Bumrungrad International Hospital
33 Sukhumvit Soi 3
Bangkok, Thailand

September 16, 2006

Dear Family and Friends,

Here are the quotations from my latest adventure:

1. "We fixed it."
2. "Wash Body?"
3. "I...want...to...go...to...sleep." 
4. "Mister Jan Robert."
5. "All my patients can walk."

                                                  1. "WE FIXED IT."

13 September, 2006 9:00am to 9:00 pm

What a day!

My MRI is scheduled for Sunday 17 September. But I am from the "Do It Now!" School of Time Management. So I call the clinic on Monday and get an appointment/opening for Wednesday morning. The MRI Department informs the Orthopedic Clinic and an hour later the Orthopedic Clinic calls me to say, "Dr. Channarong will make a special a special trip for you."

I change into hospital garb, wait my turn, and am ushered into the futuristic chamber. I lie on a sliding pallet; the technician adjusts the position of my RIGHT!!! Knee!!! (I had to correct him), and he rolls me halfway into this enormous multi-million dollar Siemens cylinder. He places ear phones on my head. I lie still for about thirty minutes and even with the headphones, the intermittent racket sounds like a Con Ed crew ripping up Madison Avenue.

Later, on his computer screen, Dr. Channarong zooms in and out and around and inside the structure of my knee. He shows me the bad news: Tear of the medial meniscus: Op, Meniscus repair Pathologic plica: Op, Arthroscopic resection. Chondral injury: Op, Abrasive chondroplasty.

In other words, Arthroscopic surgery. Tonight. 7:00 pm.

Like I said, "Do it now!" Besides, my birthday is next Monday, and I will be damned if I spend it lying flat on my ass in the hospital.

I now enter the world of The Hospital Industry: Out of control. Follow orders. Stand here. Sit here. Lie here. Undress here. Make a fist. Relax. Breathe. Breathe deep. Don’t eat. Sign here. And sign here. And sign here. Credit card, please. (As a deposit, they take about 70% of the final bill. Thank goodness my bank accepts the charge.)

From the In Patient admissions desk where I choose my accommodations, I am escorted to the medical area for the first of several pre-surgery station stops. The nurses check my vital signs and extract about a pint of blood.

Next, I am escorted to the Radiology Department and a room full of anxious people. But, after only a couple of minutes I hear my name and I am positioned for a chest X-ray.

Back to the medical area for an exam by an impartial Internist.  All my blood work indicates (can you imagine, it’s only about an hour and all the results are available?) I am good to go.  Except my BP has spiked.  Small wonder with all the stress today and a new med that doesn’t seem to be working yet.

Just next to the Internist’s office I lie down for an hour with two gel-caps dissolving under my tongue.  BP down.  Up and out to surgery.

Finally, it dawns on me. I am going to sleep.  For the first time in ten years I am going to sleep.  I am apprehensive.

As I secure my valuables and deposit my clothes and my shoes in a bin, I meet a young man from Australia. Rand reminds me of something I already know, but he is kind enough to reassure me.  I am a patient in one of the best hospitals in Southeast Asia and maybe one of the best in the world.  Everything is computerized and efficient.  Faciliies seem to be ultra-modern.  The dentists and doctors have two post graduate certifications.  I am in good hands.

The familiar face of Dr. Channarong appears above me.  After my experience with the MRI technician I tell him that I painted a big "X" on my Right knee. (Only kidding.)  The anesthesiologist begins his count: "You will be asleep in forty seconds; you will be asleep in thirty seconds; you will be asleep in twenty seconds."  I interrupt him.  "Doc," I protest. "Please.  Stop counting and just let me go to sleep!"....

....I awaken. The two docs smile down at me. "We fixed it."

                                                  2."WASH BODY?"

15 September 2006 10:00am

For two days now I am immobile in my bed.  I pee haltingly into a stainless steel jug.  And what with the saline solution IV flowing into my vein and the 1.5 liter bottles of reverse osmosis, ozonated and ultravioleted drinking water on my table, the jug fills rapidly.  And what with the general anesthesia and the plethora of pain killers, my peristalsis is on a "job action" and my lower intestinal track is on a "work stoppage."  Plus, I am growing "ripe."

Wearing light blue hospital uniforms, two sweet girls appear.  Each carries a huge steel basin filled with warm water.  "Wash body?"

