TIT

last week a mole on my shoulder started changing color and shape, and was starting to become uncomfortable. i'd heard that if that happens, it's best to get it checked out, as that could be an indicator of skin cancer. i didn't know of any skin/dermatology clinics in the area, so i decided just to go to the nearest hospital and have someone take a look at it. i arrive at the hospital, head to the admissions desk, and explain that i have a "changing mole." no one at the desk seems to know enough english to understand my situation, so i show them the mole and try to explain the concept of color and shape to them and they just look at each other with puzzled looks. as a last resort, i point to the mole and scream "OUCH!!!" they just laugh hysterically. finally a nurse comes to my rescue, sits me down, takes my weight, temperature and blood pressure and asks me to explain my condition. i point, scream "OUCH!!!" once more, and receive the same response, but this time she points me in the opposite direction and says "sit at 7." i look down and there are about two dozen doors lining either side of a corridor with patients of varying conditions sitting down the middle. i proceed to walk down the corridor and start to realize why my situation was met with laughter...during the walk to door 7 i pass several unresponsive individuals lying on stretchers, a man bleeding from his head, and a crying woman holding a limp child in her arms. and then there's me...with a mole about the size of a grain of rice that's causing me discomfort.

i sit in front of door 7 and after about 5 minutes my name is called and i'm ushered inside room 7 (general practice). i sit in front of a man wearing a lab coat - presumably the doctor - and he asks me "what's your problem?" unsure of his level of english, i go through the same pointing & screaming process. but this time the reaction is different - a look of sheer horror and disbelief sweeps over his face and he begins to speak to the nurse in thai. she, in turn, now has the same horrified look on her face and begins scribbling on her notepad. the doctor turns back to me and starts spewing a blend of thai-english to me in a very frantic manner. the only words that i'm able to grasp are "surgery", "extraction", "malignant", "cancer", "stitches", "suture" and "next wednesday." so basically they want to operate on this mole that appears to be cancerous the following wednesday? i don't really feel comfortable with the lack of information about the procedure i'm receiving, but i figure i have about a week to decide whether or not to go through with it, and i can always cancel the appointment, so i say ok. great, so the nurse escorts me out and tells me to sit in front of door 22. i assume door 22 is the place one goes to make future appointments...so i go.

after about 3 minutes of waiting, the nurse comes to me, grabs my hand, and leads me inside room 22. instead of the anticipated reception/appointment desk, there's an operating table. i try to explain to the nurse that there must be some mistake...my appointment is not until NEXT wednesday. she responds by handing me a gown, helping me onto the table and putting on her gloves. at this point i start panicking, trying to think about how to escape from the situation, but by this point the surgeon and 6 other nurses/aides had made their way into the room. i tell the surgeon that my surgery appointment is next wednesday, my final attempt at freedom, but he explains that next wednesday is when i will get my stitches out and my biopsy report. the surgery is now. at this point i'm crying because of the reality that the first surgical procedure (as small as it may be) is being done in a developing country by people with whom i can't communicate about a condition i'm not sure they fully understand given the range of responses i'd received.

one nurse preps the area, another preps the instruments, another holds my gown closed, another handles the anesthesia, and two others seemed to just be standing there gawking. the 7th nurse grabs my hand and i soon realize that her only role during the procedure is to hold my hand and give me comfort. for this i'm grateful. soon the tears stop flowing and i just prepare for the worst, while praying for the best. the surgeon injects the anesthesia and soon after he lifts the scalpel. i turn my head in the opposite direction and look toward my nurse-friend who's holding my hand for support. i find comfort in her eyes and touch...until she lets out an uneasy scream at the sight of what's going on on the other side of my body, and squeezes my hand as if she's the one undergoing the procedure. her only job is to comfort me and that's how she handled it. minutes later the surgeon announces the procedure is over, stitches me up, and sends me on my way. i felt no pain and it seemed like everything went according to plan. i went to the check-out counter, got a bag of prescription pain killers, and settled my bill. the damaged - including the dr.'s consultation, surgical procedure, and prescription - came to roughly $30. i'd been in the hospital about 45 minutes.

i went back this past wednesday, got the results of the biopsy back - benign, and had my stitches removed. the scar has nearly faded and the pain and worry from the mole is no longer present. this experience taught me a lot - about the hidden bias i have toward western, 'developed' medicine, about the inflated nature of western healthcare (time, efficiency, expense), etc. but all in all it made me appreciate and trust my new home all the more. i can't really explain it, but there's something about lying beneath a scalpel that's held by a man who you don't understand, and who doesn't understand you, with a screaming nurse squeezing your hand that just gives you a little faith once you've made it to the other side.

there's an expression that's thrown around here quite often - 'this is thailand', or TIT. it's typically used in response to a ridiculous or surreal experience one has that's uniquely thai. walking out of the doors of that hospital, i was hard pressed to rationalize what i'd just gone through in western terms, but found great solace in the TIT idiom. i welcome many more, just hopefully more non-invasive ones.