Food, glorious food!

This will not be the last of my food posts. In fact, I'm not entirely sure why I've waited so long to talk about this, except for the lack of photos and breadth of experience.

Anyway.... as we all know, I like to wander around a little bit. The other night, my wanderings brought me to a market. I won't call it a "night market", because that has connotations of deep-fried scorpions and roasted snake meat that this market was entirely lacking. But it was a market, and it was open at night, unlike the one that's across the street from the hotel where I'm staying.

(Vegetarians beware... The next few paras have descriptions of some of the animal-based foods I saw. Nothing too out of the ordinary for US palates, but if you avoid certain counters at the supermarket, you might want to skip ahead a bit.)

The market was reminiscent of an indoor Farmer's Market -- of course, not like the one at the Ferry Building. This was in a large warehouse, with fruit stands, vegetable stands, prepared food, and so on. In the two markets like this that I've been to, there are fruit and veggie stands in the front, and making up most of the middle of the area. Along the sides, there are vendors selling sausage, noodles, and bread (usually batter-based buns or flatbreads, often fried and occasionally stuffed). And in the back are the butchers and fishmongers. As I wandered into the back of this particular market, off to the left, I saw mounds of shrimp, live crustaceans (crabs reminiscent of East Coast blue crabs and some kind of flat, pale crayfish), and six or seven varieties of fish, all of them smelling sweetly of the water, eyes clear and gills pink.

Not for the first time, I wished I had a stove here to try cooking some of this stuff. Fortunately, I had already eaten, so I wasn't tempted to figure out some way to do it anyway.

The butchers are likewise impressive. Ribs hanging from the top of the stand, other cuts -- including variety meats -- on the counter below. Like the French or the Italians, the Chinese will eat everything but the squeal. (Or cluck, or moo, or what have you.) It's impressive, the lack of waste, and since chicken heads are pretty sparse in the meat department, they're remarkably cheap.

Of course, in a country where labor is still almost free, the cost of producing food is also insanely cheap.

(Okay, I'm stopping with the graphic descriptions of meat.)

It's possible, in fact quite easy and economical, to eat from street carts at least two if not three meals per day. These are nothing like New York street carts, except for the portability. I've seen everything from pre-prepared food held in a cooler (or just out in the open!), to buns steamed over boiling water, to food being fired in one of two full-temperature woks, and everything in between. Between the easy availability of bamboo charcoal to the portability of gas, it's possible to cram just about anything into a cart the size of two side-by-side shopping carts. I've even had (for breakfast) a fried egg, pickled vegetables, and sauce on a bun baked a la minute in a kind of Dutch oven. Most things are wrapped, of course, to go. This means a nigh-infinite number of thin, cheap plastic bags and food that usually has bread wrapped around it, but I've also seen soup go out in a bag, or (for eating nearby) what looks like a storage bowl, wrapped in a plastic bag to save having to wash constantly.

Getting other prepared food is pretty simple, too. Like I mentioned above, the market near the hotel has cold salads and sausage in addition to the fruits and vegetables and so on. Tonight for dinner, I had yu xiang dou fu (fish-flavor tofu), which is actually made without any fish. It was pretty decent -- on a par with the average-quality Chinese restaurants in the Bay Area, only, you know, for 7元, a little over a dollar.

Of course, there's always the supermarket nearby -- Carrefour, that famous French chain store. It's generally a good place to get fruit, though the street markets are pretty reliable for local food -- don't try to find dragonfruit, or even a banana, but apples and pomelos and jujubes (zao) are everywhere, even on the street. And corn is ubiquitous, even roasted at one of the aforementioned street vendors. Same thing with sweet potatoes, or maybe yams -- I'm not a botanist, I just know that they smell tasty and sweet roasted in a big barrel filled with charcoal.

Before anyone asks, I've already tried durian, I like it, but it's a pain to eat, and a bigger pain to find someone to eat the ginormous thing with you. I'll stick to the lesser culinary challenges, like whether or not to eat the membranes of a pomelo. Speaking of which, I have to mention that the pomelo here is nothing like the beast we get in the US. My past experiences with pomelos in the US have been less than satisfactory -- start with a fruit about the size of your head, and wind up with an edible portion that is about the same size and flavor as a grapefruit, only a little more bitter. Here, pomelos have relatively thin skins, so you end up with a sweet, unique-tasting snack for three or four. And the membrane is so thick, you almost have to peel the fruit out of them.

