Back to Work

Today is my last day before going back to work. A lot of things happened, and I finally admit that this is how life looks like, and there are many things out of our control.

When You Get a Big Medical Bill

It's not difficult to get a big medical bill in the US. A 30-min office visit without any surgery or prescription can cost you a few hundred bucks, and an ambulance ride can be more expensive than a half-month cruise trip to Caribbean. You don't want to see doctors in the US without insurance, unless you don't mind having a shabby credit record. But sometimes even with an insurance, your bill can still look ridiculous.

On Oct 15th, I called 911, who sent an ambulance and took me to the emergency room in the nearest hospital. A few hours later, I was transferred to another hospital in midnight because the first hospital was not able to handle preterm labor. A few days later, the first ambulance company sent me a bill of $2,545, and the second one sent me a bill of $7,859. The first ambulance company got my insurance information and filed the claim directly. The second one did not have my insurance info, and therefore they offered me a special uninsured discount: I only had to pay $1,200.

So my insurance company, Anthem Blue Cross processed the first bill, and sent me an EOB, saying I had to pay approximately $2,300 because that company is "out-of-network". After they received the second bill, they agreed to pay $4,600 for the same reason. As a result, I was responsible for about $5,500 for the two ambulance rides, which is even higher than the price for "uninsured" people.

This is not the end of story. It turned out that during my emergency surgery, the anesthesiologist and the surgeon, who work in the “in-network" hospital, are not "in-network" physicians. As a result, their bills were also taken as "out-of-network" as well, which added a few more thousands dollars.

Is that bad enough? No, far from the end. When you physicians insist you staying the hospital for six days, your insurance company may find only four days are "medically necessary". I stayed in ICU for four days, and then a private room for another two days. I kept receiving mails from my insurance company saying we only found the first four days are medically necessary, therefore oops we could not cover your hospitalization stays for the last two days. Well, then how about covering the first four days? We can't do that either because we only cover semi-private room while you were in a private room.

Under emergency, there are a lot of things out of control: I couldn't ask 911 to send me an "in-network" ambulance; I couldn't ask the hospital to transport me in an "in-network" ambulance when I was unconscious; I couldn't choose my surgeons and anesthesiologist after I lost 2-liter blood and fell into coma; neither could I choose a semi-private room in the hospital since I woke up two days after the surgery. However I had to deal with the extra bills which added up to more than $10,000.

When you feel you're treated unfairly, usually you are not alone. People with similar experience can provide you with good suggestions on addressing issues like this. What you need to do is to Google your concerns. And that's what I did as the first step. After studying cases online for a few hours, I established my argument and started to look for evidence.

Therefore I read the part on insurance coverage in the Affordable Care Act (ACA) and state legislation, which makes it very clear that in emergency, the insurance should cover "out-of-network" bills at the same rate as "in-network" ones; and balance bills are forbidden for both PPO and HMO policy holders. In other words, it's an obvious violation of law for my insurance company to process my bills as non-emergent "out-of-network" ones, and I should not be balance billed at all!

Then I appealed all the claims that I was not happy with. Without any new evidence (such as medical records or visit notes), all my appeals got re-processed and in-network rates were applied. In other words, with exactly the same information, my insurance company processed these claims in two very different ways. There are two possible explanations for this: (1) the company hires some unqualified people who simply do not know how to process claims without violating laws; or (2) the company is taking advantage of me, in hope that I am not familiar with the federal/state laws so that they can pay less.

We shouldn't have to be experts on health insurance to be treated fairly. Unfortunately ethical standards for some companies can be really low. Even I know they are in violation of law, what can I do? I can only appeal the bills, but I can not sue them. So for the company, the cost is very low but the gain is big: if the patient finds out that his claim is not correctly processed and makes an appeal, it probably only takes them a few minutes to re-process the claim; but if the patient does not realize he is over billed, or he does not know that he can make an appeal, then the company can pay much less than it should. This is a game that the company will never lose.

Now I finally understand why my physician gives me an eight-week disability leave - it's not for me to have a good rest, but to deal with these shits. It's unpleasant to spend hours talking to insurance representatives and teaching them the right way to process a claim, and it's also interesting to see the exorbitant medical prices. Just think about the bill from the second ambulance company: it was willing to accept a payment of $1,200 for the ambulance, but my insurance ended up paying the full price of $7,859. Its employees must have a good bonus for Thanksgiving this year.

There are a few more claims in process, and I won't be surprised if some horrifying bills come again. I only hope that I can get everything done before I'm back to work. After witnessing all the messy stuff in the US healthcare, I strongly believe that I've made a good choice in my career life, I'm in the right field.

I Got My Mum an iPad

I never realized how popular Apple products are until my mum talked to me about iPhone. She had been using a dumb phone since 2002 and hardly thought of replacing it until my stepfather Joop bought a smart phone. I asked her if she'd like a smart phone, and she said yes. First I ordered a Xiaomi Phone in China, which was thought very highly of by some of our friends. However the shopping experience with Xiaomi turned out to be a disaster. The couriers refused to deliver the phone to my mom's apartment, instead he insisted her picking the phone somewhere more than one-hour away. I finally cancelled the order after I checked the package and found out it had been delivered ten times but never succeeded in delivery for "reasons unknown".

