I’m back home from my medical adventures in Bangkok, and today I devote my entire blog to a not too serious, hopefully slighty humorous account of my sojourn at Rajavithi.
Mobi’s Medical Mayhem
It seems that every time I go to Rajavithi hospital in Bangkok, the car park is always fuller than on the previous occasion; this despite the fact that each time we go, we arrive earlier and earlier.
Last Wednesday we left home on the dot of five a.m., and as the traffic was relatively light, we arrived the hospital multi storey car park at around 6.30 –which was at least 45 minutes earlier than on our previous visit. Yet the sections of the car park reserved for us erks and patients was already chock-a- block. The car park has ten floors, but around 7 of these floors are cordoned off for the use of ‘VIP’s’ – presumably doctors and…..???
Of course, you see very few vehicles parked in the cordoned off areas, but each floor has at least two guards who quickly wave you on if you so much as slow down to glance at the empty parking bays. They ‘shoo’ you right up to floors 9 and 10, where hopefully you may find a parking spot, but on the last two occasions, these floors have all been full, despite the early hour.
So I have then been directed back down to the 3rd floor whereupon on I am told to return to the higher floors, whereupon I am directed downwards yet again, and so on and so forth until eventually, all and sundry are dizzy and sick from all their endless journey spirals.
When the guards are satisfied that if you weren’t ill when you arrived at the car park, you certainly are now, they will guide your vehicle to some previously marked ‘off limits’ area where you are told to double park in the main driving lane, but leave enough space to allow the privileged few to still drive into their reserved parking bays, when they arrive – if ever!
Noo asked the guard if we could leave the car there for 3 days, but he informed us that this was not allowed. However, for small consideration, he would be happy to find us a parking space in the main hospital grounds later that day, so she left him her phone number and off we went for the start of my three day adventure.
Again, I don’t know if it is my imagination, but there seemed to be at least twice as many people crowding around the hospital than on my last visit. There were literally thousands of them: walking limping and sitting in every nook and cranny of the massive hospital.
There wasn’t a vacant seat anywhere, and there were so many people thronging the walkways that our progress through the hospital was painfully slow, especially when you suddenly had to jump out of the way to avoid being run down by a wayward bed containing skeletal patients who looked more like corpses than patients, being pushed along by family members who clearly had not passed their gurney driving tests.
I was sporting my hospital instruction sheet attached to a load of forms, which listed, (in Thai), all the tests I had to undergo that day. Although I didn’t know it at the time, as my written Thai is pretty abysmal, the tests were: Blood tests, chest x-ray and an EKG, plus the usual blood pressure, body temperature and weight checks.
On each form (one for each test) it was noted that I would pay cash. So our first stop was at the cashier’s window to pay in advance. Fortunately there was only a short queue and I was soon handing over a thousand odd Baht. The nice cashier lady printed off a sheet and handed it over. It contained a list of all the blood tests –in English – that I was to have.
The tests fees were all 60 Baht each except for the last one which was 250 Baht. Why was that one so expensive? I took a closer look. I might have guessed – it was an HIV AIDS test. Now, even Bumrungrad would never carry out an HIV test on a patient without permission, but here, it was a matter of course. I didn’t mind, as if I did have HIV, I’d rather know than not, and frankly, I could hardly blame them for not asking permission. Can you imagine the chaos if they had to ask every one of these thousands of patients for permission before doing the test? It would all end in uproar.
There was quite a long wait for the blood tests, although they did have a ticket queue system, so at least you could follow your progress on a led screen, unlike in most hospitals I have been in – including all the private ones. They had a wonderful system; once your number came to the top of the screen, us vampire victims had to exchange our queue tickets for little plastic pots which contained our medical papers.
So Mobi joined a group of pot-toting, quivering Thais, (most Thais are terrified of needles), and was led into a room with about 6 nursing stations, where we waited for one to become free. We all jostled with each other to try and persuade the ones behind us to go first – we were all so polite. But I finally realised there was no way out of it, so I sat down in front of the prettiest nurse I could find who proceeded to fill a coterie of test tubes containing copious amounts of disease- ridden, Mobi-blood.
