A medical examination in Thailand

… and with apologies to all who have endured medical examinations and conditions past, present or future!

Part of my contract for the new job at Prem was a requirement that I undergo a health check to prove that I was “fit to work in Thailand”.

I am not sure if this was really necessary as I was already on the ground, so to speak, and the Head of School knew I did not have too many suppurating sores, that I was not coughing germs over classrooms full of healthy-lunged kids, and that my quintuple bypass operation with its associated catheters, colostomy bags and saline drips on mobile stands would probably not hamper me in the performance of my duties. Schools in Thailand have many ancillary staff and I am sure they would have been able to accompany me as I took prospective parents on tours of the hundred-acre campus, wheeling my sundry medical bits and pieces on their salengs (bicycles with large trays fitted to the front wheels) as I dragged my oxygen tanks on their little wheels behind me.

In my naïveté or stupidity I booked the medical check-up through one of the school’s three school nurses.  The check-up would take place at at the Chiang Mai Ram Hospital, the best hospital in town for Westerners, and was told to make sure I took nothing by mouth – no food, no drink, no candy and definitely no gins and tonics – for a minimum of twelve hours prior to the examination. I rather figured the whole process would take half an hour or so and told my colleague in the Admissions Office that I’d be a bit late in to the office on the day of The Examination. I rather figured it would be a case of “Turn your head to the left and cough. Umm. Cough again. Do you have any pain here? Here? OK. Get dressed. That’ll be $150.00 please.”

– Ho Ho

The Chiang Mai Ram Hospital is located just to the west of the moat surrounding the old city of Chiang Mai. I don’t know what the “Ram” part of its name means but it may refer to the mindless sheep who follow assorted doctors, nurses and shepherds from department to department not quite knowing what is going to happen next … but praying that it does not involve too many sharp knives. It is a very modern hospital and apart from the sick and dying littering its corridors and spreading their toxic germs and noxious airs, it is a clean and efficient place and an ideal location to spend a jolly morning.

– Half an hour? Ha!

Most of the staff – doctors, nurses, nursing assistants, orderlies, receptionists, car park attendants, lift operators and blood pressure measurers – speak English to some extent or even perfect English and this helps to make the process relatively painless. The Ultra Sound doctor, on the other hand, does not speak English – or Thai – or any language known to man.

From Reception to the Records section is an easy few paces – one small step for man, one giant leap for mankind – and then it begins.

– Do you have any of the following sixty-three ailments?

– Are your parents alive? What did they die from?

– Is there any history of insanity / bankruptcy / bed-wetting / cheating at Grade 3 entrance exams in your family?

– Is this the correct spelling of your name? Are you sure?

– Are you covered by any insurance?

– Take this form and go to the Fourth Floor.

The lift is just over there … where the queue of snifflers, coughers, sore-covered road-kill victims is waiting to join you in a tiny enclosed intimate space for the duration of your interminable journey from the ground floor up to the fourth. I came in here healthy. What will I leave with?

The Fourth Floor has two reception areas – Specialised Medical Clinic and Health Checks. I do not know what happens at the former as there were ashen-faced patients and nurses either side of the reception counter engaged in serious sounding conversations which may – or may not – have been which horse was going to win the 3.30 at Sandown. The Health Checks is staffed with smiling, cheery healthy-looking nurses or receptionists in stiffly-starched bonnets and aprons and superb legs that made the Prem nurses’ legs look like bamboo chop sticks.

– OK – let me take your blood pressure.

My arm was fed through an instrument where a self-inflating pressure tube wrapped itself around my upper arm like a rather disinterested boa constrictor, a button was pressed and the cuff inflated itself and deflated itself and then the machine blimped out digital red and white numbers and the nurse said, “Umm – your blood pressure is very high.” She and I then compare intimate details about the sorts of tests I would like to have conducted.

– Like? Ho ho. I would LIKE to be out of there!

– Do you want cholesterol tests? Well – OK. And blood sugar tests? Since you ask so nicely. ABI? Oh, yes please. (What the hell is an ABI: American Bureau of Information?). ECG? Oh yes – I love extra-curricular games. Stool samples? No … I don’t think so. Let me just measure your blood pressure again as it was rather high last time. Umm … Let’s try the left arm … Umm … Yes …

– Please take this form and go to Room 4.

– Good morning Mr Christ.

Hallelujah! Hallelujah!

How nice to have my divine status recognised at last! In Thailand people’s first names are used more frequently than their family names. Thai family names are often very long. I had a student last year whose family name was Pornchareonkulraj so their shorter first names or their nicknames are much more frequently used. For some reason Thais usually shorten “Christopher” to “Christ” but I have yet to see any miracles let alone make any happen.

