Political, Medical, Cultural Clash

[Guest ExChinaExpat]

In early 2008 I was offered a job in Nanjing, China, with a very large international software company. After considerable thought, I decided to accept the position. The company paid the moving expenses for me and my family at the time, and I have been living and working here since. Unfortunately, in January 2011, I ruptured my Achilles tendon while participating in a company sponsored sporting event/engineering camp. I didn't realize that my Achilles tendon was ruptured at the time, but knew for sure I was in a great deal of pain. My Chinese colleagues took me to a nearby Chinese hospital, where the doctor examined me, and said that my injury was not serious, and that I would be fine in 6-12 weeks. My colleagues encouraged me to trust the Chinese doctor, despite the fact he was smoking and dropping ashes on my x-ray film. So, I returned home and proceeded to hobble in pain for the next 12-weeks.

 

After 12-weeks passed, my condition had worsened, with swelling and severe pain. I located an international SOS clinic in Nanjing, and though quite expensive, decided to seek out a Western doctor to evaluate my injury. In a matter of seconds of the examination, the doctor immediately said, "You have a complete rupture of your Achilles tendon. You need surgery immediately. I suggest you meet with this Hong Kong doctor who will be in Shanghai next week." They made the appointment for me, and I traveled to Shanghai to meet the doctor. She confirmed the diagnosis, and made an appointment for surgery, by her at the Hong Kong hospital. That surgery was performed in April of 2011. Unfortunately, it was not successful, and a second surgery was performed by the same surgeon in August 2011, but this time in Shanghai. I was released from Shanghai hospital the next day, and returned to Nanjing. Within 48-hours of that surgery, a massive infection developed in my leg, which turned black and did many other nasty things. A friend took me to a local Chinese hospital in Nanjing, where they examined the wound and administered IV antibiotic. They suggested that I immediately return to the hospital in Shanghai for treatment, which I did.

 

I was treated in Shanghai hospital for two months, while they attempted to control the infection. They performed another surgery, called a debridement, to remove the dead tissue from the wound area. The hospital ordered that I be evacuated by emergency transport back to Hong Kong. An English speaking male nurse arrived to pick me up, and assisted me during the transport. I was flown to Hong Kong, where a driver was waiting to take us to the hospital. I remained in Hong Kong hospital for another two months, where three more surgeries were performed on my leg; including two attempts at skins grafts to cover the open wound on my leg. I was discharged from Hong Kong in late November, 2011, and returned to Nanjing.

 

My wound never healed, and I have continued to seek medical treatment that will help me. But, it has become increasingly difficult. According to China law, my accident is considered to be a work-related injury, which means my company is required to compensate and assist me. I have been to several doctors and hospitals all over China, but have not been able to find a qualified doctor or facility to treat me. I was fortunate to get an appointment with a prominent US foot and ankle surgeon who visited Shanghai several days ago. It was his assessment that: "He be allowed to return to the US and be seen in a Medical Center environment where he can be under the care of a sophisticated team that includes infectious disease specialists, plastic surgeons with microvascular expertise, and orthopaedic foot and ankle specialists who are comfortable with Achilles tendon problems and soft tissue infections. I would envision that he will need an extensive wound debridement followed by a wound VAC. Once the wound has healed adequately and there is no sign of infection, a free flap could be performed to get skin and soft tissue coverage over the Achilles tendon. Once this heals and the tissue is mature, the flap cound be elevated to allow a lysis of adhesions around the Achilles tendon or a lengthening procedure to gain more motion. I anticipate that all of this will take approximately 9-12 months of recovery."

 

Now, things are becoming even more difficult. It was this surgeon's opinion that I be treated at his facility in the United States. My medical insurance company has a North American exclusion clause, but will allow treatment anywhere else in the world. The US surgeon then suggested a colleague, and previous student of his who now works in Australia. Until yesterday, I was planning to go to this facility, until the Chinese political bomb was dropped on me by my company HR department. They knew I was planning to go to Australia for treatment, and then quickly called a meeting late yesterday (Friday) afternoon, as they knew I was planning to leave on Sunday or Monday. In summary, I was told the following:

 

"If you go to Australia for medical treatment, you will forfeit your job with our company and we will be free or any legal requirement to pay your salary during treatment, and any other compensation if your injury proves to be permanent and incurable. You have two options: 1, get a handful of Chinese doctors to agree that I cannot be treated in China and must go to a foreign country for treatment. They also stated that this has never happened for any foreigner in the history of China. 2, Get my insurance company to agree to transport me by emergency courier to the hospital in Australia. If the insurance carrier agrees to transport me, then my company would remain legally on the hook, and must pay my salary and any other compensation during treatment.