I still haven't had much experience with a proper restaurant. Maybe I'll find a way to work that out soon with one or another of my fellow interns. More when that happens.... or when I have pictures.

Sunday reflections

So, it's Sunday, and I don't have a lot to do today. I treated myself to a bit of a lie-in (a term I've always liked, to be honest), and it was black sesame cereal for breakfast, from a package, in case anyone was wondering. Nothing spectacular.




But I suppose it's time to get some more pictures posted... so here's my trip to the Great Wall:

There are a number of sections of the Great Wall that can be visited. I hiked from Jinshanling to Simatai, two adjacent sections of the wall in various states of disrepair and restoration. It's pretty amazing, to tell the truth... far more so than I'd actually expected.

My first couple of views of the Wall from the Jinshanling end. From the parking lot, you can either take a gondola up to the wall for something like 40元, or you can hike up for free. I think it's worth the hike, but as most people know, I'm a big walker. These pics above are from the start of the hike up.

Also, from the beginning, some locals invariably come along with you. It's hard to not let them attach themselves to you and help you along... which in some cases, is actually quite handy. Plus, many of them act as unofficial tour guides. I felt a little obligated to buy something from them on the hike -- I got an actually rather nice picture book for not-all-that-much -- but whatever.
The countryside is spectacular. Rugged, hilly... well, you get the picture. What used to be inner Mongolia (and is now, I think, Hebei province) is on the north side. The side that was being protected from.

I look terrible in most of these pictures, but whatever. The hike was exhilirating, and I actually felt really good in terms of how well I was doing, considering how out of shape I've gotten while in school.

At any rate, the wall winds back and forth on itself, I imagine because of the reality of the terrain and the lack of desire to completely transform the landscape. (It wasn't a lack of ability. All you have to do is look at the wall itself to realize that the manpower was available to do nearly anything, if the political will was also there.)

Another of the early sections of the wall in Jinshanling. You can get a decent idea of what the hike is like most of the way -- a lot of ups and downs, spectacular ruins, spectacular scenery, uneven pavement.

Most of the way is kind of a gentle roll up and down, as you can see in the next photo.

Uh.... well, that's more-or-less straight up and down. Reminds me of some of the pyramids in the Yucatan, only with slightly wider steps.... and much, much higher.

Needless to say, there isn't nearly as much liability concern in China as there is in the US. Note the lack of handrails and the complete absence of 小心(caution) signs.

Actually,the caution signs do show up from time to time, mostly in obvious places. But not in the places you might think, like where you might actually take a tumble off the 180-step climb.

Remember the ad-hoc guides? Here are the two who came along with me and the woman who I was hiking with.

I'm ashamed to say that I've forgotten their names. I think I wrote them down somewhere, but I don't know where.

At any rate, this is a little more than halfway through the hike, right before we went from Jinshanling to Simatai.

A view through a doorway, back west from where we'd come. This particular tower didn't have the roof still on it -- Simatai is less restored than other sections of the wall, and is the section most clearly built during the Ming Dynasty.

It's a noticeable difference, actually. Not only is there a difference in the age of the wall itself, but the style is substantially different. It's quite clear that you're walking on two seperate walls during the hike, even if they join more-or-less seamlessly.

That is to say, there's nothing but a sign to officially tell you that you're on the Simatai wall. That, and about two towers in, there's a guy taking tickets, so you have to produce one of those.

Like I said, a little more run-down looking. The footing is a bit more treacherous on the Simatai section, but the views are still spectacular, and it's still pretty manageable, even in the rain.

I mentioned in the video that it started to rain while I was there. Actually, it was right about at this spot that I noticed that it was getting darker, even though it was just about noon. I'd smelled rain all day long, but since I'd come without a raincoat, or even a jacket, I was at least mentally prepared for what was coming.

At this point, Michelle, who was hiking with me, asked what I'd do if it started to rain. I shrugged. "I'll get wet, I suppose."

But since I was getting wet, unfortunately, I didn't take too many pictures on this segment of the trip. Michelle took a few other pictures, but we haven't gotten in touch yet. Hopefully we'll be able to, and I'll have a lot more pictures to share.

