Sunday, April 18, 2010

Dr. Hsu

Peace on the wall near the lake at Chang Geng Memorial Hospital in Linkou, Taiwan

I had my first appointment with the orthopedic department of Chang Geng Memorial Hospital about two weeks after my accident. The first appointment we could get was with their back specialist. Yuni had gone back to the Taoyuan Provincial Hospital and gotten a copy of my original x-ray. We showed it to the doctor, and he just snorted. He ordered a set of x-rays and put me in a splint. He didn’t try to set anything because he was not a knee specialist. He got me an appointment with their top knee surgeon, Dr. Hsu, but the first available appointment was not for two weeks. I would go back the following week for the series of x-rays, and I would see Dr. Hsu about a month after my accident. I was offered pain medication, but since I was still nursing Peace, I did not take it.

The next week, we went for the x-ray series. The technician was quite nice, but he had to manipulate my poor leg into many angles that made me tear up or scream. I was still in a lot of pain. One angle in particular was very hard for me to hold, and it took three tries and several pillows before we got that x-ray. Apparently, though, it was the most important one.

I went home and cuddled Peace for comfort. She nursed a little, and I felt better from the endorphins. All during this time period that I couldn’t work and I was in pain, little Peace enjoyed coming over and “snacking” whenever she wanted to. It was comforting, and the act of nursing did relieve the pain. Later, I would learn that this frequent nursing actually saved my knee, but all I was doing at the time was comforting myself with my baby.

Two weeks crept by, and it was time to see Dr. Hsu. He was Taiwanese, and he had practiced medicine for five years in the US and for three years in Australia. He understood, read, and wrote English quite well. He also spoke English, but his accent was so heavy that I really did not know what he was saying. I tried to get him to speak to me in Chinese, but whenever he saw my American face, he switched into his English channel. He looked at the set of x-rays and pointed to a faint shadow on the film that had taken us so many tries to take. He said: “Tibia plateau fracture, you need a bow new garaff two.” I did not know what the tibia plateau was, and I had no idea what a bow new garaff two was. I kept asking him to speak Chinese. Finally, he turned to Yuni and explained the situation to HIM in Chinese. Then I figured out that a bow new garaff two was a bone graft. That took me by surprise. I asked why the emergency room had only found a slight crack in the tibia. He said that they had not taken the x-ray at the right angle, probably due to inexperience. He said that when my motorcycle caught my leg and slammed it to the ground, it smashed the knee at just the right angle so that the rounded top of the tibia where it met the femur had been shattered. He said that the only way to prove it was with an MRI, but he was willing to bet money that the top of my tibia was not only shattered but also indented. That was why I had had so much trouble in the “walking cast” from the emergency room.

He was one of the top two knee surgeons in Taiwan, and when we communicated in writing, it was obvious that he had spent time in the US and Australia. He just had not had to polish his pronunciation. He said that since surgeries were piled up, he would schedule the MRI and the surgery immediately. He said that we would get an MRI appointment in two weeks, but it would take at least a month to get an OR for the length of time needed to complete a bow new graff two. He was worried that because I was not yet thirty, my bone was growing back and he would have to re-break or shave off the surfaces of the knee so that the graft would take. The surgery could take up to seven hours if he needed to do that. I told him what had happened with Peace and mentioned that I was very sensitive to anesthesia. He promised to consult with the anesthesiologist who had handled my case with the twins. Apparently, they knew each other well.

I went home and continued my nursing routine. I was getting bored without being able to teach or take the babies for their walk, so I began to rememorize the Three Character Classic. I learned it both orally and written. Dr. Hsu said that I would not be able to put weight on my left knee for a full six months after the surgery. By the end of the seven months, I could write the entire text from memory. The Three Character Classic is an elementary school text that began floating around in the Song Dynasty (1100s to 1200s CE). Other people updated it with each new dynasty, and I had a version from the early years of the Republic of China when a classical Chinese education was still popular. It covers all of China’s history, basic philosophy, and important works of literature in three character phrases. It really gave me a good basis for understanding Chinese culture more deeply.

