Society

Patient-On-Doctor Violence In China Symptomatic Of A Sick And Crippled System

The recent killing of a doctor in northern China is just the latest act of violence by angry patients. A big part of the problem is an overcrowded, underfunded and sometimes corrupt medical system. By the symptoms go even deeper into modern Chinese societ

A Shanghai medical facility (Matslina)
Kai Yue

Last week, Wang Hao, a young intern in a Harbin city hospital in northern China was stabbed to death by an angry patient. Three of his fellow doctors were seriously injured. It's only the latest example of a malignant "medical condition" afflicting Chinese hospitals.

Last year alone, as many as 10 medical staff were murdered by patients. There is growing concern that if trust between doctors and patients cannot be rebuilt soon, the price will be paid in both further violence and overall declining medical care.

The violence appears to be linked to abnormal conditions becoming the norm in Chinese hospitals: queuing overnight for registration, treatment for a simple cold costing over 1000 RMB ($160), frequent occurrences of medical malpractice, the arbitration of medical disputes often dragging on for years -- the list goes on.

As for doctors, they too have plenty of pent-up resentment. They work more than 10 hours a day and can examine more than 100 patients per shift. The medical system forces them to over-prescribe expensive medication, otherwise neither they nor the hospitals can survive.

The consequence, in its most extreme form, is doctors with bodyguards. The traditional philosophy where the doctor should treat patients as a parent treats his children has been replaced by widespread animosity across the medical profession. Any prescription arouses questions by patients suspicious that the doctor might be scamming them.

Murder is an atrocious crime. Only a authorized justice system can deprive one of life, nobody else. We condemn any form of violence.

Nevertheless, we must ask ourselves why there is so much violence around us today? Why does it seem to manifest itself in the weak against the strong? The street hawkers are angry because the police chased them and knocked over their stalls. Evicted householders throw Molotov cocktails at the authorities after their houses were illegally demolished. The patient is angry at the doctor who misdiagnosed his condition or cut out the wrong organ….

Marketplace of responsibility

It's not difficult to explain the current physician-patient confrontation from a rational perspective. If we take a holistic review of each of these medical disputes we'll find that they all follow more or less the same pattern. The patient has paid an astronomical cost (materially or mentally) for treatment that is either not satisfactory, or even contrary to what was promised.

Part of the problem is that patients have no channel to vent their grievances, so the probability that some of them will turn to violence is bound to rise.

One of the more obvious ways to address the conflict is by reforming the medical system itself: finding new ways to finance medical care; building more hospitals; and streamlining regulations to resolve medical disputes more smoothly.

Friedrich von Hayek, one of the major economists and political philosophers of the 20th century wrote that the most important moral foundation of the Free Market economy is the responsibility: this ethical sense which makes each individual take responsibility for the consequences of his behavior. Any profession will eventually lose its social value if it is not based on moral responsibility.

In the face of this truth, what happens when a doctor prescribes drugs indiscriminately or even overtreats patients just to boost his own income? Can an urban law enforcer beat up a handicapped hawker to demonstrate his authority? Can an official casually tear down one's house for the sake of urban development? And what happens, as we've seen so often in China, when people are afraid to help strangers because they believe it puts them at risk of being falsely accused or sued?

Unfortunately, this seems to be an underlying illness of Chinese society today. Our food is toxic; our hospitals are unsafe; our roads are dangerous. Our society has fallen into a "mutual harming" mode. Everybody is harming everybody and can get harmed themselves. The patient could be hurt by a doctor; the doctor's house could be demolished; the patient could also be a profiteer selling "toxic milk" … you get the idea.

This is why it's not enough to blame China's current health care problems entirely on the medical system itself. Naturally, a bad system will foster the evil in human nature, whereas a good system can encourage good deeds. If each person sticks to his job requirements and controls abuse, or at least decides "not to be evil," the bad system will eventually be transformed. Otherwise, we will wind up with a society based on standoffs, where patient-doctor, public-police, citizen-politician relationships become sore points that turn the whole of society into a sick and crippled body.

Read the original article in Chinese

Photo - Matslina

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Society

Pomp And Pirouettes: When Ballet Stars Bid Farewell

On June 11, the prima ballerina Eleonora Abbagnato bid farewell to the Paris Opera, under the gold roof of the historic Palais Garnier. It's an obligatory passage for Parisian ballet dancers of a certain age, a moment that is often happy, always dreaded and sometimes salutary.

