Tuesday, August 7, 2012

Life and Beauty - This Week

Duang - One week later and with stitches removed

Yesterday we had to drive back down to Kohn Kaen for the stitches to be removed from Duang's face.  The two hour drives down and back were fairly uneventful other than the numerous motorbikes travelling the wrong way on one-way roadways; a common occurrence here in Thailand.  There were even two pickup trucks going the wrong way; not all that uncommon either.  Unlike the previous day when I almost killed a motorcyclist, there was no excitement while driving.

The previous day I had gone grocery shopping alone because Duang is still shy about appearing in public with her swollen face.  Here in Thailand we drive differently than in the USA or Canada.  We drive on the left hand side of the road.  The slow lane is the lane furthest to the left on the road.   The fast lane, the passing lane, is the furthest right hand lane of the highway.

I was in the slow lane of the two lanes of the road that go north.  A median separates these two lanes from the two south bound lanes.  The entrance to the Lotus-Tesco Shopping Center is on the left.  I put on my signal to indicate that I was going to make a left turn into the entrance and commenced to slow down to around 20 KPH (12 mph) for the turn.  I noticed a motorcycle headed towards me, going the wrong way in the gutter of my lane.  I slowed even further and determined that in making the turn I would not hit the on coming motorbike.  Just as I commenced my turn to the left. I heard a loud noise and saw a flash of color pass by on my left side in the gutter of the lane that I was in.  A motorbike flew by me on the inside of my turn.  It appeared to be going around 70 KPH (40MPH).  The motorbike driver swerved to miss me, over corrected , swerved once again and missed the oncoming motorbike.  It all happened extremely quickly but played out in slow motion in my perceptions.  I remember thinking that the motorbike driver was going to fall off the bike and kill himself if not kill the oncoming riders.  Through luck, Divine intervention, or perhaps skill, the motorbike avoided any accident and continued down the road at 70 KPH.  It was a very close call.  Unfortunately this was not the first time that I have been passed by a motorbike on the inside of a turn or been passed on the wrong side by a motorbike.

I was amazed at my reaction.  Of course I was shocked - shocked at this happening so quickly and unexpectedly as well as how stupid the motorbike operator was to have provoked the incident.  A scene from one of my all time favorite movies came to my mind, "Lawrence of Arabia".  One of his followers, a man that Lawrence had risked his life to save earlier, kills a member of another tribe. The death must be avenged and the murder punished but that would trigger the need to avenge his death if he were killed by a member of the aggrieved tribe. To avoid a tribal feud and the disintegration of his fighting force, Lawrence kills a man.  Later, obviously upset by the incident, he reports back to his commanders.  They are extremely sympathetic and try to allay his emotions with statements about how difficult war can be, and how sometimes you must do bad things in order to achieve good.  Lawrence then shocks them by informing them that they did not understand and that he was upset because he enjoyed killing the man.  No, I did not enjoy almost killing that young man but what surprised and shocked me was that I did not care that I almost killed him.

They say that life is cheaper here in Asia.  My experience is that such a perception is true.  I once commented to another foreigner that you could hire someone to kill another person for around 5,000 baht ($150).  My Thai friend added that sometimes it is done for free out of friendship.

If a Thai were to kill another Thai in an accident, he or she would be expected to compensate the deceased person's family between $3,000 to $6,000 USD.  Blood money of $3,000 to $6,000 for a vast majority of Thais, most specifically people in Isaan, is a great financial burden.  However, for me, the issue or rather surprise is that the value of a human life has been quantified, monetized, and accepted before the fact.  In the US the value is undetermined and subject to litigation on a case by case basis.  For me it seems peculiar that the value of a life is subject to the skills and effectiveness of a lawyer and sympathies of a jury.  To discuss and attempt to seek a universal value for a life before a death is a taboo for many people.

In the Muslim countries where I have lived, there was a similar attitude towards life in that whatever happened was deemed to be "God's will".  This attitude seemed to, for many people, absolve or excuse people from acting responsibly or acting prudently in terms of personal safety.

I do not make any moral judgements in this regard.  I write to inform readers how things are elsewhere.  I write to point out how things are different from place to place.

I write of this incident not to share a personal story with my readers but to share experiences and observations of life in other countries and societies.  Because I or Duang have experienced or observed things personally, I am able to write about them and to share them.  It is not about me, or us, the story is about life.

Now, back to Duang's face lift.  We went to the hospital to have the stitches removed.  Just like in America we had to wait for the doctor.  Duang's appointment was for 12:00 Noon but the doctor was not available for her until 1:30 PM.  No problem, waiting here in Isaan is very entertaining and informative.  We waited in an area that contained small offices, small rooms for medical procedures, as well as an open triage area.

It was a busy day with all the seats inside the area filled as well as some seats outside of the area filled with patients and their supporters.  It seemed that each patient had a story to tell or if they could not their support people were all too willing to tell the story.  There was a young man who was going to have a hernia repaired.  His blood pressure was 154/90 so I expect he was suffering some anxiety over his upcoming surgery.  There was a middle aged woman who was having follow up work done on her fingers and thumb.  She had sewed them together in an accident. Apparently they had become infected and the surgeon had amputated some of them.  According to Duang, the bone was good but the meat was bad.  It did seem like some of them were shorter too.  There was a middle aged woman having a procedure done on her nose - implanting a silicone shape to give her nose a more Western appearance.  There was another middle aged woman who was going to have a hernia repaired.