After a few discussion with my mum, I decided to get her an iPhone instead. Iphone was still expensive in China. Luckily Gang was about to travel to China for a conference. Therefore we bought an iPhone 5 in the US and had Gang take it back to China as a gift for my mum. The iPhone 5 we bought was about the same price as the Xiaomi Phone in China, but it's simply much better. My mum never brings her laptop around since she got the iPhone. She uses iPhone to check emails, read news, play games, watch shows and download novels, etc; and she checks wifi availability when she books hotels or trains. Anyway I don't know what she will do without her phone. I once asked her how Joop likes his phone, and my mum looked very proud: "Not too bad, but mine is much better!"

I started to sell my iPad to her after I found she spent most of her time with the tiny screen of her iPhone. At the beginning, she didn't seem to be impressed, considering iPad as a bigger and less convenient iPhone. Then one day she decided to try some games on the iPad, and found a few Mahjong Apps. Since then I don't see her playing with iPhone any more, and I'm not able to play with my pad either. I ordered an iPad online, which will arrive around Thanksgiving. Before then, I'm stuck with my laptop.

Jimmy Kimmel Show

Jimmy Kimmel probably would never invite the kids to the round table or least change the topic if he had known how the Chinese community reacted to his joke. In the show, Jimmy mocked at US government shutdown by having four kids talk about US politics, implying even little kids can do the politicians' job. He asked the kids what we could do with the $1.3-trillion debt to China. Then one kid suggested that we should kill all Chinese. Jimmy said "that's interesting", and engaged the kids in discussing whether we should allow the Chinese to live.

Many Chinese people in the US were irritated by what Jimmy said, and organized protests against ABC in Los Angeles and some other cities. A few days later, Jimmy apologized to the protesters, holding his hands together and bowing to the people several times, which he believed was a sincere way to say sorry in Chinese culture. But that apology was not accepted by furious Chinese. On Nov 9th, sporadic protests turned into the biggest Chinese demonstrations in the US history, 27 cities saw massive street protests with posters picturing Jimmy as Hitler, and slogans such as "Killing is Not a Joke" and "Fire Jimmy Kimmel". Later ABC posted an official apology on its website, which however was not well accepted either.

I was in the hospital when the Kimmel Show was broadcasted, and didn't follow the Chinese communities' activities afterwards. But I've never seen Chinese people here paying so much attention to a comedy show, and becoming so enthusiastic in politics. Most people describe this as the start of civil rights movement for Chinese, but some also consider this as an unfortunate result of lacking humor and over reaction. A lot of debate was going on in Mitbbs.com, a very popular online forum for Chinese who are living/studying in the US. There was also a great discussion on which national flags that protesters should carry - the US or China, or both? (I will talk about this later.) But most comments there agreed that Chinese shouldn't be silent, and something must be done to show the ABC that racist jokes like this can not be allowed.

However opinions are very different back in China. I read some comments on Chinese online forums and social media. Chinese netizens responded very interestingly to the show and protests. Most of their opinions can fall into one of followings:

1) Look, the US is not as good as we thought, even their TV shows advocate genocide;
2) There is no point of protesting. It's your own choice of going to the US, and if you're not happy with that, why don't you just come back to China?
3) You deserve the mistreatment because you betray your home country;
4) Stop it, it's a joke, you're humiliating yourselves (and China). You're protesting only because you're allowed to do so, imagine what you would do if you were still in China;
5) Good job, you're fighting for your dignity.
6) None of my business.

To understand why Chinese people responded so differently, we first need to understand what "Chinese" means. There are three different groups of Chinese: (1) Chinese citizens who are living in China, here I will call them Native Chinese; (2) immigrants from China who are already US citizens, here I will call them Chinese Americans; and (3) new immigrants from China who are not US citizens yet but plan to stay in the US for a long time, here I will call them Overseas Chinese.

It's interesting that a show which talked about "killing all Chinese" irritated Chinese Americans and Overseas Chinese but didn't upset Native Chinese that much, despite that "Chinese" in the show obviously referred to Native Chinese. I think Chinese immigrants were less tolerant of the joke because the word "Chinese" itself also has racial meanings - many immigrants from China and their descendants may still identify themselves as "Chinese" even though they no longer hold Chinese citizenship. And this joke can be very harmful to them and their children if audience take the "Chinese" as a racial concept rather than a citizenship. While on contrary, Native Chinese don't care that much because they are so far away from the US, and public opinions on the other side of the Pacific can hardly affect their lives.

The debate on national flags was carried mainly between Chinese Americans and Overseas Chinese. New immigrants wanted to carry Chinese national flags because they believed the show was insulting China, but Chinese Americans did not view it as a diplomatic issue (China v.s. US), but a civil rights movement (Chinese v.s. other races). After a few discussion, they agreed not to have Chinese national flags during the protests, and stayed with the idea that the ABC was advocating genocide rather than provoking Beijing. Chinese Foreign Ministry also kept silent about the event as they always do.

