America: Make an appointment and go to pediatrician's office. Doctor examines baby and gives appropriate immunizations. Go home.
American in China: Slightly more complicated...
The first time Juliana needed a check-up in the fall, we discovered we couldn't get all the immunizations she needed where we are. So we made a 12 hour trip to Beijing to an international clinic where we shelled out a bundle of money for the appropriate imported vaccines. At Juliana's second check-up in Thailand, not only was she able to get all the vaccines she needed, they sent us back with the vials we would need for her 6 month immunizations, packed up in an ice-chest for travel. We had the vaccines; now all we needed was the doctor. Simple, right?
Actually, it wasn't too bad, but it was quite a bit more interesting than your average pediatrician's visit in America.
Our student Alice lives in Weinan and is always eager to help us out with things, so she took us to the local women and children's hospital, a convenient 15 minute walk away. As soon as we walked into the hospital, the lobby was abuzz with excitement. Foreign baby alert!
The hospital was impressively clean, though the unfinished cement hallways were dim. We walked up to the fourth floor, passing the “baby swimming/bathing” section. You may recall a few months ago when we took Juliana swimming, but at a private facility instead of the hospital. The hallway was crowded with dozens of people holding tiny babies and toddlers. At least, I think there were small babies inside the giant quilt bundles. Alice said most of them are probably waiting for their babies to have a bath.
We peered into a quiet exam room where a doctor was sitting with a mother and baby in a strangely private calm. Until we walked in. Suddenly the room was filled the excited chatter of the dozen people who had joined our entourage. Nurses flocked from other rooms to squeal over the foreign baby. A crowd formed. Several women grabbed Juliana's hands while another touched her face. Several shoved their disinterested babies in her direction. They jabbered about her oh so white skin and her smile and how old she must be and how little clothes she was wearing. Juliana beamed and laughed; she loves to be in the spotlight and had just made a dozen new friends.
One difference between Chinese and American babies is that Chinese babies wear a lot more clothing, [understatement of the year]. Take this day, for instance. It was 80* outside. Juliana was wearing a fleece pajama-type outfit. Fleece in 80* weather? Sounds crazy, right? Except that Juliana's Chinese counterparts were wearing anywhere between 2-5 inches more clothing than her. The older babies were dressed in giant padded outfits (thick enough they could probably be dropped from the second floor without injury). The younger babies were completely hidden under giant blankets. Thick, adult size blankets, wrapped all the way around their heads with only a tiny bit of face peeking out. Several babies were red and sweating profusely, but the others seemed to have already adjusted, which is good, considering the lifetime of layers ahead of them. I look at them and think, never in her life has Juliana come close to wearing enough clothes.
Alice and I leave Kevin holding baby, surrounded by the crowd in the exam room to go back downstairs to pay. At Chinese hospitals you always pay upfront. Today the fee is a little steep – 30Y, or about $4.50. Back upstairs to the exam room, where the nurses have commandeered the baby and are taking pictures on their cell phones.
The doctor completes the standard exam, checking her height and weight and saying she is too small, which compared to Chinese babies she probably is. How do such chubby babies turn into such tiny grown-ups? They check her various abilities and flex her limbs like they are doing Thai massage.
We were a little concerned about her scar from the TB vaccine two months ago, which has begun to look irritated. They say it is inflamed and Alice says we will go to have another doctor look at it. I think I hear her say something about going “to surgery,” and images of Kevin's horrible experience getting his back sliced open immediately pop to mind. If they try to bring a scalpel near my baby, I'm making a run for it. Fortunately, when we walk downstairs, the doctor just swipes it with what we presume to be iodine and says it's okay.
Now it is time for immunizations, but we have a problem; since they don't know what the medicine is (the info is all in English and Thai), nobody wants to administer the shots. I am impressed and annoyed at the same time. Never in a million years would an American doctor shoot you up some unknown medication you carried in off the street. It would be a giant lawsuit waiting to happen. I didn't think it would be quite such a big deal here, though. Half a dozen doctors discuss it together, examining the medicine boxes, while Alice tries to persuade them to take the chance. Finally one of the nurses agrees to do it if we sign a paper saying the hospital is not responsible. She writes something up on a scrap piece of paper, and Alice translates so I can write up an English version, three sentences taking responsibility for these unknown drugs that are about to be given to my baby. I sign both papers and we prepare for the injections.
The second problem is that the doctors aren't sure how to give the shots. We pull out giant page of warnings and finally at the bottom find instructions. That's right, instructions. We argue for a few minutes over where to inject the medicine (the instructions say the thigh, where they were giving in Thailand, but the doctors say they never give shots in the thigh). We pull out the vials and needles and examine them together. Alice translates the instructions to the nurse, who knows what she is doing after all. Once she saw the vials she must have realized it wasn't so different from Chinese vaccines.
The nurse hesitates to give the first shot because she hates to make the happy baby cry. As the first shot is injected, Juliana predictably starts to wail. Everyone in the room (six or eight doctors and nurses) gather around, clucking and chirping and waving arms and keys and whatever else they can think of to make her smile again. Any other baby probably would have been completely overwhelmed, but for Juliana it does the trick; she is smiling again just in time for her second injection.
Except that the doctors and nurses can't figure out how to attach the needle for the second shot. Apparently it is a different type than they use in China. They ask us (as if we would know) and we make some conjectures, they fiddle around and discuss a bit more, and finally they figure it out. Not exactly a confidence booster, but I guess it will all work out. Injection two completed, baby wails for another thirty seconds until distracted by a toy. The immunizations are complete, and we stop back by the cashier desk to pay our 6Y (90 cent) injection fee before heading home.
Never a dull moment for the foreign baby.