In 1949, my grandmother started working as a nurse at the largest sanatorium in Shanghai. It had been founded by French Jesuit missionaries who were forced to abandon the city once the Republic of China dissolved. My grandma had entered along with twenty other newly trained nurses to work with four doctors and care for eight hundred patients. Yes, four doctors for eight hundred patients.
Below is an excerpt of an interview I had with my grandma about her early years at the sanatorium.
GM: When we first started working at the hospital, there were four types of patients. But before the Liberation, they were all bound and tied up. So, we had to liberate them and remove the bondage. They lashed out at us when we untied them. It was difficult, and the older nurses wouldn’t do it. Being the younger incoming group, we had to release them. One by one, we removed the straps that bound them to chairs. We also started treating them and they gradually improved.
LL: What kinds of treatments did you use?
GM: Electrotherapy. At the beginning, the effects were a slow and not ideal. Later, we had Chinese medicine and some other things, like insulin and lotus soup. (莲花汤)
LL: How did you distinguish the different patients?
GM: It was based on their financial circumstance. For some patients, the burden of care would be placed on the family. For others, the burden of care was placed on the hospital. Some patients were just left at our doorstep. Their families abandoned them, so the hospital had to take them in.
LL: How would they eat if they were tied up?
GM: We would feed them. In the morning, we would bring them to the dining room to eat and then carry them to their beds. They would wear [leather gloves] when they were awake and when they went to sleep. Some patients were tied to their beds.
LL: Did you talk to the patients?
GM: Yes, we would play Mahjong and poker. That’s how I learned to play cards.
LL: So even though it’s a mental hospital, the patients could still play cards. There was some level of clarity in their thinking.
GM: Yes, some of them were able to play, but they couldn’t always control their illness. And once their symptoms emerged, then we were responsible for them. They were fine as long as they didn’t act out. Sometimes they couldn’t control themselves. When you can’t control yourself, then that’s an illness. When you can control yourself, you aren’t sick… Once when I was pregnant with your aunt, I was out walking with about 15 patients and two other nurses. It was after some heavy rainfall, and the water level had increased in the river. Then one of the patients fabing（发病）, had an episode, ran away from the group and jumped into the river. The other nurses didn’t want to get their clothes wet. This was in the winter and it just so happened that the patient was heavily dressed. She floated in the water, which was fairly deep. I ran to call for help and one of the workers from the Department of Health retrieved her from the river.
LL: Were you scared?
GM: I wasn’t scared. Once a patient hung himself. There was a rule in the hospital that whenever you walked upstairs to a patient’s room, someone was supposed to accompany you. But when I walked up, the others were too afraid to follow. No one was behind me and I went alone. We weren’t able to save the patient. I was supposed to have help with bringing the body down, but it was just me, so I carried him out on my own. That was the only time I was frightened at work, which was years after I started. Because it wasn’t my own patient. If he were my patient, then I wouldn’t have been scared…
LL: What kinds of changes did nurses experience in the 1970s?
GM: When the Cultural Revolution started, I no longer worked in the wards. The hospital also needed to revolutionize and there was a slogan that encouraged workers to be doctors, and doctors to be workers.
LL: If workers became doctors, what did they do?
GM: They would just issue some prescriptions, do what the doctors would do. It was a mess.
LL: What about the doctors?
GM: The doctors would sweep the floors. I was working in sanitation, preparing the syringes, tubes, and IVs. It’s not like here [in America]. If you needed to use equipment, you had to clean it. So I was in charge of the supplies and not working with patients. I remember I went to work one day and no one was was there. But they still needed to have their medical supplies. Pay stubs would still be distributed whether or not you went to work. No one paid attention.
~~~
It’s rare to come across conversations about mental illness in China. You can easily find articles online that string together large institutional histories, but these overlook the daily intricacies of health care. And this isn’t any kind of health care. It is both chronic and acute. It is social. It is emergent. These classifications of the behavioral and psychosocial phenomenon that patients embodied tread on an entire field of medicine that I have yet to comprehend fully.
What is interesting about mental disorders in China is how illnesses are described. Known as “shenjing bing,” or disease of the nerves (or now more popularly known as neurasthenia), falling ill involves the entire body. It is not a permanent state of being, yet it is intimately part of someone’s way of being. Disease remains hidden, latent. As my grandmother described it, patients would occasionally become sick, or “fabing.” The word “fa” suggests a kind of eruption, like white blood cells crowding around a wound, swelling and scabbing. But after the eruption, the symptom of the disease is released. The disease is unavoidable, and instead of trying to prevent it, my grandmother and her colleagues were trained to suppress it.
My grandmother was trained in biomedicine, and even though her colleagues used very mild, generic forms of herbal medicine, maybe there is potential in drawing even more from other types of medical theory and practice. For instance, in the forms of Chinese medicine that I have studied, the goal is never to suppress disease, but to release it. If you have a cancer tumor, the answer might not be to zap it dead and wait for the patient to relapse, but to work with it. As long as the patient lives, you can mange to determine the terms of survival, not the conditions of death.
This interview was originally posted on the MIT HASTS Blog on SEPTEMBER 10, 2014