Jimmy might want to tease a country in the show, but he (or the kid at the table) used the wrong word. You do not want mess up with racial issues in the US, and the word "Chinese" is one of them. I 'm proud of what Chinese protesters did after the show was broadcasted. They might not have every step well planned and organized, but at least they made a great start for Chinese communities' impact on the American society.

10月15日-25日

这十天里，我经历了打911叫救护车、从急诊室直接送入delivery room，半夜转院，两天后病情稳定转入AP。出院后数小时情况急转直下，半夜再度从emergency入口，输血后进行手术，在ICU待了四天，普通病房里又待了两天，然后出院。这段死里逃生的经历让我全面见识了一下美国医疗体系，故值得一书。

第一次入院

10月15日星期二，是我忙忙碌碌的一周里极为普通的一天。手上的项目稳定的进展，需要的数据也已安静的躺在电脑里。到了5点40（这真是一个难忘的时间），我收拾好东西准备坐10分钟以后的shuttle去bart站，然后回Berkeley. 考虑到1个半小时的commute, 准备走之前我去了一趟洗手间. 就在这个时候，一阵contraction，我看到鲜血流出来。

911

我知道这个时候，胎儿还不能安全的出世，而这个分明又是早产的先兆。所以我的第一反应是冲回办公室，打 了911. 911的接线员问我，是否需要救护车。我说是的。电话立刻 转到救护车派遣处，而我依然处于相当紧张的状态，最后是同事替我接电话和报地址。同时电话里有人简单询问我现在的情况，指导我现在应该尽量平躺、深呼吸。

十分钟后，救护车到了公司楼下。十来个救护人员推着担架进来。一个人一边给我测脉搏、量血压、听心跳，一边咨询我的情况。我很快被移到担架上，并推到救护车里。征得我的同意后，我被送往最近的医院Mills - Peninsular。在路上，我听到其他的救助人员在联系医院，简单介绍我的情况，然后讨论是直接送到emergency room还是delivery room。同时在车上救护人员一直在监控我的血压、心跳，并给我做了血糖测试。然后该死的给我右胳膊关节处插了个IV，害得我接下来住院的三天里右胳膊不能弯曲。

送到医院，进入delivery room。此时已经是15日晚上7点。钢钢也从伯克利赶到了这家医院。因为这个医院并非我ob挂靠的医院，也非我登记准备生产的医院，所以很多关于我的数据无法获得。医生试图调出我的档案，但未能成功。于是我重新做了一系列血检和尿检。结果一切正常。但同时我的血压依然时低时高。之后我被推入lab做超声波检测。当时还不时有淤血流出，宫缩依然疼痛而频繁。超声波检测的结果却显得非常正常：无胎盘前置/胎盘早剥或胎盘脱离的迹象。医生给我用了延缓宫缩的药，告诉我，鉴于我现在的情况，有早产的风险。而这家医院没有接生早产儿的设施，所以要转院。这个时候已经是次日凌晨了。

转院

我在床上迷迷糊糊，看着各种药物从IV进入身体。然后又呼啦啦进来几个人，把我从病床上挪动担架，然后推到救护车里。钢钢开着我们自己的车跟在后面。大约半小时左右，我转入了Alta Bates Berkeley的待产病房。当时我怀孕未满26周，胎儿心肺功能尚未发育完全，医生亦开了加强其心肺功能的药物。同时我被禁食禁水，以预备要剖腹产。折腾一宿，在困倦中昏昏睡去。

10月16日，星期三，我继续接受镁注射以减缓宫缩。同时医生也开始为早产做准备。先是通过超声波确定胎位，判断头朝下可以顺产。接着有个专门负责早产儿的儿医过来，向我们详细解释了早产儿的风险。当时我怀孕26周不到，她的原话是：婴儿存活的概率是87%，存活且无重大疾病的概率是74%，存活且无一般性疾病的概率是53%。我们在同意书上签了字。

另一个负责早产的医生也来跟我了解了一下情况，然后安排了阴超。两个radiologist看了半天，各种讨论。最后结论是，无胎盘前置/早剥/脱落的迹象。于是这个医生非常开心的告诉我们，虽然我出血的原因仍然没有很好的解释，但是他们已经排除了最坏的状况。

由于医生判断可以顺产，于是我被获准进食。当晚护士给我端来了晚饭，很难吃。

10月17日，星期四，我继续接受各类药物注射，宫缩似乎渐渐放缓，胎心也一直有力而稳定。但随着血液里镁含量的增高，我的肌肉也越来越无力，整个人觉得非常虚弱，连上卫生间都需要搀扶，当时看着离病床五步之遥的卫生间，真是咫尺天涯。就连咀嚼食物也觉得非常困难，牙齿使不上劲。护士重新测量我血液里的镁含量，发现已经接近上限。于是减少了我的注射量。

这一天有惊无险的度过。我已经可以熟练操作产床起落和电视的各个频道。钢钢也学会读取旁边监控器的各类数据。当晚我从Delivery room转入更加宽敞和舒服的产前病房AP-4。

出院

10月18日，星期五，上午我的情况似乎非常稳定。护士也不再持续监听胎心和宫缩，而是每个小时监测20分钟。一切似乎非常正常。中午刚过，当天的值班医生和我的OB过来告诉我，我可以出院了。她们叮嘱我不要再工作了，最多在家VPN。我出院的Instruction里还注明了不要出门，多休息，不要拿重于10磅的东西等等。如果宫缩疼痛或者阴道出血，则应当返回医院就诊。