Here's the aforementioned end of the hike, with the bridge across the river. This is taken looking down from the second-to-last tower -- the last is the one you see across the river -- and that's the cable bridge to the right. The little white spot at the far end is the guy who takes your 5元 for crossing the bridge. If you're totally out of money, I'm not exactly sure what it is that you're supposed to do. Swim, maybe. Just above the top of the frame, there's a walkway off to the right where you can get off the Wall and hike down.

The bridge isn't really all that rickety, but since it is a suspension bridge, it definitely moves as you walk across it. Not frighteningly so, but there's no doubt that it moves.

Like I'd pointed out before, you can see that the Wall continues onward, and you can just make out at the top right part of the picture a walkway. It's about a 20-minute walk down from the top, into the parking lot, where our shuttle driver, a guy "not too tall, big round belly" as the hike organizer put it, was waiting to take us to the restaurant for our late (and well-earned) lunch.

Of course, if you don't feel up to hiking the whole way, there's always a faster way down. Yes, that's a completely-soaked me in the foreground of the picture.

The zipline cost 30元，if I remember correctly, and was a lot more fun than I'd expected. The boat ride back across the lake wasn't quite so much fun, but it was still worth it.

Lunch at the restaurant was, by the time I got there at least, pretty indifferent. They had a cafeteria-style setup for those of us on the hike, included in the price. In retrospect, I think I'd have preferred to pay less and order some of the food I saw walking by, food that was a little less dumbed-down for western palates. But those are my prejudices showing up again.

Actually, all in all, the experience was worth every penny I spent. I had a great time, met a few folks on the way, and really was astounded by the views and the sheer sense of history. Even some of the inconveniences (like getting rained on) were just added bits, things that made the experience unique. I'm glad that I chose to go out of the way for this trip, instead of the shorter, cheaper, and almost infinitely more-crowded Badaling section of the wall.

The ride back, by the way, was epic. More because of the holiday traffic than because of the rain, it took us nearly five hours to get back, while the ride out had taken a little over three including stops and waits to pick people up. I managed to sleep most of the way, but nevertheless, it kind of sucked. Dinner that night was hot pot with three Germans, which also meant beer with three Germans. But with beer going for 3元 a bottle, it was as cheap as water, so it was generally a good bargain.

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.

A little more

As I said, it's been interesting working in the clinic/ hospital here in Tianjin. Yesterday, I got to see several people get Jinjin and Yuyao punctured. (They're on either side of the frenulum, underneath the tongue, and you puncture about 5 cm deep.) Sheer acu-geeky happiness... along with the "Sheaf of Wheat" needle the instructor pulled out to show off, 35 cm long! Two of the CP kids came in, along with one I hadn't met before... they're pretty funny, because they put up a huge fight with crying and yelling while the needles are being inserted... and then once it stops, there's nothing. It's as if there was no problem at all.

I seem to remember acting the same way when I was getting vaccinations as a kid.

We got a memo yesterday afternoon that said that on Monday, the hospital saw 8,177 patients. Not too shabby for the first day back from vacation!

So, I've been meaning to post my first impressions of what an AIMC student would want to be sure and have if coming to study in Tianjin... so here's the list, subject to revision.

1. Lots of Chinese. I mean, a TON of Chinese language. Don't skip this, or you're going to feel like a dummy most of the time. Both conversational and medical. If you're willing to feel a little like a dummy, then the amount I showed up with was probably just about enough for this environment. If there were more people, and it was reasonable to slow everything down, then just the basics might do.
2. A fair knowledge of the names of acupuncture points. Even saying "手阳明大肠经四" (Hand Yangming Large Intestine Meridian Four) will get you pondering looks. If you say "合谷" (He Gu, "Union Valley"), they'll instantly understand.
3. At least a passing familiarity with Chinese characters. It's one of the reasons I keep on practicing them here in this blog.
4. A willingness to realize that not all places in the world are HIPAA or Clean Needle compliant. More on this later.
5. Good books, other ways to occupy yourself, something mindless but engaging and in a familiar language. Even if you love everything that's going on around you, your brain needs the occasional break from all the foreign experiences. In some ways, you're absorbing information as fast, and just as lost, as a baby. Only with the adult hard-wiring behind it making it more difficult. And babies sleep almost half the day to process everything.

I'm sure there's more... but that's a decent start. And now.... the first of the pictures!

This is the view from my apartment on the tenth floor of the Tian Zhong Hotel. It's usually hazy like this, except right after it rains. Right down at the bottom of the image, you can see a corner of the athletic field -- a football (soccer) field surrounded by a track. Every morning at 6:30, music plays across the city, followed by some sort of calisthenics routine that seems to be performed mostly by women.

