A Memory of Arlington Hospital

谭君久 Tan Junjiu, 1990-1991 Fulbright VRS

1991年，我在美国耶鲁大学做富布赖特访问学者。那年7月， 我参加了美中关系全国委员会组织的在美访问学者和留学生的旅行团。先是去了威廉斯堡，第二站便是华盛顿。旅行团安排我们住进美国普通家庭，一出火车站，便 有各自的房东来接。我和来自上海社科院的陈燮君一组，来接我们的杰克是个很典型的美国人，四十来岁，中等个儿，蓄一绺棕色的小胡子。他懂一点儿中文，他学 中文的目的，我已不大记得了，他好像正在读博士学位，也在找工作，一路上交谈，我们很快就熟悉了。到了他家，见了他的太太苏珊，个儿似乎比杰克高一点儿， 圆脸，不胖不瘦，留一头齐耳的短发。他们没有孩子，典型的二人世界。稍事休息后，杰克带我们出去走了走，这里是弗卲尼亚州的阿林顿县。我们第二天要乘地铁 与旅行团其他成员会合，进行华盛顿的参观考察，杰克领着我们找到附近的地铁站，就在他家的那条马路上，只有几分钟的步行距离。回家后，到了晚饭的时间，没 有什么特别准备的食物，普普通通的美国家庭便餐。饭后，就在屋后院子里摆了张小桌，我们喝着咖啡聊天，但也只是说了些我们这几天的见闻，杰克不像一般美国 人那么外向、健谈，苏珊的言语也不多。因一路有点累，杰克让我们早点休息，就忙着为我们准备床铺，原来就是在客厅里的两只宽沙发，把坐垫拉起拖开，就成了 两张很舒适的、席梦思式的单人床。道过晚安，我们就各自歇息了。

陈 先生和我简单地聊过几句后很快就入睡了，他睡得很安静，没有一点儿鼾声，可我很长时间都没睡着，直觉得胸口发热，我知道是胃病犯了。好不容易睡了一会儿又 醒了，心窝的灼热感愈来愈强烈，难受极了。接下来就想呕吐，但我不好惊动别人，努力地忍着。最后终于忍不住了，爬起来冲到卫生间，对着面盆大口呕吐起来， 吐了大半面盆，全是咖啡色的液体。我知道这是胃出血，出国前几年曾经有过两次胃出血的经验，但都是便血，泥巴状的、沥青似的大便，吐血这还是第一次。我用 手将液体中的稠汁捞一下，在盆壁上一抹，竟变成了血红色。吐过后又感到腹部胀痛，开始拉肚子，拉了很多，也是咖啡色的液体。吐完了，拉完了，稍微轻松了 些。我明白，这一次严重得多，出血量远远超过了前两次，心里有些紧张，但还是不好惊动旁边的陈先生。看了看表，还不到四点，我只好静静地躺在床上等着天 亮。大概六点刚过吧，陈醒了。我仍然静静地躺着，默默地看着他处理起床后的常规事务。他从卫生间出来了，我坐了起来，轻轻地对他说，“老陈，我出问题了”，简单地描述了一下情况，告诉他可能是胃出血。然后，我们继续等着。杰克起床了，和我们打招呼，说早安。陈先生便告诉杰克说我可能生病了，我又一次描述了病情，陈先生问杰克能不能送我去医院。杰克一听，以很快的速度和陈先生简单吃了点东西，立马去准备车。

就 在杰克发动车的功夫，陈先生给旅行团的领队蔡先生打了电话。蔡先生其实是个美国白人，一直为美中关系全国委员会服务，到过台湾和大陆，中文很好，记得他的 中文名字叫蔡瑞德，我们都喊他老蔡。虽然多次担任此类旅行团的领队，但碰到这种情况大概还是第一次，在电话里我听得出来老蔡一时也不知如何是好，只是不断 地问“你要我怎么办？你要我怎么办？”不过，老蔡倒是很快镇静下来，要我先去医院。

路上还静静的，人们还没有出行。我知道肯定得住院，但不知道要花多少钱，请杰克顺道找了一处取款机，取了200美 元以备必需。杰克送我来到不远的阿林顿医院，敲开了接待室的窗口。我扼要地说了说情况，接待员问了我的社会保障号，上网查了一下我的背景，便开始为我登 记，随后就把我收了。（后来我才知道，接待员通过我的社会保障号上网查询我的资料，其实是非常重要的工作程序，她了解了我的背景和买的医疗保险）。因陈燮 君要赶去参加旅行团当天的活动，杰克便送他走了。

