My Two High-risk Pregnancies

Before Gang and I planned to have a baby in 2013, I had never expected myself having anything to do with “high-risk” pregnancy. I was young and healthy, no genetic disease, and women in my family never had any problems with conceiving or delivering.  Even today my mom is still proud of her intense physical exercises when she was carrying me.

Things went smooth at the beginning too: I got pregnant and saw a little heart beating in the uterus during my first OB visit. We shared the news with our family and friends immediately, hearing their stories of how to raising kids and imagining how our baby would look like in the future. Every office visit went well; every test result came back fine. The only thing that bothered me was morning sickness, which also started to disappear after the first trimester.

Then something weird happened in my 25^th week. It was an afternoon in October; I was working in my office as usual, packing my things up and getting ready to run for the BART. Then I found I was bleeding. I didn’t know why it was happening or how serious it could be, so I called an ambulance immediately, which took me to the nearest hospital. I was told that I might have a preterm labor due to frequent contractions and therefore transferred to Alta Bates Hospital in Berkeley which can handle situations like this.

I received magnesium for two days, a medication to slow down contractions for women with preterm risks. Then I was told that they couldn’t find out why I was bleeding and they couldn’t identify the bleeding spot. But I was told that they ruled out the bleeding caused by placenta detachment, which was their biggest concern. I was discharged three days later and told to rest as much as possible.

I followed the doctors’ instructions and went home. I still couldn’t believe that I was suddenly considered as a high-risk pregnant woman, but I was confident that I should be fine. However later that night, I started to feel more frequent and stronger contractions. I started to realize that something may be wrong, but in spite of all the discomfort I didn’t see any bleeding or spotting, which made me hesitate to go back to the hospital. Finally I couldn’t stand the pain and we ran back to ER, where they found out my placenta was completely detached from uterus and my baby already died. And because the placenta blocked cervix, all the blood stayed in my uterus and I failed to observe them.

That was the most dangerous moment in my life. I didn’t even have time to cry for my baby girl: I fell into coma soon and woke up two days later after an emergent surgery. I lost 2-liter blood and was very sick for a long time. Later I learned that my case was further complicated by pulmonary edema, which happened 1 in every 5,000 blood transfusion with a fatality rate of 9%. But luckily, my lungs finally recovered and surgeons were able to avoid a C-section and left no scar in my uterus. I was told that I could get pregnant again in three months.

Placental abruption happened to less than 1% pregnancy, and it was even rarer for healthy women (no high blood pressure, or diabetes, etc). And even it happened, it usually detached slowly from the uterus over a long period, giving mama and doctors enough time to respond. While in my case, it was completely detached and it happened very quickly – more quickly than any of us could respond. Doctors were not able to find out the reason, but they believed that pressure and tiredness can be a potential cause. When I think about the few days before the accident, I was working late to meet a deadline, and I did feel tired every morning when I got up to catch the 6:50am BART. Maybe my body was already sending me warnings, but I was too busy to notice them.

(And for those who are interested in testing your math, here is a good question. The probability of having placental abruption during a pregnancy is 1%, and 5% of these placental abruptions are considered as severe. Let’s say 89% of women with abruption receive blood transfusion, and 0.02% of blood transfusion causes pulmonary edema. What’s the probability of having a severe placental abruption and pulmonary edema at the same time? And if the probability of having placental abruption is randomly distributed among pregnant women, think about the total number of your female friends, what’s the probability of you knowing anyone with this experience?)

Therefore I became more careful when I was pregnant again in October 2014, one year after my first miscarriage. The previous experience changed my opinion on pregnancy: it’s no longer a natural, easy process, but something that needs intense care and extra attention.  This pregnancy had a less optimistic start. During my first visit, I was told nothing was observed and we should come back one week later to try our luck. A week later, we finally saw a little heart, tiny but beating strongly in the uterus. What a relief! MY OB also explained to me that because of my history, I may want to be extra careful with this one, and follow up with her more closely. After the first few prenatal visits, I talked to my manager that I wanted to change my job to a part-time one. Luckily he was very understanding and was flexible with my schedule. But then things got worse, I had to work from home to spend more time resting in bed. And a month later, even wfh became impossible, and I was completely off work until delivery.

