Why I Love Baseball

We returned this week from our annual baseball park tour. 3 of the last 4 summers, Gabe, my dad, and I have gone to 3 or 4 baseball parks over several days. Our intent is to visit them all. There is really only 1 rule - the park only counts if all three of us have been to it together. So, for example, I have been to Anaheim, Boston, Miami, Tampa Bay - but not with both Gabe and my dad, so they're on the list. We've done 10 so far and next summer it looks like we might head to Boston (for Fenway's 100th anniversary) and both New York's.

It is a great tradition that, when I tell people, always elicits some reaction. Usually a "How cool!"

In front of the Kirby Puckett statue at Target Field, Minneapolis

It also works for us because we all love baseball. My father grew up in Cleveland and has been an Indians fan since day 1, but has never, with his own eyes, seen a championship from them. He seems to live and die by them daily. Often he'll call during a game and say something like, "They're up by a run and putting the closer in - I can't watch. Every time I do, they lose." As if his watching (or not watching) has an impact on the game. But often, he is right. My favorite, and most frustrating, memory of this was during the 1997 World Series. It was Game 7 and the Indians were 3 outs from their first World Series title in almost 50 years. They handed the ball to their closer, Jose Mesa (who my dad hated - with good reason), with a one run lead in the 9th. My dad called and said, "I am turning off the TV. Don't call me." He gave up the tying run that inning and they lost in the 11th. Gabe is a pretty serious baseball player and has an appreciation for the history, and strategy, of the game. And I have always loved baseball (despite being raised an Indians fan...) and have been coaching for the past 6 years or so.

So, as we made our way through the new Target Field in Minneapolis, Royals Stadium in Kansas City and Busch Stadium in St. Louis I took my time to look around. Baseball parks themselves are fantastic, magical places. Both in time and out of it. Look around any modern ballpark and you'll see flat screen TV's, Ben & Jerry's ice cream, and scoreboards showing highlights from that day. Modernity at its finest. But baseball, as a game, stands out of time. Not much has changed in the last 100 years. Batting helmets. The use of middle relievers. Non-wool uniforms. Unlike basketball, it hasn't added an extra run for REALLY long home runs. It doesn't change offensive and defensive schema almost every year, like football. It is what it has always been  - a game about throwing, catching, and hitting the ball. That is why it is, really, the only major sport that you can compare era to era. Argue with a friend over who the greatest running back is (Jim Brown) and you'll get a bunch of answers, most of which will be followed by "But if he had trained/played against players from this era..." Same goes for basketball. The game has changed so much - no one has a true center anymore - that you can't match people up next to each other who are more than 10 years apart! And baseball parks themselves are testaments to the game and history. All of the new parks - they're old school. I love that this is a sport that is working so hard to hold onto its past - not forget it and move on to the next best thing. Amenities are new and upgraded, but it's (usually) done tastefully and honoring the past.

Plus, the game literally exists outside of time. No other major sport does this. Golf and tennis do, but those are "man vs. self" sports. And, for me, the problem with "man vs. self" sports is that you REALLY have to care about and know the individuals for it to be truly compelling. And there aren't any truly compelling players out there - Tiger was a spectacle, not a compelling individual. In fact, he was one of the most bland and boring individuals. So the game exists without a clock. Which I love. You go to the game to be at the game and if it goes into extra's - great!

In front of the George Brett statue at Royals Stadium, Kansas City (with Uncle Jordan)

For me, half of the experience is just being at the game. Sitting. Yelling. Arguing or discussing a play. Beer is an integral part of the experience. You're there for 2.5-3.5 hours talking with friends/family on a warm summer afternoon or night. Enjoy yourself. Sit back. Watch the crowd. Watch the sun go down over the stadium.