Ballerina Eleonora Abbagnato performing at her adieux
Eleonora Abbagnato Official Instagram Account
Cecilia Delporte


PARIS — With one last look at Chagall's enchanting fresco, at the teachers who watched her grow up, at the stage that saw her blossom, Eleonora Abbagnato took her final bow. Never has a star ballerina's farewell been so dramatic, as her big exit was postponed by three cancellations due to a strike, and then the pandemic.

"I'm always positive, I think that destiny does things well," she says in her dressing room a few days before her "adieu." "I knew this evening would eventually take place!" This artist, who wanted to model her last dance on Le Parc by Angelin Preljocaj, ended up dazzling the crowd in a tribute to Roland Petit, which nicely echoed her career.

"He is someone I knew at the age of 10, so it was important to me to perform a ballet by this choreographer. The last time I danced Young Man was for Nicolas Le Riche's farewell, I was four months pregnant! It all began with Roland, and it all ends with him." The ballerina has lost none of her taste for the stage, but there are traditions that forge an institution: At the age of 42, each Opera dancer must leave the premises with a final au revoir to the public and the company.

"It's probably less painful than in other foreign companies, especially Anglo-Saxon ones, where there is no age limit but you are summoned to be told that you are no longer in the shape you were when you started out," says the former star Agnès Letestu. But how will this particular evening be remembered, as a rite of passage or the beginning of a new life? "The farewell is both a moment of extraordinary love with the hall, the orchestra pit, the backstage area ... and at the same time the turning of a page in the history of this institution. Even if the phoenix always rises from its ashes through the appointment of a new star," says Brigitte Lefèvre, the Paris Opera's dance director from 1995 to 2014.

No faux pas when choosing the last dance

This uniquely talented artist deserves the same exceptional ceremony created for the departure of Elisabeth Platel in 1999 and Carole Arbo two years later, which was televised for the very first time. For these kinds of events, the star's personal life comes into play — family members are present in the room, children occasionally come on stage. A perfectly choreographed protocol is followed to a tee, mixing various speeches with the arrival of the Minister of Culture; sometimes a special distinction from the Order of Arts and Letters is awarded. Moments of grace are sprinkled throughout the evening, such as the improvised dance between Aurélie Dupont — the director of dance at the time — and the departing star Marie-Agnès Gillot. The festivities continue into the night, charged with excitement and emotion.

These farewells are planned two or three years in advance when the time comes for the dance director to curate the future program. Aurélie Dupont, like Brigitte Lefèvre before her, likes to ask the star which ballet they prefer as their parting performance and which partners should accompany them.

These are intense moments sometimes experienced as mourning.

"There are some dancers who don't want to say goodbye because they don't like it, because the program doesn't suit them or because they don't feel fit enough," says Agnès Letestu. "I wanted to leave the Paris Opera with La Dame aux Camélias. I had talked to Brigitte Lefèvre about it. Except my farewell was scheduled before the ballet was programmed, so I had to find another one, but I did not agree. So I proposed to her to come back and dance it one month after I left the company, which was quite unusual."

Among the most requested works are the legendary ballets Giselle and L'Histoire de Manon. "The stars like to start with love stories that end badly. Everyone wants a ballet with real drama, in two or three acts, rather than a little pas de deux," says Aurélie Dupont. Dupont's first choice, La Dame aux Camélias, had already been scheduled two years earlier for the farewell of Agnès Letestu, so she settled on Manon. This work, heavy with meaning, was Dupont's big return to the stage after a serious knee injury in 1998, when she feared she could no longer dance.

Eleonora Abbagnato performing her final "adieux" at the Paris Opera

Like going to the guillotine

As for the brilliant Karl Paquette, it was with Cinderella — a ballet dear to his heart — that he retired at the Opéra Bastille, Paris' second opera house while many dancers prefer the old charm of the more famous Palais Garnier. "The story is funny, the ballet very narrative — one of the most beautiful successes of Nureyev. I loved the golden costume, the scenic effects, the finale of the grand pas de deux. The strongest moment was my entrance on stage in Act II to great applause, even as the musicians continued to play," he recalls.

These are intense moments sometimes experienced as mourning, like when Marie-Agnès Gillot cried heavily before her final step onto the stage. On that fateful day, Agnès Letestu says she felt a very special sensation, strengthening her senses, from her vision to her hearing. "Everything was multiplied tenfold," says Letestu who, a few months earlier, had the feeling of going to the guillotine. "I was very stressed four months before, I was afraid of hurting myself and not being able to dance, of not being up to it, of not enjoying every moment, of crying," says Aurélie Dupont, whose farewell was finally a calming moment. "I especially remember the applause, people were shouting, standing — it lasted more than 20 minutes. And this love is only for you."