 

However, here's the rub. They also contacted my insurance company, which is a Chinese company based in Hong Kong, and had a discussion. My insurance company was in the process of approving my treatment in Australia before the meeting, but magically have delayed their decision after my company called them. In short, I am in a terrible situation, as I am a foreigner who is being looked upon as someone who thinks China medicine is not up to international standards. Everyone knows this, but also everyone knows you should never put that in writing or say it out loud while you live and work in China. I have become a political pawn, and trapped her while in medical need. I am seeking out attorneys to help me, but something fishy is happening. It is very likely that the government is working behind the scenes to monitor my communication, and is subverting my ability to get help. I have also reached out to the US embassy in Beijing and Shanghai to assist me. They took my information, and say will call me Monday morning.

 

I know this post is very long and detailed, but I want to begin shining a light on the bullshit corner I have been pushed.

Edited May 4, 2012 by JiangsuExpat (see edit history)

[chilton747]

Jesse I have but one thing to say. You need to get your butt back to the USA and keep it here.

[Guest ExChinaExpat]

Jesse I have but one thing to say. You need to get your butt back to the USA and keep it here.

 

I know it's hard for anyone to know what to say. It's a very difficult thing. But, thanks. My plan is to return to the US as soon as I can.

[Guest ExChinaExpat]

I just took these photos of my leg to show what these butchers did to me, and now want me to continue more!

 

 

http://i50.tinypic.com/rhsi0j.jpg

http://i47.tinypic.com/j0zpth.jpg

http://i49.tinypic.com/a3h91d.jpg

http://i48.tinypic.com/34rvntu.jpg

http://i48.tinypic.com/29pff9i.jpg

[tsap seui]

Good grief, Jesse. What a helluva predicament. Very sorry to see you having to go through all this, especially with it getting down to being limb, if not downright life threatening.

 

I ran this by Wenyan, without a second thought she quickly said you need to go to America and take care of your health. I won't get into what she has to say about health care in China.

 

Good luck with whatever decision you make. With the effort you have put into living in China I'd hate to see you have to leave, but if you do, I reckon you can always find another job there, especially in your field.

 

tsap seui

 

Oh my God man....we looked at your photos and Wenyan showed me all of the dead meat (she went to school for doctor's assistant training) and her words were "man need to buy plane ticket TODAY."

 

Good luck Jesse, this has gotten way beyond serious.

Edited May 5, 2012 by tsap seui (see edit history)

[Guest ExChinaExpat]

Good grief, Jesse. What a helluva predicament. Very sorry to see you having to go through all this, especially with it getting down to being limb, if not downright life threatening.

 

I ran this by Wenyan, without a second thought she quickly said you need to go to America and take care of your health. I won't get into what she has to say about health care in China.

 

Good luck with whatever decision you make. With the effort you have put into living in China I'd hate to see you have to leave, but if you do, I reckon you can always find another job there, especially in your field.

 

tsap seui

 

Oh my God man....we looked at your photos and Wenyan showed me all of the dead meat (she went to school for doctor's assistant training) and her words were "man need to buy plane ticket TODAY."

 

Good luck Jesse, this has gotten way beyond serious.

 

Thanks for the good luck wishes. I know this is not a pretty story about China. I am learning I am one of many victims of some of the darker policies and methods of the China machine. I do love many aspects and people of this country, but certainly nothing about what is related to this issue. We live in modern times when this sort of thing should be a matter of the past. China is focusing too much on building its infrastructure at the peril of its naive citizens when it comes to health care.