I, personally, keep score at every game we go to. In part this is a way to stay focused, but it also appeals to me because of the intricate strategy involved in baseball. I know a lot of people find the game to be too boring, too slow - to them I say "You don't know or understand baseball at all." The strategy involved in baseball far surpasses any other sport. The double shift, the drawn in outfield, the pitch out, the pick off, the drag bunt - there are a million little things that happen during every game, offensively and defensively, that are calculated risks and attempts. It is fascinating to see small ball played by a team who lacks power, and the way it can infuriate and win out over a long ball team. And to see a 3 hitter or a 1 hitter - WOW. That's not boring, that is an artist at the top of his game giving a virtuoso performance. It is a thing of beauty. It is flirting with perfection. And it can't be done in football, basketball, or hockey.

Every sport is a game of inches, but I believe that baseball is the one where it matters most. The difference between a long pop fly and a home run is, literally, less than an inch on the bat. Many times, the difference between a walk and a strikeout is mere inches. A well timed jump and grab is amazing and replay worthy - a few inches off and you shake your head in shame and remorse. Incredible plays by a shortstop or 3rd baseman are often just "that close" from being a hit through the gap. In basketball an inch or two can mean a missed shot, but it could always bounce in or be rebounded for a put back. In football, an inch or two doesn't always matter so much - the ball is large and hands are big. In hockey - well, I have no idea. And it is this "flirting with perfection" that I love too. Every game, before it starts, has that ability to be "the one" - the perfect game, the no-hitter. To say you were there for one of those exceedingly rare and special events that are still talked about years later. And it all comes down to inches or less, dozens of times in any one game.

Baseball is the sport that most mirrors life. The season is extended and has many ups and downs - 162 games allows for a lot to happen. Teams start out strong and fade (see: Cleveland Indians, 2011), others start out poorly and right the ship (see: Boston Red Sox, 2011), others go through more of an up and down process, seeming to get better, then slipping, before fading out or recovering. But the length allows the growing, learning, and bonding process to happen. Football, at 18 games, is a sport where fortunes are made and sealed in any 3 or 4 week period. Lose 4 and you're done. For the season. In basketball, there's too much of a known quantity before the season starts. It's almost a foregone conclusion most years who will end up in the playoffs. The regular season is a (not so) entertaining diversion before we get there. Baseball always has surprises - the small market team that beats up on the big market (bully) one and goes far. The team that spent $100 million but can't buy a win. Aside from being an extended journey, it most mirrors life because it isn't easy. The best players in the world are unsuccessful 2/3 of the time (at batting). An average player is unsuccessful 3/4 of the time. No pitcher has ever been perfect over a season - everyone takes their lumps and loses multiple times - often badly no matter how great they are. And the dependance on the others on your team is instrumental. There is a moment, in every game, where every single individual has an opportunity to shine or fail and the fate of the entire game and team rests on one persons shoulders for that one moment - but the game is still a team game. In basketball those moments happen far more often, so become unspectacular. And in football, so much of what happens you never notice (line play) and is a protracted war versus a shining moment. Baseball, like life, is hard to master, dependent on others at times, but has enough individuality to be seen through so many different people's lenses.

In the end, I love baseball because of its history, honesty, artistry, timelessness, and because it is a shared experience. I have memories of baseball - from my youth as a fan, from my adult life as a parent, as a coach, and as a fan - that are special and shared. I share baseball with my son every summer - it is a right of passage and a symbol for us and for me - of time passing, of a shared experience, of hard work and growth - and I am lucky enough to share it every summer with my father and my son together. It is the glue that brings us together to spend time together - usually just the three of us - and is a shared love we have. So, for no other reason than that, I would love the game. But I think there are so many more reasons and so much more to love about it than that.

In front of the Stan Musial statue at Busch Stadium, St. Louis

Why 'The Help' and 'Rise of the Planet of the Apes' Are the Same Movie

I saw this weekend what I believe to be the 2 best movies of the summer - The Help and Rise of the Planet of the Apes. And they are remarkably similar despite one being historical fiction and one being science fiction.

To start with, both movies have a "true story" feel to them. The Help is presented as a biography of black housekeepers in the South and RoPA is presented as a historical accounting of a science experiment.

And both are human stories - evoking fear, hope, laughter, sadness, and pride. The stakes start out as very personal and individual for both, quickly evolve to encompass those around them and closest to them, and ultimately society at large. New relationships and worlds are opened to both Skeeter (The Help) and Will (RoPA) and by the end, neither are entirely what they were when they started.