The hospital, right next door, would be directly behind me if I could walk through the building.

I tried to take some photos of the apartment itself, but it's impossible to get an idea of the scale. It just looks like I took pictures of the corners of the room. Maybe I'll try again later... but here's where I stayed in Beijing:

The entrance to the courtyard. There's a more conventional-looking hotel across the street, but that's not as cool as this.





The floating globes are not lights, or aliens.... they're just water droplets on the lens. I still think you get the idea. It was raining, the day I left, and I was about to go squelching all over Beijing for a second day in a row.





(Chinese Medicine geekery note: two vials of Yin Qiao Pian, the first all in one go, and the other at four tabs every four hours, did the trick for my incipient Wind-Heat attack the next day. I probably should have used a third vial to be safe, though. Funny, too, when I realized that the stuff was made in Tianjin. Well-travelled tablets, just to wind up a few kilometers from where they started.)

This is the view right after you turn the left-hand corner at the back of the previous picture. Those are grapes overhead, the courtyard is over to the right through the red gateway, and the toilets are to the right, mercifully neither shown nor smelled.

This is half the courtyard... I don't know why the other half didn't really come out. Imagine another two tables on the other side, anyway. That's the tourist office and so on through the door under where it says "Internet Access"; through the doorway you can just barely see on the right is a landing leading up and down to the dorm rooms (not much to speak of, two double bunks). From the landing, you can also go left to the computer room for your 8元 per hour access, or right to some kind of meeting room that usually had a staff member watching TV there.

That didn't seem as bizarre at the time as it might sound now.

The restaurant connected to the hostel, where I didn't eat once because it catered mostly to Western palates. A few people ate their breakfasts there, but I got mine on the street.

It's not precisely the Inn of the Weary Traveller... but it's close.

I've got some street scenes, and some Great Wall photos... but you'll have to wait! I can't dole it all out at once!

Hospital daze

It's about halfway through my third day at the hospital, and I have to say, I'm really having a good time. Sure, I only understand about a quarter of what I hear, and another quarter gets interpreted for me, but I'm getting a lot out of it, if only because of the sheer volume that I see.

The room is set up with nine beds, with curtains between them -- three to your left as you walk into the room, and the other six across the far side. Plus there's a desk with a computer where herbal consultations and prescriptions can be written -- often for the first time a new patient comes in, plus some patients get medicine in addition to their acupuncture.

A prescription for acupuncture is for 10-14 sessions, usually every day or every other day. Patients come in and lie down on one of the beds, after giving a little slip to one of the interns there. The slip is pretty basic -- name and condition on one side, a grid with places for dates of treatment on the other, and the ubiquitous red stamp that makes it all official. The doctor in charge of this ward comes in and asks one or two questions -- many of these patients have had one or two courses of acupuncture already, so he knows them pretty well. It takes maybe 3 or 4 minutes to insert the 15-20 needles for the treatment, then it's off to the next patient. One lap around the room, and it's to the desk to see new patients, take a blood pressure reading, feel pulses, look at test results, or whatever.

30 minutes or so later, one of the interns will pull out the needles and send the patient on their way, a new patient jumps on the bed, and it's all over again. So I'm seeing (observing) about 40 patients a day this way. The ward I'm working in is about 60% facial paralysis (mostly post-stroke and other central neuropathies, with a few Bell palsy patients mixed in for fun). The rest are lumbar pain with nerve impingement, a couple of kids with mild cases of cerebral palsy, one man with dementia, and another with asthma.

It's all so fascinating. I'm gathering all kinds of information as quickly as I can... it's almost overwhelming. More after my afternoon shift.

北京，再见! (Farewell, Beijing!)

I can't believe I didn't actually post from Beijing while I was there. Actually, I can.... the one place I had cheap Internet, it was free and dreadfully slow. Everywhere else, it was between 6 and 10 RMB per hour.... after the 2 that I get in Tianjin, it's hard to pay that much.