When I went to get the results of the MRI one week before the surgery was scheduled, it was obvious that Dr. Hsu had known his stuff. The outer top “ball” of my tibia was completely gone, and there was indeed a hollow depression. Dr. Hsu explained that he would take bone from my right pelvis, from the part that stuck out. He said that it was easiest place to take bone on a woman. He would use that bone to rebuild the top of my left tibia. He also assured me that Dr. Ma would be my anesthesiologist again. The two of them were working out a strategy to allow me to undergo a lengthy surgery without causing me any problems. They were planning to use light general anesthesia and tons of Novocain around my knee and hip. It sounded good to me.

Of course, I had called the US to inform my relatives of the situation, and my mother was able to take time off work to come stay with me in the hospital. That way Yuni and Pa could continue to work to pay the mortgage while Ma and the unmarried sisters handled the three babies. They were not looking forward to when Peace would have to go cold turkey on the nursing, but they also knew that there was no other way. At least, she was already able to eat rice and vegetables and other solid foods (like candy from her grandpa).

And so, all the arrangements were made. During the first week of December, a full two months after my motorcycle accident, I was admitted to the hospital with my American mother in tow. We were at the branch hospital in Linkou, not far from the mountain where Yuni and I had met. The facility had beautiful grounds and a little lake. It was set up as a surgery and convalescent center. I was to be in the hospital for at least 21 days to be sure that everything was healing okay and that the bone graft “took” without infection. There was a huge food court down in the basement with all kinds of different styles of cuisine: Japanese, Chinese, American, noodles, etc. Mom learned to buy food there very quickly. She made many friends in the hospital.

Sunday, April 11, 2010

Motorcycle Accident

The day after we got back from Japan, I had to be at the university bright and early to teach my 8:00 class. Of course, I woke up a little late, and I asked Yuni if he could drive me over. He was still half-asleep and wanting to roll over and go back to sleep, so he just chided me for being too cheap to pay a substitute and take the day off. But I was paying 2/3 of all the expenses for a household of 13, and I couldn’t afford to do that. Since his discharge from the army, 20 months prior to this, Yuni had been tired and surly. His dad had tried to get him to shoulder a married man’s responsibility in the household, but he claimed he was not yet ready. So I had continued doing what I had done while he was in the army and was contributing for both of us.

I hurried downstairs and got out my motorcycle. It was surprisingly light. I shook it. There was the sound of liquid sloshing, which did not bode well for me. I opened the gas tank. There was about 1/8th of an inch of gasoline covering the deep sides of the bottom. The raised center was bone dry. There was just enough for me to get to class but not back. Or I could rush to the gas station and be a few minutes late to class. Since I was not looking forward to pushing the motorcycle all the way to the gas station after class, I hopped on and zoomed off. I filled up and went speeding along the road through the rice paddies to get to the university. The rice was just about ready for harvesting, and there were huge clumps of pampas grass at the corner of each paddy. The roads criss-crossed between the paddies, and there was no visibility at any of the corners. I made a left turn onto a narrow road just as a car coming from the other direction made a left turn onto that same road from the next street parallel to the one I had turned off of. Neither of us could see the other because of the clusters of tall grass surrounding each intersection. There was a little old man on a decrepit moped chugging along down the opposite side of the road from me. The car saw him and turned directly into my lane to pass him. The car was moving very quickly. I had a split second to decide if I was going to become a pancake or hit the sweet old man. I quickly swerved out of my lane, squeezed my brakes so hard both cables broke and aimed for the old man’s back tire so I wouldn’t injure him. My motorcycle and I bounced back from hitting the old man, slammed against the rear passenger door of the speeding car and then fell to the ground. As I was trying to jump clear of my bike so I didn’t bash my helmetless head, my knee got caught up in the motorcycle and smashed against the pavement. I tried to get up, but I couldn’t put any weight on my leg. So I sat there in the middle of the road with my motorcycle pressing on my leg.