Both are, essentially, stories about what pain and loss can drive us to. In The Help it is the loss of a maternal figure (Skeeter's housekeeper Constantine) who raised her and who was driven off by her family. While Skeeter does not know this at first, it motivates and propels her on her already burgeoning path to make sure the people around her are treated humanely. In RoPA it is the impending, and ultimate actual, loss of a father (Will's father Charles) to Alzheimer's that push Will to search for a cure. In creating a cure, he comes to understand that the other primates inhabiting our world with us are as aware, feeling, and capable of emotion as humans and deserve to be treated as such.

In the end, both portend a new world order. The Help takes place in the midst of the civil rights movement and documents (literally) the uncivilized treatment of blacks. By the end it is clear that American society will never be the same. And 50 years later that is still true - even if the hope of that movement has not yet been fully realized. RoPA takes place at the dawn of a new age for mankind - it's end as newly intelligent primates rise to the top of the food chain in a world destroyed by our own greed and failures to protect ourselves. It is a cautionary tale about power and the role it plays in corrupting those with it.

Both take a look at society, shine a harsh light on the unsavory underbelly (racism and animal cruelty), and show how they can be a cancer from the inside. Jarred Diamond has written some fascinating books about how and why societies fall and virtually all do so from the inside. Each movie looks at a potential cause of this society's collapse.

One final thought - the original Planet of the Apes movies from the 1960's were a tale of racism - which is clearly what The Help is about. All good science fiction is a means of exploring the world around us and talking about societal issues that are too sensitive to come out and discuss openly (Star Trek was groundbreaking in its time for so many reasons - but more on that another time...) I find is telling that the message behind that franchise has shifted significantly in 2011 to be about animal cruelty and the will of medtech companies to push for higher profits at the expense of consumer safety. Racism is not longer an ugly secret - it is an open one.

Two wonderfully done films that raise many questions about the world we live in, and the way we raise our "children" to think about themselves and those around us. See them both and enjoy them. But never forget that the best storytellers teach us something about ourselves.

Final Thoughts

It is hard to believe that almost 2 weeks has gone by. My first night in China feels like it was both so long ago and just a moment gone. I have done an incredible circuit of the most populous country on Earth – northwest, southwest, southeast, and northeast. I have experienced 4 distinct parts of an ancient and huge culture, been exposed to dozens more, met scores of people, and seen amazing things. I am trying to make sense of what I have seen – out it into some type of order, find a meaning.

To be sure, there are a lot of positives and things to learn. The history and culture I have seen and experienced are amazing. To think that I stood in and saw things that are up to 7,000 years old is incredible. And the Chinese history is so much more rich and diverse than I ever imagined – as only a 7,000 year old tradition of a people that spans a quarter of a continent can be. And I have met so many kind and generous people. Doctors, nurses, and hospital staff who work hard each day to ensure that children will have a better life. Businesspeople and philanthropists working for a better society than can successfully meet its own challenges. Everyday citizens who just want to share what their life is like. I have made many new acquaintances and a few friends that I hope I will stay in touch with.

Something is happening in China. It has likely been building for a very long time. It feels like there is an awakening, a growing and pushing of boundaries, a rustling under the surface. The government keeps a tight control over many of the things of daily life – the cost of bread and oil, access to information (the internet, television), education. It probably does this both because it has to and because it keeps it in control – all systems and organizations work to keep themselves in existence, it is the rare one that puts itself out of existence.

He phrase “sleeping tiger” has been used to describe China and I get it now. There is a raw power in being able to harness 1.3 billion people and what they can do. They are a mighty engine to create cheap products, a massive market to sell to, and awesome and terrible war machine, and an incredible populace that could change any social ill. One part of me thinks my children should start learning Chinese – now (sorry Gabe and Zoe) because once this sleeping populace awakes, can there be any question they will lead the way into the next century?

