Saturday, April 2, 2011

Blue Fingers and Hot Pink Pills

 Day One Of My Hospital Fiasco

A pretty popular saying they have in Bhutan is, “What to do?”  It can mean several things, but the meaning I have found most frequently used thus far is interchangeable with, “We’re F***ed!”  I try and not throw F bombs here because it sometimes feels like the country of no cursing.  Lets just say the sideways head nods came more naturally than the “What to dos?”… Especially today!
They don’t have doctors’ offices here.   Everything happens at the hospital!  Some people get teeth pulled in the same building they were born in.  When you get sick, you go to the hospital; more specifically the ER.  Consequently, I saved up my symptoms of a few different things before I decided I needed to draw the line and let a professional have a look.
This is the deal:  I have been cruising around with an enlarged, swollen pinkie for the last few weeks… maybe an infection or bite.  The tingling, numbness, and swelling has moved down my arm, and my limbs just feel wacky.  Oh, and I forgot to mention, I have a little irritated lump near my tailbone.  A doctor in the US said it is no problem.  It has gotten larger here, and I mentioned it in passing to my roommate.  Off we went!
On my walk to the hospital, I got to talking with my roommate about the one ambulance they have here.  “You’ve seen it?” I asked, as if she were a first grader who had seen Santa.
Then I realized why it took me so long to go to a doctor.  I also thought about my next weeks lesson plan, realizing that teaching articles in Bhutan was going to be different, because instead of saying things like “an ambulance”, you say “the ambulance”.
            We got to the hospital and I went into a little room.  I was walked in on several times while talking to a nurse.  I listed some symptoms… tingling hands, fat pinkie finger, etc.  Lucky for me, my roommate insisted I not leave out the lump on my upper butt/lower back.  Love that chillip!
            The nurse sent me to the ER.  I walked in and everyone stared.  I asked where to go and I was directed to the only doctor in the room, who was a man who looked just older than myself.  He directed me to one of the 7 beds.  There were newborn babies, older patients and now 2 chillips.  Since everyone could see everyone in there, I refrained from poking around in all the containers labeled with tape and sharpie.  I can’t lie that I was horrified when I saw 2 regular waste bins out in the open with signs above them written in magic marker, reading “Hazardous Waste” and “Nonhazardous Waste”.  The only thing more horrifying was when a nurse disinfected a tool of some type by pouring a fluid on it and letting the remnants of the fluid fall into the hazardous waste bin.  Lovely!
            After telling the doctor my symptoms, he told me he’d like to see the lump.  Within seconds, someone was carrying over a tiny green room divider to hide the scene at hand.  I froze up a bit and the doctor said again, “I’d like to have a look.”  At this point I said to myself, “You’ve seen one ass, you’ve seen them all.  I guess they are as open about doctors visits here as they are about breast feeding”.  I unhooked my kira and began to unwrap.
The young doctor gave me a look of terror!  I cringed.  I was not sure if he had expected me to be wearing pants under the kira or some Big Ol’, White Jolly Joes, aka granny panties.  Then, I noticed the second green divider coming around the corner.  Should have known TWO green dividers was kosher here!  The Bhutanese in the ER have officially been exposed to Victoria Secret.  I guess they don’t see undies like mine on clotheslines outside the homes here.  Whoops!
            From there, picture an Austin Powers scene from the opposite side of the curtain with a shadow of me bent over and someone poking at my rear, and asking, “Is this the spot? Have I found it yet? Here?”  All the while….no gloves!
            Next, because of my tingling limbs, the doctor wanted to do an EKG.  The green curtains returned!  F!  Two female nurses and one male nurse came over and began to hook me up with an old school machine.  At this point they knew I was a freak show.  As they cinched the metal pincher devices down onto my wrists and ankles, I couldn’t help but make a wise crack about feeling like I was undergoing shock therapy treatments and asking if I should remove the metal broach used to seal my kira.
            Joke was on me as they stripped me down and began to hook me up.  Next, the man asked me if I was married, at which point I refrained from telling him, “This is not a good time for a pick up line”.  Instead I said “no,” and he then instructed me to remove my bra.
I didn’t hold back this time around.  “Wait a minute.  If I were married, could leave it on?” I asked.  Good lord.  They hooked me up and got it over with.
            When all was said and done, I couldn’t help but peek at the doctor’s papers he put in front of me while he tended to another patient.  The EKG said “normal” and under the list of symptoms which included tingling limbs, enlarged pinkie finger, chest pain, etc., it said, “looking well”.  That must be the scientific diagnoses.  Then I was discharged with blue hands and chest pain.  Sweet!
            I was sent to the pharmacy.  I walked into the crowded little room, and there, before my very eyes, were tons of open containers of fluorescent pills lying on the table in front of me.
The man scanned over the smorgasbord of colorful gems and found a container of yellow ones.  He took a ballpoint pen and labeled a baggy “B Complex”.  Then, without gloves, he casually eyeballed a handful of pills, which he put into the bag.  Then he filled a bag with some white ones.  I am still a little unsure as to what they are.  All I know is that it is some type of painkiller; could be Tylenol, could be Vicodin… sweet surprises.  I thought the last time I would see a plastic bag of unidentifiable pills would be in IV.  I grabbed my baggies and left.  On my way out of the hospital, I saw “the ambulance”.  It is fabulous!  Use your imagination.
In conclusion, I am not really one to freak over nudity, but it is safe to say, I have an aversion to green dividing curtains.  Tomorrow I go in for the blood work.  What to do?  Stay tuned!

