samples for test and was given to a testing tube with red viral media and our own name and passport number on, and a biohazard bag. We were told to follow the flow to the COVID 19 nuclear testing area. I was called and handed the tube and bag to the testing personal and they did nasal swab and pharyngeal swab with make me sick. Then I was allowed to leave to claim my luggage.

Got the luggage and was lead to the area have different final destinations. That was used to arrange different hotel for quarantine. Our passport was collected by the staff. We were at the other category which is outside of Zhejiang province. We were also the last group to get out of the airport and get on the bus to hotel. That was about 10AM.

At the main lobby of the 1800 YIxian RD, Bao Long hotel, we were told to scan a bar code to put our personal information in and forming a barcode to show the front desk person. They scanned it and assigned a room for us and gave us a plastic bag with the room number on it. There is paper work and sanitize material in the bag. And finally, I got my passport back!

We were lucky. My sister and brother in law were allowed to stay in the same room for quarantine. They are in 8^th floor. I am in 20^th floor with good view. Everything is fine. I asked them not ordering me food since I am vegetarian and not eat much. I do not want to waste. I have my own food arranged.

Two weeks alone and stay in hotel, no worry about food and drink, no worry about going out to do anything! How lucky! I can just do what I want to do!

Here is my schedule for a day:

Get up at 5:00 AM;

Start practice and drink water;

Start drinking coffee and turn on my computer;

Start exercises: palates, yoga etc.

Reading and listening Buddhist teaching.

Life is beautiful and I do not want to complain. Just enjoy what I am having at the moment. I will be home taking care of my parents soon.

Wednesday, September 29, 2021

Suddenly, I feel hungry. Shanghai called me for the health code that I had trouble with while I decided forget about it.

Wednesday, September 29, 2021    10:18:16 PM

I am trying to be positive. But the experiences are not so positive.

At first, the quarantine hotel: I try to see the good part, not the dirtiness. The cost is 380 RMB/day, 14days; it will cost 5320 Yuan RMB. It is about $760.00. I wish they will charge my credit card so that I will not use other people’s money.

The second, all the codes, I could not deal with. I tried, very hard tried and tired. It is not worth my energy. I gave up.

The third, the community will pick me up at the airport in Nanyang with ambulance and the cost is 200yuan RMB and then there are three times nuclear tests, each time cost at least 18 yuan RMB for two days result and for same day result will cost 65 yuan RMB. I do not have any Chinese money and I do not have any method to pay as they required. My son and my sister all trying to send me money to my weichat, but my weichat would not take money.

I am already broken here in China for not even seeing my parents and my granddaughter. I prefer to spend my own money. I prefer to pay by my US credit card.

I am going to try to link my credit card to alipay.

A boy with brain tumor

                                  

         There were a 5-year-old young boy, a 20-year-old big brother, a 30-year-old young doctor, a 40-year-old senior neurosurgeon and a 20-year-old intern … those are the team I remembered. Of course, there were nurses there as well. That was the first brain surgery I attended. 

           That was about over 30 years ago when I was an intern in a large hospital in China. 

           During my rotations in surgery, I was following Dr. Wang, a young surgeon in neurosurgery team. There was a 5 year’s old boy admitted for elective surgery for brain tumor. He was very active and naturally happy in general when the headache and /or localized epilepsy not bothering him. 

           Few days ago, when Dr. Wang and I were at the clinic, a 20 year’s old young man took the 5 years little boy to the biggest hospital in the area seeking help. 

          “What brings you here today young man?” Doctor Wang asked the little boy with a smile in his face at the clinic. 

         “There is a big monster in my head, and I want you to catch it.” The boy said with unquestioned trust.

           “My brother is 5 years old, and he generally is in good health. Since last year, he started complaint of headache and sometime has seizures. The local doctor checked on him and we were told that there is a tumor in his head, and it is needed to be removed. We heard Dr. Zhao is the only good neurosurgeon in this area, so we are here to see him and want him to remove the tumor.” The about 20 year’s old big brother said to the doctor. 

            “I am Dr. Wang, Dr. Zhao’s surgery team member. Dr. Zhao and I work together. Let us do some examination and to see what we can do and Dr. Zhao will be here to check on him later.” Dr. Wang said. 

            The boy was admitted to the neurosurgery floor. Then there were blood tests, electrocardiogram, X-ray, brain angiography etc. After all the tests were done, the boy was ready for surgery. 

            The evening before surgery, Dr. Wang led me to visit the boy and talked with the big brother: “Tomorrow, it is scheduled to do the surgery to remove your brother’s brain tumor. As you knew, surgery itself has lots of risks like bleeding, incision infection, surround tissue damage and anesthesia accident, each of them could result in death and/or injury. For brain surgery, there even greater risks of these because we need to open his skull to work on the toufu like brain tissue and to find the tumor and then remove the tumor. The tumor is near the sagittal sinus and there is a great risk for bleeding. Again, any surgery has risks and benefits. The surgery will remove the tumor and get rid of all the symptoms. If you are willing to take the risks and wish the doctors to perform the surgery, here is some paperwork need you to sign for consent. Do you have any question about the surgery that Dr. Zhao is going to perform for your brother tomorrow?” 