Bed-rest is not as comfy as it sounds. Spending the entire day, entire week or even the entire month on bed is horrible. But things started to get better in May and I started to walk around a little bit. I even tried to wfh again in early June, which seemed to be a bad idea – a week after I started working, I was sent to emergency room again due to frequent contractions and high risk of pre-term labor. Doctors were not able to find out the reason for my frequent contractions, and they were concerned about my blood work result: one result showed that I might be experiencing some internal bleeding, and they were worried that my placenta might be detaching again. Therefore they decided to keep me in the hospital for observation. Luckily my placenta stayed well for another month until Alby was induced. Alby was born a little premature, but we are very grateful that he arrived safely and healthy.

I do not write this article to scare anyone about pregnancy. I only want to say, pay attention to your body and do not over trust yourself. Sometimes we are more vulnerable than we thought we are. And always get enough rest when you are pregnant.  Also I wish there are more supports for pregnant women in the US: I was lucky that I have a supportive OB who wrote notes to put me off work for half a year, and a considerate manager who approved my disability leave, and also the fact that I live in California allowed me to collect some disability benefits to pay my rent; but I know a friend who also experienced a high risk pregnancy but wasn’t able to get any rest at home because she was in a state without any disability leave. I can’t even imagine what would happen if I continued working during this pregnancy, and I’m glad that both my OB and I were more alert this time and were able to address any changes timely.

我在美国

前言——北京再见

2008年11月，北京奥运会的余温尚未散去，街头偶尔还能看到蓝天，暂时被压抑的房价还在酝酿着卷土重来。我裹着一件厚棉袄，拖着满满两大箱东西，登上飞往三藩的飞机。箱子里，有我出去旅游搜集的碗碟瓷器，有我精挑细选留下的几件最喜欢的衣裙，和十来本备考GRE的书籍。飞机在云层上的十几个小时里，我的脑袋里一片混沌，过去七年的时间如同一场梦境。

在北京，我度过从16岁到23岁年轻美好的时光。第一次远远的离开家，到陌生的城市求学；在学校里结识了来自天南地北的朋友和老师；或清醒或迷惘的选择了自己的职业道路。而我决定离开北京的前夕，也恰恰是我生活刚刚起步的时候：那时我刚通过了公务员一年的试用期，把户口落到了北京，开始打算买房子，我看到我的未来似乎和这个我打心眼里喜欢的城市密不可分。然而对我来说，又有不得不离开的理由。

当时我新婚的先生何钢，刚刚从哥伦比亚大学（Columbia University）毕业，由纽约搬到硅谷，在斯坦福大学（Stanford University）开始从事一份研究员的工作。我们在饱受纽约——北京两地生活的折磨之后，决定折衷在美国西岸团聚。相比于公务员一眼就可以望到头的生活，我甚至不知道这趟航班结束之后，从我下飞机的那一刹那，迎接我的会是什么。不确定性总会让人不安，我的这段旅程似乎也有了点义无反顾的味道。

湾区（Bay Area）

           下了飞机，迎接我的是惊艳。

           这是我人生中第一次被天气惊艳到。三藩国际机场（SFO）外晴空万里，天是好久不见的湛蓝色，暖风熏人，阳光灿烂。当时正值11月，温度却依然保持在20来度。往来的行人穿着短袖T恤、牛仔裤和凉拖。在人群中，穿着当季厚棉袄的我反倒显得有些奇怪。

                写到这里必须先介绍一下“湾区”（bay area）这个概念。沿着三藩市恰好有一个海湾，海湾沿岸是一溜小城（见下图）。城市虽小，却集合了一群赫赫有名的大公司，包括Cupertino的Apple、Mountain View的Google、Menlo Park的Facebook、Palo Alto的Tesla等等；同时还有隔湾相望的两所“世仇”高校——斯坦福大学和加州大学伯克利分校。这些小城市彼此间不过是10-20分钟的车程，却连成了一片规模相当的技术集群。因为它们依湾而建，这一带也常被称为湾区。湾区临海傍山，四季如春，常年艳阳高照，只有在每年年末或是年初的时候会集中下一个月左右的雨，就好像老天要把一年的眼泪都在这一个月里哭干。我去过十几个国家，到过上百个城市，其中不乏依山傍水的风景名胜，但没有一个地方能有湾区这样宜人的气候。而事实上，对于湾区天气的赞美，永远是社交时打开话题的不二选择：几乎所有人都会感慨一下“天气居然能这么好”。