当天下午4点，我们收拾好东西欢天喜地的回家了。我至今还记得那天正好赶上伯克利的足球赛，一路都很堵。我好几天没有见过太阳了，所以虽然堵车，但还是非常开心。还没等到家，我已经觉得很饿了，嘴里不停冒口水，于是在麦当劳停了下来，买了汉堡和薯条。匆匆吃下去以后，感觉好了不少。回到家洗个澡，还睡了两个多小时。醒来的时候窗外已经黑了，当时只觉得神清气爽。

第二次入院

没法忘记的夜晚

就在醒来后不久，大概8点左右，我又开始感觉到小腹部一阵一阵的收缩。并不疼痛，但却有轻微的不适感。我乖乖的躺在床上，期待休息一下后能有所缓解。但结果并不十分理想，收缩感依然持续而频繁。我想起医生的嘱托，立刻查看是否出血，内裤很干净，没有血迹。但是我上厕所的时候注意到，尿液里混杂了轻微的血色。不仔细看很难确定，也很难确定这是新鲜血液还是淤血。于是我给医院打电话。医生叮嘱我如果宫缩到了一小时6次，或者疼痛感加强，立刻来医院。

躺在床上，宫缩似乎还在继续，我无法入睡。不仅如此，它虽然频率不变，但似乎越来越痛。同时我感到恶心，把晚饭吐了个干净。我再去洗手间，依然只看到很淡的血色，但我已经开始感到虚脱，浑身无力。我连回到卧室的力气都没有，只能打手机把钢钢叫醒，让他给我端杯糖水。同时打电话，医生听了我的描述，说：赶紧来医院。

10月19日凌晨，我们拎上还没拆封的行李，直奔医院。所幸午夜时分，路上车辆稀少。十分钟左右我们到达医院。钢钢本来想把车停在门诊，我告诉他我已经没有力气站立了。他调转车头把我送到急诊。有人推轮椅过来，我在路上把刚喝下的糖水吐了个干净，呕吐仍然在继续。事实上我吐的如此厉害，甚至无法告诉别人我的名字。

我被安置到病床上后，护士过来听取胎心，但她找不到胎心。值班医生随即过来寻找胎心，依然未果。最后radiologist推着超声波过来，她听了一会，告诉我们，胎盘早剥，孩子已经没有心跳了。当时我躺在病床上，看着超声波显示屏上，孩子安静的躺着，只是心脏已经没有跳动了。那是我最后一次看到她。钢钢握着我的手掉眼泪。

医生说，因为胎盘早剥引发的大出血，我情况危急，必须立刻拿出孩子，否则我也有危险。我随即被推入1号产房。由于当时并不清楚我内出血的情况，立刻进行抽血检测。之后护士问我，1到10，我疼痛指数是多少 ？我呲牙裂嘴的说：“3。”护士又问，那你能够容忍的疼痛度是多少？我说：“2.”护士很囧，给我上了止痛药。

迷迷糊糊间听说检测结果出来，非常糟糕。（后来我看了医疗记录，又听了OB介绍当晚的情况才知道，确实挺糟糕的。Hemoglobin level 到了7.5，DIC是5.）因此他们不能给我上Epidure，只能打止痛药。同时一个输血专家过来开始给我输血。我只觉得身上插了好多管子，偶尔听见他们议论的声音。麻药缓解了我的疼痛，血液的流入也让我身上不再冷的发抖。一切似乎变的舒服起来。护士问钢钢我们女儿的名字，我听见他说“Janet”。

但很快，我开始觉得呼吸困难。迷糊间氧气面罩盖上了我的脸，但我仍然觉得呼吸急促而困难。我不停的说“I can’t breathe, can you slow down the blood transfusion?”但输血并没有减缓。无法呼吸带来的恐惧是巨大的，我紧紧攥着钢钢的手，说“我爱你”。之后发生的事情我都不知道了。

手术后

再次醒来的时候，我感觉到左手被紧紧的攥着。当时第一个念头是“我手术做完了没？”后来我才知道，我当时躺在ICU的病房里，尚未恢复自主呼吸的能力，肺里和胃里都插着管子。钢钢握着我的手在床边，告诉我发生过的事情。那会意识不是很清醒，大多数我已经不记得了。迷糊中应该到了下午，Sana和Alex来看我，我也没有办法跟他们交流。就在这时一位牧师过来，为我们的女儿送行。我竭力想听清楚他说什么，但是朦胧中始终分辨不清。晚些时候我似乎又清醒了些，因为不能说话，就靠在本子上手写跟钢钢断断续续的交流。我的字迹七扭八歪，十分难以辨认，就这样陆陆续续的补充着我缺失的记忆。钢钢也告诉我，妈妈已经知悉，正在赶往这边的路上。

