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Mission Hospital disappoints

Here is another first hand account of medical treatment at a hospital in Thailand. This time it is Mission Hospital and as the writer points out he was usually very satisfied with service from Mission but ended up quite disappointed this time. His story:

Looking at the scale, I knew something was wrong. The month before, I had placed myself on a strict exercise and diet regimen. I was happy with the results, even though I thought I had lost a bit too much weight. I needed to put on a few kilos. So for the past week I’d been eating too much, four meals a day and one of those just before going to sleep at night. Looking at the scale again, I realized I just might need to go see a doctor. I’d lost 4-1/2 kilos in 4 days while trying to put on weight. I weighed 85 kilos. That’s the lightest I’d been since I was 17. I’m now 43.

I’d read on-line that one of the reasons for sudden and dramatic weight loss is cancer. My sister had contracted and died of cancer at the same age. It was July 1st and a bank holiday in Thailand. There was no question of where I would be going; Mission Hospital. I’d been going there for years and had always received top notch treatment from doctors and nurses and excellent service from their support staff. I called them and had an appointment for Monday morning, my personal independence day.

I’d seen this G.P. before. He was a bit young, but earnest, professional, and showed a great deal of personal concern for his patient. I don’t like going to see doctors or even entering a hospital. I suppose it comes from seeing too many relatives pass on as a young child in the same sort of place. This doc always put me at ease and made me feel cared for and the nurse that always seemed to be there, who I later learned is the Head of Nurses, has the warmest demeanor and a comforting smile. For a Nosocomephobiac (someone who fears hospitals) like me this is important. I could never see myself going to another hospital. My impression is that many of the doctors and specialist there work full time at international hospitals in Bangkok and pull a couple of shifts a week at Mission. I recall one time when visiting a dermatologist with my better half, her doctor commenting that we could see her at her other hospital but it would cost almost twice as much.

Here I was explaining my situation to this G.P. He immediately assessed the situation and had me off to the lab for a full spectrum blood and urine analysis. It takes them a while to run the tests. So I went to lunch and upon my return saw the doc relatively quickly. He meticulously went through the blood analysis with me; no thyroid problems, no diabetes, No H.I.V. and so on. He got to the urine analysis and did the same until we got to the red blood count (RBC). Everyone has a trace amount of red blood cells in their urine. The normal measurement is between 0 and 5 RBC/HPF( red blood cells per high power field) and generally under 3 RBC/HPF. Mine read between 20 and 30 RBC/HPF. The doctor carefully explained that this could be due to kidney stones, an infection, or cancer. He would direct me to a Urologist and said I’d need a Prostate Specific Antigen (PSA) blood test to narrow the field. It seemed pretty obvious to me that it was unlikely to be a kidney stone or simple infection.

I went to see the Urologist that Friday. Before seeing him I gave another blood and urine sample for further testing. He talked to me briefly. No I don’t have any problems with urinating or erections. He then went over the new tests, which were taken for comparison with the one I’d had Monday. Everything showed the same. After examining my prostrate, he said the next step was to get a KUB (kidneys, ureters, and bladder) ultrasound to determine if there were any stones or tumors. It was a few hours later when I began to wonder about the PSA blood test I was supposed to have been given. I’m sure the G.P. had said it was important. I’d have to ask next time.

Three days later I found myself in the radiological department. I had been instructed to drink at least 500 ml. of water prior to my appointment. The ultrasound machine needs a certain amount of water in your bladder to see the prostate which is nestled just beneath it. I hadn’t drunk enough. I had already changed and was in hospital one size fits all trying to get as much water in me as I could. Finally I was on the table with an ultrasound specialist taking pictures of my kidneys, ureters, and bladder and prostate. It was anticlimactic. I was out the door in another ten minutes.

The following Friday I had a 3 o’clock appointment with the Urologist. I was a bit disappointed with the day, as it was Asarnha Bucha Day. I’m Buddhist and this is one of the holiest days of the year for me. I left my friends and loved ones to go to the hospital, arriving 30 minutes early for my appointment.