But it was amazing there! First thing I did, I walked from the bus station at the Third Ring Road to the Far East Hostel about a quarter mile from Tiananmen Square. It's in a hutong, which means that the streets are narrow and the public toilets are eye-watering (and quite public) and it's probably moments away from being razed for the sake of "progress"... but I digress. If you've never taken the time to walk the streets of a new city, you're really missing something. Every city has a pulse, an undercurrent that shows up in the way people greet you (or don't), the feel of the shops and the cars and the dirt and everything. Beijing is still in the afterglow of what is almost universally seen as a spectacularly successful Olympic Games, and the five days I was there exemplified that. October 1 is the National Holiday, which means that most businesses are closed for the week, and everyone goes on holiday. In this case, everyone went to Beijing -- five million of them.

Let me repeat that, with emphasis. Five freakin' million Chinese people went to the capital city on their one-week holiday. That's the entire population of the Bay Area, plus Bakersfield thrown in for good measure, added to the 12 million in the Beijing metro area. I went to the Summer Palace and there were 87,000 visitors that day. That's a little more than the population of Alameda at the Summer Palace, crammed into about 3 square kilometers of park and sightseeing. There was so much to do, and so many people doing it.... pure insanity. But in a good way, if you can believe that. I met a few expats -- a Brit, an Irishman, and a few Germans -- who gave me a break from the constant Chinese and broken English. "Hello! Come in! Very inexpensive! Only 100!" and "You want rickshaw? Three!" were the most common... the last is a scam where they insinuate that you're going to get a ride for 3 yuan, and instead they want 300! Such is life in a city that caters to tourists and a history of ripping them off. It turns out that the Irish guy went and got the cops to chase one guy who'd run that scam away.... China is definitely making an effort, no doubt about it.

So it was the Summer Palace, Tiananmen Square, the Forbidden City, and the Great Wall (where I got rained upon) this trip. I'm going to have to go back when the city is a little more sane if I want to do anything else... which I do. Pictures will come, but I have to get the proper cable to make the connection. Turns out that's the one thing I forgot to bring with me. That, and one of my camera batteries is DOA, so I don't have any pictures from Tiananmen Square or the Forbidden City.

Enough for now. I'm back in Tianjin, where life is somewhat cheaper and I'm actually starting clinic! More on that in my next post, along with some impressions of Beijing.

More from Day One

...even though it's Day Two.

It's a common observation of the elderly in China is that they'er not only in pretty good shape, but they're remarkably agile.

I know the secret of this. It's the loose traffic laws.

No, really. You see, it's pretty much a free-for-all out there on the streets, and the sidewalks are as often as not completely clogged with bicycles or something else. So you walk where you can, with drivers going wherever they want. Case in point: the cab driver from the Tianjin bus station to the hotel went the wrong way out of the parking lot, then the wrong way for about 3/4 of a block, just driving slowly and honking all the time. Traffic moves pretty slowly compared to in the USA, so it's not so bad... and if someone wants to cross the street, they just cross wherever. It's more common for someone to cross at a crosswalk, but since nobody's really paying attention anyway, it's common also for people to stop in the middle of the street, between lanes, until it's safe to keep on.

So my current working theory is that playing dodge-em with the traffic keeps the old folk in tip-top shape.

Anyway, yesterday was pure and complete culture shock. Today, I'm pretty sure I'll be able to get by, although it's going to require regular and constant study of Mandarin to really feel comfortable. Not too bad.

And since someone asked:

Last meal in the USA: Hot cocoa and a ginger cookie from Peet's at LAX. $4.65 US.
Meal on the flight (I slept through the first one): Ginger Chicken with rice and bok choi. Not bad for airline food.
First meal in China: Beef noodle soup from California Beef Noodle King USA (no, really, that's the name), 10 RMB (about $1.50 US). Then it was a chicken-and-faux-crab bun at a street vendor for breakfast. 2 qian, tasty, I could probably use another but won't. I declare China a good country to eat in, especially with the exchange rate.

I've already been waylaid by a 20-year-old guy who wanted to practice his English, which was kind of fun. I'd hoped to get a little lay of the land since he was working at the local superstore, but it turns out he's from Hubei and just here for the national holiday. Oh, well.

My room at the school hotel is tiny. I mean, really tiny. Reminds me of the time I lived in a converted pantry for two weeks while looking for an apartment, only with a bathroom attached. More on that when I can get the pictures off the camera.

Firecrackers outside. Must be a national holiday.... I'm on my way to Beijing today for the next three or four days, since the school is closed for the rest of the week. Should be a great time, and in a more tourism-accustomed town, I might even get the familiarity I've been looking for. See you soon.

再见！