The challenge, of course, is that they are not free to make up their minds, to explore any field of study or pursuit of expression. There is a tight control over license plates, access to college, and certain jobs. While the “American Way” is not perfect – by any stretch of the imagination – it does not require such a large use of resources just to keep the population in places. And it encourages creativity and new directions from any who want, also providing the rewards to those people in the same magnitude. The limits on people are, to a very large degree, imposed by themselves and both their ability and desire. The social contract in America is clear – you can go as far as like with the knowledge, perseverance, ingenuity, and willpower at your disposal. The government is there both to protect the physical well being of the populace and integrity of the boarders and interests of its people. (Excuse my oversimplification and incompleteness…) In China, neither side of that equation is true. There are limits to what most people are allowed to achieve, or even attempt, and the direction and will of the government are even murkier.

What is the social contract then? What is the role and purpose of government in people’s lives and what do people owe their government? Without a clear answer to this there is, as I have seen, a lack of direction (people with pointless jobs or jobs with no purpose), a mistrust of authority and systems (fear of hospitals), and a general malaise that can permeate all things.

The government is run by The Party. That inside group that makes all of the decisions. Several times I heard people talk of times when the TV went out. CNN has been allowed for a time now, but there are moments, where a story critical of the Chinese government or policies, is aired. And across China, CNN goes out. There is someone, literally, sitting there with their finger over a button that will block the signal. And parts of the internet are restricted (as I found out firsthand). These are just small examples of how The Party controls things. But it goes far deeper. There is a population control policy in place. Families in the city may have 1 child, in the country 2. Many people skirt or ignore this rule. But if you want to move up – if you want an important promotion, you’d better follow the rule. And if you get your promotion or job and then break the rule? Your job will be gone.

The Party is an organism that grows under, and through, everything around it. There are Party representatives in every industry, and in every town. No real work or advancement can get done without their, sometimes tacit, approval. While large and infiltrating every corner, they no longer take on the menacing quality of former generations. They seem to rule by suggestion and permission (given and withheld) and, make no doubt, set the direction and policy of an entire nation.

And that system has worked well in an agrarian based, class society of the 20th century. But the world has moved on and the ability to control information and access is far harder. Where are they leading the people to now? Can a single party with ultimate control continue to be a viable model? Can the party control a country this large with as many competing, and splintering, demands? Can it evolve and become a new form of communism?

Many times in my trip I told my companions I felt like there were many similarities with what I was seeing and the Israel I first visited in the 1980’s. It felt like a country with one foot in the old, and one foot in the new. There were pockets of modernity right up against grainy, old world buildings and smells. There was a mixing of cultures and history that expressed themselves in creative and bizarre ways. Hey were both jarring and creative. The architecture in some places shares some similarities, and I suppose this comes from a common communist-socialist background and a utilitarian need when dealing with large numbers of people moving quickly to cities. The stocky shape and indefinable character of buildings built out of need rather than esthetics. There is a melding of cultures that the two countries share as well, taking the shape of a variety of smells, foods, music, and a cacophony of different skin tones.

In the end, what stands with me most is that there is an immigration going on within China, It is an immigration from countryside to city. While normally this would be a migration, there is such a complete change in the social fabric, mores, and daily functioning between the two, they feel like completely different worlds. There is a generation chasm – not just a gap - that is being created in this country. It is a world of fathers and mothers that is agrarian and simple, growing up in caves and making your own food, and a world of the children which is cars, the internet and coffee shops. I do not know where it is leading to, but it was fascinating to take a step into it for a while. I know that it will stay with me for a long time and that, wherever it leads, it will have an impact on my life and all of yours.

Quick Hits & My Blog Plans

There are a number of thoughts and ideas I’ve had that either didn’t get fleshed out enough for a blog post or I just didn’t have time to address. I’ll do them below.

My intention is to do a final wrap up blog tomorrow, before we leave, and then upload the pictures to all of the blogs when I get home (I stopped trying to upload them after a while, but in many cases they make the story or add to it considerably.) If you’ve read for any reason or any amount over the last 2 weeks you’ll want to come back next week and check out the pictures! I may also upload all of my pictures and post a link to them – I’ll only use the pictures in the blogs that relate directly to them.

