East Meets West
I am writing this column from the inner city of
Beijing, living in a "hutong" — one of the
traditional houses that used to line the small streets and
narrow alleyways of Beijing — and studying Mandarin.
OK, it's a crazy idea. Now that we have that behind us, we
can talk about more important things.
Living in a hutong could be considered roughing it.
Fortunately, we are renting one that has been upgraded to
include indoor plumbing (whew!), a couple of
air-conditioning units on the wall, a washing machine and a
microwave oven. By U.S. standards, this is roughing it. But
next door, literally, are the very basic units, so we are
living in the midst of the Chinese lifestyle that is
rapidly disappearing. Sadly, the government is daily
demolishing hutong villages to make way for large
boulevards and skyscrapers housing multinational
corporations and others featuring luxury condominiums
rivaling those in New York or London.
We are experiencing directly the benefits of the
hutong lifestyle, which is very simple, with all the
necessities of life located within a few steps of our door.
There are many restaurants, with dinner perhaps running as
little as a couple of dollars, and we have had some
wonderful meals for three or four people, with beer,
costing less than $10! After the shock of living in small
and pretty basic quarters, we find the life interestingly
refreshing — wonderful small shops selling very fresh
fruits and vegetables (the Beijing watermelons are a
delicious treat you would be hard-pressed to match in the
U.S.), barbershops, massage parlors (legitimate ones, I
think, though I haven't yet sampled their services),
laundry, tailor, shoe repair and, most important for us, a
bicycle repairman.

Wendy Brody in the couple's
Beijing 'hutong.' |
Not too far down the main street outside our hutong
are the expensive places. I bet the food in the restaurants
is no better, but $10 won't get you much past a simple
appetizer. And the big Western hotels and shopping centers
feature the most expensive food and goods anywhere. The
contrasts between the ultra-rich, the rising middle class
and the poor here are tremendous. When hutongs are torn
down, the peasants are moved wholesale to suburban
high-rises — divorced from the character, and
convenience, of the hutong, albeit with indoor flushing
toilets most likely. And with many tens of millions of
migrant workers heading to the cities on the East Coast
looking for work, China has an internal "immigrant" problem
rivaling that of California or Texas.
One of the first words you learn in Mandarin is
dong-xi, pronounced dong-she, which means "something," so
you can say to your teacher, "I would like to eat
something." Also useful in a restaurant, although it is
unlikely anyone will understand you because getting the
words right isn't enough — the tone of the words is
critical, and that is hard for us lao-wai (foreigners) to
get right without months of practice.
Anyway, after working on dong xi, my wife, Wendy, made
an interesting observation. The two characters for dong xi
are the same ones that mean "east-west." And while one can
speculate how east-west also came to mean "something," one
thing is clear — nowhere is the clash between East
and West more evident than in the city of Beijing.
Traditional Chinese culture is facing the yin and yang
between Chinese herbal medicine and Western medicine,
Chinese cuisine vs. Kentucky Fried Chicken, Pizza Hut,
McDonald's and Starbucks. (I looked it up: There are 50
Starbucks shops in Beijing, and probably many more KFC,
Pizza Huts and McDonald's. Ikea just opened its largest
store outside of Scandanavia in Beijing.)
The contrast between rich and poor is striking. Since
my first trip here in 1994, when the only cars were
government vehicles of an aging vintage, today the parking
lots are filled with Audis, BMWs, large VWs, Buicks and
other luxury vehicles. And supposedly somewhere between
1,000 and 4,000 cars are being added to the Beijing roads
every month!
Pollution and traffic in Beijing are also world-class.
There are Western-style suburbs going up faster than one
can ever imagine, adding to the traffic gridlock and
pollution. We are commuting by bicycle, so we are immersed
in the traffic jams and literally taste and smell the
horrific pollution. We often get to our destination faster
than a car would go. Smoking is so common among the Chinese
that we can assume that lung cancer will be of epidemic
proportions, if not already so. We are commuting about 40
minutes each way to/from our Mandarin classes, so I can
vouch for the traffic as well as the pollution. Some days
you literally cannot see the tops of skyscrapers 20 yards
away through the blurred skies. And there are mammoth
construction projects going on to prepare for the 2008
Olympics, as well as to meet the demands of the rising
middle class for better housing and higher-class shops and
services.
