July 16-19, 2024.
It was my great honour to be invited to visit the neurosurgical department at the First People's Hospital in Lianyun gang in July 2024. Neurosurgeons, neurologists and nurses form this department have previously visited my department at King's College Hospital in London.
Lianyungang is a city in Jiangsu province on the cost of the Yellow Sea and a 3 hour high-speed train journey from Shanghai.
Building For The Future

The staff in the department take great pride in the sevice they provide to their population and the hospital is currently undergoing a huge transformation with the construction of brand new campuses for their specialist services. We began the day at a departmental handover meeting very reminiscent of what takes place in our NHS neurosurgical department. Acute admissions are reviewed within the department and a few arteriovenous malformations were laid on to discuss with me. The department was clearly very busy and incredibly well-organised.

A tour of the operating theatres and intensive care unit were arranged, One familiar finding was that the critical care beds were over subscribed. With the new build facilities that will be increasing over the next couple of years. We viewed cerebrovascular procedures in the operating room and the angiography suite using very familiar western technologies. In another section of the hospital were suites dedicated to the delivery of traditional Chinese medicine and acupuncture and this is integrated with the Western model patient pathways

Prarticularly impressive was the site-of-the-art IT facilities. There were purpose built telemedicine suites enabling video consultations with patients as far away as Northern Mongolia. There is also an arrangement to conduct case conferences live with the Mayo Clinic in Rochester, Minnesota. HD screens peppered the walls of every clinic providing live data on case volumes, waiting time and bad status. Missing were disused terminals with "out of order " signs on them.
Outpatient areas were comfortable and patients could wait in comfort although volume of people passing through these hospitals are vast. The interaction with the doctor is different to what we are used to and visiting Chinese fellows have often enquired after the sometime lengthy discussionsI have with patients in clinic about their condition even when the preferred management is to be conservative.

Monkey Magic
If lk me you grew up in the late 70's and early 80's you may have enjoyed a program on BB2 in the evenings called "Monkey". This Japanese television series related the story of the immortalised Monkey and his companions as they travel from China to India to collect holy scripts. It was filmed In North West China and Mongolia, a combination of fantasy, comedy, martial arts and often with a moral ending drawing n buddhist, Taoist or Confucian literature. It was somewhat unhinged and a complete hoot.

The origin of the Monkey legend on which was based is in Lianyugang and specifically on the nearby Golden Mountain- Mount Huaguo. The peak is over 600m above sea level and overlooks vast tea plantations around it. The monkey rock reflects where Sun Wukong- the Monkey King exploded in to the world (and the nature of Monkey is "irrepressible!"). The locals are friendly but willl rifle through your pockets without permission.
In the Tang Dynasty temple are statues of ancient Gods of Earth, Water and The Heavens. In the Shuilian Cave (Water curtain cave) are symbols carved into he stone by visiting Chinese emperors from five dynastic before the the founding of the People's Republic of China.