I couldn't let myself be overwhelmed by emotion!

Nicolas Le Riche, now director of the Royal Ballet of Stockholm, evokes a "very strong feeling of corporation, of belonging to an institution that we celebrate at the same time." He was the only artist to bid farewell not to a ballet, but to a "special evening" of total freedom, mixing pieces like L'Après-midi d'un faune by Nijinsky and Béjart's Le Boléro. On stage, tributes were paid in his honor by prestigious guests such as singer Matthieu Chedid and actor Guillaume Gallienne.

"I found this repertoire, which transcended the ages, very moving. I received a magnificent note from Nijinsky's daughter. It's an evening where everyone is allowed to be moved and to live these emotions, except the person who is leaving. I couldn't let myself be overwhelmed by emotion, otherwise, I would have taken a step on stage and collapsed!" he recalls. How long did it take him to prepare such a spectacle? "I feel like answering in the manner of Coco Chanel, who made her hat in two scissor strokes. 'But it only took you two minutes?" says a disappointed customer. 'No, Madam, it took me a whole life," she replies. The same way I drew on all that I lived through," says the dancer.

Group photo of Paris Opera dancers in white tutus dancing in front of the Palais Garnier, with placards in protest of the French government's plan to overhaul retirement age

Paris Opera dancers perform in front of the Palais Garnier to protest the French government's plan to overhaul retirement age — Photo: Maxppp/ ZUMA

To each their own swan song

While Laëtitia Pujol hesitated a long time before making her farewell, hoping to leave discreetly, others end up with departure full of pomp and circumstance, sometimes to their surprise. "It's a moment you think about all the time without really thinking about it. I certainly wasn't looking forward to it and wanted something intimate. This was the opposite," says Karl Paquette. "The director of the Paris Opera at the time, Stéphane Lissner, wanted to leave on the symbolic day of December 31. "I was doubly pressured because the farewell was broadcast in the cinema, and each of my movements was immortalized. On the last day, you are in a particular state of conditioning because you are saying goodbye to 25 years of career and nearly 42 years of life. You have to protect yourself."

When the farewell came, it was a relief.

Only Benjamin Pech experienced his farewell, an evening in February 2016, as a liberation. And for good reason: "I had a hip injury in 2014. I was diagnosed with rapid degenerative arthritis. To remedy it, I needed a hip replacement. My farewell was scheduled for 2016, so I decided not to have the surgery and continue until then. For two years, I held on by dancing practically on one leg and had to turn to a repertoire that was no longer athletic but theatrical, with compositional roles that opened up other perspectives. Isn't a dancer above all someone who comes to deeply impact the spectator? When the farewell came, it was a relief," he says.

The star had chosen to dance alongside Sylviane, an 84-year-old spectator and one of his lifelong fans, who was present during rehearsals, but unfortunately became ill on the day of the performance. Pech took his leave on a program that included Le Parc by Preljocaj, the very piece that gave way to his injury: "I have come full circle."

Bidding farewell to the word "adieu"

Shortly after his or her performance, the future retiree must pass on their dressing room to another star, a moment that is "both very sophisticated and archaic. There are the great speeches, which say that this house will always be yours, but in reality, it becomes otherwise," says Brigitte Lefèvre. "You close the door, you leave and it's over," says Eleonora Abbagnato. But how do these artists project themselves into the future? "What is traumatic is that we are heavily drilled since we entered the dance school at 8 years old, with a professional outline where everything is already decided. How can you exist professionally when you have garnered such admiration, even fascination until now? At 42, most people are in the middle of their career, ours is coming to an end," says Benjamin Pech, who has become ballet master at the Opera of Rome, directed by Eleonora Abbagnato.

It is not a door that closes, but rather another door that opens.

While many stars go on to create or run a company, many experience a profound period of confusion. "I was secretly hoping that someone would call me for a position, that I could be of some value, but it didn't happen that way," explains Nicolas Le Riche. "I had already enrolled at Sciences Po for schooling [in management and leadership]. I had to create my own opportunities."

To remedy this uncertainty, Aurélie Dupont now offers support for company members, offering them a skills assessment and training beyond dance. In the future, Nicolas Le Riche would like the word "adieu" to be replaced by the idea of celebration. "It is not a door that closes, but rather another door that opens." Because under the gold of the Palais Garnier, the stars are eternal.


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