In addition to learning why each patient was there, we also found out how much their surgeries were costing.  The young man's umbilical hernia repair was 50,000 Baht ($1,666 USD).  In contrast my similar operation in California about 6 years ago was $15,000 USD.  The woman's hernia operation was 55,000 Baht.

After a while a tall, slender, extremely attractive person in a very nice skirt and blouse walked into the office and sat next to Duang.  TIT, This Is Thailand, I knew what she was and why she was there.  I am not sure if it was a sixth sense, her protruding Adam's apple, or her low voice that lead me to believe that she was a "Kathoey' (Lady boy).  In no time at all Duang had learned that yes she was a lady boy and she was going to have breast implants done that afternoon for 65,000 Baht ($2,166).  The presence of the lady boy and the two others that arrived later was all just a matter of fact situation.  Everyone knew and no one minded.  Thailand is recognized as a tolerant culture.  The saying of "UP2U" is popular for good reason.

Turn around is fair play even in Thailand.  While Duang was getting all the personal information from the other patients, she was telling them about her face work and showing the work to them.  She then had to explain to them why she was not going to have her nose and breasts worked on.  I understand enough know to have an idea what is being said so I explained that I did not want those changed and liked everything the way that they were - much to their amusement.  I have grown accustomed to the openness of Lao Loum culture and lack of privacy - accustomed but not accepting as of yet.  Of course I smile and chuckle every time that I compare Thai procedures with American procedures.  I remember getting pages of documents outlining the eye doctor's "Privacy Policy". the Pharmacy's "Privacy Policy", the hospital's "Privacy Policy" knowing full well that there is none, and that if I want treatment I have to accept their policy.  In reality the only privacy policy that I am interested in is how are they going to ensure that I do not show my butt or anything else to other people while in the hospital.  However, I imagine that if I were sick enough I wouldn't care.

Eventually we got moved to an area outside of the procedure rooms and in the midst of the triage area.  There was and elderly woman who had fallen down the stairs laying on a gurney.  We got to observe the doctor examining her and deciding to send her to x-ray.  A younger woman was under sedation on a gurney closer to us - she was the wife of a policeman who had gone swimming three days earlier in Pattaya.  She was now experiencing "heart trouble" and tingling in her arms.

Duang was called into the room and had me accompany her.  Once again the room and equipment were not what I been accustomed to seeing in a US hospital or even a doctor's office.  The equipment was dated and the room appeared that it could be cleaner.  The doctor examined Duang and asked her about her condition.  Everything is going very well.  He answered my concern and question.  He told me that Duang will most likely stop looking in the mirror all the time in about six weeks.  We all had a good laugh.  He then had her lay on the procedure table and removed her stitches using a sterile scalpel blade which he used without a handle and sterile tweezers.  I was able to get up and watch the procedure up close.  The stitches were a very fine blue material - it looked like they were 1/5 diameter of a human hair.  I was impressed at the ease in which he could locate them and remove them. There was no topical analgesic used - only sterile saline solution and Duang never flinched.  We will have to return in three weeks for a followup examination.

After the stitches were removed, we exited the area through the area where we were originally seated.  The lady boy had two sample silicone breast implants in her hands.  She spoke to Duang and we went over to check them out.  One was larger than the other.  He handed them to me and I got to check them out.  I told him in Thai that one was "Big-Thai" and one was "Small-Thai" but to be "Small- Foreigner" he needed two of the "Big-Thai" implants.  Everyone had a good laugh.

The cost of removing the stitches was not included in the original bill.  After paying $13, we returned home.

This experience at the hospital as well as Duang's face procedure to date once again reinforced my perception that medical care needs to be only fit for purpose.  The facilities and their condition were not what I am accustomed to or expected in the USA.  However they were effective and met our needs.

Duang's face is coming along very well and even now it is obvious that the procedure was done very well.


  1. Best wishes to Duang for her new face!
    I had to chuckle about the privacy thing.
    I was in the emergency treatment area of a Pattaya hospital recently, they were going to treat an infected ingrown toenail. When I sat down on the bed, I noticed diagonally across a bed with a woman in prone position, lying on her front, with an uncovered derriere visible and sticking up in the air a bit.
    A nurse was swabbing the bare arse with a stick and cottowool and maybe iodine or so. I pointed it out to the doctor, and suggested that maybe the woman would not be happy that i and others could see her in that position, and maybe he could tell the nurses to close her curtain.

    He first thought I wanted MY curtain closed (I was fully dressed, only my toe bare) and eventually he understood and called on the nurse to close her curtain. That proved hard and took a few clothes pegs and some sticky tape.

    Thai peopel are usually very modest about nudity, I was rather surprised

  2. Thanks for the wishes and your comment Kees. Sometimes I think that some people might suspect that I make these blogs up since they are so different from what they are accustomed to. Now with your comment they get a similar story from a different source. Hope all goes well for you and Dorothy in East Timor.