我的情况，应属于急诊，进了医院，大概是临时看护室吧，在院医生为我做了简单的检查。一会儿，一个40多岁的医生来了（我已不记得他的姓名，姑且称他迈尔斯罢，迈尔斯似乎并不是阿林顿医院的医生，而是来自一家私人诊所），听了刚才那位医生的汇报和我的陈述，迈尔斯下结论说应该住院治疗。很快，一位护士来了，首先为我换了大条纹的病服。帮我整理衣服时，发现了口袋里的200美元钞票。她惊讶地说，这可是很大的一笔钱啊！（美国人一般是不会随身带这么多现钞的）。她拿来一个信封，把我的钱装了起来，记上我的姓名。

进了住院病房，我扫了一眼，这是个双人间，门旁有个卫生间，病床的对面墙上挂着一台20英寸的电视机，床头柜上各有一部简易的电话。病房里干净极了，真是窗明几净。第一印象真的很好，要知道，在90年代初期，国内的医院设施还相当简陋。接下来，安排做了X光透视，迈尔斯给我做了胃镜检查，同时安排为我抽血，说是要查我的血量。结果很快就出来了，迈尔斯决定为我输液。他询问我的病史，我记得在国内有过结论，叫做“浅表性、糜烂性球部溃疡”。可是这几个专业术语说不出来，着急中我想起了杰克，打电话问他有没有汉英词典，他说有，我便请他方便时给我送来。老蔡到底还是想得很周到，到中午时，打来电话，说是他已与国际学者交流委员会（CIES） 的恩斯特太太通了电话，通报了我生病住院的消息。恩斯特太太可能是担心我随身没有带医疗保险的资料，特地通过快递送来了相关资料（其实，这些资料后来都没 有用上，因为我的社会保障号就提供了所需要的全部信息）。下午杰克和他的妻子一起来了，带来一本十六开的商务印书馆出版的《现代汉英词典》，还带来了我的 旅行箱和衣物。迈尔斯再次与我交流，我说了上面的结论，他笑了笑，你现在说的很清楚了。哪天傍晚，同是来自武汉的旅行团成员黄先生和上海的另一位先生来看 我，还带来了他们的房东送的一束鲜花。我很感动，但当时口鼻都插着导管，不便说话，只是轻轻地表示了感谢。

接下来的几天里，治疗按部就班地进行，医疗手段的确很先进，也很周全，这些不用多说。让人感觉特别好、印象特别深的，是每天医生、护士定时查房，病服每天更换，医生询问病人的感觉很仔细、很耐心，护士们的态度很礼貌，每次来查房时第一句话就是“今天是我为您服务”，大概是她们的规范用语，语调很亲切，很温馨。再譬如说每天输液，不用每天扎一次针头，而是在手背上扎的针头带有一个软质塑料的接头，第二天再扎针时只需要扎入接头就可以了，

患 者用不着每天挨针扎的痛苦。当时我觉得很新奇，这东西其实并不复杂，可是不知为什么，至今在国内的医院也还不多见。当然，也有感觉不好的，最让我不可理解 的是查血量，国内胃出血病人查血量，主要是通过查大便来判断，医生也比较注重望闻问切。可美国的医院，动不动就是数据，查血量也是通过采取血样来检验，而 且每天抽取的血样要装满一个大号的量管。来美国之前了解过计量史学、计量经济学、量化研究方法之类，我这才真正地理解了什么叫“计量方法”，原来治病也是动不动就要计量。我对医生开玩笑说，你们每天给我输血，但是都抽掉了，而且抽的比输的多。

