by Mei Fong
These towers, dialou, are amazingly fanciful creations, inspired by what Chinese had seen working in far-flung places: a hodgepodge of Moorish arches, Corinithian columns, Byzantine domes, and crenellated walls. These McMansions of yesteryear ought to have looked garish and arriviste. In actuality, they are a startlingly romantic sight, reminiscent of something from Tolkien or Grimm.
As it turned out, Grandfather had built a tower, named Yunhoun Lou, or “The Tower of the Illusory Cloud.” That last fact gave me the push I needed. I was a little unnerved after visiting a workshop of sex dolls. What could be a better antidote than a pilgrimage to the Tower of the Illusory Cloud?
The tower turned out to be a slim, boxy mass, opening up at the top to a broad terrace with sweeping views and Corinthian columns. It looked very beautiful and peaceful, but tiny box-shaped slits on the balustrade—designed for rifles to fire through—reminded me that this tower had been built for defense. For returning Chinese who’d made their fortunes abroad, the towers were a sign of wealth and sophistication, as well as acknowledgment of the insecure times in which they lived. They were defense fortifications against the many bandits who roamed the area, the restive guanggun of their time. They were vertical panic rooms. Saddened by the turmoil, Grandfather had composed a poem carved on the tower:
Flying dragon, dashing tiger: harboring great ambitions but unfulfilled;
Only a life adrift overseas, years of void like an empty mountain.
After leaving the tower, I spoke to some Zili villagers and discovered I still had some relatives in the village, including a first cousin. We sat in his house, and he showed me family pictures. Idly, I asked him, “How many daughters did Grandfather have?”
The Fongs counted the sons, so my father was the sixteenth son, not sixteenth in birth order. I had never been too clear how many aunts I had.
“One,” he said, instantly.
“Really? I remember at least two or three aunts.”
He conferred with other relatives. They knew one daughter had been born to Grandfather’s first wife, who’d remained in the village as the grand chatelaine. She had bound feet and refused to travel overseas. Grandfather’s second wife had lived with him in Malaya and done the bulk of the childbearing. After she died, my grandfather took as his third wife my grandmother, who had been younger than some of his daughters. She had borne him four sons in his old age.
After a while, my cousin returned. “We only know of one. The others, they weren’t counted. They were born overseas.”
It was as I suspected. Zili’s little family museum detailed the far-flung births of the Fong men, even those like my father in Malaya, but the women didn’t count. It was a salutary reminder that gender discrimination was a poison in China long before the one-child policy.
But the Fongs, I discovered, could be selective. The museum traces the Fong lineage back to northern China in the 1300s. The first Fong ancestor, according to family historians, was a general who had married an emperor’s daughter and moved down south to fight the Mongols. That female, they counted.
Better to Struggle to Live On, Than Die a Good Death
The study of dying is like gazing into a reflecting pool. The waters there reflect back to us the kinds of people we have become. More than ever before then, it is timely to ask the question: what kinds of people have we become?
—Allan Kellehear, A Social History of Dying
Two wasn’t enough, that was the trouble. He’s always thought that two was a good number, and that he’d hate to live in a family of three or four or five. But he could see the point of it now: if someone dropped off the edge, you weren’t left on your own.
—Nick Hornby, About a Boy
I
In Kunming, the City of Eternal Spring, after breakfasting on his usual eggs and honey water one day in July, Ma Ke began hospital rounds punctually at 8:25 a.m.
Barely had he started, wrote Ma in his diary, when “a stir occurred. A nurse informed us that three patients were extremely unwell.”
Thirty minutes later, all three were pronounced dead.
At the end of his first hour, the death toll rose to four.
Ma found himself comforting a patient crying “so hard, tears were flowing into her ears.”
Lest you think Ma is an exceptionally bad or unlucky physician, allow me to explain that he heads China’s most famous hospice, Kunming’s No. 3 People’s Hospital’s Section on Palliative Care. Ma does not cure anyone. His job is to ease his patients’ pain and make their last days tolerable, which can be difficult for a physician primed to heal and cure.