Drained of blood, I enquired where to go next.
‘Back to the cashier’, I was informed.
‘Why? I’ve already paid.’
‘Only for the blood tests. Now you must go back and pay for the x-ray.’
‘Why couldn’t I pay for everything at once?’
‘That’s not the way they do things here.’
So back to another queue to see another cashier and pay for my x-ray, before heading off, through the ever increasing masses of the sick, to the x-ray room.
The last time I had an x-ray at this hospital, I had to follow a long line of men into the x-ray room itself where we were x-rayed one at a time. The line then moved along and back out again. I recall that I was told to remove my shirt as I shuffled along inside the x-ray room, and I idly wondered if this was how it felt when the Nazis gently encouraged the holocaust victims to line up and enter the gas chambers.
However, this time, for some unfathomable reason, it was a bit different. (Maybe some hospital administrator had read my blog and discovered that we were all in danger of undue exposure to radiation?).
We sat in a packed waiting room for about an hour, during which time, a lady with a microphone kept yelling out at the top of her voice to the assembled multitude about the procedures they must follow to avoid having to pay for their x-rays. By the time my name was called, it was clear that I was the only person in the entire room who had been obliged to pay. But there again, I was the only farang!
Whether this had any bearing on my x-ray, I have no idea, but this time I was all alone in the room, and they even took my pic twice, as the first time I messed up when I thought they told me to breathe out, but they had actually wanted me to breathe in and hold my breath!
Next – yes, you’ve guessed it – back to yet another long cashier queue to pay for my EKG.
Remarkably, the EKG room was air-conditioned – I suppose on the principal that it is difficult to attach electrodes to a slimy, sweat-stained chest. While queuing for my EKG I was I was asked my age, which was duly noted, although I did wonder why she had asked me for this information as it was clearly written in all my records, right next to my hospital number.
Upon conclusion, I was given my heart graph to take with me, and on my way back to the heart unit, noticed that I seemed to have suddenly experienced a dramatic loss in weight! Right there at the top of the graph sheet it stated, Age: 65, Weight: 65 kilos. I had just lost 25 kilos…or had I?
Back at the heart unit, I handed over a large file of papers to the nurse in charge, and was told to sit down and wait. Wait for what, nobody told me. Noo was sent on errands to various points throughout the hospital but what she was doing or where she was going remains a total mystery.
After an hour or so, I discerned that I was waiting for an available bed so that I could be admitted, and I told Noo to enquire if there were any private rooms available. Poor thing was almost laughed out of court as it was explained to her that all the other people in the room were also waiting for beds and that private rooms were not on the agenda.
Oh well, that was that and I resigned myself to sharing a ward with dozens of other men. It might be a laugh, I grimly speculated.
Eventually, I was told that there would be no beds available in the heart centre but somebody had just died and they had found me a bed in the main part of the hospital and off we went to the third floor to seek out my bed, lately occupied by a fresh corpse.
Now I don’t wish to be overly critical, and during my many years in Thailand I have seen far worse hospital wards up-country, but the ward I was sent to was a bit of a nightmare. It was teeming with men of all ages and in various degrees of medical distress, along with their relatives and friends.
Amazingly, the very large room had air conditioning, (well it was over 40 degrees outside), but it was still pretty sticky, and for some reason, the whole scene reminded me of a grotesque cartoon depicting a Victorian scene in ‘bedlam’ – an institution for the insane.
‘Yes,’ I thought, ‘this is going to be fun…’
We looked around and were greeted by a very nice ward sister who welcomed me to her little kingdom and led me to the only empty bed in the entire room, sandwiched tightly between a bed containing an extremely aged gentleman, being fed through a straw by his equally aged wife, and a middle aged man covered from head to foot in bandages and who looked more dead than alive.
