Tuesday, April 10, 2007

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When Your Child Falls Ill
In a Foreign Country
March 30, 2007

Nothing makes you feel farther from home than being a temporary single parent with a sick kid in China. When illness strikes, it's easy to feel extremely isolated and unsure about how to proceed, a feeling greatly magnified when you find yourself home alone with the kids -- a common occurrence here, with so many people (mostly men) doing so much business traveling.

There are two medical facilities with Western and Western-trained doctors in Beijing and I feel comfortable with the primary care available at both. Still, there is always a nagging sense of unease having an ill family member, partly because a serious medical problem may well involve traveling to Hong Kong, Tokyo or even America.

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Any brush with illness -- particularly involving kids -- evokes these feelings. But it also makes me pause and appreciate the fact that we have these options available. SOS International Clinic has been here for about 12 years, Beijing United Hospital for nine. Neither is perfect, but both provide solid primary care and alleviate some of the panic you feel setting in with the realization that you have an ill child in China. Before these facilities had established themselves, expats here did not have this safety net, which is still a luxurious fantasy to foreigners living virtually anywhere in China outside of Beijing and Shanghai and in many other parts of the world. And of course to many Chinese, who must contend with a less-than-stellar, profit-driven hospital network and often prefer to use these hospitals when they can afford to.

Yet, for all that these facilities offer, and the security they provide, there's much that we lack -- including a reliable ambulance service, and the self-assurance of knowing that you can pick up a phone and dial 911 in the face of a crisis. We're on our own to get to the hospital, about 20-30 minutes away. That lends some extra weight to the "do I take him to the hospital to be checked out?" decision, particularly as night falls, and all the more so when you find yourself flying solo.

That is the situation I was in recently when Rebecca boarded a predawn flight to Taiwan. Before she had even landed in Hong Kong, Jacob and Eli were up with high fevers that made it clear they'd be staying home from school. (You can't fly directly from mainland China to Taiwan, which makes it a long trip, one not easy to reverse on a moment's notice.)

This is where being a male trailing spouse can become a little tricky. I was immediately conflicted about how much information to relay, how quickly and with what urgency. Although I don't think it's a major issue with us, I am sensitive to the feelings of guilt which seem to flicker somewhere inside every working mother.

I committed myself to being Doctor Dad for a day and seeing how things went. Six-year-old Eli had a fever but not much else and I was confident he'd be better soon, but nine-year-old Jacob was really struggling with a badly upset stomach. At times like this, the technology I discussed in my last column is nothing but good. I call my pediatrician father for medical questions as frequently as I would living in America. Both a phone consultation with him and a doctor's examination indicated it was likely a stomach bug that would pass soon.

A day later, Jacob's stomach was still rumbling and he required constant nursing, which was exhausting, frustrating and occasionally frightening. He was going to the bathroom often and experiencing sudden, violent cramps that left him too uncomfortable to even watch a movie. I was worried that he was getting dehydrated and might need an IV. My conflict deepened. Ask Rebecca to come back early and I'd alarm her, cause a massive logistical headache and toss a monkey wrench into a day or two of meetings. Worse, I'd brand myself a wuss. All of this would be magnified if things turned around quickly, as I expected. On the other hand, I risked being a foolish martyr if I bit the bullet and said everything was fine.

On his third day ingesting nothing but crackers and ginger ale, I decided that he was looking worse -- pale and sunken-eyed -- and sent Rebecca this text message: "Jacob not good. Think you should return." She replied that she was on her way to the airport. But just 20 minutes later, Jacob woke up from a nap looking almost normal. I felt both relieved and guilty, and I still had a long day ahead of me.

Eli was home again, but feeling fine and bored to tears, bounding around the house like a caffeinated Chihuahua set loose in a pediatric hospital ward while I attended to Jacob. Adding to the chaos, my Chinese teacher arrived because I had forgotten to cancel class. I threw a DVD on for the kids and gave the lesson a try, only to be repeatedly interrupted by Jacob screaming for help and Eli playing spy. I walked back downstairs once and heard my ayi (nanny) and teacher Dong discussing what a good father I am.

That should have been a nice compliment, but it seemed a little pat and they were speaking in hushed, conspiratorial tones. I felt sure they had seen me coming, muttered the Chinese version of "ixnay on thatnay" and shifted into prearranged praise. They were likely saying, "What do the laowais [foreigners] expect to happen to their kids the way they leave their heads and toes exposed all winter?"

The ayi had already pointed out that three-year-old Anna was underdressed, making her extremely vulnerable to the demon virus. This was no surprise, as it is common for Chinese, particularly middle aged or older, to tsk-tsk us on the street, in parks -- anywhere -- for our kids not being properly bundled up. They are adamant about kids being thoroughly wrapped up if the air has the slightest chill. This always seemed odd, since many Chinese toddlers waddle around year-round with their rear ends exposed through split-back pants designed for diaper-less living.

Dong also offered to have his Taoist monk friend mix up some special herbal remedy. I'm not sure what this traditional Chinese medicine was supposed to do, but I probably would have tried it were I the patient. I opted not to make Jacob a guinea pig. Nonetheless, he continued to improve, and I began to feel silly for initiating Rebecca's return. After the kids were asleep, I waited for her to get home and enjoyed my first opportunity to reflect after several exhausting days. I was struck by how much I benefit from a double standard. I receive a lot of praise as a dad on the frontline of parenthood, more so here as an expat, simply because the gender divisions tend to be sharply drawn. It is not uncommon for a wife to be left alone for weeks on end while her husband travels the globe.