         “Will he be awake after surgery?” The brother asked. 

          “It depends. After we take him to the operation room, the anesthesiologist will admit anesthesia to him, and he will be in sleep during surgery. After surgery, he will wake up, but sometimes it takes time. It maybe takes up to half day for him to wake up.” Dr. Wang answered.

         “What should I prepare for him to eat after surgery? Will he be able to talk, and all his headache and seizure will be gone after surgery?” the brother asked. 

          “As soon as he is awake from the anesthesia, he can eat. Anything rich in protein will be good for his recovery. Yes, the goal for this surgery is for him to be free of headache and seizure and able to lead a normal life. But he will have some headaches after surgery from the incision and surgery site. But that will be temporary.” Dr. Wang answered.

          “OK. Then I will sign the paper and thank you very much Dr. Wang.” The brother said. He signed the consent for surgery. 

            Dr. Wang shaved the boy’s head and asked the brother to wash his head and no food and drink after 10PM. The shaved little boy looked like a cute little monk: clean, pure and smart. At the time we left the room, the boy waved us “goodbye” with a big smile on his face. 

           The next morning, the operation room was ready. The boy was wheeled to the OR. On the equipment table, there were army of saws, hammers, pincers, Scissors, forceps hemostatic, needles, suture lines, needle holder and forceps etc. 

           There was the famous Dr. Zhao who was wearing a heat and mask. His both hands are scribed and sterilized with disinfectant hand sanitizer (bromo-geramine solution). The solution was still dripping. And there was Dr. Wang and I, we both were scribed and sterilized. The instrument nurse was ready before the doctors and patient arrived. Of course, there were circulation nurses, the anesthesiologist. 

           The boy was already out due to anesthesia. The doctors and I dried our hands and arms with sterile towels, started to put sterile gowns and sterile gloves on. And then everybody got to their place and the surgery had begun.

            Under anesthesia, the boy’s head was prepared, sterilized and covered by sterile towels. The skin was cut, and the skull was exposed, and the saws and hammers got to work, the doctors opened the boy’s skull, and the white, toufu like brain was in front of us. 

            Dr. Zhao was very carefully examining the brain and he found the tumor. It was close to the cerebral venous sinus but still can be removed safely. The doctors worked together and smoothly removed the tumor and the surgery was a success at the point. 

           The whole process was so smooth and seemed easy even the chief neurosurgeon was satisfied. But just before wrapping up the surgery, Dr. Zhao saw a small spot of calcification on the boy’s brain. He wanted to remove the calcification spot to make the brain look perfect. It seemed easy and small. He could just take it out with a Toothless tweezers. So, he did it. The calcification spot was out but the operation area started massive bleed. “Crap! The venous sinus is broke.” The two doctors were hurrying up using every possible measure trying to stop the bleeding. 

           But venous sinus hemorrhage was far serious than one can imagine. And at that time reconstruction of the ruptured venous sinus is almost impossible. The boy’s blood pressure was quickly dropping and … 

          “Please call the director in. We need do a carotid artery ligation stat! (That will cut the blood supply to the brain! But that is the only way can get the boy out of OR alive!)” Dr. Wang, the unit director was called in and performed the ligation. The surgery site stopped bleeding. The surgery wrapped up and the patient was sent back to his room.

           He was still at "sleep" but was breathing and had a heart rate. His brother was at the bedside. 

          “We successfully removed the brain tumor. But during surgery, the venous sinus was broken, and we could not save your brother.” The doctor told the big brother. The next day, the boy died. 

         “Well, baby brother, they tried to cure your headache. Now you will never have headache again and you have lived a good life. Please Rest in peace.” That was all I remembered that big brother’s sentence.

           “I am so regret! I am regretting to die! I should leave the calcification spot alone!” Dr. Zhao was bitterly remorseful and in deep sorrow. He felt that he killed the little boy. 

           Yes, indeed, if he did not touch the calcification spot after he removed the tumor. The boy would still be alive and have a good life without headache and seizure. 

          But life does not believe in “if…” does not allow one for regret, especially in medicine. 

         “Just carefully following the plan and no more before carefully planned when you do surgery on people’s brain.” That is the lesson I learned from this tragedy.

The COVID 19 vaccine

yesterday，I went ahead got my COVID 19 vaccine. It feels like just a flu shot. But during night, I started feel painful of the injection site. with the time goes by, I feel better. Thanks for the vaccine. Next month, I will need the second dose. I hope everything will be fine.