I was given my hospital pyjamas and was told to get changed. ‘Where?’ I wondered; surely not in the middle of all these people? Noo told me to go to the bathroom, which was when I first started to wonder if I could get through all this without going crazy. With all due the respect, the toilet block was terrible – in a very dilapidated and in bad state of repair, with just a single ‘wash’ cubicle containing a large bucket and a cracked water scoop.
The WC’s were, frankly, disgusting, and it was in one of these that I gingerly changed into my hospital garb. I don’t know if any of you have had the pleasure of trying to tie up hospital pyjamas in this part of the world, and if so, did you ever succeed in getting the trousers tight enough so that they don’t slip down to your ankles as soon as you stand up?
The problem is that the pyjamas are held up by a single, unbroken, cord and the idea is to try and tie a tight knot from a chord loop – in the front, a task which for this hapless farang, has always proved totally beyond my understanding and capability.
So I hobbled back to my bed, grasping my pyjama bottoms for all I was worth, terrified that I would let them slip and inadvertently become the comical high point of the day for the assembled masses.
Sitting on my bed, feeling a bit down about it all, Noo valiantly offered to check again if there were any private rooms available. I really don’t know what I would do without her. She had already been knocked back once, but was willing to try again. A minute later she was in deep conversation with the nice ward sister, and my hopes started to rise.
The sister had said something to Noo in Thai which has no direct translation into English, but means something along the lines of ‘ So this is all completely beyond the limits of his toleration is it?’ although in Thai it is but a single word. The sister said she would check to see if there were any rooms available, and I thanked her and politely told her that if not, I would just try to grin and bear it. After all, I didn’t want to make an enemy of her, in case I was obliged to stay there.
To cut a long story short, there was one room available on the next floor up, which just happened to be the VIP floor, but when I was shown the room for approval, I was advised that the window curtain was broken and couldn’t be closed, so when I slept, I would be exposed to the night sky. The stars and angels would be watching over me, whether I liked it or not.
Choosing between having to put up with a non-closing curtain in a cool, fully equipped private room with all mod cons and being stuck in a steamy bedlam, with filthy toilets and dozens of disease ridden patients, was a bit of a hard choice to make; but in the end, I gritted my teeth and resolved to suffer the terrors of the dysfunctional curtain. In other words I couldn’t wait to get signed in.
The room was everything the other room wasn’t. TV, fridge, electric power shower and all the usual equipment and personal supplies you would expect in an Asian private hospital. I must say, it was a bit of a sad indictment of the culture, as I became aware of the respect and how charming everyone is when they discover that you have money; but it as something I was reluctantly prepared to tolerate. Money still means everything – particularly when you are surrounded by people with far less, and the treatment I received in the hospital from then on in was almost as though Noo and I were minor royalty.
I was treated far better than in all the other private hospitals I have ever been in. In private hospitals, the patients are all the same; you all have money – and you are one of many, and do not merit special treatment.
But in a government hospital where most of the patients don’t have two ha’pennies to rub together, anyone with money is on a different planet, and they let you know it. I was fussed with and tended by dozens of beautifully groomed nurses; from the moment I entered the room to the moment I departed, 2 days later.
The main event of the afternoon was the ritual shaving of Mobi’s pubic hair by the most delectable nurse I had ever had the pleasure of setting my eyes on. Believe me, it was an effort to stop myself from becoming embarrassed. She was so pretty that I even kept smiling when her blade went astray and drew blood.
‘Oh, sorry,’ she said, with a look of concern. ‘Does it hurt?’
‘No…no…’ I replied, still smiling but inwardly smarting from the pain.
In spite of all the privacy and comfort, I had a lot of trouble getting to sleep and only succeeded in getting about 3 hours sleep before I was woken at some ungodly hour and two hours later I was back in the heart centre to await my angiogram.
I was separated from my beloved Noo and parked on a gurney in a corridor near the O.R., so she took off to Chatuchak market to spend the family jewels and I was left to wait, and wait and wait…
Two hours later I was still waiting, feeling thoroughly bored and unable to move due to being connected to an intravenous drip. Another hour and Noo returned but I was still lying there. It was just my luck; there had been an emergency with the patient ahead of me who had needed a stent to be inserted in his artery, and so everything was delayed.