Warm Water
The Chinese do not drink, or serve, cold water. This is a tea culture and they are used to warm drinks at breakfast, lunch, dinner, and snacks. Water is, at worst, served slightly warmer than room temperature, and at best steaming hot. Even if you do not want tea at a meal, you will get a glass of steaming hot water. Several people commented on our Western desire for cold water – something one of our hosts (a nurse!) said was bad for our stomachs and digestion. She would NEVER drink cold water – especially not in the summer. While strange for us, like everything else in this country, it is a cultural touchstone which speaks to the way they live their lives and their thousand of year old history and tradition.

The Bathroom Experience
Going to the bathroom in China is always an adventure. First, the sinks are generally outside the bathrooms, no big deal. But rarely is there any soap – even in the hospitals we have been in (!!) That’s on the way out, what about the way in? Before entering a stall, you had better check to make sure it’s not a squat toilet. The majority of toilets in public, and I imagine all in the countryside, are a porcelain hole that you squat over. (Sorry, couldn’t get a picture that wasn’t utterly disgusting…) Oh, and don’t forget to bring your own napkins or paper. It won’t be found in the bathrooms in public (airport, etc.) Finally, there’s the signage. My favorite was a green placard over a toilet in the airport that had a cartoon panda on it holding up his thumb with the caption “Aim carefully!” A common problem in general is the literal translation done by many companies when trying to add English. Chinese is a character driven language, so individual “letters” can stand for an entire thought. That’s how you end up with the following sign Estelle saw on the door of a handicap woman’s toilet – “Deformed Man Ending Place.” The mind boggles. One can only wonder.

The Traveling Experience
Flying in China is still like the old days in the States. While not a luxury, it is treated as special. Meals are served on every flight. They come by to serve you or refill dinks 3 times (on a 90 minute flight) or more.

The landing process is something passengers, apparently, don’t have time for. Every time, the plan lands and, before we have even achieved a complete 4-point landing, people are unbuckling, standing up, getting down luggage, and stepping into the aisles. And god help you if you get in their way in the aisle.

I have been in 5 airports now. I have one bag – a large one – I am traveling across the country with. It cannot be brought on, so I have checked it each time. The majority of the airports we have been in have not been large at all. It takes less than 5 minutes to get from your gate to the baggage claim. And most often are bags are on the conveyer belt within moment. The efficiency is amazing, and something we only wish for in the States.

A Job for Everyone!
China is a big country. It has an immense population (1.3 billion, and currently the largest in the world, although its population control policies will lead to India taking over that position in the next 10-20 years.) And things are tightly controlled by the government. We saw 1 homeless person during our entire journey (although we were told by many of our hosts that this issue is a fairly new and quickly growing problem.) Apparently there is a job for everyone.

You see evidence of this all over – the person whose sole job is to empty the trash cans – 20 times a day in a nearly empty building. The woman whose job it is to push the buttons on the elevator for you. The overstaffing is everywhere – if there were less than 8 stewardesses on a flight or 6 waitresses in a small restaurant, it was an anomaly. And at nice restaurants it was almost obscene – people to bring the food, people to place it on the table, people to simply refill cups, the person whose job it was to stir the dishes so they didn’t gel up… It got to feel overwhelming and almost oppressive. Were they there to watch us? Maybe we UNDERstaff in the West.

Probably not, or at least that’s what I decide after we had dinner one night with a particularly worldly host of ours. When asked what their spouse did and, with some regret and embarrassment, they told us that their spouse worked for the state run company. It was a nice job – but they only worked 2 hours a day. At least, they went in for 2 hours a day. Even then there isn’t much, or anything, for them to do. Yet their spouse doesn’t feel right not going in at all. Our host was embarrassed knowing that their spouse was being paid – by the state – to do nothing. Unfortunately, we were told, this is quite common and that a “good boss” allows this, especially since they have a baby at home. Our host was apologetic about this common practice because they had a lot of experience in the West and worked at a particularly busy job.

With so many people, and a desire to make sure they aren’t living on the streets, the option the country has taken is to employ nearly everyone, even if they don’t have anything to do.