Upon arriving, I was surprised to see so many people there. I had my blood pressure taken and asked the nurse what it was. She said, “Normal”. “Yes”, I replied”, but what is it?” Three times I asked and three times I got the same reply, which I found really odd. I don’t know much about medicine and the only indicators I get over time that are measurable to me are my heart rate (usually in the low 60s) and my blood pressure (generally in the high teens over the 70s). Now here was a nurse refusing to tell me what it was. That’s weird.

The TVs were blaring with a tinny grating noise so, after explaining to the nurses where I was going, I went over to the emergency entrance to wait. It was nice, comfortable, and quiet there. After about 30 minutes I checked with them to make sure they hadn’t forgotten about me. No they understood where I was and hadn’t forgotten. As I was walking back I passed the specialist I was waiting to see.

Another 30 minutes passed and I checked with the nurses again. They said there was a queue of 8 people ahead of me. Well, this got me hot under the collar. Why did I have a 3 p.m. appointment? I went to the front desk to complain. I immediately knew I wouldn’t see the doctor for at least another 45 minutes. The customer service representative was so nice and sincere I felt ashamed of being upset and calmly sat back down and waited my turn, thanking her for her help.

At 4:28 p.m., two hours after I got there, an hour and a half after my scheduled appointment I was called to see the doctor. The crowd of people that had been buzzing before was gone. There was one man watching a TV show and I got the sneaky feeling he was there because he just wanted to finish the show before going home. He looked too relaxed. I sometimes have a sneaky suspicious mind and could help but wonder if I hadn’t been put to the end of the queue for complaining about the waiting time.

Finally here I am. The worry that I may or may not have cancer could finally be solved running through my mind. That’s the only reason I kept this appointment on this holy day. The doctor was speaking especially fast. I got the feeling that I was the last patient of the day and he wanted to get home. He went through the KUB pictures without showing me anything, just proclaiming them “clear”. This resonated with the nurses earlier “normal”. Then he went through the blood and urine tests from the week before and told me I was “hemoetasists, hemeotastic, uh,,, hemeothatic, well I can’t pronounce it” he explained “But it is normal for about 10% of the population to have a high RBC/HPF.” I told him I was especially worried as my sister had contracted and died of breast cancer at my exact age, 43. He laughed and said,” Well, she didn’t die from prostate cancer did she?” I was shocked. I went on to tell him my grandfather had died of prostate cancer when. He cut me off and glibly said prostate screening should have begun at 40 then. I was getting the impression I was being rushed out the door. I asked about my PSA to which he replied “You’ve had one” but after glancing back and forth from my charts to his computer screen he realized I hadn’t and offered to have me take one immediately. I couldn’t as I’d already been there for two plus hours and had other things to do. He scheduled my one for three months down the road in October. Amazing, I had one more question for him, “I’ve been having pain in my pelvic for three weeks now, that I have never experienced before and you’re telling me to forget about it?”His answer, an emphatic,” Yes”

I wrote to the hospital and expressed my disbelief as this was the antithesis of everything I have experienced at Mission Hospital. In response I was sent to another urologist, who has me on a series of tests to determine, as he put it, my “perennial pain”. I also had appointments with the Head of Physicians, the Head of Nurses, and the Head of Customer Service for Mission Hospital. They offered their apologies for any dissatisfaction on my part and extended every courtesy to me. As I told them at the time “This is the only hospital I ever go to and I can’t see myself going anywhere else.” That one day was truly the exception.

This story serves as another reminder that despite how nice a hospital is it is the doctor that makes all the difference. Many patients have stories of questionable treatment by doctors at the private hospitals in Bangkok, which makes one wonder if the hospitals are at all concerned. After all, when a doctor comes across as rushed or uncaring it reflects strongly on the hospital and often results in permanently losing a customer.

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