They gently remove my hospital gown.  With sensitive, caring strokes, they clean me up from top to bottom, paying particular attention to crevices, folds, digits and orifices.  Drugged up as I am, and with Thai, Cambodian and Israeli room mates present ... this event could almost have approached the erotic.

They dress me again in a perfectly handsome pair of green pajamas with the Bumrungrad International logo as the pattern.

For two years now at Bumrungrad International, first as an Out Patient and now as an In Patient, I have enjoyed the most sensational service...as good as any five-star hotel.  And as my old friends and colleagues can attest, I have visited quite a few.

Door Men and Porters greet me as I enter the busy, huge, three-story atrium lobby filled with palm trees, upholstered sofas and chairs and marble coffee tables and Persian patterned rugs.  A flower shop and a gift shop and a Starbucks are on my right.

The staff at the Information Desk speaks fluent English. They wear attractive, custom-tailored light jade silk suits.  On the second floor is an information desk with a fluent Japanese speaking staff who assist the more than one hundred Japanese patients every day.  On the third floor is an area devoted to hundreds of Arabic speaking patients and their families.  The multi-lingual staff usually accompanies the patients to the clinics.  The young Thai lady from the Guest Relations Department who interviewed me in my room speaks French.

The administrative staff in the clinics wears smart blue suits; the nurse’s aids wear light blue uniforms (body weight, blood pressure, temperature). And the nurses. The RN’s. Wow!  How do they maintain their absolutely spotless, bright white, urgently pressed dresses, shirts and pants and caps?  And how do the Thai women, with their traditional long black hair, how do they roll it all up into a neat little net-enclosed bun with a bow in the back of their neck?  And not one hair, not one, out of place.

The waiting rooms in the clinics are inviting and comfortable with carpeted floors, padded chairs, attractive wall coverings and paintings.

And everywhere, in all the outpatient clinics are young women dispensing hot tea and sealed plastic cups of drinking water.

Back in my room, I confront the daily Thai/English menu.  Menu?  Yes, menu: "Please tick only one box for your choice of meal."

"Oriental Food: Steamed Rice, Spicy Roasted Pork Salad, Chicken Wing with Red Sauce, Minced Pork Soup with Jelly Mushroom, Thai Dessert."

"Western Food: Sliced Chicken Breast with Hungarian Sauce and Mash Potato, Onion Soup, Fresh Fruit."

"Japanese Food: Ebitamadon, Miso Shi, Tsuke Monno, Kudamomo."

"Guest Chef Menu: Prawn, Crisp Fish Green Mango Salad, Mackerel, Tamarind Broth, Rice Trio, Longan in Syrup."

"Beverage: Milo, Coffee, Tea, Milk, Ginger drink, Soy bean milk, Chrysanthemum drink, Bel drink."

Normally I select the Oriental Food menu items. I am not thrilled with the selections today.  And since my Japanese is non-existent, I am not adventurous enough to attack those unknown items
either.  So, I must decide between the Western Food and the Guest Chef Menu.  The young girl from the Eurest Food Service Company will come by soon to pick up my ballot.

On the back of the menu: ROOM SERVICE. "Room Service is available every day 24 hours should you wish to compliment your daily meal choice, or should your family and visitors wish to join you in having a meal in your room.  Just call us and we will be happy to serve you.  Please see our comprehensive Eurent Room Service Menu, located in your room."

On the bottom, in bold type: "If you would like a Muslim/Halal Menu or Vegetarian Menu, please call 71337." 

                                               3. "I...WANT...TO...GO...TO...SLEEP."

15 September 2006. 11:00 pm

Two days ago, the admitting manager offers me a photo album and a laminated list describing the accommodations:

a. 4 Bed Room....$57.00 US (Room, Food, Nursing Fees.)
b. 2 Bed Room....$77.00
c. Single Room...$139.00
d. Single Deluxe. $182.00
e. VIP Suite...     $297.00
f. Royal Suite..    $468.00
g. Royal Suite..   $565.00 With Guest

As I don’t have a "guest," and as I anticipate the stern, insufferable and remorseless attitude of my HMO, I request a 2 Bed Room; but none are available.  So I choose the 4 Bed Room and hope for the best.

Beside me, for two nights, and on the other side of a curtain is an older man (probably younger than me) with a deep, persistent, phlegmy, basso profundo cough that seems to begin in his toes, rising and vibrating through his thighs and abdomen before exiting his lungs and lips and nostrils.  I am able to sleep through this.

