Nick Castle took his zest for life and University of California degree to China in 2012 as a Peace Corps volunteer at the age of 22. He went to teach English and dived headfirst into Chinese culture.
In February 2013, he died in China from an infectious disease, after what may have been a series of mistakes or miscommunications. If things had gone differently with his medical care, it’s possible that Castle would still be alive.
The New York Times recently investigated Castle’s story, labeling it “medical missteps,” while an initial investigation by the Peace Corps concluded that Castle’s death was not preventable, that is, that Peace Corps and the medical staff in China did what they could and should.
Was anyone clearly at fault? We may never know. Perhaps Castle’s time had come, regardless of the specific circumstances, but I would offer that cultures heavily influence how people react at critical moments. Cultures can make the crucial difference at moments of life and death. It may be that no one individual was at fault, but that the culture of contemporary China played a role in Castle’s death.
When I heard Castle’s story, I thought, “That could have been me.” When I was Castle’s age and fresh out of college, I volunteered for the Peace Corps and taught English in Thailand. I was hospitalized three times there, and the care I received was good and well-coordinated. My care was entirely the product of Thai culture.
Your Life in Their Hands
When we are at home, we can lull ourselves into thinking that we have a great degree of control over our lives. When we leave our country, we become aware that in fact our lives are in the hands of strangers and their values, the values that stem from their culture.
How fast and how skillfully do people drive in that place, and are the intersections well-designed? How clean is the water coming from the hotel tap? How knowledgeable are people about how to handle accidents? (In Thailand we watched people lift up the injured bodies of motorcycle accident victims by their four limbs and then throw them into a pickup truck, instead of strapping them to a board to immobilize their spines, or waiting for an ambulance. We wondered how many of those poor souls were paralyzed for life due to well-meaning ignorance.)
And how good are they at communicating and cooperating in moments of crisis? To a large degree, this crucial factor stems from culture. We Americans have our collective faults, but in our culture, people band together with great generosity and energy in times of crisis—just watch people filling sandbags when the river is going to overflow its banks, or think of the first responders and volunteers who flocked to ground zero after 9/11, at great risk to themselves.
Yes, our lives are in the hands of strangers when we leave the country—and the lives of visitors are in our hands here. Foreigners die in America from what might be called a failure of culture. Think of the Australian baseball player who was out jogging in Oklahoma in 2013 and was gunned down by three teenagers in a car. Physical violence is a dark but real element of modern American culture.
It is the job of Peace Corps volunteers (PCVs) to be exposed to and integrated into the culture of the country that they work in, to a far greater degree than any diplomat, soldier, or corporate worker on assignment abroad. Two of the three major goals of the Peace Corps are about increasing understanding between cultures. PCVs often live without any other Americans for miles around.
Contemporary Chinese Culture
In telling the story of Castle’s final hours, The New York Times reported events that are key clues to contemporary China’s culture.
When the Peace Corps physician, Chinese-trained Dr. Gao, decided that Castle’s physical condition required him to be moved to a hospital, she called the Peace Corps office to have the office vehicle brought right away. “But the Peace Corps vehicle was in use by the agency’s country director, an internal inquiry later found,” said the NY Times, “and none of the medical staff members ‘felt empowered enough’ to ask her to give it up ‘even during an emergency.’”
After the medical team called for an ambulance, it got “lost in Chengdu’s streets,” and arrived late.
Intravenous fluids became available, “but after a debate between the ambulance doctor and the Peace Corps medical staff, they postponed giving them to Mr. Castle in favor of getting him into the ambulance. Since the ambulance stretcher would not fit in the elevator, he had to be carried down three flights of stairs.
“In the ambulance, a disagreement broke out between [the Peace Corps medical team] and their Chinese counterparts. ‘We struggled to keep his airway open by turning him on his side,’ Dr. Gao later wrote. ‘The ambulance physician and nurse were fighting the position because they were intent on starting an IV and getting the blood pressure cuff in place.’”
To recap: staff were scared to ask the boss for a vehicle in an emergency; the ambulance got lost; two different groups argued over how to care for a critically ill patient; the stretcher could not fit in the elevator; and the two groups physically struggled over what to do with the patient.
The NY Times noted that the Peace Corps internal investigation revealed that “no one seemed to be in charge in the crisis” and that Dr. Gao worried that, if Castle were admitted to the huge local hospital, she and the Peace Corps “would ‘lose all control’ of his care.”
A Chinese friend tells me that the situation feels all too familiar. She recounted the story of a friend whose father died in an ambulance when the drive to a nearby hospital took six hours.
When American tourists return from China, they are often in awe of the tall, shiny buildings and the fast pace of development. But the fate of Nick Castle casts a different light on the realities of the culture there today.
John Nania is the editor-in-chief of Epoch Times.
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