All over the Map: At the Hospital

Sunday saw my son's first visit to a Thai hospital. On Friday, he started with a little cough and sniffles. I was a little worried because my son also has asthma, which is usually not a big deal until he gets a cold with coughing, which on occasion can affect his respiratory system and bring out his asthma symptoms (mainly wheezing).

By Saturday, his cough was a little bit worse, so I had a feeling we would be visiting a doctor soon, though we tried to avoid it by giving him his inhaler, which works most of the time. I was really dreading having to go to the doctor here just because it would be such a process. We also had heard from others that Thai doctors like to push every medication on their patients (especially antibiotics) and hospitalize for every little thing, even just a cold.

By Sunday morning, though, it was obvious that his inhaler wasn't doing it and we would need to go see the doctor. All doctors here practice at hospitals; no doctor has a private office. There are public and private hospitals. The private hospitals tend to have more English-speaking doctors. After spending the morning with a friend at a hidden gem of a market by the khlong (which will have to be another post), we hailed a taxi and headed out to the hospital where my husband had gotten his physical exam last month.

It was a nice hospital, with excellent facilities. There was some initial confusion about registration because this was my son's first visit and the staff spoke little English. We were asked for our passports, which we did not have with us, but the staff was very understanding and accepted my husband's work I.D. card instead. [Living here also has made me much more sympathetic towards those in America who don't speak English. Unlike us, they probably don't have the benefit of patience from those they might try to communicate with!] After waiting an hour (because, remember, hospitals here aren't just for the sick), we saw a wonderful pediatric allergist who was patient and thorough. She spent about two hours total with us (she would see other patients while my son was getting his treatment, then go back to him once he was done) and explained what she was doing every step of the way. And she spoke decent English, for which I was very grateful.

The only aspect I disagreed with was that the doctor, true to the warnings we had gotten, wanted to prescribe for our son a couple of unnecessary medications. She also used the nebulizer on him a couple of times, and even mentioned using it a third time if she could still hearing some wheezing, which in and of itself surprised us. She wanted his lungs completely clear before allowing us to go home. Luckily, the wheezing was gone after the second time. Before sending us home, she wanted to prescribe a couple of antibiotics in addition to an anti-inflammatory (which we had used before), just in case the inflammation was due to some kind of bacterial infection. And she even mentioned doing a chest X-ray, which we nixed right away. We really had to explain ourselves and our discomfort with taking medication for no reason before she relented and agreed to wait until the follow-up visit to prescribe more medication, if necessary. I mean, we've dealt with this situation before, and never once was it due to a bacterial infection. My son always got better once he took the anti-inflammatory medication, so why the heck would we need the antibiotics?!

In the end, it cost only $40, including filling the prescription. And that was without health insurance coverage -- because we have not received my or my son's health insurance card yet, the hospital wouldn't take the insurance. Overall, it was a good first experience with the health care system here. But this experience also gave me pause. As expensive as health care is in the U.S., we are at least familiar with how the system works and how to navigate it (well, for the most part. I think.). We had doctors whom we loved and trusted, who knew our medical histories, and whose treatment philosophies agreed with our own. Everything also was close by us. And, importantly, everyone spoke English. (Geez, I really sound like an ethnocentric American right now, don't I?....)

So, it looks like if we want to continue to live abroad with a child who may require more medical care than others, health care is one more factor we'll have to consider when looking for our next destination. Not that we hadn't realized this before, but actually living abroad now and having had this experience, we know now what questions to ask to learn what the real story is. I know some of my reservation stems from unfamiliarity with a new system and country (after all, we've been here for only about a month so far), and from old habits of reflexively worrying. I will say that I am grateful we're at least currently in a country where we have access to good health care and good doctors.