Thursday, January 23, 2014

Example of an "Exploration of World"

Jean Chang
CTWR 533A
Sean Hood

The World

This research hospital is a monolithic building, comprising 3,000 hospital beds and 25 floors. It functions like a well-oiled machine, seemingly independent from the rest of the world. It is its own ecosystem and employees 5,000 people. This is the daily patient load: 8,000 outpatients,400 emergencies, and 400 chemotherapy treatments. Yellow taxicabs are perpetually parked outside by the curb, waiting for the never-ending stream of patients to hobble out.

The large lobby has a modern atrium with frosted glass, and, upon entering, it is easy to mistake it for a train or subway terminal. People of all kinds are always coming and going: attendings in long white coats, residents in shorter white coats, locals, a smattering of foreigners, and executives in suits and ties. There are two large banks of elevators. The elevators are usually stuffed to the hilt from 9:00 A.M. until 5:00 P.M.

To the left of the entrance in the lobby is a FamilyMart, which is a 24-hour convenience store that’s prevalent throughout Asia. Think of it as a fancier and more ubiquitous Famina (which is FamilyMart’s U.S. franchise). This convenience store is an inviting oasis in the middle of the somber hospital. It is brightly lit and done in gleaming white, green and blue. The store carries 20 different kinds of ramen, dizzying arrays of soft drinks, coffee, and alcohol, Lay’s chips in unfamiliar flavors (seaweed sushi, chicken), magazines, toys, and basic household goods. There are warm snacks available 24-hours a day: hot dogs on rotary grills, tempura and fish balls on sticks, tea eggs in vats, buns in small ovens, soups, sandwiches, and Spam sushi. In the coolers, you’ll find a huge selection of combo lunch plates in cute disposable bento boxes. Take one out, have the clerk microwave it, and he’ll slide it into a geometric caddie made out of tissue so you can transport it without burning your hands. Doctors and nurses often come in here for quick hot bites to eat.

On the opposite side of the FamilyMart is a 24-hour drug store, where they sell band-aids, vitamin juices, wheelchairs, baby formula, commodes, and even take-home hospital beds. You can also buy Korean facial masks and deodorant that purport to make your skin and armpits paler. The hospital houses a “B” (basement) level, which you get to after walking down a low-ceilinged tunnel with concrete walls. It’s an underground shopping mall for patients and visitors. It has:

• A spacious cafeteria (about twice the size of an average American mall cafeteria), where there are several types of coffee shops and cuisines: Chinese, Japanese, Korean, vegetarian buffet, Mos Burger, etc.;
• A Bossini retail store: a Hong Kong clothing store specializing in sportswear;
• An Italian leather footwear store;
• An orthopedic footwear store;
• A store specializing in pillows;
• A grocery store;
• A mini farmers market that sells freshly-cut flowers and fruit baskets;
• A well-stocked bookstore;
• A laundry service center;
• A bank;
• A post office;
• A candy store;
• A full-service beauty salon;
• A Yamazaki: a donut and pastries shop, where you use pink plastic tongs to pick up donuts onto trays. Once you check out, the cashier takes the donuts off your tray and wraps them individually in plastic bags with ribbons.

Upstairs, the patient rooms are divided by class. First, there is the “free” room (paid by national healthcare) that normally consists of 2 or 3 beds. Each room also has beds embedded into the walls for family and/or friends to stay overnight to care for their loved ones. Next to and above these beds are cabinets so family can store their belongings. Every room has small tiled showers that are meticulously cleaned on a daily basis.

Upon entering a regular patient room, it can look as though the whole family has moved in. Clothes, bags of chips, yesterday’s Apple Daily newspaper, and cutlery line the windowsills. The vinyl on the built-in beds get easily wrinkled or cracked. Bundles of blankets, brought from home and tied together by red string, line the floors. Uncles, cousins, and friends wander the halls at 3:00 A.M. in their pajama bottoms, clutching toothbrushes.
Like clockwork, the maintenance staff (usually middle-aged women), wearing burgundy aprons, surgical masks, and headscarves, come into every room on a daily basis, checking the garbage for recyclables, which they pluck out with tongs. They put the trash and recyclables in separate bags, tutting loudly and shaking their heads. “There is a recycling container next to the trash can!” they’d sometimes mutter on their way out.