感 觉不大好的另一件事是饮食。住院的膳食供应是不错的，做得很精致，很卫生，护士准时送来菜单由病人点餐。开始我不敢多点，怕花钱，后来才知道餐食其实也是 免费提供的。可是，真要多点时，一看那菜单却犯难了。每天的菜单分流食、半流食和常规餐食三种，但具体品种基本没有变化，天天都是那几样东西。头两天只能 吃流食，有过胃出血经验的人都知道，按照国内医生的主张，这期间绝对不能吃和饮用刺激性的东西，包括茶。可流食菜单上，提供的竟是咖啡、冰淇淋之类，最要 命的是唯一能喝的牛奶也是冰的，这让我怎么喝啊！没办法，只好将就，点一杯牛奶，放一会儿，稍稍温了再喝。待到能吃半流食了，也没什么可吃的，有了果冻， 我问有没有粥或者面条，没有。后来我发现有一种东西可以凑合着吃，那就是土豆泥，味道还不错。直到最后两天，能吃帄常食物了，情况才稍有好转，有面包，米 饭，菜也很清淡，没有什么辛辣的东西。

同病房的是个老头儿，应该有70来 岁，他得的什么病我也不记得了，应该不算严重。每天一早，他的太太就来了，两位老人道过早安，行过吻礼，就一直陪伴着。再晚一点，老人的儿子和媳妇、女儿 和女婿就会来看望。儿子常常留下来陪着两位老人。交谈中我才知道，儿子这段时间失业了，暂时没工作。但看起来，他对失业并不怎么在乎，因为有失业保障，而 且，他相信过段时间找个新工作应该不太难。儿子一般会待上一两个小时，和两位老人聊着天，而老太太整天都陪着，直到傍晚才告别回家，很恩爱。

就这样，我在医院里整整住了一个礼拜，出院那天，医生给我开了一张处方，我刚收拾好行李，来了一位50来 岁的员工，穿一件红色的马夹，还推着一辆轮椅。行李箱有点儿沉，我把箱子塞到轮椅下面的支架上，准备和他一起走下楼。没想到他要我坐轮椅，我觉得这事有点 儿滑稽，我好好的，又不是不能走路，何况还有电梯。可他很认真地坚持，说这是规矩。我只好坐上轮椅让他推着进了电梯。来到楼下的接待室办手续，心一下子又 悬了起来，该怎么结账啊！那位女士找出了我的资料，拿出一个信封，我一看，不是别的，正是我的那200美元！签过字，接过信封，我依然站那儿等着，以为还会有什么手续要办。女士看看我，说：Finished。我问：Is Everything OK？她说，Sure。 我悬着的心终于放了下来，从进来到出去，竟然一个子儿没花！这才想起还有那张处方，便取出来问她在哪儿取药。她告诉我，要凭处方到市面上的药店去买药，并 且特别提醒我，处方只能在本州内有效，出了弗卲尼亚州就无效了。这时，杰克如约开车来了，我请他先送我到一家药店，买了两种药，我看了看说明书，一种应该 是继续养护出血的伤口的，另一种成分中含铁质较多，大概是辅助养血的，共花了110多美元。然后，杰克送我去华盛顿火车站，乘车去纽约回归我们的旅行团，继续参观考察的行程。

结束了旅行团活动，回到所在的纽黑文。但是，心里依然悬着，这住院、治病的费用最后究竟怎么了结啊？半个多月后，我收到来自阿林顿医院的一大叠账单，和国内医院不同的是，住院的账单是分开的，住院、看护、用药、X光透视检查，还有迈尔斯诊所医生的访诊，等等，算了一下，总共是8千多美元。天哪，按当时我在国内的收入，这可是我将近40年 的工资啊！再仔细看看，里面还有保险公司提供的委托书，给我提供了两种选择，一是我先付款，然后向保险公司报销，二是我在每份账单上签署一项委托授权，由 保险公司直接向阿林顿医院和迈尔斯诊所支付。我毫不犹豫选择了第二种。同时，我把出院后买药的支出做成一份报告，附上单据，一起寄给了保险公司。这笔支出 究竟是否可以报销，其实我并不清楚。过了两个多月，没有任何消息，我想，大概不能报销吧，也懒得打电话询问。不久，我就回国了。

回国后，身体慢慢恢复，按理说，这次在阿林顿医院住院的经历到此也就结束了，住院账单的事我也早就抛之脑后。可是，过了一年多，到了1993年的5月吧，我突然收到那家保险公司寄来的一个大信封，打开一看，里面有张80多美元的支票，另附有一份那次住院8千 多美元的总账单和一封信。信中说，他们已经为我完成了全部支付，并把给我报销的购药费寄给了我在美国时的地址，但是被退回了，于是又寄到了我当时从事研究 的耶鲁大学政治学系，还是退回了。几经周折，他们才得到了我在中国的地址。我算了一下，报销的应该是养护出血伤口的药费，而辅助养血的药费大概没有报。