 

Many Chinese often say, "Why don't you just go back to America and be treated there?" It's difficult to explain that while America has the best hospitals and doctors in the world, it comes at great cost. I do not have medical insurance in the USA, and my injury would be classified as pre-existing. I am pressing my insurance company to order an emergency evacuation to the hospital in Sydney, Australia. But, it's a weekend, and the decision makers don't return to work until Monday? What's that? The hell you say? You mean your staff sips on a drink and has a leisurely weekend, while one of your covered members is awaiting an emergency evacuation? Oh, sir, your treatment will be very expensive, and must be approved at a higher level. Well, then, call them up on the phone now and tell them to get to work!

 

If the emergency evac to Australia is approved, then my company will be on the hook to provide my monthly salary during treatment, and also reimburse me for travel expenses. Otherwise, I will have to give up all of it, go to Australia on my own dime, lose my job, and forfeit any compensation that my company would be forced to pay me if I remain in China.

Edited May 5, 2012 by JiangsuExpat (see edit history)

[DennisLeiqin]

Good grief, Jesse. What a helluva predicament. Very sorry to see you having to go through all this, especially with it getting down to being limb, if not downright life threatening.

 

I ran this by Wenyan, without a second thought she quickly said you need to go to America and take care of your health. I won't get into what she has to say about health care in China.

 

Good luck with whatever decision you make. With the effort you have put into living in China I'd hate to see you have to leave, but if you do, I reckon you can always find another job there, especially in your field.

 

tsap seui

 

Oh my God man....we looked at your photos and Wenyan showed me all of the dead meat (she went to school for doctor's assistant training) and her words were "man need to buy plane ticket TODAY."

 

Good luck Jesse, this has gotten way beyond serious.

 

Thanks for the good luck wishes. I know this is not a pretty story about China. I am learning I am one of many victims of some of the darker policies and methods of the China machine. I do love many aspects and people of this country, but certainly nothing about what is related to this issue. We live in modern times when this sort of thing should be a matter of the past. China is focusing too much on building its infrastructure at the peril of its naive citizens when it comes to health care.

 

Many Chinese often say, "Why don't you just go back to America and be treated there?" It's difficult to explain that while America has the best hospitals and doctors in the world, it comes at great cost. I do not have medical insurance in the USA, and my injury would be classified as pre-existing. I am pressing my insurance company to order an emergency evacuation to the hospital in Sydney, Australia. But, it's a weekend, and the decision makers don't return to work until Monday? What's that? The hell you say? You mean your staff sips on a drink and has a leisurely weekend, while one of your covered members is awaiting an emergency evacuation? Oh, sir, your treatment will be very expensive, and must be approved at a higher level. Well, then, call them up on the phone now and tell them to get to work!

 

If the emergency evac to Australia is approved, then my company will be on the hook to provide my monthly salary during treatment, and also reimburse me for travel expenses. Otherwise, I will have to give up all of it, go to Australia on my own dime, lose my job, and forfeit any compensation that my company would be forced to pay me if I remain in China.

The US Supreme Court will rule on the legality of Obama care in June. Your pre-existing condition will be a non issue if the court rules favorably. Interestingly, I wonder if you are for or against Obama care now?

[Guest ExChinaExpat]

Good grief, Jesse. What a helluva predicament. Very sorry to see you having to go through all this, especially with it getting down to being limb, if not downright life threatening.

 

I ran this by Wenyan, without a second thought she quickly said you need to go to America and take care of your health. I won't get into what she has to say about health care in China.

 

Good luck with whatever decision you make. With the effort you have put into living in China I'd hate to see you have to leave, but if you do, I reckon you can always find another job there, especially in your field.

 

tsap seui

 

Oh my God man....we looked at your photos and Wenyan showed me all of the dead meat (she went to school for doctor's assistant training) and her words were "man need to buy plane ticket TODAY."

 

Good luck Jesse, this has gotten way beyond serious.

 

Thanks for the good luck wishes. I know this is not a pretty story about China. I am learning I am one of many victims of some of the darker policies and methods of the China machine. I do love many aspects and people of this country, but certainly nothing about what is related to this issue. We live in modern times when this sort of thing should be a matter of the past. China is focusing too much on building its infrastructure at the peril of its naive citizens when it comes to health care.

