I never imagined I’d have to talk to my boss about my ovaries, but that’s just what happened when I came up against a blockade in the insurance system.
I was going through a harrowing few weeks of stress and pain that culminated on my twenty-sixth birthday. My periods had been getting more and more painful for a while, and I got a recurring dull pain at other times in the month, but I self-medicated and continued to ignore it. It took a pain in my abdomen so sharp that a full night of drinking couldn’t take the edge off before I knew I could no longer stand it.
It still took me two weeks to see a doctor.
“Should I making this public knowledge?” I cross-examine myself. It’s literally a sensitive issue.
I’ve vowed to myself that my body is my public, political sphere as well as my private, personal sphere. It’s my mannequin on which to display my beliefs, my vehicle in the fight for gender rights, my pathway to strength and to weakness. I’m not afraid to bare the truth to the world.
What doesn’t help is feeling that the system is pitted against me because I speak a different language, because I am a foreigner, and because I am a woman.
In September, I’d asked a friend to help me get an appointment at a Chinese hospital where I knew they’d accept my insurance. She had to call for me, because I couldn’t speak enough Chinese to get through the phone system. She was the only friend I felt comfortable asking this of. We discussed dates. She called. We tried and tried to get an appointment. But there were just too many people to get through the system. I kept waiting, trying to ride out the pain.
By the last week of December, I was desperate. I couldn’t wait for the Chinese system to find space for me, and opted for an appointment at an international clinic.
It was New Years Eve when my boyfriend and I finally went to the clinic. I felt frail and scared and lucky to have him there with me. It was a Thursday, so I’d had to teach an 8am class that morning but had the rest of the day free, tomorrow would be a holiday followed by a weekend. I’d done the legwork to ensure a few days’ rest incase something drastic had to be done about whatever was going on inside of me. I was terrified that what I felt was an ectopic pregnancy – an embryo growing outside of my womb, either in the fallopian tube or just floating around between my organs – caused in part by my IUD.
The place was almost empty – a privilege I paid for – and there wasn’t much of a wait before a nurse weighed me, tested my blood pressure, and showed me through to the doctor’s office. I was glad my preference for a female gynaecologist had been heard; she made me feel so much more comfortable. She was gentle but feisty, professional yet funny. I realised I would have been fine if I were on my own. I was in safe hands.
The initial examination didn’t uncover anything but good health, which worried rather than placated me. I insisted that there was something wrong. I had never experienced pain so bad. So she gave me an ultrasound, showing me where my IUD was, and what my ovaries looked like. Then she found it.
It wasn’t an ectopic pregnancy, thank fuck. It was something far more common and much simpler to treat. I had a cyst on my right ovary that was 5 centimetres in diameter (which is pretty huge). She prescribed me three month’s worth of the combined Pill (oestrogen and progesterone) and told me to come back in three months to make sure the cyst had gone.
I left feeling positive about everything but the price. It had cost me 4000 RMB, which is a little under £500 (or $600 US), and about 70% of my monthly salary at the time.
Harking from the UK, I am not used to forking out for my reproductive health. A country where the National Health Service is managing to cling to high-expenditure existence after almost 70 years, women get most forms of protection on the house. My only saving grace was that my job provides insurance. All I had to do was provide our International Cooperation Office with the invoice.
My Chinese colleague at the ICO took a few minutes to process the number she saw in front of her. She told me she didn’t think the insurance could cover this cost, that she’d need me to get further paperwork from the clinic, and asked why I hadn’t just gone to a “normal hospital”?
Communication across a language barrier, however minimal, doesn’t help when trying to explain that it felt like an emergency, that I’d tried getting appointments in other places, that I worried about having a male doctor, that I couldn’t explain my pain in Chinese.
She looked back at the invoice and tried to tell me it was the wrong colour for the university’s insurance provider to accept it. I didn’t have to go to the one they’d recommended, but this international clinic was not registered as a hospital and therefore wouldn’t be covered. Additionally, the amount I’d paid exceeded the maximum insurance payment for the year by double. She might be able to get me 2000 RMB, but there was no guarantee.
She mentioned that next time, I should go to a Chinese hospital, that she would recommend a doctor, and that gynaecologists in China are all female.
Two months later, when I’d returned from a vacation feeling stronger and healthier than ever, if haunted by the Pill that I was eager to finish taking as soon as possible, my direct boss called asking me to come over. He needed to talk to me and he couldn’t explain over the phone.
I sat down in a low chair opposite him in his book-strewn apartment, wondering what on earth this could possibly be about. He explained he’d had a long, winding conversation with our female colleague at the ICO (the only female colleague I had any regular contact with, for I was the only woman among the international teachers at the time). He thought it better if he explain the inner workings of the insurance system to me himself, to save time. I believe that was a genuine concern, since our colleague’s English tended to falter when the subject matter got tough. Still, it did not seem fair that my medical issue had been discussed without my knowledge, nor did I want my older male boss involved in this issue.
He essentially repeated what she’d told me two months earlier (I’d gone back to collect 2000 RMB in cash, thanked her for her hard work, and we’d discussed insurance), thinking he was doing me a favour by initiating a tense conversation about my health.
He stressed again that the insurance would not pay anything towards another appointment of any kind at an international clinic within twelve months. He didn’t want to force me into going to a Chinese doctor, if I believed this was a risk to my health, but I really must try to trust the local system. It works for everyone else here, he told me, and my last appointment had been so expensive compared with the salary.
Suddenly this conversation became a way to assess my ability to assimilate with Chinese culture, and being affected by a “woman’s problem” wasn’t helping the case. My boss did not seem to think me capable of making informed decisions about my own health and my own money. Never before had I felt my womanness was an obstacle in this job, despite having only male colleagues and no-one to ask for help. Perhaps he was worried how this health issue could affect my ability to do my job.
I had not foreseen ever talking to my boss about my ovaries, but there I was explaining the pain and the cyst and the stress and the small likelihood that I would need surgery if it didn’t deflate. And there he was, suddenly compassionate.
I didn’t think I was biased against the system. I would go to a Chinese hospital for a problem with my eyes or my kidneys, but this was different. The mainstream system hadn’t worked for me. I had found a (woman) doctor I trusted and liked, at a clinic that provides the full range of healthcare options I expect as a westerner, and that doctor had my medical records so was best equipped to carry out the check-up later.
I did look into other options, but I ultimately decided to go back to the place I knew and trusted. The place where I knew I could communicate, where they knew my medical history, and where I felt comfortable going alone. That second appointment cost me close to 8000RMB – almost £950 (or $1,200 US). But that’s a story for another time.
Read on
Mostly It’s Just Uncomfortable is feminist artist Zoe Buckman’s response to the attack on Planned Parenthood in the United States. Check out this and other work on her website.
Zhēn de Gender 