Next up is the single room, which you pay a little more for (the bills for the rooms are regularly dropped off on the patient’s side table by the mail staff). They resemble the regular rooms, except you have no roommates and the TV is a better make.

Then there is the VIP room, for which you pay a sizeable out-of-pocket amount. These larger rooms are located at the ends of the halls on every floor and have wide-screen LED TVs, large wardrobes, and leather couches that fold out to full-sized beds. Doctors tend to make longer visits to people who pay for these rooms.

Each floor has a lounge, where there are rows of wooden tables and chairs, a common old TV, a sink, and a table of two old computers with CRT monitors. This room is primarily reserved for loved ones wanting to eat outside a patient room.

By every nurse’s station on every floor is a stainless steel warmer—mini ovens to keep the hospital food warm. Everyone uses these—patients, doctors, and visitors. Next to the elevator on every other floor are laundry rooms with coin-operated washers and driers.

The nurses are almost always attractive with feminine voices that would seem at home on any cartoon program. They wear baby pink uniforms with white Peter Pan collars. They push little carts of medicine and keep meticulous notes in identical notebooks.

Attendings sweep into patient rooms unannounced, already late, already ready to leave. A group of medical students trail behind closely like a pack of wolves, each holding a clipboard and a stack of notes. Since medical school begins after high school here, it is not rare to see a doctor so young that you think he or she might be better suited for working at Abercrombie. The attending states the facts of the patient, often acting like the bedridden is deaf or dumb, and then moves on to the next patient, leading his herd and repeating the process.

Salesmen often sneak into the hospital to accost patients in their beds. “Look at this amazing battery-operated back massager! It will cure you!” they proclaim to the ill and bed-ridden. “Look at this magic weight belt that will help you shed the pounds!” Never mind that some of the patients already look emaciated.

If not salesmen, there are proselytizers—kind-faced men and women in non-descript clothes who pad into your room and gently pat your forehead and ask in dulcet tones, “Have you found God, sir/ma’am?” If they are shooed away, they simply move to the next patient bed, repeating the same question much like the attendings do. They are not afraid to wake up a patient. The sale, be it a massager or a religion, trumps all.

The outpatient wing of the hospital looks more like the DMV: candy-colored plastic chairs as far as the eye can see, long queues, and even number dispensers like the ones you’d find at a butcher counter. TVs hanging on the wall keep track of the number they are currently serving. Traditional prescription bottles are rare. More often than not, outpatients leave with bags full of colorful pills in cellophane envelopes with nebulous instructions printed with what looks like a dot matrix printer.

June to October is typhoon season, which means the senior doctors may not come in as regularly. Surgeries are canceled. Electronic signs flash messages about how ORs 1-15 are not, well…operational.

The ICU wing is a different animal. The waiting room is located next to the ICU double doors, and half of it contains luxurious leather movie theater recliners (as though the hospital is saying, “Sorry your loved one is in the ICU, but hey, here’s a cool seat”). The other half of the room has burgundy chairs that fold out into beds. The recliners and the chairs all face an old TV hanging from the ceiling up front next to the hot water dispenser. It’s usually playing a melodramatic Korean or Chinese soap opera that involves lots of crying and beautiful women dying. In the back of the room is a bank of lockers. ICU visiting hours are announced by a pre-recorded sing-song voice coming over the speakers declaring in Mandarin that it is okay to visit. The ICU visitors jump off their chairs or beds en masse and head to the metal chest of drawers next to the double doors. Each ICU patient has a number associated with a drawer, which contains special pukegreen scrubs and caps for his or her visitors. Visitors must put them on, snap on surgical masks, and douse their hands in sanitizer before being allowed in. When it’s time to leave, the same singsong voice comes over the speakers, talking to visitors as though they were toddlers or severely stupid, a nursery melody akin to “Twinkle Twinkle Little Star” playing underneath: “Thank you for visiting us today! It is time to leave now, okay? But don’t worry! You can come visit another day, okay? Thank you so much for coming! We will see you soon! Buh-bye!”

This is a major Taiwan hospital, considered one of the best in Asia.


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