What has been the result? In 1996, there were forty thousand international patients, including resident expatriates and foreign travelers and in 1999, there were 162,000, the largest number from the Japanese expat community, followed by Americans and British. This business, Shroeder said, represented thirty percent of the hospital revenue and it made Bumrungrad the “largest international health care provider in Southeast Asia.”
That was the situation when I checked myself in, got my body bathed and shaved by three attractive Thai nurses (not an altogether unpleasant experience), and was wheeled into one of the operating rooms. Briefly, one of my arteries was completely blocked (“calcified” was the doctor’s word) and two others were about fifty percent blocked. I had not had a heart attack, only recurring angina pain, so I was making the assault. Call it a preemptive strike.
The plan was to take a long piece of a vein from one of my legs and use it to make the bypasses that would skirt the blockages and return full blood flow to and from my heart. I was assured that it would be at least six weeks before I could lift a bar girl weighing more than thirty kilograms and that the pain in my chest and leg would go away much sooner. I also had to sign a form wherein I assumed full responsibility for whatever they did while I was sedated.
In the days that followed surgery, there were moments. Many of them. The worst may have been when the team of nurses in the Coronary Care Unit extracted the breathing device that had been inserted into my throat and it seemed to have got stuck on the spot where my gag reflex resides, so that I couldn’t stop gagging and felt like what Richard Pryor described in his routine about Forgetting How to Breathe and I went at the sweet little caregivers as if I were Jean-Claude Van Damme. I make light of this, but my friend (now wife) Lamyai arrived in the middle of this affray and burst into tears.
There was also the wonderful experience a few days later having the catheter yanked from my penis.
Worst of all were paranoid fantasies equal to anything Stephen King had devised that accompanied the morphine painkiller that was delivered via one of my IV drips. I swear this is true: both nights that I was being eased and sedated by that scurrilous chemical concoction, I was totally convinced that one of the nurses on the midnight-to-eight shift was a serial killer out to murder foreigners. It was like a peyote trip I took in the early 1970s, when I fell into a suicidal pit; I knew, intellectually, that the depression was drug-induced, but that didn’t mean the desire to kill myself wasn’t real. Now I found myself confronting the nurse every time she approached my IV bottle with a syringe, inhospitably.
“What’s that?” I demanded.
“Med-ih-CEEEEEN,” she lilted in her adorable Thai accent. “What KIND of medicine?”
“Pain-kee-LAH!” she replied.
You get the picture and will appreciate why I was pleased that on the third day I was given Tylenol with codeine instead.
Recovery was quick and by the fourth day I was complaining about the food (think airline economy class or primary school cafeteria) and enduring sponge baths delivered by nurses that made me feel like an old Buick under assault by towel boys in an East L.A. carwash.
On the fifth day, most of the ten IV ports, drains, catheters and assorted monitoring connections were removed and I was in a double room alone with one of my docs telling me I was an ideal patient. (Pants on fire.) Attitude was a large part of the process, he said. There were many men who came into the hospital for what is called “elective coronary artery bypass surgery” expecting to die—between one and two percent do—and they recovered much more slowly. To assist me, I was given what looked like a child’s toy and asked to take breaths deep enough to raise three balls to the top of three chambers, thus re-expand my lungs. I was also given a red, heart-shaped pillow with the hospital’s name on it to hug to my chest when I coughed, which felt like being stabbed the first few days but apparently was necessary to keep fluid from accumulating. I was told to carry the pillow everywhere the first two weeks. Sure.
Lamyai was with me at night and much of every day, helping me pee and turn over and sit up, massaging my back, changing my sweat-soaked PJs, sharing my morning rice soup, peeling and feeding me fruit that was brought by visitors. One night three friends from the bar where she worked arrived at two thirty a.m on their way home, giving the nurses on duty something to gossip about for days. Lamyai was actually encouraged to stay—it’s the Thai way—and I couldn’t have done it without her.
On the eighth day I went home, where I sat with three looping patches on my pump, a humungous bag of pills, my dry, splotched, nearly hairless skin reminding Lamyai of an ancient Chinese man she once worked for, wounded (and missing) veins, tender former IV entry ports, cramped muscles, aching joints, blisters on my feet from the crappy slippers the hospital gave me for my forced eight-hundred-meter marches up and down the hallway, occasional floating spots before my eyes, entrails still partially compacted, and a seven-day growth of hair that looked far better on George Michael’s chin than on my torso, limbs, and genitalia, as I waited for the next adventure in my life.
I had a friend who e-mailed my kids every day I was in the hospital and when my daughter and I finally talked by phone, she said that when she heard I was bitching about the food, she knew I was going to be okay I was, too. Within a short time after discharge, I was climbing the ninety steps to the Bangkok Skytrain without getting short of breath, the pain had stopped in my left arm, and the whole thing cost me only US$8,000. A friend of mine in the States had virtually identical surgery about the same time and it cost him US$55,000!
Okay. After all’s said and done, the question is: would I do it all over again in Bangkok?
Yes. But only if the nurse who shaved me before surgery is in charge of the post-operative drugs.
The Visa Dash
My friend Chris Moore was bragging about how quickly he passed through immigration on one of his recent visa trips, then immediately through immigration again, to satisfy Thailand’s Byzantine requirements to remain in the Kingdom legally.
Chris is a Canadian novelist living in Bangkok and like most expatriates in foreign countries he must leave the country of his chosen residence regularly to keep his visa current. Chris generally has a visa good for six months at a time, but he must leave the country during that period, even if only for long enough to get the requisite rubber stamp on his passport, proving an exit and re-entry. Chris told me he once did a turn-around in Singapore in eighteen minutes, a stunning accomplishment.
The time came for me to make a similar visa run and I decided to challenge his mark. Singapore’s airport is remarkably efficient, so desiring an even playing field I made that my destination, too. Although I gave it no significance at the time, I was carrying a bag that weighed about twenty-five kilograms, following a week-long holiday on one of Thailand’s southern islands.
Trouble arose even before I left Thailand, when the plane was an hour late in departing. This meant that I wouldn’t have ninety minutes in which to do my immigration boogie, but only half an hour. That left me a very small window of exit and re-entry, should I not be so lucky as Chris, or as quick.
As we approached Singapore, I shared my concern with an airline flight attendant, who referred me to the purser, who told me not to worry. She promised to turn me over to the airline’s ground staff on arrival, which she did, along with a Chinese Singaporean who worked in Bangkok and was making the same turn-around visa sprint.