Partly, I suspect, as therapy, and partly because he finds the topic of how we face our last days deeply fascinating, Ma has made copious observations over the years, a Pepys of palliative care. His entries are whimsical, ironical, and sometimes tortured.
Over the years, he has evolved pet theories on the particular nature of China’s aging and dying. One: China’s recent wave of materialism has made dying especially hard. Two: those without children have it worst. Not so much for financial reasons—“People of my generation, we will have savings, pensions. But a country with so few young loses creativity,” he said. “Loses hope.”
It is this last point—unsurprising but most evident in the land of the one-child policy—that led me to him.
It is perhaps no surprise that China, as the world’s most populous nation, also has a gargantuan share of the elderly. However, the peculiar element that singles China out from the global herd is not so much the size of its aging population, but the speed at which it is graying. I do not, of course, mean the Chinese are somehow growing old at a faster rate. It is a matter of proportion, as China’s number of retirees is fast outstripping its number of workers.
Currently the Middle Kingdom has the kind of worker-to-retiree ratio that rejoices the heart of its economic planners, a five-to-one ratio. Lots of productive, taxpaying workers to pay for retirees. But in a little over two decades, China’s attractive five-to-one ratio will shift to 1.6 to one, a ratio that is about as economically enviable as foot-and-mouth disease. It spells shrunken tax coffers, reduced consumer spending, and all-around diminished productivity. This kind of transition—more older people, fewer young—is happening almost everywhere in the world, for we now live longer and on balance have fewer children than people did a century ago.
Even so, this transition to a graying society took shape over more than fifty years in the West. Consequently, countries there have had more time to stock up for the gray years ahead economically and socially. (Many might argue that even these preparations are inadequate.) In China, the aging transition will happen in just one generation, and the cupboard is woefully bare.
This aging transition is the result of two things happening at once: people living longer, fewer being born. The former has nothing to do with the one-child policy; the latter, everything. Because of the one-child policy, China’s aging transition will be a tsunami, its speed breaking with enormously forceful effect.
By the mid 2020s, China will be adding 10 million elders to its population each year but losing 7 million working adults. China’s army of pensioners is already creating shortfalls: in 2013 pension shortfalls reached 18.3 trillion yuan, over 30 percent of GDP, and will continue to escalate. Half of China’s thirty-one provinces cannot pay retiree costs and must get bailed out by the central government.
Of all the negative potential repercussions of the one-child policy, this is one we can see happening before our eyes. We don’t know if China’s gender imbalance could lead to a more warlike nation or greater domestic turmoil. We can’t be sure if China’s cohort of Little Emperors could make for a nation of pessimistic, solipsistic, low risk takers. We can’t even be certain of the extent to which the one-child policy will crimp China’s future economic growth.
We do know that short of some cataclysmic plague or war, China’s vast cohort of workers will grow older. And that means by 2050, one in every three people in China wi
ll be over sixty. Ted Fishman, author of Shock of Gray, notes, “If they were their own country, China’s senior citizens would be the third largest country in the world, behind only India and China itself.”
II
In our family home my mother kept three porcelain deities in our living room.
Fu, Lu, and Shou—the gods of Luck, Prosperity, and Longevity—were not of course as important as Guanyin, Gautama Buddha, and the ancestral tablets, which occupied the place of honor on a special five-foot-high rosewood altar.
When I was a child, this altar loomed above me, brimming with flowers, incense, and fruit. I associated this cornucopia with corporal punishment, for, after suitable chastising for my various misdeeds, I would be made to kneel before it, clutching my ears.
Naturally, I grew to hate it all: the incense, the ancestors, and even Guanyin’s calm simper. More comforting to the eye were Fu, Lu, and Shou, little dolls the length of my forearm, a child’s fingertip to elbow. The affable trio perched separately on a wooden cabinet, each with its own little plinth. I didn’t have to kneel to them. No fresh flowers ever graced this trinity, but nonetheless, there they were, a visible manifestation of all that could be hoped for in this life.