Diagonally across from my bed is Tu, a young Cambodian man with a neuralgic/rheumatologic problem that no one can diagnose.  Three different specialists interviewed and examined him.  Tu and I chat a bit.  He is a charming man and I promise to visit him in Sihanoukville.

Across from me is a bearded, long-haired young Israeli punk with a bandaged face and nose.  He says he was a boxer in Israel but I wager he lost his last bout, cavorting on Khao San Road – a rough neighborhood of drinking and scoring backpackers and late-night Thai thugs.  I tell him his new nickname is "Barney" and suggest he Google "Barney Ross" sometime soon.

This Sabra pugilist has a ring-side of visitors: young Israeli women...you know the type...hot looking, voluptuous, with revealing tops (big) and revealing bottoms (bigger)...and skinny young guys with colorful circus-like pants and tee shirts.  Do we have a minyan?  And when they bring some food, it's like an "oneg" on a "kibbutz."

Late at night "Barney" is having a conference with his corner-man. That hard, consonant-ridden Middle Eastern jabbing tone with the inevitable crescendo is hooking my blood pressure.  As I limp past his bed he looks up and asks, "Chow (ch as in challah), Chow are you filling?"  I know my opponent.  I summon up my best Mediterranean stance, "I would feel a lot better if you guys quieted down!!"  His apologies are sincere and profuse.  He repairs to the large lounge area next to the nurse’s station to continue the late night picnic.  A respectful kid, after all.

On my third night, the older man with the cough is replaced by a young man with a cell phone and bandages and a sling supporting his left arm (I assume a "motorcy aksiden").  Thais do have large families but this is ridiculous. The whole mishpacha is fussing over this boy.

At 10:30pm, I push the red button on that electronic do-it-all gizmo next to my bed. A nurse arrives a minute later.  I inquire, sotto voce, "What’s the policy on visitor hours?"  "10:00 pm" she answers.  I give her a "look" and motion towards the boy on the other side of the curtain. She smiles.

At 11:00pm, with his cell phone chiming and the unmistakable sweet aroma of barbeque chicken and rice invading my curtain-shrouded cubicle, I make a couple more phone calls to no avail.  I hop on my crutches and crutch my way to the nurse’s station.

Now I know that complaining in Thailand is just not done.  I know that a loud or demanding tone will just make me enemies.  I know that this three-legged stroll down here will get me nowhere.

Nevertheless. I approach the desk.  I stand up straight.  (My mother always pressed me, "Jan, stand up straight.")  I throw my shoulders back as I clutch my crutch.  I make penetrating, serious eye-contact with one of the nurses. (I remember my presentation skills seminar.)

This surgery of nurses is gabbing and puttering about.  They all stop.  They all stare back with blank, uncomprehending glares.  Bravely, quietly, firmly, slowly and with a stone face expression, syllable by syllable, I articulate my frustration, "I ... WANT ... TO ... GO ... TO ... SLEEP.  I ... WANT ... TO ... …GO ... TO ... SLEEP, NOW."

                                                   4. "MISTER JAN ROBERT"

November 2004 – The Present

I registered at Bumrungrad International for the first time almost two years ago.

I arrive at the busy dental clinic and wait to be called.  After a few minutes, a nurse emerges from the warren of consulting rooms.  She is holding a sheaf of papers.  She carefully and melodically calls, "Mister Jan Robert."

The dental nurse wears a surgical outfit and a surgical mask.  But her eyes are large and bright and welcoming and smiling and caring ... two slightly watery pools of grace and dignity.  As I answer to my name, she puts her palms together and places her hands against her chin as she bows gently from the waist – a typical Thai "wai" and sign of respect.  She asks me to confirm my name and birth date.

This ritual is repeated during my five weeks of dental treatment, and in every clinic and office until this very day. And every time, I have the same reaction: I am a human being; I am cared about and cared for by other human beings.  My own eyes are teary.

A year ago last spring and just two days before my departure from Bangkok for a two month trip to Australia and Indonesia, an unwelcome toothache arrives in one of my remaining molars.  I call the dental clinic where I am a "regular."  "Sorry, Mr. Jan.  All full today.  Sorry, Mr. Jan.  All full tomorrow."

I am determined.  I arrive at the clinic, show my Bumrungrad ID card, and hope for an opening.  After about twenty minutes a nurse emerges.  I hear once again what has become music to my ears, "Mister Jan Robert."

