Vienna, in the nineteenth century: At his teaching hospital – the Allgemeines Krankenhaus der Stadt Wien – a pathologist named Karl von Rokitansky institutes an autopsy on every single patient who dies there. After the autopsy, clinicians and pathologists sit down together to compare notes: The Morbidity/Mortality Conference is born.
New diseases were found, old diseases became better known, medicine improved greatly, and Vienna became a magnet for physicians who wanted to learn there - it still is Europe's biggest hospital. My father spend some semesters studying medicine in Vienna. In Europe, one is not as wedded to one's alma mater as one is in the USA; in Europe, it behooves everybody to seek out good schools and good teachers to learn as much as possible. For instance, I studied in Nuremberg (Nürnberg), Brunswick (Braunschweig), Kiel and Hamburg, and finished degrees in mathematics, philosophy, social sciences and medicine. Here, if you change schools, you are frowned upon. – Both methods seem useful in their own way – I am not sure which one I prefer.
Back to pathologist Rokitansky. For about a century after he made them mandatory, autopsies were the norm, especially at teaching hospitals. Now they are the exception: Barely one in a hundred dead bodies get a second look, to find out what the cause of their demise was. Autopsies are not “cost-effective”, and different imaging procedures, done when the patient is still alive give the patient a better chance to stay alive.
But medical knowledge and skills are in decline – and patients complain. It seems as if physicians don’t want to be confronted anymore with their mistakes. Before, a physician learned from every case. Now the physician just tries to handle the case load.
This time it seems it is up the patient to demand an autopsy … Read More
Blog: On Health. On Writing. On Life. On Everything.
Watermelon And Terracotta Soldiers
July 22, 2011
In Traditional Chinese Medicine, there are two different kind of heat afflictions: “red” and “white”. Red is what we call a heat stroke - when one is extremely overheated; white is when one has what in Western medicine would be called an electrolyte imbalance. Potassium depletion seems to play a major role.
In Dunhuang, I suffered a heat collapse. Visiting Mogaoku – the Buddhist caves - at around one hundred degrees, was a bit much for my system. In the evening, I refused to eat – which alarmed everybody. At that point, I could barely walk, and in a restaurant they built a make-shift bed for me from several chairs. While they were dining, I waited for them – for about fifteen minutes, or so I thought. In reality, one and a half hour had passed; I lost time (but not consciousness) – a weird feeling.
A few years earlier, after a visit in hot, hot Wuhan – another little dot on the Chinese map; turned out it has twelve million inhabitants – in July, I had a similar collapse in Beijing. That one was worse: I could not lift my head from the pillow anymore.
In both cases, my friend Hong was with me, and she gave me freshly pressed watermelon juice. Within ten minutes, in the Beijing case, I could lift my head, and from there I started eating and drinking again. This time, with the watermelon juice and a good night’s sleep, I woke revived the next morning.
The watermelon juice advice may come just in time for the heat wave in the USA.
Meanwhile, we traveled from dry Dunhuang to rainy Xian – the city that starts the Silk Road. The rain does the land good, and me, too.
Xian is famous for the Army of Terracotta Soldiers – which I have wanted to see for such a long time. It’s magnificent – but also scary because ancient records show that about 700.000 people had to die helping one megalomaniac emperor build his tomb. He, more than 2000 years ago, unified China and became the first Emperor.
Before, the regions had suffered many fiefdoms. The First Emperor of China (of the Qin dynasty) built roads, unified money, measurements and language, and built at his tomb for 38 year; it has the form of a grassy pyramid and is the largest grave installation in the world. When he died unexpectedly at age fifty – speculation goes he was afraid that any one doctor might kill him, so he had several and probably took too many Chinese herbs from too many doctors simultaneously – his son buried him in a pompous ceremony, walked out of the tomb and banged the door shut – leaving all the wives and concubines and court people including 450 Confucian scholars locked in; they died of suffocation. The son then had the tomb entrance camouflaged and killed the people who did the camouflaging. This son was the second and last emperor of the Qin dynasty and hung on only for three more years, then the farmers rebelled against the unimaginable exploitation and killed him. After fierce fights between two rivaling farmer bands, the Han dynasty was established.