后来在陆续的交谈和阅读当时的医疗记录后才知道，当晚因为输血过快我肺里积水甚多，以至于要往肺里插管子的时候都不停的有液体外冒，无法找到肺的位置。差点休克。由于失血过多，而宫口只开三指，医生对于是要让我顺产还是C-section有过分歧。后来Dr. Lee Hambrick把Kurt Wharton医生从家里叫过来，告诉他有个非常complicated病人，需要他过来。Wharton医生花了20分钟，把孩子从我身体里接生出来，子宫未受到创伤，身体亦未有伤口。接下来的一个半小时，医生都在给我止血。我一共失了两升血，输了2 units的血，包括7袋红细胞（血浆）和3袋血小板（据钢钢不甚准确的回忆）；手术后还输了一些。

从手术室出来后，虽然我自己没有意识，但钢钢说我能听懂他的话，能够用点头和摇头来跟他交流。他在床边握着我的手时，医生说“这是你先生”，我的眼泪就从紧闭的眼睛里流了出来。

手术后的24小时，我是重点监护对象。2个护士轮班给我测量和监控各项身体指标，给我翻身、换床垫、检查出血状况、更换注射药物等等，据钢钢说场面十分壮观——头天的吊瓶占满两个架子，有三层之多，吊管密密麻麻如森林一般。

插管子的一天

10月20日星期日，这一天的记忆我还是大多保留下来的。早上有两位医生来看我，其中一位应该是Kidney specialist。我听见他说，我之前有Acute Kidney Failure,现在情况在好转，但没有完全恢复。然后我的主治医生，一位Lung Specialist，过来介绍了我的情况，表示要预防肺炎。接着又有两个医生过来看我，其中一位是被从家里叫过来的医生Kurt Wharton，我还记得他说当时开车好快啊，很担心警察把他拦下来开罚单。我口不能言，在本子上写了”Thank you”。忘记了什么时候，又有两个医生过来，告诉我为了保险起见，决定把我肺里和胃里的管子再留一天。由于我一直躺在床上，没戴眼镜，这几个医生是谁，长啥样，一个都没记住。

后来为了让妈妈不要担心，钢钢让我努力睁开眼睛拍了张照片发过去。妈妈后来说，她看到我“half dead”的样子差点昏过去。不过在她冲到美国使馆，给那边的工作人员出示了这张证明“我女儿快要死了”的照片之后，也很快拿到了签证。钢钢还让我写了“我很好，妈妈不要担心”的字，拍了照片给妈妈发过去。当天妈妈和Joop拿到签证，买好机票，第二天到三藩。

后来晚些时候还来了一位社工，对我们安慰之余，也提到了Janet的后事，带来了一堆paperwork要签字，说三个星期后我们会收到Janet的骨灰。

这一天过的并不十分痛苦，因为药物的缘故，我依旧时睡时醒。因为插管的缘故。偶尔会有急促的咳嗽和呕吐感。这个时候钢钢总会在旁边说“深呼吸”，是我当时的灵丹妙药。

我醒来后，当晚钢钢也终于能够放心的睡上一觉。

管子拔掉了

10月21日星期一，一大早的好消息就是我可以拔掉肺里和胃里的管子了。拔之前护士问钢钢，由于场面比较彪悍，他是否要回避。钢钢坚强的表示不用。我只觉得俩护士在我面前跟拔河一样把两根管子拔了出来，不痛，但是肺里突然觉得少了什么东西。我张嘴却说不出话了。护士安慰说，过俩小时你就能发声了。之后医生给了个呼吸训练器。我当时卯足了劲肺活量也只能到500，时有咳嗽，会把肺里的痰和血咳出来。想想子宫里的事情，居然把我的肺伤及至此，真是躺枪。

这天BART罢工，钢钢去机场接妈妈和Joop。我们都十分庆幸在他俩到来之前把管子拔掉，否则场面必然十分悲惨。虽然我鼻子下还围着辅助呼吸的管子，但整个人看过去没有那么惨兮兮了。护士过来告知我血检的结果“比昨天好”。一会两位工作人员抬着机器过来给我照X光。

胃里的管子拔出来以后，我终于可以开始吃饭了，但面临的另一个挑战就是泡沫状口水开始不停的分泌，比怀孕的时候有过之而无不及，抹的我只冒火。医生不能确定口水是源于胃酸/迷走神经，还是肺炎。我可怜兮兮的用掉了不知道多少卫生纸，也不知道让护士拿了多少次“clean towel”。

上午钢钢接到了妈妈和Joop。他们到ICU的时候，我已经可以吃东西和说话了。看到我的样子，妈妈也放心很多。然后他们注意到我的眼白里有大片血块，大概是当时DIC太高的后遗症吧。下午他们回家安顿，我在病房里，两条胳膊上四个IV。我虽然还很虚弱，无法坐起或翻身，但已经可以用手机知会我的manager我不能上班了。晚上钢钢回来陪我的时候，经我口述，他帮我处理了我不省人事期间收到的邮件和短信。

与此同时我开始分泌乳汁。虽然Janet未能活着来到人间，但是我的身体已经接收到“孩子出生”的信号，开始自动履行妈妈的义务。OB叮嘱我胸涨的时候也不要去挤，不然乳汁会越来越多。所以虽然时不时涨的难受，也只能自己忍耐。根据OB的偏方，钢钢从家里带了卷心菜，痛的时候敷两片叶子，很是能缓解一下。