Is Hotpot Kosher? AND When Old Meets New - A Tale of Rural Internet Access

Last night we went to a hotpot restaurant. Hotpot is a local custom and involves a large table with a huge vat of boiling broth in the middle. There is an inner bowl and an outer bowl. The inner bowl is just broth. The outer bowl is broth mixed with spices and, especially, Szechuan peppers. This is the Szechuan province, after all, and it is known for and proud of its spicy food.

In hotpot you order a bunch of different meats and vegetables and, in courses, either dump them into the broths to let them cook or hold thin pieces of meat in the boiling broth to cook it between your chopsticks. Sometimes you reach (with chopsticks or a ladle) into the pot and – surprise! – something from a former course comes out. Little bits and pieces of some of everything mix together and cook up so that, by the end, the broth is an amalgam of everything thrown into it during the course of the night.

For me, this was a big hurdle. The first course was some type of whole bottom feeding fish and leeches. I passed. But the damage was done. Anything else that went into the mix was going to be infused with what just went in. Could I push aside the fact that my upcoming beef would be boiling in whatever came before it? Now, mind you, our hosts were keeping quite tame. Andreas (my colleague, and a far more extensive world traveler than I) went a few years ago and they had monkey brain in the hotpot. There was nothing like that tonight. Pork went in soon after, as well as pork dumplings, beef (2 kinds), mutton, sweet pork balls, cauliflower, tofu (2 kinds as well). It was spicy, and very good (at least the things I ate…) and I did a marvelous job of pushing aside the fact that all of my tofu and beef was marinating in pork and leech juice…

Eating, in China, is a different experience.

First off, there are no real main courses. There are hot and cold dishes. They are brought out continuously and, in general, you order 3-4 cold and 5-6 hot dishes in a meal, plus some type of noodles or rice. The preparation for a single dish can be extensive – so 8-10 is unwieldy in a home. But you get to try several different options at any one sitting. It is a much more participatory arrangement. I just ate from my chopsticks, but I stick them into the bowl or plate to grab more. So does everyone else. Can you imagine how THAT would go over in America? If I stuck my fork into the salad, ate off it, then stuck it back in? In China, this is the norm. You share, you serve each other, there’s no “this plate of food is mine” – it’s a collective, shared experience. There is something very nice about it.

Second, when you eat together in a group, you eat in private rooms. I’ve been told, by some of our hosts, that it’s in part because Chinese people are very loud and noisy and this facilitates conversation with your own group better. The Chinese also take meals very seriously, and want to make sure you are enjoying yourself. At most meals our hosts are walking around, making sure our glass (of beer or otherwise…) is always full. And since toasts are a big part of meals, there is a lot of refilling to do. There is also a lot of truth in the fact that deals, in China, get done over food. You don’t want others hearing your business. You also don’t want others to know if you’re meeting with the government, or if you do, what you’re discussing. Private rooms help facilitate that.

Finally, there are the toasts themselves. Business gets done over meals. And what seals deals, and shows the depth of your relationship, are toasts. They are expected and they are plentiful. Your host makes the first toast – to your partnership, long history, new friends – and everyone drinks up. Then, toasts get made in roughly the order of the importance of the people in the room. Those slightly below make toasts to those above them – their wisdom, health, help in career advancement. And you drink up. There are some rules (at least, I have been told…) – if a woman toasts a man, he has to drink up. If someone says “Gambe” – which means “bottom’s up” – you have to finish your glass. They drink a lot and take it as an affront if you don’t drink deeply (or so I’ve been told – I tried my best not to offend my hosts at any time during the drinking…). Only an “I’m driving” (drunk driving carries a 15 day stay in a jail like facility) or “my doctor says I shouldn’t” works to get you out of the expectation, woman or man.

As to the question I posed at the beginning? The answer is, clearly, a resounding “No”.
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We went out to a county hospital today to see a demonstration of their telemedicine project. In China there are 3 levels of healthcare hospitals and clinics: township (clinics), county (small hospitals – a county hospital might serve 3 townships with 200,000 – 500,000 people overseen), and city (large hospitals). You enter where you are – if you live in the countryside, you have to go to your township clinic. If they can’t treat or identify the issue, they refer you to the county hospital, etc.