 

Many Chinese often say, "Why don't you just go back to America and be treated there?" It's difficult to explain that while America has the best hospitals and doctors in the world, it comes at great cost. I do not have medical insurance in the USA, and my injury would be classified as pre-existing. I am pressing my insurance company to order an emergency evacuation to the hospital in Sydney, Australia. But, it's a weekend, and the decision makers don't return to work until Monday? What's that? The hell you say? You mean your staff sips on a drink and has a leisurely weekend, while one of your covered members is awaiting an emergency evacuation? Oh, sir, your treatment will be very expensive, and must be approved at a higher level. Well, then, call them up on the phone now and tell them to get to work!

 

If the emergency evac to Australia is approved, then my company will be on the hook to provide my monthly salary during treatment, and also reimburse me for travel expenses. Otherwise, I will have to give up all of it, go to Australia on my own dime, lose my job, and forfeit any compensation that my company would be forced to pay me if I remain in China.

The US Supreme Court will rule on the legality of Obama care in June. Your pre-existing condition will be a non issue if the court rules favorably. Interestingly, I wonder if you are for or against Obama care now?

 

I remain completely against the plan standing before the SCOTUS now. I can get medical treatment as I have good medical insurance. The problem now is if I leave China, my company will forfeit my job, monthly salary, and my company now claims they will be free of any obligation to provide me compensation for a work related injury. They are essentially trying to force me into getting treatment in China, or else.

Edited May 5, 2012 by JiangsuExpat (see edit history)

[Mick]

So sorry to hear you are in this predicament. From the photos, it appears you are beyond the critical stage. You need treatment right now, not "in a few days." When I lived in China I had a good friend and neighbor who had a similar problems with the Chinese health system, though not for a foot problem. He was diagnosed with a ruptured appendix, but when they opened him up for emergency removal, his appendix was fine. So they went exploring and ended up removing his gall bladder. Massive infection set in and his was eventually air lifted to HK, then back to Canada, where he lived prior to coming to China.

 

I know your medical condition needs treatment right away, but there are so many side issues here related to your job, your coverage, etc. If you lost your job, would that mean your visa would be revoked as well? If you go to Australia and your company is "off the hook," does that mean you might not be able to return to China? I know this is not the main point, your foot is, but it is a side issue.

[tsap seui]

So sorry to hear you are in this predicament. From the photos, it appears you are beyond the critical stage. You need treatment right now, not "in a few days." When I lived in China I had a good friend and neighbor who had a similar problems with the Chinese health system, though not for a foot problem. He was diagnosed with a ruptured appendix, but when they opened him up for emergency removal, his appendix was fine. So they went exploring and ended up removing his gall bladder. Massive infection set in and his was eventually air lifted to HK, then back to Canada, where he lived prior to coming to China.

 

I know your medical condition needs treatment right away, but there are so many side issues here related to your job, your coverage, etc. If you lost your job, would that mean your visa would be revoked as well? If you go to Australia and your company is "off the hook," does that mean you might not be able to return to China? I know this is not the main point, your foot is, but it is a side issue.

Yeah Mick, those side issues. I really feel for Jesse and anyone in this sort of predicament where they are where they want to be but the health care there is like a State Department manual.

 

Good luck to you Jesse. Those photos of the open wound, dead meat, etc are very telling evidence and hard to justify.

 

I can't help but picture you wearing shorts to work and to any meetings with the powers in charge so they can get a look at your....I mean... the companies "health care" plan as carried out by "their" doctors.

 

My wife says it's nothing for the doctors to just tell you they can't do anything for you, you need to go home and die. Pretty sad. Not trying to cut down Chinertucky. I like it, it's just is what it is. We have a very beautiful and comfy home in China and I love it, but I knew in my heart (of all places) that if the State Department turned us down again, I was leaving my excellent doctors in America to live out my days with my wife. I also knew my days were numbered but what the heck, lil' rabbit is worth it.

 

Wish you a speedy recovery buddy. China will still be there should you decide to go back and pick up where you left off.

 

tsap seui

[ljb]

If you do go to Australia on your own dime, be forwarned. I found out that the cost there is the same as in the U.S. (Luckily I had travel insurance) Singapore's Raffles hospital is one of the best in Asia for half the cost of the U.S. if that helps.

[A Mafan]

Clearly, the US medical system is much better at trauma, infections, and treating things like this.

Clearly, you should be in the US as soon as possible.