Last June, I return to Bangkok from Kuala Lumpur, Malaysia.  Limping on my damaged knee, my hiking stick and I present ourselves at the appointment desk at 9:00 pm.  We make an appointment for the orthopedic clinic for 9:30 am the next morning.  At 9:35 am, a nurse sings out my favorite melody.

Two weeks before the MRI/surgery decision, I come to see Dr.Channarong.  The nurse apologizes.  He is in a "traffic jam."  The Thai expression is "rot tit" which translates literally as "car stuck."  Now, here in Bangkok "rot tit" is a very reasonable explanation for delay.  And since my mobile telephone number is in their records, they will call me when the doctor arrives.

To ease my pain, the nurse hands me a green and white business card that reads, "With our compliments." The Starbuck’s, au bon pain, and McDonald’s logos appear on the card. "Select One." From Starbuck’s, "Short coffee of the day." Or from au bon pain, "Beverage size 16oz 1 cup." Or from McDonald’s, "Beverage size 16oz 1 cup or 1 pie or small french fries or 1 ice cream Sunday (sic) or three ice cream cones."  (If two of you want to join me we can have a party.  I saved the Bumrungrad card as a souvenir of a business that knows how to do business.  By the way, they dip the cone into a cup of hot fudge to produce a thick wall of chocolate coating encasing the vanilla soft serve.)

Thirty minutes later I answer the Cingular tune.  What do I hear?  You guessed it.

                                                  5. "ALL MY PATIENTS CAN WALK."

16 September 2006. 1:00 pm

Dr. Channarong Kasemkijwattana strides purposefully into the room and directly to Bed 728 where, for three days, I lie comfortably on the adjustable hospital mattress.  He carefully examines my right knee and asks me to bend it and then to lift my leg.  Satisfied, we decide on my discharge later in the afternoon.

Earlier in the morning I had limped around my room and ventured, unassisted, down the corridor. So, as Dr. Channarong is leaving, I ask, with a touch of pride and curiosity in my voice, "Don’t you want to see me walk?" Dr Channarong responds, professionally and confidently, "All my patients can walk."

I should be back to normal in a few weeks. No stairs!  Swimming is good. Codeine tablets, just in case.

I am so sad. It’s my last day in Bed 728.   Who wants to leave a five star establishment with three delicious meals and this remarkable service?

And I am waiting.  Every time the door opens to my little ward, I quickly glance to my left.   I am waiting and hoping.   I am hoping and waiting.  Just once more?  Just once more?   But as it turns out, my waiting is in vain and my hopes are dashed.  I am hoping that just once more I will hear that sweet, shy refrain, "Wash body?"

The hospital telephone rings for the last time at my bedside on the seventh floor.  "Mr. Jan.  Please come to the cashier on the sixth floor."  O.K. O...K.... "Hey wait a minute," I am thinking.  "I am the guy with the bum knee." Do they have psychics at Bumrungrad?  A minute later the phone rings again.  "Sorry Mr. Jan. Cashier come to room."   I am happy.

On my way to the lobby, the Porter wheels me past the nursing station.  He clips off my white plastic bracelet that has my name, date of birth, age, BI ID number, and a tiny black and white photo of yours truly. I do have a big smile.

From behind their desk, the white chorus smiles and waves and sings out, "Good luck, Mister Jan."

The logo at Bumrungrad International says, "A World of Care."

Good health to you all!

Mister Jan Robert

PS  In case you are wondering, Jan is not "short" for anything.  What would it be short for, anyway?  Janet?  Janice?  Jeanette?  Try to imagine my mail for all these many years: Miss Jan.  Mrs. Jan.  Ms. Jan.  And those telemarketers don’t have a clue either.  Hasn’t anyone heard of Jan Pierce?  Jan Murray?  Jan Hus?  Jan & Dean?

In actual fact, I am named for my great grandfather, my father’s grandfather on his mother’s side, Jan Tausig.  Jan is the Czech equivalent of John, as it is in Germany, Poland, Holland and Scandinavia.  Cf: Jean, Giovanni, Joao, Ivankor, Ivan, Ian and Sean.

Robert is from my great aunt Roberta.  (My mother was fond of "Robert." She encouraged me to use my middle name or middle initial.  I am grateful to her.)

Thai girls find "Jan" difficult to pronounce. It usually comes out as "Jam" until I explain, "Jan same-same January."  "You born January?"  "No, September." 

And so it goes my friends. And so it goes.

Hey, I am thinking about girls again.  I must be recovering.