至 此，在美国生病、住院、享受医疗保险的经历才算最终结束。想起我出院回到纽黑文时，见到我的朋友斯蒂文和安迪夫妇，聊起我住院的经过，我说这场大病虽说是 件不幸的事，但也因祸得福，我因此获得了在美国住医院的经验，亲身体验了美国的医疗保障体系。现在来美国访问的学者不少，可有机会亲身体验美国医院的不 多，输过血的更是凤毛麟角！安迪一听乐了：哦，你这才是典型的中国哲学啊！

In 1991, I visited the United States as a Fulbright visit-ing research scholar at Yale University. That year I was part of a group traveling to the United States for an academic exchange program between China and the U.S. First we went to Williamsburg, then to Wash-ington D.C. The organizers arranged for us to live with ordinary American families, who were meeting us at the train station. Mr. Chen and I were both from the Shanghai Academy of Social Sciences, and we were greeted by a very typical American, Jake, about 40, average height, with a small brown mustache. He un-derstood some Chinese, he studied Chinese, I al-ready don‘t remember it clearly, but he seemed to be doing a doctoral degree and be looking for a job, and talked the whole way, so we quickly got to know how very well.

When we got to the house we met his wife Susan, who seemed to be a little taller than Jake, with a round face, not fat, not thin, with short hair. They did-n‘t have children, a typical two person world. After some rest Jake took us for a walk in Arlington, Vir-ginia. The next day we would take the subway to meet the rest of the group, for a study visit to Wash-ington D.C. Jake helped us find the nearest subway station, just a few minutes from his house. When we came back dinner was ready, nothing in particular, a normal American meal. After dinner we drank coffee at a table in the back yard, and talked about the day and our impressions, and Jake didn‘t seem as extro-vert as most Americans, but was a good conversa-tionalist. Susan didn‘t say much. Because we were all tired, Jake let us go to bed early, busying himself with making the beds, originally two large sofas in the liv-ing room which converted to two comfortable single beds. After saying goodnight, we prepared to go to bed.

Mr. Chen and I exchanged a few sentences and went to sleep. He slept very calmly, without any noise, but I had trouble falling asleep, and had a sick feeling to my stomach, caused by stomach problems. Is slept a little and woke up again, my heart felt increasingly hot and I felt very sick. I felt nauseous and like throwing up, but I didn‘t want to wake anyone, so I silently en-dured it. I finally could not bear it, and went to the bathroom where I threw up violently, all coffee colored liquid. I knew this was gastric bleeding, which I had experienced before when traveling when I experi-enced blood in my stools, but I had never spit up blood before. I scooped some of it in the water basin, which turned completely red. My stomach felt painfully swollen and I experienced diarrhea, which was the same color. When I was done I felt a little better. I know that the hemorrhage this time was far worse than the other times and I was a little nervous, but didn‘t want to alarm Mr. Chen. I saw that it was only four o‘clock and I lay back down to wait for daybreak. Chen woke up around 6 a.m. I silently watched him get up, and saw him go about the business of getting up. When he came back from the bathroom I sat up and I gently told him: ―Old Wen, I have a problem‖ and I told him what had happened. I told him that it might be gastric bleeding. After that we waited for Jake to get up, who, when he did, came in and said good morning. Mr. Chen told Jake that I might be sick, and I told him what happened. Mr. Chen then asked Jake if he could take me to a hospital. When he heard this, Jake, after eating something with Mr. Chen, im-mediately went to get the car.

While Jake was getting the car ready Mr. Chen called our group leader Mr. Cai. Mr. Cai was actually Cauca-sian American, and always served as the China-U.S. exchange coordinator. Having been to Taiwan and the mainland, his Chinese was very good. I remember that his Chinese name was Cai Ruide, but we called him ‗Old Cai‘. Although he had been a group leader many times, this was the first time he had run into this type of situation, and I heard him say on the phone that he didn‘t really know what was the right thing to do, but kept asking ―What does he want me to do? What do you want me to do?‖ Nevertheless, he quickly came down to where we were and shared the opinion that I should go to the hospital first.

