My visit to the Shanghai Skin Disease and Sexually Transmitted Disease Hospital

It started two weeks ago: drinks on a beautiful Shanghai evening with a visiting American couple at Barbarossa, a surreal Arabic-themed indoor/outdoor restaurant right in People’s Square. The husband was a doctor, here for a consultation on product-safety issues. “I’m a dermatologist, and so….” I stop listening to the sentence at that point but corner him as we’re leaving. “Funny you should mention you’re a dermatologist. Would you mind taking a look at….?” People ask me this kind of favor all the time, and I usually say yes. (Will I read Cousin Sally’s book manuscript? Can I suggest a publisher for a collection of poems?) In the cycle of karma, it was my turn to ask advice.

That very morning I had noticed a tiny rough patch of skin on the bridge of my nose. Just the normal collapse and decay, or something more specific to worry about?

The visiting doctor, whom I’d first met one hour earlier, took a look and said, “Actinic keratosis. You can just have it frozen off some time.” A sun-damaged area, no doubt the price of long summers from ages 6 through 18 at the beach in California, plus thousands of other hours on the tennis court, back in the ignorance-is-bliss / pre-sun-block stage of human evolution. “It’s amazing you’ve never had them before!” he said cheeringly.

The reason to get it removed is that such areas were more likely than normal skin to turn into skin cancer. Could I wait the five or six months until my next planned visit to my normal doctor, in Washington? “You might get it looked at before that,” he suggested—and gave me the name of a Shanghai dermatologist he had just met.

The next day I sent an email to the local doctor, and asked if I could make an appointment to come see him. Sure, he wrote back, by mobile phone text-message. Suggest a day! We set a date, and he said I should come “in the morning.” Any particular time? I asked. There was no reply.

I look up the doctor’s name on Google; sure enough, he has written a number of papers for international conferences. I look up the address he gave me: it’s the same as his institutional affiliation in those papers, the Shanghai Skin Disease and Sexually Transmitted Disease Hospital.

I figure out where the hospital is and that the fastest way there is by subway. I head out this morning, through a short-lived downpour and walk the few blocks from the Zhongshan Park subway station to my destination. I find myself in a big courtyard something like a train station waiting room, with a number of tellers’ booths on one side and people in various stages of discomfort standing around or sitting on benches. This is unworthy, but I can’t resist classifying patients as I look at them: That old man, with the big raw rash on his face, is probably here for the Skin Disease department. That young man, looking healthy but downcast, is probably here.. for other reasons. Then I realize that I have no grossly-visible skin problem. (My little bridge-of-nose area is as large as a grain of rice and hard to see except with a magnifying glass.) So that, plus Westerners’ general reputation for being randy, would tell onlookers that I….

I know my doctor’s name in Chinese, but I don’t see it anywhere in the all-Chinese signs and listings. So I send him a text message on my mobile phone saying that I have arrived. A minute later, a teenager wearing sandals, khaki pants, and an untucked shirt walks up – listening to an iPod. This is my doctor. We walk up the concrete stairs to a little anteroom on the next floor. He has me sit on a stool and he looks closely at my nose. “I think – electricity!” he says, in English. “I ask the surgeon.” He disappears.

I start preparing myself for the next return appointment to get the surgeon’s advice. Electricity (whatever that might entail)? Freezing (which somehow sounds less painful)? I am blissfully unfamiliar with medical procedures in the Unites States, but when I had another tiny skin-related procedure done in Washington a couple of years ago, I had to make several consulting visits ahead of time, and wound up submitting an insurance bill of nearly $2,000.

While I am just beginning to muse in this area, the door flies open and a surgeon walks in, apparently straight from the operating theater. Green scrubs, face mask, gloves, sterile cap over his hair. He pulls off his gloves, puts on a set of new ones, and grabs my nose and stares at it. Dianli! he says in Chinese. Electricity. Then, in English, “come with me.”

I follow him down a concrete hall to another room – the operating theater! An older Chinese man stumbles out, and around him is the unmistakable and alarming smell of burned flesh and hair. Hmmm. I take off my shoes and put on clean paper booties. I walk over to an operating table and, as directed, lie down on my back. Sixty seconds after I had first seen the surgeon he is injecting Novocain (or something similar) into my nose. A cloth is draped over my eyes – hey, no problem, I’m not about to open them! – and I hear the also-alarming buzz-humm sound of an electric arc. Then the buzz sound is closer and I can feel and hear it moving across the top of my nose. Eight seconds of this – I count them off to myself – and the buzz stops. There is just enough of the burned smell to depress me.

 Hao de I hear the doctor say – “that’s fine.” I hear him say some more things I don’t understand to the nurse. Naturally I fantasize that they are remarking upon the nose-bridge itself, which is one of several indicators that I am not ethnically Chinese. He sticks a small bandage crosswise across the zapped area and says in English, “You can go.” Less than five minutes after I first greeted my original child doctor, my treatment is complete.

I go out into the hall and send another text message to that original doctor (a more polite form of, Where are you? What do I do now?). He reappears and takes me to the cashier’s window. I have brought a huge roll of RMB with me – might this cost a hundred dollars? A thousand? Will I have to pay in cash? The cashier says something in English that I think is “fifteen hundred RMB,” about $200. Good thing I’ve brought more than that with me! No, she actually meansfifteen RMB, $2. I hand over the money and get a bunch of forms to fill out. She tells me that only two lines are important, so I enter the information in those two. I am entered in the clinic’s records as ‘FALLOWS: MAN.”

Now it’s back up to the operating theater, with the forms to give the surgeon. He takes them, fills them out some more, and tells me to go to the cashier again. OK, I see: the $2 down payment was just my registration with the clinic, plus payment for a fancy Smart Card for me to keep with my patient info embedded in it. Now I have to pay the full fee – operating expenses, consultation, anesthetic, nurse who assisted the surgeon. The calculator churns and shows the total: 240. That RMB, not dollars. A total of just over $30 for the entire treatment, done on the spot.

Maybe I’ll be saying, “You get what you pay for,” when I take off the bandage, as instructed, three days from now and see what’s underneath. But right now I am marveling not so much at the “China price” of the treatment as at the prompt, no-nonsense, no-excess-formalism approach to getting things done. Was this special foreigner-handling I was getting? It didn’t look that way, apart from the glosses in English. Everyone else seemed to be bustled in and out at about the same pace.

I draw no large conclusions about Chinese medicine from this encounter. It is as often complained-about as Chinese education and other practices. But I am grateful to the surgeon, and the original doctor, and the American doctor who steered me to them. And I’m glad to be enrolled with the Shanghai SD/STD Hospital for whatever future treatment FALLOWS:MAN might need.