Posts tagged “tom williams”

Tom’s War Story: Go with the flow

Tom Williams, Principal of Point Forward is confronted with his own health concerns, and with some unexpected practices for managing bureaucracy.

Our ethnography research team visited a small neighborhood health clinic in Beijing to study its workflow. It was 2009 and concern over H1N1 swine flu was at its peak. There was a special flu screening at the airport and yet the folks at the clinic seemed concerned that we, as Americans, might be seen as potential carriers of the virus that was causing near-panic at the time. To make matters worse, I had awoken that morning with a scratchy throat. It was just a reaction to the hazy air quality in Beijing but still, it would be very bad to be coughing in this situation so in the taxi on the way to the clinic I stuffed multiple cough drops into my mouth.



The Health Services clinic in Beijing where ethnographic research was conducted. Inside, a dispenser for free contraceptives.

Doing field research in China is always a little bit surreal for me, an American. The cultural differences are pretty subtle on paper but can be stark in person. They reveal themselves in that weird way that cultural differences do; unexpected little variations in design, procedures, or personal manners. In this setting in particular, lots of little things stood out when first walking into the clinic: the scale to weigh patients was in the waiting area, not near the exam rooms. Next to the scale was somebody’s bicycle and a broom was propped in the corner. The waiting room chairs were plastic, not upholstered and there was a vending machine offering free contraception. There were brochures but no magazines.



The clinic’s waiting area.

“How long have you been here in China?” the nurse manager asked us through an interpreter. “Three days,” I replied, willing myself not to cough. “Well, we occasionally get unannounced spot-checks by government health officials and, because of the swine flu, if they show up while you’re here doing research we’ll need you to say you arrived in China two weeks ago, not three days ago.” Huh? Wha? Lie to Chinese government officials? Is that in my job description? I’ve seen way too many prison movies to be comfortable with this. Plus, isn’t my time in the country a pretty easy thing to check on by just – oh, I don’t know – looking at the stamp in my passport? And the request was made in such a matter-of-fact, this-is-no-big-deal way that we weren’t exactly given a chance to voice our concerns; it was simply on a list of mundane procedures for the day: “the bathrooms are down the hall, you’re scheduled to interview two nurses, then two doctors, then you’ll do an hour of straight observation, then we’re gonna have you lie to government officials, and by then it’ll be time for lunch.” Ugh! Fidgeting nervously, and imagining what would happen if this were a movie, I glanced around to see if there was a back door for a hasty exit (of course – fleeing from government officials is surely better than lying to them!).

We were taken to a room for our first interview and the oddness continued: we sat in reclining chairs normally used by dialysis patients. They graciously served us tea and watermelon but then placed bucket in the middle of the floor for seeds and rinds. I was wondering what the bucket was normally used for but decided not to ask. We interviewed a very kind and helpful nurse but she kept a surgical mask on her face the whole time.



My colleague Priya mans the video camera near the tea and watermelon while the rest of the team discards seeds and rinds into a bucket.

But then something happened: it was the simple magic of focusing on what I was there to do: field research. I got absorbed in hearing people tell their stories, obsessing about getting good video and good still photos, asking good questions, and listening closely. I enjoyed the watermelon and stopped worrying about how weird it felt to be spitting watermelon seeds into a bucket during an interview. By letting myself go with the flow, I actually forgot about my scratchy throat and even forgot about the possibility of being confronted about the date I arrived in China.

The interviews and observations went very well and for all my initial impressions of differences, we noticed many similar workflow patterns to clinics we had studied in the U.S. and Europe. In the end, there was no surprise visit by health inspectors. After feeling uncomfortable as an outsider at the beginning, by simply sticking to the process and not pushing against prevailing cultural norms, I now felt at ease. We truly bonded with the clinic staff and developed a very solid understanding of their process. We said our goodbyes, left the clinic, and walked to a nearby Buddhist vegetarian place for lunch. When we stepped into the crowded restaurant, all the customers turned in unison to look at the foreigners. I reached in my pocket for a cough drop and the process started all over again.

On the subject of me: Five Things

Troy Worman pings me for this new-ritual blogger effort (it’s called a meme, but is a chain letter a meme? The propagation is built-in, rather than being a side-effect of the compellingness of the content….) where you post “five things” about yourself. And then tag a bunch of other bloggers to do the same thing.

There’s no threat of deadly peril as in old-school chain letters, so that’s nice. But I’ve found it a bit exclusive. The “cool” folks got pinged months ago with this thing. In the interest of inclusiveness, I’m going to throw this open to anyone who wants to contribute their own five things. If you’ve got your own blog and want to participate, consider this your opportunity. Email me, or trackback, or comment, and I’ll add you to the body of this post. If you don’t have a blog (and let’s face it, most don’t) then leave your five things in the comments. If you want them anonymized more than the blog will let you, email me, and I’ll post it for you.

Five things about Steve

  1. In my public school (called elementary school in the US) the default assumption was that boys took shop and girls took home economics. I was the first boy to take home-ec. I simply asked. They weren’t trying to stop me, but they were very worried when they called my mother to verify this was acceptable. If it had been 10 years later, they would have drafted a release from liability, just in case. The next year, of course, all students took both. I was no Rosa Parks, but I did create a small change that was past due.
  2. Our dog Brody (Golden Retriever, 5 1/2, rescued) is my first pet (I’m not counting several goldfish named George).
  3. Back in the 90s, Tom Williams and I tapped into the latent storytelling need that would re-emerge as blogging when we created Turn Signals. A fax (originally) newsletter that took stories from the press and rewrote them in a dryly bemused tone. Indeed, we were always passing photocopied articles to each other in the office and so it was suggested that we productize it. You can see a few issues here (PDF).
  4. I really like cereal. I have my preferred cereal system, where boxes are stored in a cabinet from oldest to newest, so nothing goes stale. I like to have two boxes open at one time; where one is sweeter and the other is healthier (although they are all pretty damn sweet these days).
  5. In 1992 I started the first online community for Rolling Stones fans. It’s still going to this day.

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