Beijing – Peking Union Medical College Hospital
Hutongs are a common structure in Beijing’s city center. These neighborhoods are formed by traditional courtyard residences, which are divided by small alleys. After an era of modernization of Beijing, the hutongs are again protected to preserve this aspect of Chinese cultural history. The picture was taken in October 2017 during the 19th National Congress of the Communist Party of China, which explains the flags and the unusually high number of officials in China’s capital.
The old entrance area of PUMCH speaks of the hospital’s history. It was founded in the early 20th century with support of the Rockefeller Foundation. Its set-up was modeled after Johns Hopkins University School of Medicine. Peking Union Medical College was nationalized in 1951, then closed during the Cultural Revolution. PUMC is now often referred to as one of the best medical school in China.
Chief technologist Yun Wang is satisfied with his department, but sees room for improvement in technologist education within China. The education levels between universities for technologists differ too much and teaching is often outdated, he says. He believes standardized national curriculums would be a solution.
Ling Yuan is an example of the department’s focus on international education. The radiology resident has spent part of her education in the US. Doing research besides the clinical routine is tough, she says. She spends eight to ten hours per day in the reading room. The weekends are reserved for whole body MRI research on adipose tissue.
Lanzhou – Second Hospital Affiliated to Lanzhou University
The Zhongshan Bridge was the first permanent bridge over the Yellow River. It is one of Lanzhou’s landmarks. It was contracted to be built by the German Shangtailai Company and was initially called “Lanzhou Yellow River Iron Bridge”, but was renamed as Zhongshan Bridge in memory of Sun Zhongshan (Sun Yat-sen, the first president of the Republic of China) in 1942.
Patients tend to come to the big hospitals, because in the community hospitals there are good scanners, but often no trust in the medical personnel, says department head Junlin Zhou. His hospital serves as a quality center for Gansu. The radiologists try to export their knowledge to remote areas and give support through telemedicine.
Radiology team members do not only use their knowledge within the department, they also travel as far as 1000 kilometers into remote areas in Gansu to educate local radiologists and technologists. “The image quality in these areas is getting better,” says female technologist turned-radiologist Jianli Liu (not on the photo).
Second Hospital Affiliated to Lanzhou University looks like it could be situated anywhere in the world. It is in fact, well connected: Agreements for medical teaching and research cooperation’s have been signed successively with universities and hospitals in the USA, UK, Germany, Japan, Israel, Australia, Norway, and Sweden.
“Lan Lan”, a lily with a yellow sweater representing the Yellow River is one of the mascots of Lanzhou’s yearly international marathon. The river is enormously important to Chinese history and is seen as one of the cradles of Chinese civilization. Lanzhou used to be a major trade hub of the old Silk Road.
White Pagoda Mountain allows an excellent view of downtown Lanzhou across the Yellow River. The city, which is 1,600 meters above sea level, was among the ten most air polluted cities in the world in 2013, according to the Asian Development Bank. This has changed: Lanzhou has since reduced its Air Pollution Index at the fastest speed across China.
Zhengzhou – First Hospital of Zhengzhou University
Beijing and Zhengzhou are more than 600km apart, but the train ride with the Beijing-Guangzhou high-speed railway just takes a little more than three hours. The train runs through three provinces including Beijing, Hebei and Henan, before arriving at Zhengzhou East Railway Station. It just takes four hours by train to get to Shanghai. The trains are officially greeted when they leave and arrive at a station.
Zhengzhou is one of the most important cities in mainland China. It belongs to the eight Chinese ancient capitals. Its history dates back to the Shang dynasty (1700-1100 BC), although few of its ancient trances remain. When the Communist government gained power in 1949, Zhengzhou was a commercial center with hardly any industry. It was then developed into an industrial hub. The city's industrial growth has led to a growing population, predominantly from industrial workers from the north.
Initially, Zhengzhou’s industry was concentrated on the west side of the city, so the northeast winds would carry fumes away from the city. These times are gone: The city is now chronically plagued by smog. Many citizens on the streets of Zhengzhou wear protection masks. Government and industry have recently put effort into combating pollution – China has been waging a “war on pollution” since 2014.
Saturday afternoon at First Affiliated Hospital to Zhengzhou University. The hospital has also switched to weekend mode. The plaza in front of the outpatient building looks quite different during workdays: it is usually full of people. They wait outside for half an hour just to get into the main hall.
Shantou – Shantou Center Hospital
Shantou with its more than 5 million inhabitants is part of one of the most densely populated regions in China. Shantou was one of the first four special economic zones in China. The city used to be poor, but nowadays contributes approximately one forth to the economy of the Guangdong province, which has highest GDP among all provinces.
Communication in Shantou is not as easy as foreigners may expect. Most Shantou residents speak Teochew, one of the oldest Chinese dialects that holds many features from ancient Chinese. Many medical professionals at Shantou Center Hospital speak this special Shantou dialect in order to communicate with their mostly local patients.