终于离开ICU

10月22日 星期二，还是在ICU的一天。这个医院的伙食我已经吃的想吐了。一大早我还睡的迷迷糊糊的时候，一个人影在面前晃。我极力想支起身来，就听见他声音洪亮的说：“我是Dr.Wong，你可能不记得我，不过没关系，你以后也不会看到我了，因为你的肾脏已经完全恢复了。”我还没来得及摸到眼镜，他就高兴的走了。至今都不知道这位Kidney Specialist长什么样。

此时我仍然插着导尿管，有气无力的躺在床上，一边吐着口水一边咳着带血的痰。由于我器官里依然积水甚多，我的主治医生让我继续注射排水的药。下午我出现原因不明的头晕。医生的猜测之一是排水过多，导致我轻微脱水。但我倾向于认为是饭菜太难吃，我饿过头的有点低血糖。

我每日一次血检仍然在继续，结果算不上正常，但是每天都“improving”。肺活量也有点改善，偶尔能达到750. 护士告诉我，我已经是ICU病房里“最健康的人”。

身体慢慢恢复，也就是人有点“缓过劲”的时候，往往是精神上开始脆弱的时候。当天晚上，我和钢钢说了很长时间的话，想到Janet，也痛痛快快的哭了一场。之后的几天里，我们时不时的还会哭一哭。但每哭一次，心里积累的压力总会小一些。我们决定给Janet做个网页，纪念她在人间短暂的六个月。https://sites.google.com/site/janethewei/ 这个网页后来通过Facebook分享给了朋友们。

10月23日星期三，这一天的进展是，我可以拔掉导尿管和左臂上的两个IV。护士叫我深呼吸，然后趁着呼气的时候拔掉导尿管。我尽力坐起来，为接下来站立和行走做准备。我问护士，ICU的卫生间在哪。护士说，ICU没有卫生间，因为这里的人都用不到…

当时医生已经决定把我转到普通病房。围在我身边的护士和来探望的医生也少了很多。我的右臂仍然插着两个IV，没有力气玩游戏，电视里的节目也不好看（他们还在放95年的friends）。其实有点小无聊。下午我见识了医院的无效率——他们花了至少3个小时才办妥我转病房的交接工作。我的OB很想把我转到宽敞舒适的AP病房，但我的主治医生坚持把我转到普通病房。OB的解释是普通病房是“their fields”，所以她也没办法。于是当晚我入住了同在六层的普通病房。面积只有AP的一半，也没有AP的设施齐全，不过还算清净。窗户对面就是我之前待过的ICU。远远望去，十分感慨。

刚进普通病房没多久，我的几位同事来看望我。顺便八卦了一下最近的工作。Alex还从附近中餐馆带了晚饭过来。可惜我还是不能吃，只好继续啃医院里难吃（但安全）的病号饭。之后我也开始处理一些诸如申请休假的表格和手续。

康复

10月24日星期四，第三个IV从我手臂上拔出来，只剩下右臂上方最后一个。我还在接受抽血检测，注射抗生素和镁（因我血液中镁含量偏低）。医生将注射型抑制胃酸的药换成了口服的药，效果也较之前更为明显。胀痛的乳房渐渐变的柔软，乳汁也不像之前那么多。我可以扶着吊瓶架自己缓慢的挪去洗手间，能够自己洗手/洗脸，也在镜子里看到自己血红的眼睛和乱成一团的头发。

住院的时候，之前在AP的护士Tina经常来看我。她当时也在我的手术现场，所以也会零星跟我说一些当时的状况，聊一些妈妈在这边可以去的地方，还说起我昏睡的时候钢钢做的事情。

当天下午钢钢去学校，妈妈和Joop过来陪我。妈妈带着她熬的八宝粥和几个菜，忧心忡忡的看着我。下午东扯西扯的聊了很多。心情也渐渐好起来。

与此同时，大概是由于长期IV和测血压，我左臂十分酸痛。一测血压就要要血管爆裂的感觉。不得不放弃机器测血压，改成人工测量。当天晚上，我所有IV都已输完，位于右上臂的最后一个IV也可以拔掉。起初我以为它只是一个插入静脉的针头。拔的时候才知道，这是一个长达40厘米、直通心脏的管子。场面非常血腥。拔的护士告诉我，她先生曾经在住院期间，因为这个IV感染而险情迭出。之后她就立志成为一个护士。相较之下我还很幸运，没有出现感染的症状。管子拔出来以后，我盯着那个血洞看了半天。

时间很快过去，10月25日星期五，一早我的OB来告诉我，她和我的主治医生商量后，我可以出院了。很快我的主治医生也过来，最后一次听了一下我的心肺，说非常好。Wharton医生听说我出院也过来祝贺我。我当时没能认出他，只好说“thank you”。这一次paperwork办的很快，11点半，我获准出院。

至此，我已经在医院里待了10天。

Numbers Can Lie

I was trained as an economist, and now I work on big data analysis. By looking at the numbers, I analyze the trends and probabilities, and make predictions. You can imagine how frustrated I am when I have to deal with a situation that can not be explained by numbers. The causation, or the correlation that I have strong belief in simply does not work in my case,  or in other words, I'm an outlier.

