Richard Constable

What's up Doc!?

A recent visit to a private Bangkok hospital

I heard a voice call, "Mr.Richard!," I went over to the initial testing bay and sat in a relevant chair.

The nurse held out a card with the word Richard written on it and asked, "That you?"

I replied, "That's why I came when you called me." while smiling amicably.

She responded by looking at me as if she were still waiting for an answer. I obliged, "Yeah that's me, I'm Richard."

The nurse again, "You want doctor certificate?" while drawing an airframe reminiscent of Lionel Blair on TV's 'Give Us a Clue,' still with only about one-tenth of the enthusiasm.

I retorted, "No, I don't have health insurance."

The nurse bluntly, "You have health insurance!"

Me firmly, "No!" gaining eye contact, "I don't!"

After the formality of strapping on an arm monitor to check my blood pressure/heart rate and having apprehensively taken my temperature. That is, she tentatively placed a thermometer under my tongue while carefully peering into my mouth as if something might be about to jump out. All done, the nurse pointed to the only free chair in the waiting area and said, "You!"

Promptly, I went and sat down and I waited. . .and I waited . . .and I. . . waited.

Wherein, I started to try to guesstimate why it was so busy here today on a Wednesday afternoon. Were many of the people here cause of the smog, haze, er pollution or was it dust? I mean, with related respiratory diseases brought about through a lack of thought and preparation via any number of former governments over the past few decades.  

Roughly, thirty drawn-out minutes later, an attractive willowy nurse was ushering me through a side door. Therein, to the left side of the door sat at a small desk was who I surmised to be a doctor. A diminutive beady-eyed fifty-something Chinese-Thai whose body language and face conveyed to me she'd had a very long-hard-day.

Appropriately, I gave her a high wai subsequently lowering my head; polite greeting "Sawadee krup," while she gave me a curt nod of the head indicating for me to sit down at the chair facing her desk.

She began, "What happen today?" wherefore, I explained I'd had a fever since the early hours of Monday morning and that I still had very little energy. What's more, I'd hardly been able to eat anything, and more alarmingly I'd dropped 3.8 kilos.

The doctor, having listened, told me to lie on an adjacent bed; I found myself lying face down. The doctor checked my kidneys, either side of my upper back - all fine. Then telling me to cough she said that my lungs were good.

Though I doubted it had any relevance to my present condition, I elected to tell her that I often had a severe pain either side of my back. Between those areas, the doctor had checked.

She responded, "There is only muscle!"

Moreover, I'd been experiencing pain in my back there for some time, and I wasn't going to let it go. "I get severe pains on a regular basis."

She shook her head and reiterated, "Only muscle!" and walked back to her chair.

Moments later, we were seated and facing one another again. The doctor asked inquisitively, "What you think you have?"

Me, "I don't know, that's why I came here today in the hope that you might tell me."

The doctor widening her small nipped-eyes, whilst I don't think she was exactly sure of what I'd said - she'd gotten the gist and the detracting undertone. Consequently, I feared we were now approaching the vicinity of a place I didn't want to venture.

Having sensed this, I tried to politely and clearly communicate the fact that the symptoms I had experience were worse than any I'd suffered before, and so I was concerned I might have something serious. The doctor merely sat there staring at me with much ambivalence and had elected not to reply.

After uncomfortable thirty-seconds, I found myself blurting out, "Perhaps pneumonia or dengue fever albeit something as serious!"

The doctor becoming animated, "Ahh, so you think you have dengue fever - so you want to test for dengue!" sounding like this idea appealed to her.

I was regretting my words, "Well, not exactly for dengue, er how would you do a test?" concerned about the cost.

The doctor reassuringly, "With a blood test."

Me, not at all sure, "Would a blood test check for other illnesses too?"

I received a resounding, "Yes!"

"Okay, if that's the case I'll have a blood test."

Fast forward and so many minutes later, pleased to say, the blood extraction on the second floor was a success, the male nurse that took it seemed extremely efficient.

Now being back on the ground floor waiting foyer, having passed the doctor's room of my earlier swift examination and having found it to be empty. Needless to say, I am feeling tired and uncomfortable on a hard-chair, and trying to convince myself that it will all be worthwhile.

After about fifty minutes, I was beginning to wonder if I would ever get to know the result. The waiting area was virtually deserted now, except for a twenty-something Japanese woman and a somewhat bewildered English teacher - yours truly.

Of course, there were several nurses standing around aimlessly, a few more floating about with some purpose. One of these decided to come to tell me it would not be much longer. From her manner, tone of voice and facial expression - I devised she was actually concerned for my well-fair. (Incidentally, I knew my face was as white as a sheet and that I looked as rough as I felt.)

Next, she then positioned herself outside the open door of a doctor's room - I believe that she was tactfully pushing the doctor to hurry up and see me. Just another few minutes and she would be waving me across.

On entering, I quickly perceived a different doctor much younger than before, be-speckled with a prime and proper persona who was placing down her mobile.

I greeted her, "Good evening!"

The lady responded with a patronizing grin, "Good ev-en-ning!" she was off like a gun  "Are you feeling tired?" before I'd managed to sit down.

