This is continuation of a series we are calling Best, Wang Shi Kai. Dr. Rich is an Emergency Medicine Physician from Los Angeles who picked up and moved to China where he is currently practicing. He was given the name Wang Shi Kai by the Chinese Medical Board. In this series of posts we feature his emails sharing his unique experiences practicing medicine in China. Here are the links to his first email which gives some background Email 1 Part 1, Email 1 Part 2

Ni Hao Ben,

I appreciate the concern for my hair. My last cut was the worst yet. I was caught off guard by an overzealous young barber who shaved the back of my head before I could yell stop! At least it only cost me the equivalent of $6 US Dollars. It's been about 7 weeks since then and everything is growing back nicely, you'll be happy to know. I walked by the barber shop the other day and it is now a noodle restaurant. Not sure where my next cut will be. Maybe the cooks in the noodle shop also cut hair?

Now that I've been here for 5 months I've had some time to collect my thoughts on things I've observed in the ER and around town:

-100% of the parents who bring their child to the ER for a laceration repair (and there are tons of them every day) are concerned about whether the wound will leave a scar. There has yet to be a case where a parent hasn't asked me whether there will be a scar. This applies to the tiniest of nicks which don't even need sutures, to giant flaps and gaping wounds. It can be a nerve-racking experience to suture a child with the entire family watching over your shoulder, commenting on every move. I do about 8-10 moderate sedation procedures per shift. I've had people say that I am a master, an artist, a genius, and others say that they think they saw my hand shake. And there's always a Grandmother present who likes to wipe the blood away (completely unsterile, of course) as it trickles from the wound. I've given up trying to keep them at a distance.

-Vaginal bleeding in pregnancy is another very common complaint. The patients all want to know what their Progesterone level is and demand injections if it is low. The American College of Obstetricians and Gynecologists don't recommend this. I go along with the flow (no pun intended). I did consult OB recently for one of these patients and her recommendation was that the patient must change her mood in order to stop the bleeding. I just passed on the advice.

-A pregnant patient's husband came to the ER and demanded that an Obstetrician and nurse come to his home to evaluate his wife who was having some bleeding but was too emotionally upset to come to the hospital. He had to be restrained when he became violent after being told no.

-I got some pushback from a Surgeon to whom I wanted to admit a 15 year-old girl with fever and RLQ pain and equivocal ultrasound because her WBC was only 9. She had a temp of 39C and negative UA.

-It is not that common, but I saw a domestic violence case where the wife was beaten pretty badly. After her x-rays, scans, and sutures, she said that she wanted to talk to the police because this wasn't the first time her husband had hit her. The police didn't wan't to come to the hospital but I finally persuaded them. They took the woman and her husband, who was sitting in the waiting room and had even brought his wife to the hospital, into a room for "education". In less than 5 minutes, they told the husband to stop hitting the wife, and they told the wife to behave. The wife thanked me and they left happily.

-There are no restraining orders in China... TO BE CONTINUED

In the next post the rest of the first email will be revealed. Dr. Rich continues to share the cases he has had to manage and China.

-There are no restraining orders in China.