我就这样刚从北京这样几千万人的大城市里到了这一片充满田园气息的小城市群，我恍然置身于另一个世界。周围不见高楼大厦，房屋普遍低矮的多；最常见的是一、两层高的小洋房，前后院花团锦簇，很是别致。路上也难得看到熙熙攘攘的人群，行人屈指可数，大多牵着小狗，三三两两并肩而行，很有点悠然自得的味道。我们俩拖着行李箱上了当地的城铁（Caltrain）回到我们在Palo Alto的住所。已经习惯了人挤人的北京地铁的我，面对只有两、三个乘客的车厢目瞪口呆，有一种“这都可以啊”的感慨。后来我才意识到，在美国搭乘公交是多么罕见的一件事。这里的公共交通落后到令人发指，车辆班次少、路线少，票价却不便宜；相比之下廉价的汽车和汽油让普通民众不得不选择开车出行。就连钢钢这样坚定的环保主义者也在我到的第二天买了辆二手车。

车坚强

                这部蓝绿色的Nissan Altima是我们在美国的第一辆车，3000美元从斯坦福同事那买的。这是一辆1996年的老车，到我们手上的时候已经跑了12万mile，直到2012年卖掉它换新车的时候，又增加了4万mile, 却一直保持着零故障的纪录，故而被我们称呼为“车坚强”。

                来美国之前，我没有在国内上过驾校，连方向盘都没有摸过。所以在美国生存第一课就是学开车。和在国内考驾照一样，这边考驾照也分笔试和路考；但和国内不一样的是，这边不需要考生们去驾校上课，只要你能通过考试就行。笔考还算比较简单，你可以选择用英文、西班牙语或中文作答，问的都是基本问题。（当然即便如此，我第一次还是没有考过，被朋友们嘲笑好久。）真正麻烦的是路考。而路考的规则也因各州而有不同。比如在麻省，你必须会平趴（parallel parking），而在加州你只要会靠边停车（pull over）即可。对于菜鸟司机来说，还一个喜大普奔的地方是加州路考不用上高速，相传是因为以前有位考官在指导考生上高速后不幸因公殉职。本着以人为本的原则，DMV决定保护考官不参与让新司机上高速这样的危险行为。

           本着省钱的原则，钢钢担任了我的教练。在我学车之前，也收到若干警告，比如“千万不要让老公教开车，绝对是夫妻关系的第一杀手。”如果要我总结一下的话，宽容的老公真的很重要。我学车的地方是在Palo Alto和Mountain View交界处的一个大Plaza，那边停车场很大，赶上08年经济不好车还特少。我就在那边停车场上一遍一遍的兜圈子，试验刹车和油门。等钢钢确认我能准确分辨左右和刹车油门之后，才放我到小区里溜达，他坐在副驾上神气的“左拐”、“右拐”的下指令。然后就在我学车不到一星期的时候，他神奇的把我指上高速。我还记得自己当时面对前后车辆的灯光，心惊肉跳，钢钢自己也紧张的把手一直放在手刹上。1 mile之后我从出口夺路而逃，体会了一把速度和激情。

                不过上高速似乎还有些壮胆的作用，我学车的经历在此之后似乎也变的顺畅起来。即便如此，我头两次路考依然因为一些脑子短路的行为挂掉了。按照这边的规矩，考驾照要交26美元，这包括三次笔试和三次路考的机会。如果三次之后还没过，就得重新交钱考试。       好在第三次考官高抬贵手，让我成为了拥有驾照的亚洲女人！对于在美国居住的外国人而言，驾照的意义不仅在于你可以开车，还意味着你去任何地方都不需要再携带护照了，驾照等同于你在美国的身份证。

在拿到驾照之余，我也会感慨和国内动辄上千的驾校费用相比，在美国考驾照似乎是个极为平凡的事情。一方面大概是因为在这里，汽车是生活必需品，而非奢侈品，天价的驾照不太符合民众对于驾驶的一贯印象；另一方面DMV也没有胆子把驾照作为生财之道，敢把它高价外包给驾校。不过今年我回国感受了一下中国司机的驾驶风格之后，倒是稍微有点明白了国内强制要求驾校学习的意义。虽然中国交通规则似乎很严格，但是路上换道不打灯、在路肩上开车、强行并道、不尊重行人、无视交通灯的车辆随处可见。我想，也许要在这种野蛮的环境里开车，还真的需要受过专门训练才行。

