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Coincidentally, I’d interviewed the CEO of Bumrungrad recently for a story about Bangkok’s emergence as an Asian health care center, and was impressed even more than I’d been during my six years of residence—during which time I’d visited the hospital’s dermatology, EENT and internal medicine departments, where I always got excellent care. I also talked with the resident doc at the U.S. Embassy, who told me he could send expat heart patients home and used Bumrungrad instead.

Before getting on with what happened to me in surgery, here is a part of the story I wrote following that interview with the CEO and sent to my kids, making it clearer (I hoped) why they were concerned and perhaps why they didn’t have to be.

• • •

Countries are a bit like entertainers: they want to be the center of attraction and make a nice living by being so. They also want to be taken seriously. Certainly this is true in Southeast Asia, where nations compete eagerly to be a regional center for this or that, or in the current business parlance, a “hub.”

Thus, Hong Kong and Singapore battle it out for pre-eminence as financial centers and telecommunications and import-export hubs, while Shanghai threatens to overtake Hong Kong by merging its stock exchange with that of Shenzhen. At the same time, Hong Kong, Singapore, and Bangkok are in a three-way contest as transportation links, and Kuala Lumpur has staked a claim as THE software manufacturing center to be reckoned with… as Myanmar and Cambodia haggle over which produces the most and best quality gems, and Thailand, Indonesia, and the Philippines all say they have the best beaches. We won’t even touch the subject of where the best shopping is, nor where the most beautiful women reside.

As the members of ASEAN, and southern China (arguably a part of Southeast Asia, at least economically and culturally), scramble for control of various markets, some of them make an occasional, amusing stretch. When the Love Bug devastated computers around the world in 2001 and the culprit or culprits were said to be young hackers in Manila, for instance, then President Joseph Estrada, a onetime film actor, said his country should strive to become a center for developing anti-virus software. It sounded like a bad movie plot.

So, too, did a plastic surgeon’s call in Thailand when he said Bangkok could become the world’s center for sex-change operations. In fact, the doctor, himself one of a number of physicians active in waving his magic scalpel to turn one sex into another (mostly men into women), actually was on the right track. He was just taking too narrow a view.

Others in Thailand already had tried to promote the country as a destination for foreign retirees, without any notable success.

But one of the things offered to such retired persons did seem, by itself, reasonably exploitable—and that was the recognition given the country’s new levels of medical proficiency.

Not long ago, if you needed medical assistance in Southeast Asia, conventional wisdom said the best—only!—places to go were Hong Kong and Singapore. I remember a half-dozen years ago asking Andrew Toth, the American consul in Bali, what his biggest problem was. He said it was trying to convince foreign visitors to the island that just because they were staying in a five-star hotel, they could not get five-star medical treatment.

“I told them that if they had anything more serious than a broken leg,” he told me, “they should somehow get to Singapore. Because the hospitals in Bali didn’t even provide medicine or food.”

It was for this reason that many expatriates in Indonesia, and elsewhere in the region, had clauses in their medical insurance policies that covered “med-evac” (airlift) service to Singapore or Hong Kong.

Happily, medical treatment has improved in Indonesia and elsewhere in Southeast Asia in recent years, but it’s still pretty shaky in much of the region. In most Southeast Asian countries, even the capital cities don’t have much to brag about when it comes to modern medicine.

Of all the countries, Thailand may have improved the most, and there is no better place to start than in the office of Curtis Schroeder, the American CEO of Bumrungrad Hospital in Bangkok. He believes that Thailand’s medical services now are as good as those offered in Singapore and that with prices one-half to one-third of those in that city-state, Singapore no longer can compete.

The shift began, he said, in 1997, when Bumrungrad opened its new building and six months later the baht was devalued. The Singapore dollar subsequently lost only a little of its value, but this led to its losing most of its Indonesian patients when the rupiah dropped to less than a third of its previous value, making Bangkok the more attractive destination for health care.

Schroeder also credited Bangkok’s location, within quick and easy reach of numerous countries that don’t offer much modern medical treatment—from Nepal and Bangladesh to Myanmar, Laos, Cambodia and Vietnam.

“These fundamentals are not specific to our hospital,” Schroeder said, “—they apply to everyone in Bangkok.” He also recognized that eight other hospitals (in Chiang Mai and Hat Yai as well as in the capitol) have been certified by the Swiss-based International Standards Organization (ISO), which evaluates and guarantees work systems but not services quality. However, so far, he said, Bumrungrad was (at the time of my interview in 2000) the only one with Hospital Accreditation (HA), the approval given by a non-governmental Bangkok organization that judges actual hospital care by American and Canadian standards.

To win this international acceptance and patient base, Bumrungrad sent marketing teams to meet doctors throughout the region, from Kunming to Jakarta to Bhutan, and opened fulltime offices in Dacca, Ho Chi Minh City and Yangon (staffed by a physician, who makes references), and representative offices in Phnom Penh, Colombo and Kathmandu. The hospital also began hosting medical teams from throughout the region and introduced a web page that attracted over three thousand hits a month.

“Our forms are now in Thai, English, Japanese and Mandarin,” he went on, “and we have a staff of interpreters, including seven who speak Japanese. Many of our physicians are internationally trained. Our nurses receive cultural sensitivity training. For instance, Thai patients take the pills they’re given without question, but Americans and Australians want to know what they’re swallowing, so our nurses have to know. For our Muslim patients, they also know where Mecca is and prayer rugs are available.

“In addition, we’ve tried to create an international feel to the place. Much of the hospital signage is in English and Japanese as well as Thai. We offer vegetarian, western, Japanese and Oriental [Chinese and Thai] dishes on our menu and employ guest chefs from leading local hotels who create healthy gourmet lunches. We have Japanese and Thai restaurants in the hospital, along with a McDonald’s and a Starbucks, and soon will have two Cybernet cafes for our patients.”

The chain restaurants have drawn some criticism, with one Bangkok journalist writing “fill up now on fatty hamburgers downstairs and when your arteries are clogged come upstairs and we’ll replace them.” Schroeder shrugged and said they were a “way to create a world ambiance. Our lobby doesn’t look or smell like a hospital. It’s less intimidating. We believe this creates a better environment for healing.”

This setting further includes fully-serviced apartments for friends and family members. When a man comes from Japan for heart surgery, say, he’s admitted to the new hospital building and his family checks into the old one, converted to comfortable oneand two-bedroom flats.