Friday, May 6, 2011

Getting My Money's Worth

As Anna's written about, trips to the doctor in Korea are cheap and strange. I don't want this post to turn into a diatribe of my half-formed opinions on healthcare policy, but I suspect there's a connection between the $5 charge for a doctor's visit and the fact that Koreans go to the doctor for everything. I ran into two of my students recently who were walking to "hospital" (this is a Korean word meaning "regular doctor's office which is in no way a hospital"). One of them was going to have a cast removed from his hand, which seems reasonable, except that he was wearing the cast because he's a football goalkeeper who stopped a ball with his bare hand. I used to play in goal and I know that you don't need a doctor to fix this, unless you need a doctor to tell you to shake your hand a bit while making a "hsssss" sound. The other student was going to the hospital for a bee sting. I don't think he was allergic since he was showing no signs of even mild discomfort. Oh, and he was walking there.

I also suspect a connection between cheap doctors, constant medicating of even the tiniest complaints, and the exorbitant cost of our compulsory medical insurance. Anyway, a couple of weeks ago I went to an internal medicine doctor to sort out my heartburn. The visit was brief and slightly unnerving, but in between strange jokes and complaints about how much more American doctors get to charge, he told me I'd have to come back for an endoscopy, which would involve sticking a camera down my throat and looking around.

I told my school I'd be late on Friday morning and went back to the clinic, where I discovered that the benefit of not being able to make an appointment means you get to wait for an hour unnecessarily. When I finally got into the doctor's office he asked me if I wanted an anesthetic for the endoscopy. The brief research I'd done online said that patients take a mild sedative and don't remember the procedure, and I wasn't really expecting an option. I was sold on the drugs when the doctor told me they would allow him to examine my stomach "precisely". 

At that he motioned for me to leave, so I went and sat in the hallway again. At this point I'll pass the story to the strange feverish narrative I scribbled in my dairy from what I would later discover was the recovery room. The full thing is long and meandering, so here's the edited highlights: 

I find myself in a small cubicle with an ornate vase motif on the wallpaper and a middle aged Korean man dozing in the other bed. I think I remember walking here from the other room where the procedure was supposed to happen. I decide I might as well get some sleep, since I seem to be stuck here. But there are loud voices outside the cubicle and I can't manage it. 

On closer inspection I realise the bed is just a raised platform a bit shorter and much narrower than a single bed. Around the outside is a cushioned border. The centre looks like a giant marble paving stone. The marble is heated. I do not know why I'm here. I wonder if I've been asleep on this platform. I vaguely recall being led here from the other room, but it is a hazy, dream-like memory. 

For a long time I was waiting for the nurse to come back and take me for the endoscopy. Now I think it has happened and I don't remember it. A nurse came in a few minutes ago and inspected the drip attached to my room mate. She took no notice of me. I feel no pain, but very disorientated. It is now eleven o'clock I think. I have been in here since ten at least. At 9:10 I was sent in to see the doctor. After some waiting around and a quick chat with him I was led into another room, a small curtained-off partition.  

The nurse had me lie on a small hospital bed. She placed a big green bib around my neck. Next was a squirt of something in my mouth. This I was instructed to swallow. It was gluey and dehydrating and made swallowing difficult afterwards as it lined my throat. Next was a spray of antibacterial tasting stuff. Then I got a small injection in my hand and the nurse disappeared. She was back a few minutes later with another injection. Then she got me to turn on my side and put a thing around my neck that sat in my mouth and kept it open. With this thing in I felt like I was choking. I was able to breathe, but I felt like I couldn't, because I couldn't close my mouth or swallow.Next thing I know a tube is being shoved down my throat.

My perspective: the tube is incredibly uncomfortable and way more than I can cope with. I thrash around and scream as much as I think is healthy with a tube down my throat. The nurse realises this is a horrible way to treat someone and takes out the tube. She leads me over to the weird recovery area with its heated slab.

I think the next bit was going to be the nurses perspective, but I was interrupted and sent back to the doctor's office. What I think really happened is this: the injection was the sedative, and while it was working the nurse set up the procedure. I made some mumbling noises and then dozed off, only to awaken as they were removing the tube. The nurse led me to the recovery room so that I could experience the crazy that the sedative apparently causes while scribbling in a notebook in a hospital ward, rather than wandering around in public trying to teach English and getting run over (which would mean going back to the hospital anyway.) 

I went and saw the doctor, who showed me this photo:

"It looks like a butt" - Anna.
That's what my stomach looks like, which I'm sure you've been dying to see. In hindsight, I should've asked the doctor more questions than "Can I have a copy of that?" He told me I have reflux esophogitis. The circled part in the top photo is apparently the cause of the problem. This can be cured by taking medicine for three months, so because this is Korea he gave me a prescription for ten days. That means I get to go back there every couple of weeks, sit in his waiting room for an hour with the ajumas and listen to his bizarre jokes.

The other thing that's wrong with me is some pretty horrible migraines. I've had them a lot since getting here, and though they're not as bad as what I know some people have, there pretty debilitating and I get some symptoms most days. Since every doctor here is a specialist, I had to go to the neurologist for this. I've been here a few times before and spoken to a couple of different doctors, neither of whom seemed interested in giving me medicine strong enough to actually fix the problem, but I thought I'd try again. 

When I go here, the five receptionists always giggle and try to fob me off on each other, even though all they have to do is look at my health insurance card and motion for me to sit down and wait. They do the same thing when it's time to pay, even though I understand Korean numbers and 감사합니다 (thank you), which is all they need. This is something I've gotten used to, people being afraid of dealing with me even when it doesn't involve speaking English or doing anything they don't do a hundred times a day anyway.

Today's doctor was a bald, middle aged twelve year old with a nice smile. He spoke less English than the other doctors I've visited in Buan, but he was able to get the gist of what I needed. I tried to ask about some medicine that other English teachers had recommended, but the nurse who's always in the room and whose only job seems to be looking up drugs on the computer couldn't find it. He said he would give me a prescription for five days (again, fantastic for a long-term condition). He also said I would need to have an injection. I wondered if they would do it at the clinic, or if I had to do it myself at home, so I asked: "Do we do it here?" and pointed at the floor. He replied: "No, in the butt." 

The nurse led me into the next room where another nurse looked at me sheepishly and told me to pull down my pants. If you read Anna's post about the doctor then you already know that they slap you on the butt before they stick the needle in, so I was prepared for that. I wasn't prepared for her to keep spanking me once the injection was done though. It was pretty weird, but at least she had the decency to look embarrassed about it.   

I went and did my follow up visits to both of these doctors the other day, and also went to the ENT doctor with the open plan office to get something for a cough that doesn't seem to go away no matter how much I ignore it. I came back with this impressive array of mystery pills.

That's still only about a week's worth though, so it looks like I'll be seeing a lot more of the doctors.

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