The China Adventure

They were waiting for us when we arrived at the Shanghai Airport. A Chinese surgeon named Car and the driver. They stuffed bouquets of flowers into our hands and then photos, before they ushered us into a waiting van for the 4 hour drive to the small city of Taixing. They explained it was not really a city, but a province. Cramming 12 million into the small province in my mind made it one of the largest cities in the world….. After travelling 24 hours to get there, we passed out in the car. Accompanying me were my wife, Ileana, and Qin Dai, a PACU nurse and interpretter extraordinaire from Sunnybrook.

Ileana and I were visiting China for the 7^th time. This time we were with the Bethune Medical Development Association of Canada (BDMAC). They had invited me to visit 4 hospitals and give lectures. I would also visit them in the operating room and give them feedback on their surgical techniques. They lined a few troublesome cases up for me to give them advice. We would spend most of the time seeing the sites, eating in fancy Chinese restaurants and staying in 5-star hotels.

I learned about Norman Bethune ahead of my trip. He is still a hero in China, although he died in 1939. Every Chinese student learns about this eminent surgeon in elementary school. They worship him. They talk about him as though he had superhero powers. Probably every surgeon’s dream, to be worshipped like him…. but most of us remain in the ordinary surgeon category.

Norman Bethune was born in Gravenhurst, Ontario. His Grandfather was a prominent surgeon at the University of Toronto. His father was a meek pastor. Bethune grew up with a fear of being mediocre, instilled into him by his emotionally strict father and domineering mother. To describe him as mediocre could not be further from the truth.

Bethune was an early proponent of socialized medicine and formed the Montreal Group for the Security of People’s Health. In 1935, Bethune travelled to the Soviet Union to observe firsthand their system of universal free health care. During this year he became a committed Communist and joined the Communist Party of Canada. When returning from the Spanish Civil War to raise support for the Loyalist cause, he openly identified with the Communist cause.

In January 1938 Bethune travelled to Yan’an in the Shanbei region of Shaanxi province in China. It took him 3 months travelling from Shanghai after sailing across the Pacific Ocean to get there. He joined the Chinese Communists, led by Mao Zedong. Bethune performed emergency surgeries on war casualties in China and trained medical staff. He did not distinguish between sides in treating casualties. Bethune, a member of China’s Eighth Route Army during WWII, injured his left middle finger while assisting a wounded soldier on October 29, 1939. Three days later, on November 1, while operating on another soldier with neck erysipelas, his finger wound reopened and got infected. Probably because of malnourishment, which gave him a weakened state, he contracted septicaemia and died on November 12, 1939.

He was a disruptive force in the medical community while working as a surgeon in Montreal before being asked to leave. It well suited his forceful personality on the front lines of the Chinese-Japanese battlefield. He brought rudimentary blood transfusion practices and saved many lives. His statue greats visitors in many of the hospitals of throughout China.

Norman Bethune in China with Nie Rongzhen (centre) and an interpreter, 1938. Statue of Bethune at Wanping Fortress, Beijing

My presence in China was a lot less dramatic than Bethune’s. Nonetheless, the surgeons greeted me like I was a rock star, and I confess, I did not try to dissuade them or re-direct them to my ‘ordinary surgeon’ status. After a very professorial discussion about the management a patient with multiple gastric ulcers, they complimented me on my insight and wisdom. I neglected to mention to them I had discussed the case ahead of time with a surgical colleague, Laz Klein and my MIS fellow, Mattan at Humber River Health, so I was up on my management advice…..

Taixing was a wonderful experience. They took us to see some beautiful Chinese historic sights.No expense was too great. Ileana mentioned she would like to buy a bottle of wine. They turned up with one costing $400 and asked if it would do. They would not allow us to pay for it, insisting the pleasure was all theirs.

Ileana said it was perhaps the best wine she had ever experienced…..

After giving a few lectures, and watching a beautiful laparoscopic hernia repair performed in the OR, they drove us to Yangzhou, and took us on a fabulous tour of a beautiful lake and the colourful history going back over 2000 years

The food was amazing. Half the time, I had no idea what I was eating. Sometimes my imagination got the better of me. I came across this morsel in a soup I was wolfing down, and I briefly considered eating it as well, but a thought flashed through my mind. To me it looked like a shrunken human hand. I texted my daughter in Toronto who is one of the most sensible persons on the planet and asked if she would eat it. “Not a chance!” was the reply….

Our hosts bombarded us with gifts. The bought us chinese-styled slippers, books, postcards and many ornaments. The chief of surgery caught wind that Ileana liked wine and turned up at the hotel with an assortment of 5 bottles of white and red wine. We were given boxes of tea, Chinese saugages, spicy snacks and many other boxes we have yet to open. We bought a new suitcase to house all of these gifts. We are hoping that there will be no other gifts, as we have no room, although Ileana is doing her best to make a dent in the wine inventory….