I went to see my OB again yesterday, which was my first visit to her after the surgery. We reviewed what happened and tried to figure out the reason, but we were not able to. I seem to be a healthy mom as I don't drink, smoke, or use drugs, and my family never suffer from genetic disease. I strictly followed the FDA's suggestions on healthy diet during pregnancy, and took prenatal vitamins every day. My pregnancy was under strict and regular monitoring as well: I had my blood pressure measured and my urine tested every month, and had my ultrasound tests and blood tests in each trimester. All the results were perfect. Even when I bled and had contractions, physicians still decided to discharge me from hospital when my situation was stable given my previous wonderful records. However the worst situation still happened, which is "very rare" according to my OB. For her, I'm probably an outlier whose numbers fail to predict the risks in the last few months of pregnancy, however for me, it was the most painful experience in my life, which could have cost my life.

There are so many things that we do not understand that usually we can only talk about "probabilities" when we are making predictions. Given the available information, we calculate a probability for a certain outcome. However no matter how confident we are, it's always difficult to be 100% sure in the outcome. We do not usually get worried when the probability is high, like somewhere between 90% to 99%. But what if you unfortunately are the 10 - 1%? You do not make any difference to data analysts: numbers do not change, and their analysis will largely stay the same. But your life can be very different. Individuals are always powerless in statistics.

I thought of many possibilities in that night. What if I decided to go to the hospital earlier? What if my blood transfusion was given in a different way? What if physicians failed to insert the tube into my lungs to help me breathe? And what if OBs decided to do a C-section instead? I felt lucky that I survived from the emergency and have recovered quickly. And I know no matter how well I monitor my life, it's hard to be risk free. Numbers can lie, and we have to be strong.

Things that We Do Not Know

Over thousands of years, human beings have been learning more and more about this world, and have figured out many ways to avoid risks and make our lives easier. Even in ancient times, we used fire to scare away animals, built simple boats to cross rivers and lakes, and armed ourselves by sharpening stones and sticks. In nowadays, with advanced technology and instrument, people know the world better than ever. We use high-quality astronomical telescopes to study outer space, looking for the possible resources and neighbors in the quiet universe; we use high speed computers to calculate and create machines which are cheap and easy to use; and we also explore ourselves and develop a series of lab tests to monitor health status and control diseases. It's surprising how much people already know about this world, and how much we've changed our lives by using the knowledge we have. For people like me who are used to "modern lives", it's almost impossible to survive in the wild any more (actually a shut down of wifi can cause great panic among us).

But if you assume we know everything, that's also wrong. Knowing a lot doesn't rule out the possibility of ignoring the 1% which can make things very different. This is what I learned from my pregnancy which ended in the 6th month due to a placental abruption. I started to see my OB/GYN every month since the first trimester, taking prenatal vitamins regularly, doing all the lab tests to make sure we were expecting a healthy baby. All the results looked promising, and we thought we would have a healthy baby girl in January next year. Even in the week before placental abruption, when I was in the hospital because of a sudden bleeding and contraction, doctors ruled out "all the bad possibilities" after reading my blood tests and ultrasound tests. Unfortunately it still happened. Two days after I woke up from the emergency surgery, when I had my tubes in the lungs removed, I asked my doctor :"So what caused this?" She said, "I don't know, we probably will never know."

I guess sometimes we have to accept the limitation on our understanding of the world. Despite how much we've already known about the world, there are things that remain mysterious. Like my pregnancy, which was considered as normal and non-risky by modern medicine, turned out to be an outlier. As a mother who still want to have kids in the future, I do want to know the reason so that I may carefully avoid situations that could trigger it again. However, I got no answer. And the only thing I can do, quoted from the doctor, is to "more closely monitor your pregnancy, and order more lab tests". Seriously? I was having lab tests the day before abruption, and you were still not able to predict it.

After discharged from the hospital, I sometimes do feel frustrated for living in this day and age because of what happened, and I feel very powerless in addressing situations like this. But meanwhile, I also feel lucky for living in this era - if I'd lived decades ago, I could have lost my life. I still hope that in my lifetime the reason of my abruption can be found out. But I already accept the fact that there are simply things that we do not know. No matter how well you plan and monitor your life, there are uncertainties that can not be detected and thus can not be avoided. We are only human beings.

怀孕日记——第八周

怀孕果然是一个漫长而又让人无奈的过程。

在被“我到底怀孕了吗”之类的问题困扰了大半个月后，我终于迎来了可以用测孕棒的伟大时刻。尽管不同测孕棒都会标榜自己在不同时期的准确性，事实上由于着床时间（着床，多么专业的词啊）的偏差，我们很容易成为误差里的一份子。而我第一次测试的时候也未能幸免。于是各种类似于“是不是时间没算对”、“是不是子宫位置不好”、“是不是前段时间情绪波动太厉害了”之类的猜测纷纷出现。然而一周之后的检测证实我们还是如愿以偿。短暂的喜悦之后是痛苦的第一期。

处在第一期的准妈妈必须接受的一个现实是：你的身体已经不是由你说了算。虽然想到十个月后，可能整个人生都不是由你自己说了算，但当前的这个发现已经足以令人沮丧了。（尤其是想到你先生仅凭一颗精子就能把你折腾的死去活来，忿忿之情更是溢于胸间。）于是在五月中下旬的某天晚上，我回到家突然发现自己对排骨汤的味道无法容忍，昨天还很美味的红烧猪蹄简直不能直视。很快，我没法接受米饭，不能碰荤腥，不想沾油腻。每天主要靠稀饭素菜包子和酱瓜过活。上班的时候必须和铺天盖地的疲劳感做斗争，下班的时候则继续是反胃恶心感做斗争，然后一天就过去了...