In Szechuan there is a highly developed medical record system which is tied in to a telemedicine project. Doctors can speak to each other to consult or teach up and down the continuum. X-rays, MRI’s, and records are shared instantaneously through the same system. It is quite impressive. We have been looking for something similar to test the ability to connect our partners around the world so that they can remain in touch and a greater level of training and consultation can take place.

What has amazed me throughout this trip has been the clash of old and new, modernity and tradition. We were in the Chinese countryside – an hour from the city – and the hospital and city were rudimentary, by any Western standard, but we were using the peak of medical telemedicine technology. The room we were in had no air conditioning, the paint was peeling, there were 4 walls and a desk – but the level of care and treatment, and the knowledge by the medical staff, was extremely high.

There are no easy answers, things are not black and white in China. Just when you think you have it figured out or pinned down, you are surprised. It may be, that from an outsiders perspective, things are like that in the States as well and this is just a cultural issue. But I don’t think so. I think this is part of the culture clash – the explosion of modernity – that is happening here. The government decided internet access is a high priority, so everyone gets internet access – countryside, farming villages.

Tomorrow we leave for Beijing for the night and then fly home early Friday morning!

Tradition! (It’s Not Just for European Milkmen Who Play the Violin…) AND My First Cardiac Surgery

I was in the OR to view my first ever cardiac surgery. (Come to think of it, my first ever surgery viewing, period.) Wow. What an incredible experience.

There is a very intense and complicated dance that goes on. Cardiac surgeons, perfusionists, anesthesiologists, nurses… And everyone is constantly preparing for the worst, and hoping for the best. The activity, clearly, centers on the patient. But the activity around them is immense. Scrub nurses are constantly cleaning or preparing instruments, should the surgeon need something. An additional nurse is getting supplies and refilling them. Perfusionists are monitoring and administering the heart-lung bypass machine, which the patient comes off of and goes back on at different times in the surgery. Anesthesiologists keep the patient sedated and ensure they are doing well.

Surgery did not go as well as hoped for today. Which is extremely sad to me. I met this patient last night – a 17 year old boy – bright, articulate (more than passable English), hopeful. His parents were sweet and appreciative. They were not destitute and looked like a lower middle class family – well dressed, well spoken. Only a portion of what they hoped for occurred. He will require another surgery to get to the portion they could not. It is late for this child to be having this surgery, which adds a complication.

I gained a great deal of understanding, and appreciation, for the work done by the surgical teams. And I have a much greater understanding of how the ICU team takes care of the patient and is really the lifeline for them. Surgery (generally) takes a few hours and is critical, but the post operative care is essential if they are to survive. My understanding is that pediatric cardiology requires more teamwork and multidisciplinary work than most other specialties. Without exception, the people I have met – from the Toronto team we brought and the local team – are caring, hard working, down to earth individuals who care deeply, and respectfully, for their patients.

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In China there is a deep seated cultural reverence and deference to the more experienced members of society. This cultural more goes back many thousands of years, probably in part because if you managed to live into your 60’s, you must have done something right.

The implications of this and the ways it expresses itself is interesting. On a simple level, when walking down a street, people move to the side for the elderly. Slightly deeper, this is still an apprentice society – you learn your trade at the feet of a more experienced elder. Whether that trade is woodworking or medicine, society is structured in ways that require patience and waiting. While I have not yet been able to figure out the medical training system here (and neither have my colleagues), it is very different from the United States. You get a “medical degree” and then work for several years with more experienced doctors before passing a large examination and then studying to become “a doctor”. Along the way, it seems, you get “sponsored” by an existing physician who oversees your training and development.

And in China, you never just enter a room for a meal and take a seat. There is, for every dining experience, and order and hierarchy to the seating. The most senior person sits in the center of the table, facing the door, with the next most senior (or important or an honored guest) person on their left, and the next most senior (or important or an honored guest) on their left, and so on. Where you are asked (or told) to sit is a clear message to others in the room. And someone joining the party in the middle of a meal can result in a significant reshuffling.