There was little traffic, people were not out yet. I knew I would definitely need to be hospitalized, but didn‘t know how much money that would cost. Jake took me to an ATM on the way and I took out 200 dollars in order to pay for the essentials. Jake took me to Arling-ton Hospital, very nearby his house, and knocked on the reception window. I told them my situation and they asked for my social security number, and checked my records online so that I could be regis-tered (later I realized how important it was for them to check my records. It allowed them to see my medical history and find out what kind of insurance I had). Mr. Chen wanted to attend the group‘s activities of the day and Jake brought him to Washington D.C.

Since my situation was an emergency, I was assigned a temporary room and nurse, while a doctor did some basic checks. After a while, a doctor of over 40 en-tered the room (I forgot his name, but I think it was Myers). Myers was not a doctor at the hospital, but came from a private clinic), and based on the situation and what he was told decided that I needed to be hospitalized. Soon, a nurse entered, and helped me change into a hospital gown. She helped me straighten my clothes, and found the 200 dollars in my pocket. She said that was a large sum of money (Americans do not carry much cash around) and gave me an envelope to put my things in and wrote my name on it.

In the hospital room, I saw immediately that this was a two-person room, with a bathroom, a 20‖ television and a simple telephone on the bedside table. The room was extremely clean, extremely neatly kept. I really had a good first impression, and wanted to know why in the beginning of the 90s our domestic hospitals facilities were still so crude. Next, I was taken for an x-ray; Dr. Myers gave me a gastroscopic exam, and arranged for a blood test to have my blood levels checked. The result came quickly and he de-cided I needed a blood transfusion. He inquired about my medical history and I remembered one diagnose that I was given in China, which was ―a superficial erosive bulbar ulcer‖. But I didn‘t know the words for that and I called Jake to nervously ask him for a Chi-nese-English dictionary. He said he had one, and I asked him to bring me one when it was convenient. Old Cai was very attentive and came at lunch time,

bringing a telephone. He said he had already in-formed Mrs. Ernst from the Committee of International Exchange Scholars (CIES). Mrs. Ernst may have been worried that I had not brought my health insur-ance card, and had them delivered by express mail (actually, these materials were not of any use, since my social security number had already provided all the necessary information). Jake and his wife came in the afternoon, bringing a dictionary, as well as my things. Dr. Myers explained my situation to him and he laughed; now it made sense. That evening two more members of our group came to see me, Mr. Huang from Wuhan and another gentleman from Shanghai, bringing fresh flowers from their host fam-ily. I was really moved, but could not say anything at that time because of all the tubes in my nose and mouth, so I just motioned my gratefulness.

The next few days I was under treatment, and the health care was really quite advanced and compre-hensive, no need to say more. It made me feel really good, and had a deep impression on me. Doctors and nurses made their rounds every day at a fixed time, hospital gowns were changed daily, the doctor asked the patient about his health nicely, very patient, and the nurses were very polite, their first sentence al-ways ‗I‘ll will be helping you today‘. It was their choice sentence, with a warm and kind intonation. For in-stance, with the saline drip, I didn‘t need a needle every day, but there was a permanent needle in the back of my hand with a plastic connector. The next day when I needed an infusion, they didn‘t need to prick me again, but used the needle that was already there, eliminating the need for further suffering. At that time I thought this was really modern, but actually it‘s not really complex, and I don‘t know why, but domes-tically we don‘t use it very much. Of course, there were also negative things. What I really did not under-stand were the blood tests. In China, the way to test the blood of a gastric bleeding patient is by examining the stools, and doctors stress the importance of medi-cal observation. But American doctors are frequently interested in data, and examination is done through blood samples, and a large sample is taken every day. Before I came to the U.S., I was engaged in how to measure history, econometrics, quantification of research methods, and the like. After my experience in the hospital I feel I really know what ―measuring‖ means. To treat an illness is often also ‗to measure‘. I frequently cracked a joke with the doctor: ―You give me blood every day, but you also take it out again‖.