Two To Make It True

“Where do I get blood drawn?”
“Oh, diabetes?  That way.”
"Thank You!”
I walked up to a window in a large waiting room.  I was handed Poker Chip 19.  I sat in the crowded lobby next to anyone in Thimphu who also needed blood drawn.  I graded test papers.
When I heard the loud ding and saw my number, I walked up, gave a woman my chip and plopped down into the chair in front of anyone who cared to watch.  As a kid, I fainted with needles.  Now I have become less amused, only slightly squeamish.  I sure as hell was not about to be the chillip on the floor in a kira due to one small blood test.  I laid my arm down on a padded thingy with a little dried blood on it, and I looked away.  It seemed longer than usual as the man toggled the needle a bit, but nothing weird.  Pretty standard.
“Come back tomorrow for the results.”
Off to teach.

After school, my friend told me she had gotten in contact with a neurosurgeon whose daughter went to our school.  He could see me right then and there.  Back to the hospital.
A tall, straight faced, and elegant older man in an army uniform came into the room.  He is a top neurosurgeon in Bhutan.
In between each symptom I listed, the doctor said phrases such as, “Huh?”,  “Oh man!”, and  “That’s weird.”  Finally he said, “Wonder what this is.  What do you think it is?  We better look it up.“  At this point, he pulled out his iPhone and a hospital intern walked in.
The doctor grinned ear to ear and said, “I know what is wrong, and now I’d like to see if my intern can figure it out.”  Right then and there, I thought to myself: “You got me sir.  This man is genius, hilarious, and doesn’t look horrible in a uniform.”
I have what they think is Raynaud’s phenomenon and arthritis.  Raynaud's is a vasospastic disorder (crappy circulation) common in women and triggered by cold weather.  Basically, reddish blue limbs that won’t heat up, chest pain, blah, blah, blah.
The doctor prescribed me three medications.  He told me to bring him some blood work results in the morning, and he said, “Don’t have drinks until at least two of us can join you.”
He followed it up with, “If you want to come back at ten a.m. tomorrow with the test results, great. If not, go to hell.”  He smiled and added, “Oh, and if it gets any worse, don’t call me.”
From there, more blood work, then back to Willy Wonka’s Pill factory.  I was given one pill bag that had three circles on it, and another with two.  Now I know to take the first one three times a day and the other twice.  The special education teacher in me, who believes in creating access to all, really enjoys this simple fact.

Third Day’s A Charm… Right?

By the third day, I kind of enjoyed the central heating, as the hospital is one of only several buildings in Bhutan with this luxury.  However, the smell had come to drive me batty.  I would have taken a bleached, cold, sterile hospital to that warm sour smell any day.
Right smack in the middle of the waiting room, was a bloody stretcher, and nobody looking twice at it.  I walked around a bit, looking for the doctor who helped me the day before.  There was a stray dog that had wandered into the hospital and clearly gotten lost in the maze of chambers.  All around me were signs labeling the different wards.  Scattered among them were signs that said “No Spitting” (red doma).  One blue sign said “Patient Clothing Drying Area”.  Just out the window hung any type of laundry you can imagine except a single hospital gown.
It is amazing how desensitized you become to the interesting things around you.  It feels all right until you have moments when you flash back to reality, cringing at the stained hospital bed sheets you lied down on the night before remembering that most laundry here never sees hot water.  Then the sicko in me says, “What to do?”, and returns to the game, count how many places you see dried blood.
Finally, a random man in the waiting area asked if he could help me. He put out his hand.  Without hesitation I handed him my doctor files (3 papers).  Again, things are weird here.  Everyone trusts everyone, everyone helps everyone, and handing a random person your medical history ain’t no thing.  I’m surprised the man didn’t read “ass lump” and run for the hills.
Long story short, I found the doctor I was looking for, and I handed him my results.  “Hmmm, looks like they ran out of the reagent they needed to test these two main things in your blood.  Get back to me in a week, and they may have it then.”
What to do?  Two hours later, I left the hospital, passing the same bloody stretcher I had seen on my way in.
Off to the pharmacy in town.  I needed one more medication for dizziness.  I tried four pharmacies and nobody carried it.  This should have irritated me, but in a sick way it put me at ease.  Can’t be that important if they don’t have it.  What to do?
Perhaps American health care professionals could learn a thing or two about keeping their patients calm here.  Great care, kind hearts, few resources.  Details…
I went to the market, bought the first fresh asparagus I have seen in months and used that high to trek back up the hill to my home.  Shimbe! (Tasty!)

Oh yah.  And the lump… I stopped inquiring.  You would too!

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