But if I really need to, I can throw up an SOS flare and my wife will cut a business trip short to zip home and rescue me, yet no one will note this as any kind of special devotion. You can be sure if a man did the same thing to attend to an ailing child, he would be ridiculed and praised in equal measures for his intense dedication.

The next morning, Jacob was still unwell and Rebecca decided that it was time he saw another doctor. A culture revealed that the infection was bacterial and a dose of antibiotics seemed to help turn the tide. A few days later, we found out it was salmonella -- extremely ironic considering the kid lives on spaghetti, cereal and granola bars. He is by far the least likely member of our family to eat anything exotic.

Jacob probably would have been miserable for 5-7 days and then gotten better no matter what we did. But don't tell Rebecca -- she gets credit for taking him to the doctor and I was happy to have her home and in the loop, rather than feeling stranded in China and forced to make these decisions alone. Whether that makes me a wuss or not.

Have you faced a medical emergency in a foreign country? Have you dealt with an ill child while your spouse was on a business trip? I'm looking forward to hearing from you. Share your thoughts.

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Readers Respond

Write to me and I'll post selected comments in a future column. Please let me know if you want to share your thoughts but don't want your letter published. Below are selected, edited responses to my previous Expat Life column, on how technology has changed the expat experience. The column drew a lot of emails and posts on my forum.

Your article seemed to mirror my own existence in Panyu, China (a suburb of Guangzhou).

I too drooled over the prospect of a Slingbox. I even took it a step further and wanted to add a Tivo into the mix. That way I could "time shift as well as place shift". During a trip back to the US I spent 3 whole days wrestling with the connection of the router, Slingbox, telephone company etc. Finally, I got it working only to be told that my mother's DSL connection was too slow to be effective at uploading the images. Of course I knew the finding someone with a cable modem connection would overcome the problem, but I took it as an omen that I watch too much TV anyway.

I remember when I first went to China in 1987. Calling was outrageously expensive well over US1.00 per minute. Before I left for China, my father gave me his company's fax number. His salesperson had talked him into buying a fax machine telling him people would fax in orders. He didn't believe it. Then to economically and quickly communicate to me in Beijing by fax felt to him like magic. He said that alone justified the fax machine purchase.

By the way, have you had the experience of going to some fabulous place for vacation and your kids don't want to leave the room because it has Cartoon Network?

-- Bill Grolicki

Yes. We have had that experience more than once.

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I lived abroad both for a semester during college as well as for a couple of years split between Europe and Hong Kong. The difference between the two periods was dramatic. One of the great things about not having the internet was that you read news publications that gave a different perspective on events throughout the world. Heck, it was just nice to have a more global view vs. the focus on local news, which tends to be more prevalent in the States. I think it helped me see how other countries perceive the US and to this day, I still check international news sites to see what the external view is of some of the items that take place here.

That being said, I live in Seattle and have the New York Times as my home page. Ha!

-- Jill Beck

I go out of my way to have some insight into local views of things, but it's not always easy when you can't read Chinese and can only understand a fraction of the news on radio or TV.

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I lived in Israel during the late 70s and early 80s. The thought that 15 years later one would be able to be in Tel Aviv and watch US based television seemed so ludicrous that it makes it that much more amazing to me that all this connectivity is now possible. I recall having a subscription to the Sporting News and anxiously awaiting its arrival by mail, sometimes two weeks after the publication date, so I could know what was happening in my beloved Major League Baseball. The local English language newspaper, the Jerusalem Post, had an expanded Sunday sports page that did on occasion print the MLB standings, but that was no substitute for the comprehensive overview a true fan relishes.

Similarly, the one local radio station that broadcast in English, the now defunct but forever loved, Voice of Peace, once aired an American Top 40 special feature with Casey Kasem. It was such a shock to hear his voice, albeit just that one time, while living so far away, in the Eastern Mediterranean. Today's ability to stream music, or more importantly, radio stations, from nearly every country on the planet, is simply amazing to this writer who knows what life is like without those luxuries, and believe me, it's better to have something and deal with the need to resist its temptations (as you described in your column this week) then to not have it at all, and not have the ability to have it even if you want it.

-- David Alpern

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Thank you for your insight into Expat living and the evil Slingbox. We have lived in Seoul for two years, with two high school daughters who attend a wonderful foreign school and love it. They have been nagging us for a Slingbox for a year now. As this city is the internet/electronic Mecca of the world, pretty much everyone I know has one. We have refused for the very facts you state in your article. We love that TV viewing is at the bottom of the list of things to do in Seoul. We are happy when we turn it on, and there is nothing to watch. And guess what, in this huge city, we can walk outside and find a million more interesting things to do!!

-- Nancy Makki

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We lived in Saudi Arabia from 1974-95. When we arrived, if we wanted to call home, we called our company operator and "booked" the call. Usually the next day (sometime longer) the operator would call us and connect us to our stateside number. In case of an emergency, we could drive about 20 miles to Dammam, the capital of the Eastern Province, and visit the government telecom center where an operator would usually connect us within an hour or so. Because all radio, TV, magazines and newspapers were censored, we bought a shortwave radio to listen to BBC or VOA.

Our three kids were born there in the early '80's and, like you, we were happy that TV was very limited and there were no commercials. When we returned to the states, they were teenagers and were relatively uninformed when it came to the latest fashions or gadgets. None of this seems to have hurt them and they caught up quickly.

By the time we left Arabia in '95, calling the states was easy and instantaneous but expensive. One could watch lots of TV via satellite (much to the consternation of the government) and the internet was about to arrive.

-- Bill Plank

Thank you for sharing your stories.