I exclaimed, "I've been here over an hour and thirty minutes, and I was feeling tired before I arrived."

Not accepting the hint yet flying in again, "Do you have ache and pain?"

"No, not anymore, I am only numb."

Firing away instantaneously, "Have you high temperature?"

Not pleased and wondering why I was back at square one, "How high is high?"

Informing me, "Oh, very hot!" suggesting further, "Sweating!" at the same time circling both hands around either side of her temples with almost as much enthusiasm as good old Lionel Blair in his 'Give us a clue' heyday.  

However, I wasn't in the mood for a game at this particular moment so indicating with squinting eyes and a slight shake of my head, "Weren't you able to determine that from the thermometer reading? that she surely knew.

"Oh!" she said, as if I'd caught her out - she looked disappointed.

Moreover, I was keen to get to the point and to be home. "What about the blood test?" as if I were reminding her about something she'd forgotten.

"Ohhh," she'd chirped up again now glancing to look at some papers on her desk and immediately picking them up. Getting them straight in her hands, she then held the first page towards me. Indicating with her left-hand's index finger on the paper and stating, "You don't have dengue fever."

I responded, "Why dengue? without pausing, "What about anything else?" going on, "I understood I was to have a general blood test, not a specific test for dengue fever."

Lighting up as she read on, "Ahh!" mouth open and eyes agog, looking at me as if she had a surprise, "It's all clear!" and then "There can be no infection because there are no dead white cells!"

I knew from my biology lessons some forty-years ago that phlegm was dead white cells. And not having been producing any was one of the reasons I felt prompted to check. Not quite sure, but getting there. Speaking with an amicable tone, "So does that mean no pneumonia or any other disease?"

"Yes, that's right!" She has obviously relieved at my reaction it was as if she had expected me to be trouble.

Anyway, I was happy now, relieved and about to stand when, "Get a lot of rest!" and "Relax!" furthermore "Don't eat dairy product, yogurt em. . . or any milk!" It all sounded like the good advice my grandma used to give me when I was a kid. I eased myself up to my feet and thanked her very much, while making my way out the door heading with haste to the cashiers' desk in the main foyer.

Sitting there running back through the nonsensical and now apparent unnecessary events of the last past ninety odd minutes. I resolved to pay the bill as long as it was no more than two thousand three hundred baht. I reasoned that if I attended an ethical doctor she/he would have told me to go home and rest as they would soon have diagnosed that I had nothing serious. Possibly charging me somewhere around twelve to fifteen-hundred baht.

Theorizing that having had my basic requests ignored, having been belittled, jerked around, generally disrespected and thoroughly patronized. Not to mention the fact that I was partially exhausted and feeling terrible. In any event, I wasn't going to allow myself to be screwed over on a highly inflated charge.

At long last, a cashier called my name and was soon handing me a bill. It read among a number of other items, dengue fever check 1,495 baht, total 2,220 baht. Near enough, the bullshit amount I had surmised, I passed it back to the young woman along with my cheque card.

Momentarily, like a past-mastered magician, she produced another bill and presented me with that. (Of all the slimy underhanded ways to skin a cat!) This one read along the lines of two doctors three hundred baht each, equals six hundred baht.

I felt incensed, "What?" questioning "How much is it?" I calculated, "Two thousand eight hundred and twenty baht!"

The young woman cashier was nodding with a look of astonishment that said, what's your problem!

I bent over the desk and saw my cheque card which was resting in a switch machine, reaching over I pulled it out. At this point I snapped, No!" glaring "Farang mai dai."

No more than a few seconds had passed, when like an Aladdin's Jeannie, up popped a Philippine HR lady to my left shoulder. "How can I assist you, sir? she said, sweetly.

I briefly explained why I felt strongly that the bill was over the top. She turned, rattling away in Thai with the cashier who wasn't going to be swayed - or no more so than a bulldog with a bone.

The patient HR person turned back to me, and suggested, "Sir, please go and sit down over there," pausing, "for just a minute" I acted accordingly and she was gone.

Feeling fragile and marginally disorientated I started to calculate the chances of walking out of the foyer before I would be stopped by a member of staff, and again making it out of the grounds before being confronted by a surly unsympathetic security guard.

Having decided that the odds were pretty good, and once I was on to the public path I would be as free as a Bangkok city rat.

Thoughts as I ambled home, were about the poor Philippine HR person she'd played her part well and the caring nurse, I hoped they wouldn't be penalized in any way.

For the doctors, I didn't have the least bit of sympathy for either of them. The way I saw it, the first was an uncongenial individual who first having had her feathers slightly ruffled. Then seized the opportunity to hit out and try to do some financial damage to an unwell person. A person who in spite of the fact couldn't easily afford to check - as he has the responsibility of a family - felt he had to.

As for the second doctor, who was presumably put in a position that she would rather have not been in. Nonetheless, there were two ways that she could have handled it. One way would've been to act as an educated and privileged member of the noblest and caring profession by showing respect to her patient. Another way, was how she chose to act like a buffoon assuming that the victim of the farce was a person that could be played like a puppy dog.


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