你以为呕吐和疲劳就是孕期之集大成者，那就错了。在上周换了一种维生素之后，我才发现流口水居然都可以流的这么疯狂。胃里激烈的翻腾之后，嘴里开始吐泡泡——没错，像螃蟹那样吐泡泡。网上经常有人说“幸福的吐泡泡”，这么说的人一定是没有吐过泡泡啊！白天吐泡泡无非就是不能说话，蹲在垃圾桶旁边不停的吐啊吐。真正悲催的是晚上。泡泡在你还没有准备好之前就充斥了整个口腔，如果你想睡觉就只能放弃抵抗，张嘴让它们乖乖的流到枕头上。反正你怀孕，没人敢刺激你说你现在看起来像个弱智。

总之，这才只是开始。你永远不知道下一刻那个小东西又会想出什么新招来折腾你。活着，且能吃能喝就是一种幸福。不说了，说多了都是泪啊。

家庭私房钱账户管理细则

说明：

家庭的理想状态固然是夫妻的所有收入都上缴共同账户，一起挣一起花。而实际上由于双方各自效用曲线不同，很难做到每笔开支都得到双方的共同认可。比如，太太愿意花一千刀买个包，而先生未必认为这是合理的消费，从而拒绝承担自己的经济义务（即500刀）。当双方就一些开销不能达到共识的时候，会产生一些矛盾。而成立公开的私房钱账目则旨在解决这些问题。

实施细则：

（1）      每个月两人的共同收入中取出10%，平均分给双方作为私房钱（每人5%），由双方自行决定这钱的使用方式。每个月没有用完的私房钱可以累计到下月。私房钱的数目根据家庭收入的变化而变化。

（2）      私房钱账户是一个“虚拟账户”。亦即，夫妻双方不单独开设银行账户存入私房钱，而且将钱依旧放在共同账户，只是每个月采用另记账的方式，单独列出在共同账户下双方实际持有私房钱的数目。

（3）      出于两人共同利益进行的消费，如每周的grocery shopping, 买车买房养孩子的开销等，由共同账户支付。基于生活必需品和社交的消费，也从共同账户支付。得到对方认可的消费，也可以从共同账户消费。

（4）      而不能得到对方认可的、或者于对方无益的消费，则从私房钱账户里扣除。如上述花钱买包的费用。

（5）      私房钱的消费必须共同透明且基于良好意愿。

备注：根据法律效力不溯往的原则，以往的开销不予追溯。从下月起开始实施。

Think as the Older Generation

Last night Gang and I went to a friend's birthday party. He is an Asian American and has been living in the bay area for a long time - he was born here, went to schools here and built up his career after graduation in the same place. But he's planning to relocate to central US for family reasons. We talked for a while, and at the end of the party, we said to him: "come back." He laughed out loud: "My parents said that to me too!" His parents are about my parents' age, probably even older. For me, it's amusing that immigrants from East Asia always find similarities between me and the older generation. My roommate at Princeton, whose parents were also from Taiwan, used to say "my mum said that too" during our conversations.

I do think there are some differences between me and the older generation. Like most of my peers, I view myself as one of a new generation who enjoys the tech booming in the information era, getting news from internet rather than newspapers and learning more from Google than neighbors. I live in a more globalized world in which I can expose myself to different cultures, traditions and ideas. And all these benefits make it easier for me to gain more diversified knowledge than the older generation. Besides, the world is changing so fast that people today care about different things than decades ago. Therefore I have enough reasons to believe that I think differently from my parents. It is probably true - they worried less about climate change and gas price, and my husband spends most of his time on these topics. My parents also keep a higher saving rates than me - a habit developed in 1980s when the Chinese government encouraged people to save to support the "socialist construction".

But other than these, it's hard to identify any fundamental differences. When I say "fundamental", I'm referring to key issues such as values and beliefs, most of which have been kept well across generations for centuries. Although I'm younger than my friend's parents, we share similar ideas towards family because of our life experiences back in China and Taiwan in early years. That's why we both said "come back" because we both believe people should return to their hometowns one day no matter how far away they once traveled, just like falling leaves returning to roots in the end. So neither of us took his relocation as settlement, but more like a long journey in his life. He found the phrase amusing while we found it natural, and this is the discrepancy caused by culture rather than generation gaps.

I can hardly picture what my children will be like, and what they will be thinking in the future. But I'm certain that my life will largely determine how their childhood will be like and what values they will be developed before they leave for college. I will be delighted if one day after school, they say to me: "Mum, I found someone in my class who said exactly the same thing like you."