2004.05.10 Urumqi, China

I had to be rushed from Chapchal to the hospital in Ghulja for surgery. It's probably easiest to sum it up by including the text of an e-mail message I sent the other day:

Dear Greg, Mike, and Mala,

I'm writing to all of you as I've had an injury while traveling and you are the three who come to mind as most resourceful and well-connected.

In short, my right hand was badly cut and two tendons were severed.

I'm going to go into some detail, hoping that you might be able to pass the specifics along to doctors you know. There are plenty of hospitals here and I'm making use of their services, but there's definitely a different concept of medicine in China. Furthermore, it's hard to communicate as my Uighur and Chinese language ability isn't all that strong. I'd love to have some feedback from a Western-trained physician who shares my native language.

I took the Mayday holiday to travel and was in Chapchal, a town of about twenty-thousand. I returned to my hotel just past midnight Xinjiang time, the morning of May 6. Buildings in China--even hotels--tend to be completely locked after hours. This generally means just shaking the doors and yelling loudly enough to get an attendant to unlock them. I yelled and shook for about ten minutes. Finally, one of the double-glass doors completely shattered, embedding a shard of glass perhaps 3 inches long by half-an-inch thick into the back of my hand.

When I pulled the glass out, blood began gushing out. With aid from passers-by I made it to a clinic across the street. They couldn't do much other than tie off my upper arm with rubber tubing and wrap some gauze around the wound. They said I'd need to be driven 30 minutes to Ghulja, the nearest city with medical facilities. The hotel proprietor and a random Uighur boy of about twenty accompanied. I loosened the tourniquet myself while en route, weighing the chance that if it was tied in place for too long the limb would need to be amputated.

At the hospital in Ghulja the wound was then cleaned with iodine, and I believe some additional shards of glass removed: I couldn't bear to look at what they were doing. I was attached to an IV drip. With what language we could, I was informed that two tendons had been severed and--if I had enough money on me--could be re-attached. If they weren't re-attached, my hand would always be weak. Even if they operated immediately it would never be as strong again. I asked if the surgery could wait until after I returned to Urumqi (hoping to find a better hospital) but they said this wouldn't be possible.

It sounds sick to say, but these doctors were definitely more interested in whether I could pay cash directly at that moment than in performing any necessary operation. The doctor who wound up performing the surgery just sat by, picking his toes while waiting for me to decide what to do. I scrawled my name as best as I could using my left hand on three forms I couldn't read. They insisted that I sign more legibly.

Of the lot, only one--a Uighur nurse--showed any concern. She rebuked the others for forcing me to sign something which I couldn't understand. She was able to speak a few words of English and apologized that she didn't have the ability to explain what was printed.

I was given an anesthetic delivered through a needle in my neck. I could definitely still feel much of what was happening, though. (Having a tendon pulled into place feels like a sharp electrical shock.) My flesh was stitched back together; I was given two more bottles of IV fluid and several injections before leaving the hospital.

I'll skip the details of the day of May 6, except to say that I made it back to Urumqi about 1:00 A.M. on the 7th. I slept for 11 hours, then went to a hospital along with an Australian student who speaks Chinese and Uighur well, and another friend, the owner of a cafe on campus. Having them along to interpret was relieving, though this hospital didn't do much either. They redressed the wound, gave me another IV drip and prescribed another drip daily--for a week. They told me to have the wound re-examined after two weeks. They said it was too late for further surgery.

One of my friends took me to a more central location this afternoon. The doctor at this hospital was concerned that the fingers and back of my right hand are puffier than the same areas of my left. He prescribed additional medicines to be administered intravenously. The IV drip seems to be the default antidote here. All the hospitals I've been in have rooms set up for patients to sit while the fluids flow. I think the main purpose of the IV drips is to deliver a huge quantity of anti-biotics, but I'm not too clear on anything to be honest. I do have my patient records from Ghulja, but can't read what they say.

It's now the evening of May 8 and I'm back in my dormitory. The hand doesn't hurt much, though pain flares up occasionally at night. Perhaps I just notice it more then because it interferes with my sleep. I am able to wiggle all fingers, if weakly for a short ways. The digits with intact tendons don't move very far either, so I'm hoping it's more a matter of tightly stitched skin than permanent loss of mobility. Most noticeably, I can't hold the hand out with the palm facing down: I need to have it supported somehow if putting it in this position. I can't flex my right wrist terribly well, let alone clench the hand into a fist. To be honest it's not able to do much right now. Everyday tasks such as tying my shoes or opening a tube of toothpaste have become impossible. I'm composing this message entirely with my left hand.

If you could pass along the relevant bits, I'd love to hear some feedback from medical professionals you might know. Is it best to continue with the IV drips and have it re-examined two weeks hence? All sorts of medications are available without prescription here--could I be taking something different? Should I be doing any kind of exercises, or is it best to just leave it be? Is further surgery truly out of the question? I wouldn't rule out going elsewhere (e.g. Beijing, back to the US) for better treatment if there are options. Will I ever be able to use it again?

I probably won't be writing much e-mail, though will definitely be checking messages often. If you want to ring me, my dormitory number is (86) 991 858-9903. I also have a mobile which tends to have poorer sound quality: its number is (86) 13999150097.

Love you all,