Trip to the Emergency Department

We were just telling the OMF Medical Adviser last week that our family has been in pretty good health for the last 4 years.  We hadn’t been to a Thai hospital for an emergency since our second son fell from the tree house in Lampang about 2 metres onto concrete, knocking himself unconscious. We still think it is a miracle that he didn’t suffering any brain damage from that fall.

Then a couple of nights ago, our youngest son was sliding down the stair railing when he slipped and fell from the second floor stairs to the bottom of stairs, head first opening up a deep and nasty gash on his forehead which needed a trip to emergency.  Again, we are thankful to God for sparing us a major head or neck injury.

In Chiang Mai there are a numerous hospital options, especially for those who can speak Thai (like us).  For those who can’t speak Thai, the two main options are Chiang Mai RAM and Bangkok Hospitals.  They cater for foreigners and are the quickest to get seen but they are the most expensive hospitals.We ended up going to one of the these two hospitals (I won’t say which one), because it was the closest hospital to us and it was peak hour traffic so we didn’t want to be stuck in traffic.

We weren’t impressed on entering the emergency department as there was no one in the reception area.  It was a few minutes before we could get the attention of some of the staff inside the door of the treatment area so that we could get our son seen.  After my wife carried my son into the treatment area led on by a nurse, I went back to my car which was idling outside the doors of the emergency department to find a parking spot.  When I returned to emergency, again there was no one at the emergency reception area so I just walked into the treatment area.  I was surprised that the doors just opened and I could just walk in start searching the cubicles to try to find my wife and son.  You wouldn’t see that in any major hospital in Australia. 

Generally, we received excellent care in the hospital.  We were seen by the nurse initially and then the emergency doctor within 15 minutes or so.  We waited another 15 or so minutes before a surgeon came and started to suture my son’s head wound.  All up we were there for an hour and half or so. What I wasn’t impressed with though was the emergency doctor recommending that our son get a head CT.  Initially we agreed, but I started having doubts almost immediately.  Having been a physio and worked in a hospital for a year, I thought that it was a bit over the top recommend a CT when there were no neurological signs and he didn’t lose consciousness when he had the accident. He wasn’t even complaining of that much of a headache and was pretty normal apart from the deep cut on his head.

I rang the OMF medical adviser and asked for his advice whether a head CT was necessary in this case.  He agreed that if there was no neurological symptoms such as vomiting or decreased consciousness that a CT was not warranted.  That was all I needed and I told the nurse that we didn’t want a head CT anymore.  She had a sign a waiver stating that we declined the medical advice to get a CT.

Another issue was the doctor prescribing antibiotics.  It was a pretty clean wound and I doubted whether my son needed antibiotics.  So I consulted with the OMF medical adviser and he confirmed that no antibiotics were needed.  By that stage the medical bill had already been printed and the hospital pharmacist had put stickers with my son’s name on the antibiotics so I couldn’t really cancel them.  

It is pretty common to order test and give medicines that you don’t necessarily need in these hospital catering for foreigners.  We’ve experienced it many times before but I was surprised especially about the CT as they aren’t cheap even in Thailand.  

We were given appointment cards to come to the emergency department to have the bandages changed everyday and also see the surgeon for a followup appointment and appointment to remove the stitches.  We haven’t gone to these apart from the final appointment which we will go to to get the stitches removed.  I figured that I could change the bandages without too much trouble and save the extra fee from the hospital.  

The total bill was over 8,000 Baht (AU$320).  Not too expensive if you had the same procedure done in Australia but almost half our monthly rent in Thailand so it was pretty steep.  

A Very Different Neighbourhood Reception

Our house warming party

I have been surprised by the difference in the reception we have received by our Thai neighbours between our old neighborhood and our new one.  In our previous neighbourhood we weren’t able to really get to know any of our Thai neighbours at all.  We tried to great them whenever we saw them but apart from a polite greeting, they did not really want to engage with us at all.  However, in our new neighbourhood, our Thai neighbours have been much more friendly and we know more about them in our first month of living here than we did in 8 months of living in our previous home.

What could explain the difference in reception.  Perhaps one reason could be that in our previous neighbourhood we lived in there was a large number of missionaries or expats renting and in our small street, half the house would have been missionaries or expats.  Due to the transitory nature of the work missionaries and expats are involved in, there is a lot of moving in and out of these houses.  The Thai neighbours who live there may have experience this and are not willing to engage with the foreigners who they know will not stay long term.  That is understandable.

In our new neighbourhood we don’t have any missionary or expat families living in our surround streets (except for one man with a Thai wife).  The family who had lived in our house had been in it for 10 years.  So they are have not experienced the same amount of change in foreign families moving in and out.

Also, we made the effort to have a house warming party and personally go and invite all our neighbours.  Although only 3 households actually came and stayed at the house warming party, many came with gifts and an apology of not being able to make it. 

So although being close to so many other missionary families had it benefits in terms of friendship for our kids, it had a detrimental effect on our relationship with our Thai neighbours.  We feel so much more connected in our new neighbourhood and look forward to getting to develop our relationship with our neighbours.