More general thoughts on Tianjin

1. I've already mentioned the traffic, but multiply it by about a squillion. I'm not sure I'll be able to walk across the street in the US safely, ever again, because instead of just going where they're going and slowing down a little (a lot), the helpful driver is going to swerve at top speed and plow right into me.
2. Everybody smokes. I. Mean. Everybody. Smokes. And I'm seeing the results in clinic, too, as we're getting stroke patients in their 40s and 50s. And with all the secondhand smoke around me, I suspect that they're not all smokers.
3. Most of the men drink. Again, this is based on what I'm seeing in clinic and on the street, but again, there are men in their 40s and 50s with alcohol-based encephalopathies and (I imagine) cirrhotic livers.
4. But! People are generous and helpful in ways that we in the US just couldn't imagine. People watch one another's kids while they're getting a treatment; in one case, they watched another person's aged father with dementia. It doesn't always seem like it, especially when there's money involved: if you're in a financial transaction, be on your guard since nobody wants to leave money on the table. But outside of that, I've seen some generosity that would knock your socks off.
5. Privacy is a myth. I alluded to the fact that HIPAA doesn't exist for the Chinese, and I've described the clinic in which I'm observing, which obviously makes medical privacy a bit of a challenge. But it goes deeper than that, since most people show up for their acupuncture treatments with a friend or family member, and since that person is sitting around for the better part of an hour, they usually get a good look at what's going on with another patient, and sometimes offer their opinions. Similarly, in public restrooms there may be no divider between the (squat) toilets, or there may just be a token one about a meter high. Now I'm not sure if it's the anonymity of the masses, or (more likely) just a cultural lack of concern for such things... but I know that it would totally freak my mother out.
6. Things are simultaneously more and less disposable. For instance, everyone carries their own reusable bottle for water or tea. But you get the cheap, thin plastic bags with EVERYTHING, and if something is packaged at all, it's probably overpackaged. On balance, I think a little less waste is generated... a little. But it's hard to tell, because littering is a part of the culture where there are people picking up the trash every couple of blocks in Beijing, and about half that in Tianjin.
7. Oh, and acupuncture needles? After one use, they're dropped in a pan of alcohol, where they're taken out at the end of the day, straightened, and autoclaved. And I'll bet there are ten guide tubes in the whole city. Good on the waste factor, bad on the painless insertion and ultra-clean-needle factors. But that also means I've gotten to see a three-edge needle in use! Very cool, and I can see how it's much more versatile than a single-use lancet, which really is neither long enough nor broad enough to do the job sometimes. And I haven't seen a single needle break, even with VERY vigorous stimulation. (Dr. Zhang goes EASY in our class, by comparison.)

This isn't what I'd expected, to be honest... but that's not a bad thing. I'm still amazed at what a wonderful experience this has been so far, and I only expect it to get better as I get more comfortable.