A number of people were at the Earth God’s Temple a block up the road. They came out when they heard me slam against the car door, but when they saw I was white, they were afraid to come over. When I didn’t get up, two men came over and pulled my motorcycle off me. Then they waited for me to get up as they scolded me for sitting in the puddle of leaked gasoline. I told them that my leg would not work. When they heard that I spoke Chinese, they were relieved. They called to one of the women to run home and get a little washing stool for me. The two men half-dragged me to the side of the road and set me on the stool beside my motorcycle. I gave them our home phone number, and asked them to call to have someone come get me. I also asked them to have my husband call the university and tell them I would not be coming to class that day.

And then I settled down to wait. I was less than ten minutes from home, but an hour later, when the last worshipper was ready to leave the Earth God’s temple, I was still sitting beside the road. He went to his house and came back with a car. We left the motorcycle at the Earth God’s temple so it would not get stolen, and my Good Samaritan drove me home. I got home just as Yuni was pulling in. He had been searching for me at all the Earth God’s temples on the other side of the university. The man told him that he had clearly stated the street name. Yuni just looked miserable and said that he had been too nervous to hear clearly. Pa and the man bundled me from the man’s car to the back of the van, and Yuni rushed me off to the closest hospital.

I arrived at the same time as two ambulances. One held a dying woman and the other held a man whose hand had been almost completely severed in a factory machine. Based on triage, I came last. Two and a half hours later, two interns came over and told me that they were going to put a cast on my leg because all the doctors were working on the man with the severed hand. They said the x-ray showed a slight fracture just below the knee. Then they wrapped the cast from the knee down my leg and sent me home. They worked quickly because the emergency room had to clear cases within three hours according to that hospital’s policy. They gave me a follow up visit the next day in the hospital’s orthopedic out-patient clinic.

Yuni bought some crutches at the hospital supply store next door to the hospital, and I went home. Whenever I put my foot down, my toes turned black, and the cast was very tight. I went to the clinic the next day, and the doctor gave me diuretics. The following day was Wednesday, and I had three classes at the Gloria English School. I went to teach them, and my toes got really swollen and black. One of my American colleagues had a sports med-tech degree. He asked a lot of questions and then told me that the cast had been wrapped backwards and was cutting off circulation. He told the school’s owners that if I didn’t get the cast cut off, I could lose my leg. The owners found a substitute, and I had Pa and Yuni come pick me up. They took me home and cut off the cast with a tile saw.

That evening Pa made several phone calls. He found the best Chinese medicine martial arts specialist in Chungli and pleaded until he got me an emergency appointment that night. The doctor felt my leg and manipulated it. I told him that the x-ray had shown just a slight fracture. He said that in his opinion the entire joint was damaged on the inside. He gave us two names of the top knee surgeons in Taiwan. One was at the same hospital where I had had my children. Despite the problems giving birth to Peace, I thought that they did have my records, and if the surgery was planned liked the twins’ birth had been, I would do all right there. First thing the next morning we made an appointment with the hospital. That surgeon was booked for the next month, but the department told us to come and get the MRI and other tests ordered. If the test results were severe enough, the surgeon would make room for me. So I took the first appointment available, which was the following week. Then I settled down to embrace the pain of an unsupported broken leg and knee.

Sunday, April 4, 2010

Three Generations with Frequent Flyer Miles

Towards the end of summer, Ma got a call from Grandma Chu. When we went to the US the previous summer, we had all signed up for frequent flyer miles. The airlines kept sending notices in English to Grandma Chu’s house, and she wanted to know what they were all about. So later in the week, she had one of the uncles drive her up to Chungli with her letters safely wrapped in a plastic baggie in her purse. She sat around in our living room waiting for me to come home from class. As soon as I saw the letters, I told her that we all had free airline tickets to any place within Asia and back.