Fu and Lu, both black-bearded gentlemen in flowing robes, were hard to tell apart. Shou—Longevity—was the easiest to recognize, a bald old man with a bulbous forehead. Put a red stocking cap on him and he could pass as a Sinified version of a benign Saint Nick.
If you look at modern China today, of these three, Fu, Lu, and Shou, probably the weakest is Shou.
Longevity, after all, is now easily achievable by all but an unlucky few. The average Chinese person can expect to live until seventy-four, a big jump from World War II, when the average life span in China was just thirty-nine.
Luck, the most ephemeral of beasts, is still hotly pursued. Prosperity is equally desirable, given there won’t be much of a social safety net for China’s huge elder cohort. Nobody wants Shou without Lu, and yet almost certainly China will have one without the other.
It’s now an old saw, the saying that China will “grow old before it grows rich.” I’ve heard this gloomy prognostication offered by economists, academics, politicians, and the average person on the street, said with an air of inevitability and submission. Nobody, it seems, is raging against the dying of this light. As the Chinese saying goes, it would be like playing a lute to a cow, an utter waste of effort. It feels irreversible, inevitable. Deng’s economic reforms may have lifted 500 million above the poverty line, but that still leaves nearly a quarter of its 185 million retirees living on less than a dollar a day. China’s graying transition is a first-world problem, but China hasn’t achieved first-world prosperity yet. Despite becoming the world’s second-largest economy, its per-capita GDP is just a sixth of South Korea’s, and one-ninth the United States’.
Some, of course, see prosperity in China’s longevity boom. Ninie Wang was an executive at Motorola when she came up with the idea of starting a company that would be a version of AARP, the American Association of Retired Persons, and the UK’s Saga Group. It would offer a range of lifestyle services such as dancing, travel, and computer lessons to affluent middle-class retirees. She even envisioned classes for teaching modern child-rearing methods, geared toward doting grandparents.
Wang wrote up a business plan that won her the Roland Berger prize, awarded to the INSEAD student with the best entrepreneurial concept.
She christened her brainchild “Pinetree.” “I wanted Pinetree as a name because the word for ‘pine’ in Chinese, song, sounds similar to the word for ‘relax.’ I didn’t want traditional, depressing names, like ‘Golden Sunset,’” said Wang.
Wang is in her mid-thirties but looks younger because of her clean-scrubbed look and honey-colored complexion. With her unflappable air and commonsense pronouncements, Wang comes across as the girl who always gets voted class president, the one who seems older than her years, who ticks all the right boxes. And so she did: raised by a loving extended family, Wang studied economics, found a suitable marriage mate, and was a rising executive at Motorola before heading to business school. Her professors at INSEAD awarded her the Berger prize not because her business plan was flawless, but because they felt confident the capable Wang would execute it.
When I first met her at a vegetarian restaurant near her office in 2013, Wang appeared to have only a couple of items left unchecked on her bucket list: having a child and growing Pinetree.
Wang built Pinetree’s original concept on what seemed like a sound premise. In China, the arc between retirement and terminal illness is probably longer than anywhere else in the world. Men retire at sixty, and women at the staggeringly early age of fifty, long before their contemporaries elsewhere.
Wang figured this herd of retirees would need something to do with all their leisure time, and she meant to fill it. In 2004, she launched Pinetree, with annual membership rates priced at about 10,000 RMB, or a little over $1,600. She forecast the company would hit $1 billion in revenue by 2008.
But Pinetree flopped. After two years, it had only two thousand members, and only after Wang slashed subscriptions several times.
“People loved it, but they didn’t want to pay for it. It came under one of those ‘nice to have’ things, but it wasn’t something they had to have,” said Wang.