Daiying Lin is the radiology department’s Vice Chair at Shantou Center Hospital. She is responsible for MRI imaging. Usually more men than women are seen in higher department positions. “When I got my scientific degrees and my tenure afterwards, I got up at five in the morning and went to bed at 11 at night. But it pays off. I love my work, but I also enjoy family life,” says Lin.
The eleven-kilometer mega bridge is linking Nan'ao island to the mainland. The Nan’ao area off China’s Southeast Coast is includes the main island and another 22 smaller surrounding islands, covering an area of approximately 130 square kilometers. Nan’ao is about an hour drive from the city of Shantou.
The Medical Union concept implemented by the Chinese government has made more and more patients stay close to home instead of overcrowding the large city hospitals, says Xianheng Wu. He has sent one of his young and experienced colleagues to the community hospital on Nan’ao to take care of the radiology department. With the expert close to their home, patients have started to build trust in their doctors again.
Working at Nan’ao hospital is not quite as busy as in the big city, which is quite a change for the young radiology experts during their one-year rotation on the island. Things like being able to go swimming before work are a definite advantage. The responsibility is higher than in the city: Telemedicine helps, but the next expert is an hour away.
The Kung Fu tea ceremony is deeply rooted in the Shantou area. Kung Fu (or Gongfu) means the art of doing something well. The ceremony consists of various steps, which are easy to master and take only a couple of minutes. Shantouians usually use Oolong tea (which is partially oxidized, compared to fully oxidized black and non-oxidized green tea) for this ceremony.
Shanghai – Zhongshan Hospital
The roundabout is right next to Pudong’s landmark, the Oriental Pearl Radio & TV Tower, which used to be the tallest structure in China until 2007. Shanghai is known to be a comparatively open city: The Shanghai-Jiangsu-Zhejiang region is one of two that allows passengers from 53 countries to transit for no more than six days without a visa. The other visa-free zone one is the national capital region Bejing-Tianjin-Hebei in the North.
Emoticons are very popular among Chinese internet users and have become a part of Chinese pop culture. WeChat, the Chinese “App of all”, provides a huge variety of these characters. They have not only become a means of communication, they are about to become like Disney characters that can be seen in real life – like in this coffee shop window in Pudong.
Zhongshan Hospital is mainly diagnostic, with a set-up similar to the Mayo Clinic in Rochester/MN, USA. It has an excellent reputation in China and even the APAC region, especially for cardiovascular and liver disease. About 50 percent of all patients at Zhongshan Hospital come from Shanghai, the rest is drawn from adjacent provinces, mainland China, and abroad.
The hospital is affiliated to one of the most prestigious universities in the country, Fudan University. The hospital is named after Sun Yatsen, the pioneer of the Chinese democratic revolution, who overruled the Emperor of the Qing dynasty. The hospital just celebrated its 80th anniversary in 2017.
The schedule of medical specialists and their consultation hours in the main hall of Zhongshan Hospital allows every outpatient to pick a specialist. Radiologists also take part in this private patient service: The radiology chair sees private patients during two half days per week. A patient has to pay around 300 Renminbi (the Chinese currency) for a consultation; this equals 45 Euro.
The hallway separates daylight from darkness – radiologist Roufan Sheng talks to a colleague in the X-ray reporting room to the left. Imaging is everywhere: The pictures on the walls are landscapes photographed by radiology employees. The green bulletin board showcases the papers from Zhongshan Hospital published in 2017. Roufan Sheng’s latest publication in Abdominal Radiology is right there. The CT operation room can be entered through the door on the right.
Contrast is regularly used in the radiological department at Zhongshan Hospital. “A lot of other hospitals also have many patients, but they use contrast on a much smaller proportion of patients,” says head technologist Caizhong Chen. This is partly due to the specialized indications at Zhongshan Hospital, he says. The hospital is one of the biggest centers for liver, renal and heart transplants in the whole country.
The CT waiting area during an empty moment… Radiologists work from 8 a.m. until 8 or 10 p.m., excluding the commute, which can easily be one and a half hours, despite the good public transportation system in Shanghai (owning cars is regulated and license plates are auctioned, costing up to 15,000 USD). Yet there is still time to earn some extra money for young radiologists by doing regular clinical exams. The documents for these patients can be picked up in the little glass cubicle in the waiting area’s center.
The medical personnel works long hours – but there is also rest. Radiologists are entitled to take a two-hour break around noon between 11:30 and 1:30. The hospital provides two canteens and a cafeteria for patients, nurses and doctors. The inpatient wards require presence of the personnel, of course.
The revolutionary hero statue built during the Cultural Revolution in Huángpu Park, on Shanghai’s Bund, tells the story of a different Shanghai from not too long ago. The Bund is the old pedestrian promenade overlooking the Huángpu River. What is now called Huángpu Park was the first park in China open to the public. It was designed by a Scottish gardener and initially included a resting pavilion and a tennis court. It was created for the rising number of foreigners living in Shanghai after the city became an international trade port in the 1840s.