(or Singapore, Thailand, or India, actually. Medical Tourism is a growing business, because there are places you can get excellent treatment for inexpensive prices...suggest you do some searches)

 

However, I would caution anyone from believing this sort of thing doesn't happen in the US, too. For example, staph infections:

http://www.doctorslounge.com/infections/articles/nosocomial/staph_hospital/index.htm

 

Malpractice kills 195k/year in the US:

http://en.wikipedia.org/wiki/Medical_malpractice

 

Of course, the US system leaves you with more recourse in the case of malpractice than the Chinese system, too.

 

I guess my thoughts are: if you want to get good treatment in China, you have to be politically connected. If you want to get good treatment in the US, you have to be prepared to pay. Since excellent medical care is a finite resource, there must be some limiting factor, and since hard work to earn money is an option available to everyone, I infinitely prefer the latter.

 

But this anecdote also highlights the importance of getting a second opinion and being actively involved in your care, asking the right questions, etc.

 

In any case, I hope you are able to choose the path that returns you to full health as quickly as possible, with the lowest tangible and non-tangible costs!

[Guest ExChinaExpat]

Thanks to all of you for your replies. Mick, I appreciate your words and observations as you have experience both living and working in China for an extended period of time. Thank you also AM for your for words. I agree with some of what you say, but with a few clarifications. I have outlined them as follows:

 

 

Clearly, the US medical system is much better at trauma, infections, and treating things like this.

 

Yes. I agree. US hospitals and doctors are the best in the world. Virtually all countries of the world agree with this, which is why so many countries send their best people to be educated at American medical schools and hospitals.

 

Clearly, you should be in the US as soon as possible.

 

I don't agree with this AM because of the "side things" that Mick pointed out in his observation. Medical treatment in the US is very expensive. While every hospital emergency room in America must treat whoever walks in the door, whether or not they are broke, and whether or not they have medical insurance, they will not agree to performing and treating a patient with ongoing therapies, send in teams of doctors, and so on. They will simply stabilize the patient as best they can and send them on their way.

 

As I stated previously, my company in China has made it clear that if I seek medical treatment outside the China mainland they will:

 

1. Consider the my relationship with them as employee null and void

2. They will be free of providing any compensation to me for a work related injury, and be off the hook for any lawsuit.

3. They will not have to pay my monthly salary

4. I will lose my China residence permit and not be allowed to return to live and work in China

 

 

(or Singapore, Thailand, or India, actually. Medical Tourism is a growing business, because there are places you can get excellent treatment for inexpensive prices...suggest you do some searches)

 

These are not an option for me AM, as I have previously stated. If I leave China, I will be on my own, and forfeit everything. The reason I sought treatment in Australia, is because my medical insurance will cover treatment in any country in the world at 100%, but they will not cover treatment in North America. However, my company HR and legal department have stated that if I seek medical treatment outside China mainland, that they will be free of any obligation to me.

 

However, I would caution anyone from believing this sort of thing doesn't happen in the US, too. For example, staph infections:

http://www.doctorslo...pital/index.htm

 

Malpractice kills 195k/year in the US:

http://en.wikipedia....cal_malpractice

 

Of course, the US system leaves you with more recourse in the case of malpractice than the Chinese system, too.

 

To prove malpractice is difficult anywhere in the world. That is a different topic than what I have posted here and will likely confuse anyone who reads it into thinking that a malpractice case is the same as a "work-related" injury case. China in fact is required by China law to compensate any employee who is injured while working, or deemed to have a work-related injury. Settlements in China however are far less than the hundreds of thousands of dollars sometimes awarded to US citizens seeking compensation. Awards in China are negotiated according to a percentage value between the employee, judge, and employer. It usually doesn't amount to very much.

 

I guess my thoughts are: if you want to get good treatment in China, you have to be politically connected. If you want to get good treatment in the US, you have to be prepared to pay. Since excellent medical care is a finite resource, there must be some limiting factor, and since hard work to earn money is an option available to everyone, I infinitely prefer the latter.