Wang, like other entrepreneurs eyeing China’s vast retiree market, had come up against a dismal truth: the market was huge, but China’s retirees simply weren’t willing to spend. Unlike America’s, who’d prospered during the postwar boom years and felt entitled to enjoy their golden years, people in China, who’d lurched from crisis to crisis following the Japanese Occupation, had fewer resources and also, said Wang, an inherently different mindset. “They want to save money to pass on to their children and grandchildren.”
So she went back to the drawing board, asking herself, “What do old people in China want?”
The answer was surprisingly easy, and probably much the same as anywhere else. Old people in China want to live at home and maintain their lifestyle and independence as long as they can. More to the point: their children—many of whom pay the lion’s share of bills—also want this, for putting your folks in a nursing home is still stigmatized in China’s Confucian society.
Home health care is still largely a private concern in China, unlike in other countries where it is funded through a mixture of government services and insurance. China’s insurers are currently rolling out some eldercare packages, but targeting people currently in their forties and fifties, so these products are still largely theoretical. China’s current crop of people in need of home health care, people mostly in their mid-sixties upward, are generally paying out of pocket.
Wang relaunched Pinetree in 2010 as a provider for home nursing services. For modest per-visit fees ranging from as little as $16 to about $120—laughably little by Western standards—Pinetree’s personnel make house calls, monitor medications, and supervise physical rehabilitation. Unlike home health-care aides in the West, these are trained nurses, therapists—in some cases, even doctors—and they don’t cook or clean.
Business grew quickly. In 2009, Pinetree had 20,000 subscribers. Two years after its relaunch, Pinetree had more than doubled its number of subscribers to 50,000. By 2015, this had jumped to 170,000, and Pinetree had expanded to Shanghai. Pinetree broke even in 2009 and is now profitable, says Wang, who aims to expand Pinetree into a nationwide franchise.
World domination it isn’t, though. With such small costs per transaction, Wang depends on large volume. Handling a large, mobile staff requires good management skills to ensure consistent service. On the bonus side, Pinetree needs little capital infrastructure spending, so Wang is able to grow the business quickly.
“It’s not rocket science,” said Wang with a laugh. But for all her self-effacement, Wang is fiercely ambitious. She is lobbying for government funding and wants to expand Pinetree’s services to suburban areas. She wo
uld like Pinetree to eventually cover 5 million senior citizens. “The whole world is aging. I’d like to think maybe China could offer some solutions for how to handle this gracefully,” she said.
It’s unclear yet what those solutions could be, for much of Pinetree’s model—relatively cheap and abundant trained personnel, high population densities—seems unique to the Middle Kingdom. I learned a little of this through accompanying some of Pinetree’s nurses on their in-home visits.
One summer day I met Nurse Gao at Chaoyangmen’s subway station. To keep costs down, Pinetree’s nurses take public transportation or bicycle to their various appointments. It’s not easy in a place as sprawling and traffic choked as Beijing, requiring smart scheduling.
Nurse Gao, twenty-five, was a tanned native of rural Jiangxi Province. She’d been with Pinetree three years. We headed to a five-floor walkup nearby. The patient, let’s call him Chen, was a seventy-three-year-old retired government official who suffered from early-onset Parkinson’s and Type 2 diabetes. Two years previously, he broke his hip and had since been wheelchair bound. With no elevators in the building, he had scarcely been out of the apartment.
Before entering the apartment, Nurse Gao slipped on a mint-green overall with the Pinetree logo and pinned on a nurse’s cap, also green. She put plastic covers over her shoes and handed me the same.
Chen and his wife lived in a spacious one-bedroom apartment with a sunny balcony. Their twelve-year-old grandson was playing computer games in the living room. Chen spoke slowly but was chatty. As Nurse Gao took his blood pressure, they chatted about his daughters and how city folk preferred girls to boys now. He told me about his niece, who had a good job and a flat in Singapore but was unmarried and a source of worry to her mother.