Another not so good memory was the food. The pro-vided meals were not bad, the service and hygiene really good, and the nurse brought the meals on time. In the beginning I was afraid to eat anything, because I didn‘t want to spend any money, but later I learned that meals are provided free of charge. When you really want more, the menu doesn‘t really provide it. Every day there are several choices of liquid food and solid food, but the basic choices don‘t really change. I could only eat liquid food for two days, and everyone with a gastric condition in China knows that you abso-lutely cannot eat anything that irritates the stomach, including tea. But on the menu they put coffee as liq-uid food, and ice cream. What was most strange is that the only milk that was available was cold. How could they let me drink that! I had no choice, but had to make due. When I got a glass of milk, I‘d take a sip, put the glass down, and lie down a little to let it get lukewarm; then I‘d have some more. When I could start to have half liquid food, there was also nothing to eat. There was fruit jelly. I asked if there was porridge (zhou) or noodles, but no. Later I found something I could eat: mashed potatoes, which didn‘t taste bad. The last two days I could eat normal food and the food situation got slightly better. There was bread, cooked rice, lightly cooked vegetables, nothing spicy.

There was an old man in the same room; he must have been at least 70 years old. What illness he had I don‘t remember, but it must not have been that seri-ous. Every morning his wife came to visit. After saying good morning, they exchanged a kiss, and she stayed the whole day. A little later, their son and daughter in law, daughter and son-in-law would come for a visit. The son often stayed to keep them company. Hearing them talk, I knew that the son was temporarily out of work, and he didn‘t seem to care much about being unemployed. He received unemployment benefits and believed that he could easily get another job. He usu-ally stayed an hour or two, chatting to the two old folks. But the wife stayed the whole day, until she went home in the evening, very devoted.

This way, I spent a good week at the hospital. The day I was released, the doctor gave me a prescrip-tion. I had just finished packing when a 50-year old attendant in a red Chinese jacket came in with a wheel chair. I stuffed the box with my things in the wheel chair and prepared to walk with him to the re-ception. I had not thought he wanted me to actually sit in the chair, since I was perfectly able to walk, and there was an elevator as well. I thought it was very funny. He was very persistent, explaining to me that it was a hospital rule. So I sat down and let him push me to the elevator. When we came downstairs and went to the reception area, my heart jumped in my chest. How was I going to settle my account? The lady looked at my materials and took out an envelope. It was my 200 dollars! I signed everything and stood there waiting, contemplating how I was going to han-dle this when the lady said ―Finished!‖. I asked ―Is everything OK?‖ She said ―Sure.‖ My heart finally came down from its elevated position. I unexpectedly didn‘t spend a dime! I then remembered the prescrip-tions and I took it out to ask her where I could get the medicine. She told me, that I needed to take my pre-scription to a pharmacy to get the medicine. She told me I could go to any commercial pharmacy to have the prescription fulfilled, but that it was only valid in Virginia. Jake arrived with his car as promised. I asked him if we could go to the pharmacy first to buy two kinds of medicine. I looked at the instructions, one type of medicine to assist with stopping the bleeding, the other was high in iron and would help me keep my blood levels up, together 110 dollars. Afterwards he took me to the train station and I made my way from Washington to New York to continue my visit with the group.

After the trip I went to New Have for my program year. But my heart was still unsettled. How was I going to settle the hospital bill? Half a month ago I received a large invoice from Arlington Hospital. It was different from a domestic hospital bill, all costs were separated: the costs of the hospitalization, the nurse, the medi-cine, the examinations, the x-ray, and Dr. Myers vis-its, etc. I counted it and altogether it was more than 8,000 dollars. My goodness! According to my salary back then, that was about 40 years of income. When I looked further, I found a letter from the insurance company. They gave me two options: one was for me to pay the hospital and they would reimbursement, the other was for me to authorize them to pay each itemized bill directly to the hospital and Dr. Myers‘ clinic. I didn‘t hesitate to choose the second option. At the same time I submitted the receipts of the medicine I bought after I was released from the hospital. I sent all of it to the insurance company. I was actually not clear if I could submit those expenses. For two months there was no news, and I didn‘t want to call and ask. Before too long I went back to my own coun-try.

When I came back home, my health slowly went back to normal. I soon pushed the hospital experience to the back of my mind and pushed the invoice situation there as well. But, more than a year later, in May 1993, I suddenly received a big envelope from the insurance company. When I opened it I found a check for more than 80 dollars, an accounting statement for my hospitalization, and a letter. They explained that they had paid the full amount and had mailed my re-fund to my temporary American address, but it kept being returned. They had sent it to the Political De-partment of Yale University, but again it was returned. After several setbacks, they were able to get my ad-dress in China. I counted and realized that the money I paid for the medicine had probably not been re-funded.