 

'Good treatment' is arbitrary and subject to the interpretation of the patient, doctor, medical facility, and legal judgement. I disagree however that someone needs to be politically connected to receive 'good treatment' in China. If anyone wants treatment in China, they have to pay for it. If they want better educated doctors, and higher-end hospitals, they also have to pay for that. The rich have more options anywhere in the world. That applies to China, and to the USA. I was fortunate to meet with Doctor Thomas Clanton in Shanghai a few weeks ago. He is considered by many to be the number one foot and ankle surgeon in the world. He is well respected in China, because he is the surgeon who operated on both Yao Ming, and Liu Xiang: the Chinese olympic hurdler who ruptured his Achilles tendon. Doctor Clanton did such a good job with Liu Xiang's repair that two months ago he broke another world record. Doctor Clanton was the sports surgeon for the Houston Rockets, and has his office in Aspen, Colorado. I took the following photo at the new American Medical Center in Shanghai during my visit with him:

 

http://i50.tinypic.com/30sy0ja.jpg

 

But this anecdote also highlights the importance of getting a second opinion and being actively involved in your care, asking the right questions, etc.

 

In any case, I hope you are able to choose the path that returns you to full health as quickly as possible, with the lowest tangible and non-tangible costs!

 

In any event, I have the following three options when it comes to my case:

 

1. Leave China mainland for medical treatment and lose my job, lots of money, and perhaps even the right to return to work in China again.

2. Get treatment in China mainland and continue to receive my monthly salary and keep my company on the hook for any legal compensation for work related injury

3. Hope for a magic fairy to appear who can create a third option

 

It was very difficult to find and get the appointment with Doctor Clanton in Shanghai. I saw him in Shanghai on April 24, which was the day after the grand opening of the new American Medical Center there. This facility is a new attempt by China to increase the level of medical care in China, and also allow for the best doctors in the world to meet with China patients and doctors and evaluate, and teach them better methods.

 

http://www.shanghaid...2Bin%2BMinhang/

 

--edit--

 

I want to also add, that if I choose to go to Australia, that my medical insurance will pay 100% for the treatment there. However, my doctor suggests I will need 9-12 months of treatment and recovery. It's unknown whether if I go to Australia that I will be an inpatient for the duration; meaning that I will be provided meals, housing, and 24/7 assistance. It's very likely I will be discharged for a period of time and then asked to return for both inpatient and outpatient treatment. That means I will have to seek housing and pay my own expenses during this time. During that time, I will have no income, and no way of getting income, so everything beyond medical care is on me. I am just not in a position to do that. If I were independently wealthy, perhaps. So, at the moment, I have about 90% decided to seek the best treatment available in China. Despite my previous bad experiences, not everything was a nightmare. Many of the difficulties I experienced are culturally related. Some of the other experiences may be attributed to bad luck. That bad luck includes a bad doctor and questionable sanitary methods.

Edited May 6, 2012 by JiangsuExpat (see edit history)

[A Mafan]

I guess my starting point and ending point is: it is your health.

 

If you are not willing to pay for fixing your health, if you are not willing to sacrifice or choose between less-than-optimal alternatives to improve/resolve your health problem, on what basis do you expect anyone else to care or sacrifice more than you are willing to?

 

Yes, it should have been done right in the first place. It wasn't. Now what? There's no such thing as a free lunch. Every choice has costs.

 

Socialism promises that no one will ever have to face that decision...but it has never delivered on that promise for anyone but the politically-connected.

Now you live in a semi-socialist nation that lacks the mature medical and insurance practices that could have prevented this situation.

 

Sure, it sucks. We all feel bad for you. What sacrifices are you willing to make to have your problem fixed?

 

I saw your reasons for not being able to take certain steps. From what I could tell, those restrictions were imposed only by you, not by law or ability.

 

As Yoda said, there is no try. There is only do, or do not.

 

Good luck to you. I hope you are able to return to full health as quickly as possible and at the least cost/sacrifice possible. I fear you won't be able to do that under your current situations, but I would be ecstatic to find out I was wrong and you were able to wring the concessions from your employer and health "insurance" to find a doctor in China who can heal you rapidly.

[johnxiaoying]

I'm sad to hear of your horrible situation. Medical care in China is one thing that keeps me from wanting to live there for any length of time.

 

I would have thought that there would be some excellent care in Beijing, Shanghai or Hong Kong. If not, perhaps India. I did a quick search and came up with the following:

 

http://www.apollohospitals.com/

 

Are you a veteran? I'm not sure I would want to go to a VA hospital for this type of surgery.

 

Best wishes.