Everybody has seen photos of the life-sized terracotta army – but to stand there and look into the faces is amazing. They were built after living models, and we know that each soldier sculpted here had to die for the Emperor. Each face is different. The faces look modern – one sees similar faces now on China's streets. To me it feels less like an army, more like a photo gallery of ancestors. Each gown and uniform has different adornments; even their postures are individual. All look serious and serene, as with a higher purpose.
China’s greatness does not lie in her past only. Every single American owes China about 6,000 dollars. For many years we lived above our means (and was it worthwhile???). Clearly, we can’t put the blame on our Government alone; we were in this together. Only hard work and frugality will get us out now.
I am not saying that everything is better in China than in America – we know that's not true – but I am in awe of the Chinese people who got themselves out of the mess Mao Zedong had put them in. Read More
How Many Chinese Does It Take To Screw In A Light Bulb?
July 21, 2011
This is not a joke, of course. This morning, they came to the hotel room – three of them: A woman, politely knocking and explaining the procedure (by gestures – my Chinese is bad); a man who carried the equipment; another man who screwed in the bulb nimbly and knowledgeable. The bulb was the energy-saving kind.
And all along they had fun, not bothered by efficiency or other Western values. This way, the Chinese government gives everybody a job – at extremely low wages. The Netherlands are another country that thrives on job sharing: People work less hours per week, take a cut in their salaries – and enjoy their increased free time. We, on the other hand, rather have excellent salaries (or the dream that we some day will have them) - and pay with stress, competitiveness and joblessness.
This light bulb changing took place in Dunhuang, in the Gobi Desert. Dunhuang is an ancient oasis and now a modern tourist attraction, with sand dune buggy rides (which I really can’t stand – but the males in our group think differently), camel rides (which I am not sure about) and a wonderful hotel that looks like an ancient desert fort.
In case you think Dunhuang is a little oasis like in the cartoons, it is a city of nearly 200,000 inhabitants that accommodates about a million visitors per year.
In the bathroom is a sign that reminds us that water is the “spring of life” and asks us to preserve every drop of it. Dunhuang is an oasis that is fed by a river that comes from the nearby mountains. Last months, they told us, the river was swelling above the bridge and areas were under water. Now the riverbed is stone-dry.
The Gobi Desert is – unlike the Namib Desert in Africa, about which I wrote before – a man-made desert: People cut down all the trees without reforestation. Without the deep roots and the leaves that fertilized the earth, the soil could hold no longer water. The result was sand, sand, sand – desert. And as always with deforestation, the cities and cultures that were once blossoming faltered and vanished.
Around Lanzhou, in a totally arid region, there is a huge reforestation program underway. I heard it is done this way: Every worker is getting one day per week off to plant trees and to maintain the trees. The outcome can easily be monitored: The trees live or die.
Near the Dunhuang oasis are the Mogaoku – a row of hundreds of caves cut into the rock and furnished with Buddhist shrines. This oasis that has revived travelers for thousands of years was the perfect place to pray for a safe return from the perilous desert crossings – or give thanks, on return. The caves had been built from the earliest Qin times until the thirteenth century, when nomad hordes threatened the area. So, the cave entrances were covered up by bricks and plaster and rocks – and sandstorms further made the sites unknowable.
In 1900, a monk discovered one of the caves by chance. By selling a script or a statue here and there, Western museums got wind of the treasures here, and came in several expeditions and bought up everything they could lay hands on. Thus, the old manuscripts and statues ended in the museums of Great Britain, France, Germany, Japan and the USA. There they have been preserved probably better than in China – nevertheless, it is a loss China deeply regrets. Other than the lootings of Jewish property by the Nazis and allied forces, these were regular transactions, and it is unlikely that the Chinese will recover the treasures. Read More