I was tired, so I went up to bed. Grandma Chu had already sent the uncle home and was spending the night with Ma. The next morning they accosted me as I was taking the kids out for their morning constitutional. Could we use those airline tickets over the Confucius’ birthday holiday at the end of September? Grandma Chu wanted to prove to the uncles that she could travel anywhere so they would take her along when they went to Southeast Asia with the Lion’s Club tour group. The uncles told her that the only reason she had done so well in America was because I had family there. They really did not want their mother along to spoil their fun. How could I say no to such a sweet old lady? (or to spoiling a selfish uncle's fun?)

And so another flurry of planning took place. Since the Lion’s Club always went to Southeast Asia, we decided not to go there. Grandma Chu wanted to go someplace that her sons had never been before. We decided against Hong Kong because Pa had been there in his youth. In the end, Ma, Pa, and Grandma Chu all wanted to go to Japan. I was fine with that because I had an uncle there who could help with hotel recommendations in Tokyo. My uncle did better than that. He worked with his company’s hospitality department to get us 50% off two rooms in the New Otani Hotel. It was a five-star hotel in the center of Tokyo. We had a two room suite. Each room had two king-size beds and a lovely wooden crib. Ma and Grandma Chu shared a bed in one room, and Pa had a bed to himself. Truth slept in the crib next to Pa’s bed. Peace and I shared a bed because I was still breast-feeding her at night, Yuni had the other bed to himself, and Love had the crib in our room.

Fortunately, I had taken that business trip to Tokyo five years previously, so I had some idea of what to see in the city. We went to the Tokyo Tower, the Imperial Palace gardens, and the electronics markets in Akibara. The old folks were not interested in the zoo, but Pa wanted to take the girls to Disneyland Tokyo. It was very new in 1989. The nice thing about five-star hotels is that you can get just about anything you need at the concierge’s desk, including the directions to Disneyland Tokyo. So another day of our vacation was spent at Disneyland. The following day we took a bus to Mt. Fuji where we hiked around. We did not go all the way to the top because of the grandma and babies, but we got pretty far up the mountain. We had a great view. After coming down, we took the bullet train back to Tokyo. On our last day, we took a day tour out to some Shinto temples in the outlying areas around Tokyo. We got back in time to go to dinner at my uncle’s house and let my first cousins play with my kids. (My brother and I were deprived as children. Our oldest first cousin is seventeen years younger than I am, so we had no one to play with growing up. But my cousins all had a great time with my kids.)

We had a great time in Tokyo. I had taken two years of Japanese in college, and I could speak enough of the very formal style Japanese with all the honorifics to get us what we needed. Unfortunately, I could not understand the answers because they were given in more colloquial Japanese. But Pa and Ma and Grandma Chu grew up in Taiwan when it was under Japanese rule. Pa had even attended three years of Japanese elementary school, so they could understand pretty much everything, but they could not string a proper sentence together. When we wanted to buy something, Pa and I would go to the counter. I would politely ask how much. The proprietor would answer in rapid, colloquial Japanese. Pa would fish in his pocket and pull out the money. If Pa had anything to say, he would tell me in Chinese, and I would then put it into my schoolgirl Japanese. Because Tokyo street signs have both characters and Romanized spellings, we could figure out street names and directions. I think it gave Pa, Ma, and Grandma Chu a great sense of power to be able to get around a foreign city and understand a fair amount of what was going on.

Of course, the Confucius birthday holiday was just the Friday of a three-day weekend, but we spent five days in Japan. I took off a few days from school earlier in the week, and we returned to Taiwan on the Sunday at the end of the holiday. Everyone was tired and happy. It had been a good trip. The maternal uncles all greeted us at the airport to pick up Grandma Chu and take her back to Toufen. They were quite relieved to find her none the worse for the wear.

That winter, when the Lion’s Club took its annual vacation trip to Southeast Asia, Grandma Chu went along to visit Thailand and Malaysia. She was a trooper, and she certainly kept up with the tour group, although when she got back and visited Ma, she told us that tour groups couldn’t hold a candle to the trips that I planned. She did, however, enjoy visiting the khatuey shows in Thailand. (Khatuey are the Thai third sex, the males who dress like beautiful females. Khatuey shows seem to be a must-see event for all Chinese and Taiwanese tour groups to Thailand.)