china: day seven (special swine flu edition)

I want to preface this by saying that I completely understand just how dangerous a new strain of influenza could be to China's population. People live so close together in the major cities, and have so much contact with each other, that a disease as easily transmitted as the swine flu could never be contained once it got into the country. Even with as low a mortality rate as this disease has, the effect would be devastating. China is right to be cautious.

I also want to clear up some terminology. H1N1 is just a name for a subtype of influenza A, and it's as old as dirt. A strain of H1N1 was responsible for the 1918 flu outbreak, for example. Your annual flu vaccine prepares you for H1N1, H3N2, and influenza B. It's a really, really common virus. While it's accurate to say that swine flu is of subtype H1N1, the unfortunate moniker "swine flu" refers to the specific strain of H1N1 that has been in the media so much recently. To use "H1N1" as a synonym for this new strain is imprecise. The actual strain responsible for the swine flu brouhaha hasn't been given an official name yet. So when I say "swine flu," don't correct me. I'm trying to refer specifically to this new strain, and not to all variants of H1N1 ever throughout history. If you raise pigs, I'm sorry, press and television in the U.S. just trampled all over your business. Take it up with them, not me.

(Edit 6/21: "Swine flu" isn't a very precise term either. The term "S-OIV," or "Swine-origin influenza A virus," is beginning to come into common usage to describe this strain.)

There is a national policy in place right now to investigate any fever above 37.5 degrees Celsius, or 99.5 degrees Fahrenheit, measured under the arm. Stay above that for more than two consecutive measurements and bad things happen. I was, unfortunately, unwise enough to let my temperature slip upward just that much.

When I got back to the dormitory last night, my temperature measured 37.6. The administration had me measure it again (37.5) then told me that 37.5 was right on the edge of the temperature at which the national response triggers. They said a hospital might or might not have to send a car for me, and that I should wait in my room until they found out. I went upstairs, and ten minutes later, I got a phone call asking for a "Peter." I told them they had the wrong number. Moments later, a knock on my door: "Peter? Peter!" Right person, wrong name. Unfortunate. They handed me a face mask and said a car was waiting for me outside to take me to a clinic for a doctor to measure my temperature professionally.

This was a good introduction to the Chinese art of lying.

By "car," they had meant "ambulance with flashing lights and an entourage of smaller hospital vehicles." By "doctor," they meant "team of doctors in biohazard suits." By "measure my temperature," well, I'll get to that. I suspect this tendency to lie comes from a China's high-context communication style. If, for example, I had looked outside and seen the flashing lights, I would have been able to parse "car" properly. I found out later, of course, that in China it is more appropriate to tell a reassuring lie and let the listener be blindsided by the truth later than to tell an unsettling truth and be responsible for your words upsetting the listener. In America, we become more upset at the act of lying. When in Rome, eh? I still can't figure out, though, how that meshes with China's uncertainty avoidance. I would have expected high uncertainty avoidance to appear in the same places low-context communication does. In any case, the most important things in conversation with Chinese people seem to be maintaining the face of the person you're talking to, and not saying anything that might alarm or unsettle that person.

Now, to explain what they meant by "measure my temperature." The ambulance took me for a half-hour ride to the opposite side of town. Now, I've read two books on body language, and I was giving off every tell for calm and composure that I could remember. Either my stillness was giving me away, though, or the lady in the back of the ambulance with me was projecting, because she kept telling me to calm down. After I exited the ambulance, a man in a biohazard suit sprayed it, the ground I had walked on, and the medical staff with disinfectant. Then, I was asked for my passport, and I heard my flight numbers spoken back and forth. A nurse pulled out two cotton swabs on long sticks and shoved one up my nose and the other down my throat. I didn't fully understand what the purpose of this was, but I think she was trying to make me cough and sneeze. They took me inside for a chest x-ray, followed by a full medical examination--blood pressure, lymph nodes, stethoscopes, the whole nine yards. They then took a blood sample and told me the test would come back in half an hour. I asked why all the other tests were being taken when the blood test was the only important one, and received this answer: "We don't really know what the symptoms of H1N1 are yet."


One hour later, I was told the test was inconclusive, and that I would need to wait a little longer. I was offered a hospital bed for the night and two mystery pills. I asked what they were, and the woman who gave them to me had to go back and ask. Hmm. They turned out to be antibiotics. The hospital was handling out antibiotics like candy to a man suspected of having a virus. Fortunately I was able to refuse them without any major consequences. They said, "It should be OK to drink some warm water instead."

I'm not sure whether this is the Chinese version of the Hippocratic Oath, or a set of instructions for this particular hospital.

All throughout this, I was referred to as "mei guo ren" (American) even though they had asked for my name twice and seen my passport. Maybe it was just the distressing circumstances, but I found this to be really, really offensive. I can't imagine Xing or Mahmoud back in the States would appreciate being called "Chinaman" or "Iranian." It was sure great for the old self-esteem to be a faceless, foreign national security threat in the medical team's eyes.

At 7:00 AM today, they brought me breakfast. It was a nice gesture, and I'm sure they never meant me any harm, but I am still irrationally angry at them. Forty minutes later, the blood test results came back from a regional testing center they hadn't told me about. Surprise! I do not have swine flu. My one-degree fever is, in fact, just a one-degree fever.

Here were the three things that raised the WTF flag the highest throughout the evening:

"A car will come to pick you up." After I found out that this was a baldfaced lie, I should have been a little more prepared for everything else that happened.

A single dose of antibiotics for a low-grade fever, without a prescription? I can't imagine the superbacteria that must be developing over here.

Now, the biggest: "We don't really know what the symptoms of H1N1 are." Really? Really? You're doctors. I assume you have access to medical journals, or the Internet at the very least. There are how many documented cases of swine flu worldwide? Just how many people have been forcibly detained for having symptoms or being in circumstances completely unrelated to the disease? How many hours, how much money, have been spent on quarantine facilities and testing because you don't even understand the illness? I can only hope that others have been as fortunate as I have to escape without permanent harm. Please, for the love of all that is good and holy, match your impressive temperature detection equipment and medical facilities with enough research and knowledge to put them to their best possible use. Don't flail around in blind panic.

On the plus side, though, I now get to add "abducted by the Chinese government" to my resume.