the beatings go on . . .

image

The article title is “A Good Shenzhen Doctor was Beaten, He Refused to Prescribe Unnecessary Medicine or Vitamin Drip”. The article reminds Shenzhen readers that although it is common to abuse doctors in neidi, it has not been common in Shenzhen. Moreover, as the article points out, often the beatings occur even when the Doctor is doing her job.

The use of the word “good doctor” and the assumption that sometimes doctors deserve to be beaten for (corruption, expensive medicine, fill in the angry blank) underscores the tense relationships between patients and doctors in China generally, but also Shenzhen, our low number of reported conflicts notwithstanding. As in the US and elsewhere, in contemporary China lay people assume that role of medical care is to return patients to perfect health, immediately. More distressingly when this result cannot be obtained, patients and their families assume that their ongoing dis-ease is deliberate and that the Doctor is withholding care in order to receive a bribe. Hence, the beatings.

In my experience, it is important to know one’s doctor because some Chinese doctors do put a price tag on treatment. Sometimes they do prescribe expensive, unnecessary treatments. Like US doctors they often preen and show off their knowledge. But more often than not, like their patients, Chinese doctors are caught in an ugly web of mistrust and impossible desires. Doctors cannot heal everyone all the time, and they are shackled by all sorts or regulations and administrative cost. Moreover, as in the US, hospitals and clinics do turn away those who cannot pay but won’t die from lack of treatment. Also as in the US, patients want the best modern medicine without paying for it and often those who can afford medical care oppose government subsidies for those who cannot.

But there’s the rub: except for the very rich few people can afford out-of-pocket treatments and so they only go in when very sick or for antibiotics and other instant (preferably cheap) cures. There is little conversation about general prevention, and less about two unavoidable facts–our collective lifestyle makes us sick (cancer and diabetes, for example) and despite all our technology, we will get sick, age, and die. Hopefully, with grace and dignity.

The hope for graceful lives and dignified deaths changes the conversation about whither medical care. As a society, we need investigate what it would mean to provide equal and gracious access to care. We need to think seriously about what constitutes a dignified death. And we need to take responsibility for the contamination that our dependence on petrochemicals and nuclear power has introduced into shared environments because not only humans are suffering from our hubris.

what is the price of a human life?

If my friends are to be believed, doctors occupy the same hated position in China that lawyers occupy in the United States; they are the white-collar workers who represent all that is wrong with the system.

Indeed, the similarities between stereotypes are striking: Chinese doctors are said to be only working for money; if you go to a public doctor, you can expect substandard care, and; the purpose of medicine is to keep you in the system, paying for unnecessary tests and medicines. Good doctors are few; they work against a system that is stacked against them, and the common people suffer for the greed of the majority of bad doctors. Similarly, not a few Americans hold the same ideas, albeit about lawyers. Private attorneys are only in it for the money; if you have a public attorney you can expect to lose your case, and; the purpose of legal advice is to keep you in the system, paying for unnecessary hours and court appearance. Good lawyers are few; they work against a system that is stacked against them, and the common people suffer for the greed of the majority of bad doctors.

Not unsurprisingly, there are all sorts of Chinese doctor shows — both for entertainment and self-help, just as there all sorts of US American lawyer shows and call-in programs. A popular trope in both countries is the renegade who addresses the injustice of the system, dispensing healthcare and legal aid without thought for his or her personal gain. In these shows, lives are at stake and doctors and lawyers save the day in happy endings and loose the day in tragedies. Likewise, an assortment of hacks lurk in these programs and take advantage of unsuspecting or desperate folk, who have nowhere else to turn. Moreover,there is generally an implied moral entitlement: good characters should receive top medical care in China or the very best representation (in the US).

Interestingly, the contempt that common Chinese and ordinary Americans feel for their doctors and lawyers, respectively, is directly related to the fact that (unlike other white-collar workers), doctors and lawyers represent the highest political values in their country. The purpose of government in China, for example, is to provide for the wellbeing of the population. This care includes healthy food, affordable homes, and timely medical care. Indeed, it is remarkable the outrage and press coverage that these three issues consistently generate in the Chinese press, online, and now through weixin (Tencent’s We Chat app).  In the US, we hold our government accountable to protect our rights, both from each other and against corporations. In China, doctors are the last line of defence in securing wellbeing. Likewise, in the US, we turn to lawyers to secure our rights. And yes, those who break the law and get away with it repeatedly show up in the headlines, while taking on the legal system and calls for particular uses there of can turn mere pundits into talk show personalities and ordinary people into national heroes.

Speculation du jour: Chinese doctors and US American lawyers have been cast as villians and heroes in national dramas because neither system is providing the “good life” for its people. In China, wellbeing is the highest value and doctors exist to maintain this wellbeing. In the US, fairness is the highest value and lawyers exist to ensure a level playing field. However, in both countries, those in most need of healthcare or legal aid are most likely not to receive it. Moreover, Chinese doctors often can’t provide adequete healthcare without bankrupting patients, just as UA lawyers can’t provide decent representation without bankrupting clients. In both cases, systemic breakdowns break ordinary lives. Nevertheless, public anger has not (yet) led for widespread calls to change either the Chinese or American systems, but rather nasty jokes about and threats against doctors and lawyers, respectively.

Sigh.