At long last I was wheeled in to the enormous O.R. and manhandled onto the operating table. Although I had experienced a ‘conscious’ angiogram many years ago in the UK, I could not recall anything approaching the events that followed.
Except for the fact that I was required to have my legs flat on the table, for all the world, I could have been a woman being placed in the delivery position. I had to put my hands up behind my head and grip onto a metal bar, and my legs were spread wide apart and my manhood was revealed for all to admire – well at least to the attendees in the OR, of which there seemed to be dozens.
The procedure then commenced and the doc opened up the artery in my groin and injected some dye, and then he followed up with a micro camera which travelled up my artery and around my heart. Above me, all manner of large pieces of equipment on hydraulic dolly’s were whizzing round and lowered within millimetres of my heart – sometimes even touching my body – and there was much commentary and chattering in the background.
The whole thing lasted about an hour, and finally I was lifted back onto a waiting gurney and wheeled back to the corridor. The doc followed me out and proceeded to close up the wound in my groin. This proved difficult as the bleeding stubbornly refused to stop, and he had to continually apply pressure to the wound for almost another hour before – in his own words – ‘coagulation was achieved’. I guess being a thirty year plus diabetic and taking a daily aspirin to thin my blood, (although I had stopped it for 4 days), hadn’t helped the ‘coagulation process’ too much.
I was given the good news that no bi-pass would be necessary and that now I had to await a call from the hospital to advise the operation date to replace my aortic valve. I was told it might be in anything from 1 – 3 months’ time.
Despite the doctor’s best efforts to have me transferred to his heart ward, it turned out the ward was still full up and it was with much relief that I was returned to my ‘home from home’ in the VIP wing.
I was not allowed to move my leg for a total of 8 hours, so, for the first time in my long and chequered medical career, I was obliged to use a bed urinal to relieve myself. I actually had doubts whether I would be able to go, but with young Noo holding the accoutrement in place – it was a like pissing in the wind…well almost!
(In case you may be wondering, in all previous occasions when I have been bed bound in hospital , I have had a catheter attached to the offending piece of Mobi-anatomy which obviated the need to use the dreaded bed urinal.)
I had two further visits from the doc, one that evening, and another the following morning – to check on the wound and give me the all clear to go home. This was supplemented by continuous visits by sisters and nurses who checked my vital signs and the condition of the wound. Or maybe they just wanted to have a look at a farang’s manhood….
One particularly diligent young lady decided to clean up the wound and re-dress it, but somehow succeeded in getting her cleaning alcohol swab onto my right testicle! I almost jumped out of my skin – to the the vast amusement of about 4 nurses who had gathered around in fascination.
The overall treatment, the attention to detail and the follow up for possible side effects was far and away above anything I have experienced during my 3 previous angiogram procedures, and although I concede that some of these benefits may have been due to me having a private room, by and away the majority of the care would have been given regardless of where my bed was located.
All this wonderful treatment and care has given me considerable reassurance about what to expect when I go back for the major operation and it has taught me that whatever the extra cost, I must make ensure that a private room is available for my post op recuperation.
The cost of the room is around 3,300 Baht a day, including 3 meals and as far as I’m concerned, it was well worth every Baht. If I had been in a general ward, it would have cost me at least 1,000 Baht to pay for a room outside for Noo to stay overnight, whereas having the private room meant that she was able to sleep on the sofa and provide me with 24 hour care.
Sure, the unbelievable bureaucracy and constant waiting around can be annoying and frustrating, but I do not believe it detracted from the overall patient care, and is probably not much different to the bureaucracy and delays that are experienced in most if not all state healthcare hospitals in the west.
So here endeth my marathon report on my 3 day stay in hospital. Hope it wasn’t tooooo boring.
BUTT…BUTT…BUTT…I don’t give a hoot!…