The drive to Lingyi took about 5 hours. We were greeted again with flower bouquets and there was another wonderful dinner. The food is placed on a round rotating table. As the food slowly passes by, the plan is to capture a few pieces with the chopsticks and place it on the plate in front of you. Not all the pieces make it onto the plate, but it provides hours of entertainment for our patient hosts as we make a mess of our placemats and our clothing. During the dinner, there is a tradition where the host will come up to you with a thimble of spirits and you have to knock it back in one gulp. Thankfully, I don’t drink, but Ileana was up to honouring the tradition by taking one for the team…. again and again.

We were honoured to be given honourary staff appointments at the hospital. I mentioned that I had a pain in my knee from running. Well, it was my lucky day because the hospital had a thriving traditional medicine department. I was led into a treatment bay and hooked up to accupunture device for 1/2 hour. After the treatment, they applied a green goo to my knee and wrapped it all together with my knee in saran wrap. The rest of the stay was keeping track of me so they could change the treatment.

At one point they tracked me in a restaurant and gave me a treatment there! The doctor took my pulse. She said that it was her specialty. She asked with an worried look on her face if I had any abdominal complaints.

“I had a spicy hot pot last night and have some heartburn,” was my answer.

“Aha,” she said while placing acupunture buttoms in my right ear. She instructed me to sqeeze them for about a minute 1-2 times per day. My hearturn disappeared…..

There was an orthopedic surgeon specializing in avascular necrosis of the hip. We saw a patient of his getting treated in what appeared to be a fume cupboard. There was a green stick stuck in his umbilicus which had been set on fire and there was thick smoke coming from apparatus. He said this stuff works. Many of the hospitals practicing western medicine also have a traditional medicine department. The landscape around the hospital is covered with traditonal medicine herbs and plants. The chinese do not practice socialized medicine. Many of the hospitals are huge. This one in Linghy had 2000 beds. There are huge expenses. All patients must pay for their medical care, so if they want to set their umbilicus on fire and pay for it….well why not?

The next hospital we in Lueho, we connected with Dr. Lee Errett. On December 3^rd, 2022, Professor Lee Errett, MD FRCSC FRCS, George and James Swan Chair in Global Surgery at U of T received a Chinese Government Friendship Award for 2021. This recognizes Dr. Errett’s contributions over many years to the field of surgery in China, where he has provided voluntary specialist surgical care, developed surgical training programs and given hundreds of academic lectures.
At the Award Ceremony, Chinese Ambassador, H.E. Cong Peiwu described the award as “the highest award to commend foreign experts who have made outstanding contributions to China’s modernization drive”. 

Lee receiving the highest award given to foreigners from China

Lee gave a great lecture to the hospital describing the importance of global surgery and how it is important for China. There are 10 surgical teams from Canada giving lectures and visiting operating rooms that come twice per year, including the team of me, Ileana and Qin (the PACU nurse turned interpretter)

We were all treated to one of the most spectacular light shows on earth. It was a river cruise with the opera performers coming alongside the boat. Spectacular cannot describe the performance.

Some of the days were spent in the operating room. My obsevations were that the surgeons are very skillful laparoscopic surgeons. The volumes of colorectal and stomach cancer are huge. They would ask me for advice during a case, but many were better surgeons than I ever was….. especially now I am retired from surgery. Nonetheless it made me feel useful and important. Their kindness and respect made me feel very welcome.

I was having more pain in my knee, so I agreed to have it put in a fume cupboard and then they set my knee on fire……it felt better afterwards

While I was busy at the hospial during our last hospital visit in Changzhou, Ileana befriended Steve, a chinese traditional doctor, Steve now lives in Richmond Hill, but had some friends in Changzhou, one who was a manufacturer of Jade jewelery. He asked if Ileana wanted to visit him. You can guess how she answered. The factory had six floors. He was one of the largest Jade jewelery producers in the world. Here is a video of the show room.

When the owner couldn’t find one that he felt suited Ileana, he sent his wife to bring one from their private collection that was not on display. It was a flawless, rare black jade bracelet. When she asked how much it was going to cost her, she was told “You don’t want to know.” The owner gave it to her. Then he was off to catch a private plane to Russia to inspect a new delivery of Jade before it was sent to him.

What impressed me most about the visit to China was the kindness and warmth of everyone that we met. The real life experience has only been a very positive one. If everyone could see the real China, and feel the genuine kindness and beauty of the people that live there, the world would be a better and more accepting place to be.

I brought 50 of my books “The Sailor” and gave them as gifts to everyone, while Ileana and I were getting gifts of expensive Jade and beautiful art work…… It was hardly a fair trade, but their kindness and warmth shone through. Each thanked me profusely for my gift to them as though it were more valuable than gold.

The night before the trip back to Toronto, Car, the surgeon and Rebecca, a radiotherapist drove from Taixing, the first hospital we visited to see us before we left. They brought a suitcase full of gifts and we had dinner together. It was a tearful good-bye. One of my personal goals was to re-establich the relationship of having our surgical trainees visit China, and having Chinese surgeons visit us at Humber River Health, like we had before everything got shut down with the pandemic. Car said to sign him up as the first one!