This reverence and honor of elders is extremely deep seated. While it can be confused with a deference to authority, it seems to me that that is actually secondary due to the nature of life – older tends to be senior. You don’t question your elders, you wait for them to unfold their plans or share their thoughts in their own time. And because you did this for them, you expect the next generation to do the same for you.

I do not know how modernity will impact this age old tradition. There is something calming and assuring about knowing your place and the expectations of you. The reverence feels like it comes from a place of love and respect, not some expectation that is forced on society. And it is deeper than “It has always been done this way…” With the change to city life and the fast paced nature and get ahead mentality that often associates itself with it, I am unsure how, or if, this cultural and historical norm will be affected. I am not sure it will last. It may be like Tevye - a lonely milkman pushing back against the ever growing crush of modernity. But certainly something will be lost from the world.

Goodbye Lanzhou, Hello Chengdu

(I apologize for the second post in a day - the post before this one was supposed to go up yesterday, but through a combination of internet issues and my own stupidity, I lot it and had to reconstruct it...)

We woke up this morning and had a tour of Lanzhou planned before we left for the airport to fly to Chengdu. We were met by Fiona once again, who took us to the Gansu Province Museum. On the way there we passed the largest mosque in the city and around the area were a lot of Muslim men and women. Women covered their heads, but not their faces. We had seen a scattering of Muslims throughout the city during our day - they fit in, interacted with everyone else, and were accepted. This is an example of Lanzhou's long history of minorities.

Gansu (which is where Lanzhou is located) has an almost 8,000 year history. It sits on the Yellow River - the "Mother of China" - and vied with the Tigris & Euphrates for the start of civilization. We were supposed to have an English guide, but something happened, so the Assistant Director of the Museum, and Head Curator, came down to give us the tour. I should say here, this is nothing out of the ordinary in China. Everywhere we have gone everyone is so willing to drop everything and help us - it doesn't matter who they are or what they are doing. Needless to say, the tour was fantastic.

Gansu was the home of the Silk Road and there was an extensive exhibit of its history and artifacts (but very little to no silk...) We saw the famous bronze "Flying Horse" - the modern symbol of Chinese tourism. (I promise, once I get home, I will add pictures. Some of them are just outstanding and breathtaking...) We saw pottery, bronze, jade, and porcelain - some of it almost 7,000 years old!! We then saw an exhibit on the minority antiquities, with an emphasis on Buddhist art and statues. They were phenomenal.

The local dish is Beef Noodles and Fiona took us to a beef noodle shop where they showed you how the 4 different kind of noodles were made and made them in front of you. (Round, flat, wide, and triangular.) We then went to the Waterwheel Park. As recently as 1952 Lanzhou had 250+ waterwheels on the river. The park itself was beautiful - with antique waterwheels and a long, tree lined path along the banks of the Yellow River. There were families out playing badminton and taking pictures. We saw a bride and groom - many couples come to this park to take pictures. There was a traditional style Chinese bridge and an amphitheater where the Chinese Opera does summer concerts.

Then, it was off to the airport, with Dr. Tang joining us. He will be staying in Chengdu for a week to observe and learn with his colleagues in what, we hope, will be the start of a wonderful relationship between the two hospitals. It was a quick trip - 1.5 hours - from Lanzhou to Chengdu, which is located in the Szechuan province and is known for its spicy food.

We landed and immediately you could feel the difference in the cities. Chengdu is calm, stable, not in a hurry. The traffic was manageable - almost sane. There were not flashing neon lights all over. Event the architecture was more subdued. It is a modern looking city, but not flashy and vying for your attention every second, it seems to be calm, confident - aware of itself and saying, "Here's who we are. We hope you like it. If not, that's okay." And in the few hours we've been here, the people are the same. Shanghai seems like and exciting and wonderful place to visit. Changchun was trying so hard to prove it belonged. Lanzhou was a bustling, lived in city trying to stave off windstorms and poverty. Chengdu is a place you could live.

At least, that's my impression after 5 hours...