                而车坚强则默默的见证了我从刹车和油门都会踩错、到可以和钢钢在长途旅行中换手开车的过程。也因为两个人可以轮流开车，我们得以实施一些长途的旅游计划，比如从湾区向东开14个小时到黄石公园；向北开两天到西雅图（Seattle）；向南一直到边境的圣地亚哥（San Diego）以及更远的拉斯维加斯（Las Vegas），凤凰城 (Phoenix)和图桑（Tucson）。美国的高速公路四通八达，平整宽阔，一路上人烟罕至，却往往能看到别有风情的地形地貌和景观。

（to be continued)

关于英美

如果不是有个诱惑的工作机会摆在面前，我们大概一辈子都不会考虑搬家到英国去。也正因为如此，所以当我们需要决定是否搬家的时候，有过很多反复和踌躇。

我从没在英国生活过。但是11年曾经在瑞士住了三个月。正经事没做多少，把周边的国家玩了个遍。最深刻的感觉是“欧美”是完完全全两个世界，对欧洲大陆的印象基本上差到“宁可回国也不要呆在这里”。后来反思发现这种偏见主要是因为我个人艺术修养太差，觉得去卢浮宫排队看画还不如直接上Google Arts Project，可以反复看，仔细看，慢慢的看； 在加上对户外抽烟、喝酒等欧洲人以为的浪漫情调，以及大小城市满地垃圾和烟头的不可容忍，我觉得这辈子跟欧洲实在没有什么缘分。

在瑞士毕竟是旅居，而这次考虑定居的问题，顾虑也就不一样了。我先说英国的好处，再说美国。更确切一点说，我比较的是伦敦和湾区。

作为饱受美国扯淡的医疗体系之苦的人，英国的NHS简直就是发达国家的范本。虽然它医疗技术落后，看病周期长，但仅靠免费二字，就可以秒杀美国医疗。对于职业女性而言，长达九个月的产假足以令零产假（按联邦法）的美国孕妇羡慕嫉妒恨到死。

还有不少人谈到的英国职场的吸引力在于其工作压力小，节奏慢，更不用说英国的faculty进门就是tenure了，各种没有压力啊。在伦敦工作的话，虽然要挤地铁上班，但想想也是节能环保啊。

英国人普遍各种绅士，各种nice，实在客气的让你无地自容，叹为观止。

英国的绿卡好拿，公民好拿。基本上你有工作了，就板上钉钉。

当然还有个好处就是，根据国家间政治，中美之间或有一战；中英之间。。。想都不要想。

发现关于英国的好处已经扳着手指数完了。

美国地域辽阔，各个地方相差很大，我只说我熟悉的湾区。

天气。湾区各种阳光明媚啊，常年温度不超过25度，不低过10度。不需要雨靴、不需要雨伞，一件T-shirt，一条牛仔裤穿一年。

Casual life style. 我们公司唯一的dress code是，不要光脚，其它的你爱穿什么穿什么。话说我们是给government工作这样真的不要紧吗。

便宜的生活成本。车各种便宜，即使是湾区油价也不过是英国的一半。如果是生活重度依赖汽车的人，搬到伦敦会很辛苦吧。更不要说Costco这种为广大人民喜闻乐见的物美价廉的杂货铺。

工资还是比较高的。同行业，类似经验的职位，湾区的工资大概是英国的1.5 – 2倍（把英镑折合成美元后）。

宽敞的住房条件。我万万没想到自己会打出这几个字。湾区几个million的小黑屋非常有名，常常遭受德州人民的嘲笑。但是只有看过了伦敦及其近郊房屋条件和售价之后，才知道湾区的房子多新、多大、多舒适。

华人力量大。人多决定生活质量。湾区华人数量众多，于是各种中餐馆、中国店、中国习俗得以尊重。

所以，要实现朴素的中产阶级的生活理想，美国是不二之选。这个世界上，只有美国梦，没有法国梦英国梦，还是有一点点道理的。

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.