August 22, 2009

Frist Update and Expectations: Written on the plane to Shanghai

Just getting used to the new Prius. I am taking a lot of heat from my family who see me more the Tahoe or Suburban type. It was tough trading my 1992 Suburban (my only car) because of the family memories that centered on that car. I had saved some money back in ‘92 by getting a two wheel drive (though I regretted it later when in DC I kept getting stuck in the snow - sometimes doesn't pay to be too cheap); it was the car the boys learned to drive in the narrow streets of Georgetown (side mirrors a little scratched). I resisted this clunker deal initially because I thought it wrong that the taxpayer was buying my new car for me, but after a few days I broke down on the moral argument of mileage, pollution, etc (and the gift of the average taxpayer!!). I always buy my cars from Lee Beaman; his dad and mine were best friends. Christi, who works with me, picked out a great Yukon for me. But I opted for the Prius - why? Because it gets 4 times the gas mileage and I want to reduce gas consumption since so much of the proceeds goes to those who feed terrorism. And it is cheap - we actually ended buying two Pri(i) - one for me and one for my brother Tommy - for the price equal to one Yukon. Still hate to see the Suburban go - and it sounds like they poison it to kill it. Ugh.

Last week Karyn and I were in Nantucket and we hosted an annual clambake for family and friends. Brother Tommy and Trisha come up each year and on Friday night he said that he was going to China in two weeks. "Bill, why don't you and Karyn join us? You know many of the Chinese leaders from your previous Senate trips there; if you were there we could explain what we are doing and what we could potentially do to the central government." You see Tommy and his son-in-law are constructing a hospital that is public-private (government is 70%) in a community about 2 hours south of Shanghai.

Karyn and I had a trip planed to Italy that was to begin on September 1; we hade never vacationed in Italy and it was time for me to take her there since most of our friends at our age that we see day to day have been there multiple times. Our summer vacations have been working and doing surgery in Bangladesh, Mozambique, Uganda, southern Sudan, Darfur, and the Congo. Doing surgery in the bush is a far cry from Florence and Venice and the Amalfi Coast (as I was reminded by Karyn); Italy is the destination this year (and no surgery). No skimping here, I called the famed travel agent Andrew Harper and said just put together the rip for us. Karyn deserves it.

So now 2 weeks before departing to Italy how was I going to get a visa for us to China and then organize a trip there? With a lot of help we did it, and this morning at 3:15am we got up to board Delta to Atlanta and then Atlanta to Shanghai to Beijing. At this point, we have no idea what the plan will be until we see the Minister of Health on Wednesday (today is Saturday in the US).

I am not a China expert, but I am fascinated by the country and when I am advising young people today I tell them to focus on China and figure out some way to go there and live for awhile. The demographics and economic direction are just too clear as we look forward over the next 30 years.

In terms of health, the central government has made a major commitment in funding health services throughout China. And though the "down-side" of central command we all know in America is lack of democratic decision making and transparency, the "up-side" is that once a decision is made there is not a fiddling around to fund and accomplish the result. So with that much boldness directed at solving health inequities and improving health services, coupled with huge investment, I knew I wanted to be in China and get the lay of the land.

We will build the next 8 days around health and healing, be open to opportunities to share our expertise, learn from their culture and approach, and then just see what happens in the future. We're in the information gathering stages ... we are not up to the "conceive it, believe it, do it" phases frequently quoted by my mentor the pioneering heart surgeon Dr. Norman Shumway.

Everyone has a bucket list and we tend to pay more attention to them the older we get. Tommy says Tibet is on his, so the group said let's go. Then we heard that the altitude is 14,000 with no acclimation; I get altitude sickness and he had a minor heart procedure two weeks ago so the doctors said wait 6 months. A relief to me because I know I would be sick. Karyn does well at high altitude (like when we hiked the Virunga Mountains on the order of Rwanda and Uganda looking for the mountain gorillas - at 12,500 feet we eventually found them but I was so hypoxic I don't remember anything we did. Karyn thrived. I should just keep my medical work with the gorillas focused on the National Zoo over in Washington, DC instead of trekking in Rwanda, which was last year's trip - I know ... that is why we are doing Tuscany and Florence!).

So now that Tibet is out, we will do a non-health side trip to Xi'an, China, the ancient walled city, once the capital of China, and often overlooked. It is now known for the unearthed Terracotta Army of Warriors and horses of Emperor Qin Shi Huang. Apparently at night the city becomes the City of Lights and an atmosphere that leans on fantasy. One article describes an 18 course dumpling banquet (at De Fa Chang). That is the extent of what I know about the area now, more to come once Karyn and I figure out to get there.

So what is the kernel behind this trip in the first place? It starts with my oldest brother
Tom Frist who founded and ran Hospital Corporation of America, the largest hospital company in the world, and his son-in-law Chuck Elcan who two years ago set out on building a hospital in partnership with the government in China. The location for the hospital (approvals and funding have been obtained) is the city of Cixi (1.8 million people in immediate area) which is in the Zhejiang Providence. Cixi is directly east of Hangzhou and is a little over 2 hours south of Shanghai (directly across the bay).

So that hospital will be built and staffed and locally run (manages using the systems that have been fine tuned by years of western hospital management expertise). If that works and works well, what would the next step be? Our trip and our meetings with the government will help answer that, so it will be fun sharing my observations with you as we go through all this over the next 8 days. What we do know is that the Chinese government is making an unprecedented and monumental commitment to its health sector; they could use, I would think, some western expertise. This is not a venture of HCA. Luckily the third partner Henry Zhou lives in China and will be our host once we hit the ground.