The language school we are attending, ironically, is
the Taipei Language Institute. It features one-on-one
tutorial instruction and is considered one of the best in
China, even though its headquarters are in Taipei. A large
cadre of students attend, many Americans but also Koreans,
Japanese and Europeans, all ages and from all walks of
life, though most are in their 20s looking to make a career
around the emergence of China. We met a Korean woman who is
a current SAIS student, spending the summer here studying
Chinese between her first and second years. The instructors
are nearly all young Chinese women in their 20s and early
30s. An American colleague who has lived and studied in
Beijing says he has never met a Chinese language instructor
over the age of 35, and he wonders what becomes of them.
The bicycle repairman, Mr. Yang, is our best friend
and life support system. He said his family was quite
prominent, with several of the older generation being
professors; but after the communist regime took over, his
family wasn't allowed to attend school, so he ended up
fixing bicycles and renting out a few that he owns. He is
quite proud that he had put his son through school (you
must pay to send your children to the public primary and
secondary schools) and that he is now a dentist. With a
great smile, he showed us his beautifully perfect set of
false teeth that his son had made for him.
Mr. Yang operates on bicycles right on the sidewalk
and is found at his station seven days a week, 12 hours a
day. He is as good a diagnostician as the best Hopkins
internist and as manually adept as a top professor of
surgery. And he is generally busy most of the time we visit
him. Nearly each day we need some adjustment to our bikes
(air in the tires, brake adjustments, etc.). The bicycles
are old but quite comfortable and ridable, and we learned
that the older bikes are generally more durable, and also
less likely to be stolen. We often get thunderstorms in the
evening, and the rain falling on the bikes quickly changes
to rust, freezing up something — hence the need to
see Mr. Yang for an urgent clinic visit.
The commute is quite hectic and the driving more
challenging than in Boston or New York City. Here there are
bike lanes on most streets, but the bike traffic may be
two-way; cars and buses not infrequently use the bike
lanes; and, of course, there are lots of pedestrians. You
learn not to make eye contact with cars; if you do, you
lose all available rights of way open to you. We are
exhausted by the end of the day from our commuting, but it
is a great way to explore the city.
The emerging middle class is starved for things
Western, while the culture remains profoundly Eastern.
Gucci and Rolex, Starbucks and KFC, golf, World Cup soccer
and Formula One. How all this will end up is anyone's
guess. But I want to close with one observation, not of my
own making.
An economist named Roemer many years ago made the
observation that certain entities generate their own
"demand." Roemer pointed out that the more hospital beds
there are per capita, the higher is the utilization of
hospital services. Ditto for doctors. The Dartmouth Atlas
of Health Care points out that communities with twice the
number of cardiologists per 100,000 population will have
much higher utilization of patient visits, procedures, etc.
Although I haven't seen a study, my guess is that Roemer's
law holds for lawyers as well.
Roads, too. When a road is built — generally if
the economy is robust — developers will buy up land
now made accessible and construct houses or factories that
require people to commute longer distances, hence filling
up the new roads. And since new roads allow the addition of
more automobiles, one can never get ahead of the power
curve. Beijing today, compared to my first trip in 1994,
amply illustrates how the large supply of four-lane
boulevards and wide ring roads has generated a "demand" for
more and more cars. When your family lived in the hutong,
there was no need for any transportation, save perhaps a
bicycle or small motor-driven vehicle to haul cargo for
your vegetable market.
Another important point to consider about China: While
right now it has a relatively young population, that
population is quickly aging, and by 2030, because of the
country's one-child policy, it will have the same inverted
age distribution that Western Europe, the United States and
Japan will have. How China will pay for medical services is
an issue right now but is likely to emerge more importantly
in the future.
While the demand for high-quality Western medical
services is growing and could present some important
opportunities for Johns Hopkins, one should not overlook
the fact that it will be a focus on public health that is
likely to make the most dramatic improvements in the health
of the country over the next few decades.
The only books I am reading these days are Chinese
language instruction books (written, mercifully, in
English), so, somewhat apologetically, I have none of my
usual summer reading recommendations.
For now, have a good summer, and zai jian. Till we
meet again.

William R. Brody is president
of The Johns Hopkins University.