– Let me take some blood. Thank you. Let me measure your blood pressure. Oh dear – your blood pressure is very high.

– Yes. I know. The last nurse who measured it told me so.

My height and weight were measured as were my waist and my hips (both pre- and post-removal of wallet from my hip pocket) and I was asked to grasp a thing that looked as if it should be linked to a Game Boy console but instead it measured my body mass or something and I was told that at 75 kilograms I was clinically obese.

– Please take this form and go to Room 10.

In Room 10 were machines which looked like something out of the Rocky Horror Show or Star Trek (Beam me up Scotty!) with leads, clamps, sensors, earthquake-quivering needles scratching patterns on slowly-rolled out sheets of paper and ominous tubes of gel which were applied to various spots of my anatomy as the (new) nurse tested me on my knowledge of the Thai language – a test I failed just as poorly as the machines failed – so I had to go through it three times. The medical test – not the Thai test.

I think the ECG machine was rather pathetic: its puny seven probes worked well enough and told the nurse that I did have a heart and that it was beating and that there was blood flowing to most parts of the ancient Hall frame. But the ABI machine was a bit of a worry. I think “ABI” means “Ankle Brachial Something starting with I” and it had clamps attached to both ankles, both wrists, electrodes attached to four parts of my upper torso, a couple more tucked in here and there and the whole thing was automated so the nurse would push a button and various cuffs would inflate and deflate and beeps would sound and the printout would not happen so we would do it again … and again … until there were several pages with interesting squiggles and graphs generated by the computer.

– Please take this form and go down to X-Ray on the Ground Floor.

– Please drink these three bottles of water so your bladder will be distended for the ultrasound later on.

– Take your shirt off. Stand here. Deep breath. Thank you.

At about this stage a small child in a wheel chair was trundled into the X-Ray Department, with assorted family members and hospital staff carrying saline drips and other bits and the child vomiting onto the floor and in great pain and distress.

– Please take this form and go down to the basement.

OK – let me take your blood pressure … Umm … It is very high … YES I KNOW!

– Please pull down your trousers and pull up your shirt while we rub this amazingly cold gel on your stomach, into your underwear, onto your shirt and into your pubic hairs … Nope … Sorry … Your bladder is not distended enough yet … drink another two bottles of water please … and wait for the doctor … and if you need to go to the bathroom please call me.

Bathroom? No thanks! I want to go to the lavatory with now five litres of water squishing around in me and no breakfast – although once I had given my blood sample I was allowed to eat. The hospital thoughtfully gave me a small package with a tub of orange-coloured imitation juice and a bun with violent violet bean paste in it.

And then enters the Ultra Sound doctor for her second conjugal visit.

– Pull down your trousers and pull up your shirt. Move closer to me. (Every bachelor’s dream dialogue so far!) Let me run a second glob of amazingly cold gel onto your stomach, trousers, shirt, belt, underwear and anywhere else I feel it will be a major nuisance … Umm … Move closer (!!) … Roll over (!!!) … Umm.

… and then she disappeared.

The photographs she had taken were still on the giant television monitor above my bed of sorrows but she was gone leaving me with a nurse who rather vaguely wiped off some of the glop and asked me to provide a urine sample in this jar and to leave it just over THERE.

OK – let me take your blood pressure … Umm … It is very high …

– YES I KNOW! It is getting higher every time you measure it and will probably pop the mercury out of the tube if you measure the bloody blood pressure again!!!

I’d rather not detail the actions of the urologist who checked my prostate or the actions of the ENT man who checked my ears, nose and T: some of you may be reading this over dinner.

Then …

– Please take this form and go to Floor 4 for the Cashier.

– Thank you Khun Christ. That will be six thousand four hundred baht. (About the price of a good pair of shoes in the old language.) Please come back at 2.00 and the doctor will tell you the results of your tests. Please sign here.

I got to school about 1.00 pm after four hours of prodding, probing, measuring, measuring blood pressure and just to make sure, another measure of blood pressure or two. A few days later I went back to the hospital for results.

– Please take this form and go to Room 10.

– Yes, your blood pressure is very high and these squiggly lines tell us something while those percentage points tell us something else.

– So am I fit to work in Thailand? And what blood type am I?

– Oh we did not check that. We will do that on your next visit … or shall we do the tests all over again?

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• Original examination 2008 … but annual visits since mirror the fun and games of this first check-up
• Text  © Christopher Hall 2014
• Photographs downloaded from the Internet.
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