I Prefer to Have My Surgery in the United States

On the inside back cover of the very first international travel book I ever bought (Peru), there was a list of supposedly common Spanish phrases and their English translations. Tucked between Where is the bathroom, please and How much does this cost was a phrase that, at the time, I found quite funny:

I prefer to have my surgery in the United States.

I can’t remember why I thought it was so funny, but the phrase stuck with me and now my wife and I use it often in jest in our travels, when we are about to do something we know to be risky. Before we try the raw-egg-and-fish in Sao Paulo, or before we accept a ride from a shady cab driver at midnight in Morocco, we look at each other and laugh and whisper:

I prefer to have my surgery in the United States!

It’s become a light-hearted mantra for us, a verbal talisman that hopefully protects us from ever having to say it for real. Today, though, for the first time ever, the humor is completely missing as I head to a government hospital in rural India as a patient.

I think I caught the bug on the series of overnight flights from Atlanta to Mumbai. Five days immersed in the soupy smog of the largest city in India nurtured it and transformed it from a sniffle into a nasty infection. Now, ten days into the seven weeks of my India trip, I am feverish, hacking, coughing and completely miserable. Days of popping ibuprofen and guzzling bottled water haven’t helped. The truth is that I’ve gotten worse.

Next week our itinerary calls for us to fly to Northeast India, the most remote, most rural and least-developed section of the entire country. Tucked between Nepal, Bhutan, Bangladesh and Myanmar (and sharing a disputed border with China) it’s not a place where you want to be seriously ill. So, my wife insisted that I visit a doctor while we were still in mainland India in the hopes that treatment might resolve my condition before we left.

This isn’t the first time we’ve experienced the health-care systems of other countries. In fact, every international trip I can remember featured at least one episode requiring the services of a medical professional. The worst incident was during my family’s first visit to Europe, where my daughter had a bicycle wreck resulting in a concussion and a broken clavicle and hospital visits in four countries. Once, while hiking the Camino de Santiago in Spain, I blew out a knee and spent a week in a Pamplona hospital. In every case, my experience with European doctors and hospitals was as good as, and usually far faster and cheaper, than any comparable emergency-room visit I’ve ever made in the United States.

With that in mind, I’m not too worried about visiting an Indian doctor. India is quite famous for medical tourism; thousands of people a year come to have joints replaced by expert surgeons and recuperate in luxury hotels for the fraction of the price of the same procedure back home. How scary can a visit to a Indian doctor be?

-*-

Our driver takes us into the nearby village of Adimaly, to the Taluk Head Quarters Hospital, a government-run, full service establishment. From the moment we turn into the tight, crowded alley, I realize that I am entering a world so alien I’m not even sure what I am seeing.

The Taluk Head Quarters Hospital is a collection of dingy one-story brick structures that seem old enough to have been built during British colonial times. They are clustered together in a small compound, facing each other over a courtyard of dirt and broken concrete. The entire courtyard is covered by an iron awning that blocks out most of the sunlight, leaving the buildings in an uneasy, dusty twilight. The endless honks and horns of India’s traffic echo through the approach alley. Communist party graffiti, flags and posters decorate the utility poles.

The courtyard is packed with people.  Most are small and thin with hard, sun-darkened faces. A few wear disintigrating rags, others wear ornate robes. The women are in colorful saris or black Islamic burkas. Everyone is wearing some form of traditional dress; unlike the streets outside, not one person here is wearing even a hint of western clothing. The children are all quiet, clinging to their parents. The entire crowd circulates restlessly around a pair of long queues that lead to two windows, one marked LADIES and the other GENTS. Above both windows is a large blue sign that says CAUSAULTIES.

Our driver, Kal, mutters something to himself that doesn’t sound encouraging. He drives directly into the crowd, which, like all Indian crowds, magically parts to allow him to enter the courtyard. For all practical purposes, we are driving through the middle of an ER waiting room. There are several scooters and bicycles parked in the courtyard, but ours is the only car. We reach the middle of the courtyard. Kal stops and motions for us to get out.

Seriously? Faces in the surrounding crowd are staring suspiciously into the car. In fact, everyone is staring at the car. I have absolutely no idea what to do. Kal recognizes my distress. “Don’t worry. I will park the car, and I’ll be right back.”

I climb out, followed by my wife. Every head is turned toward us. Children move behind their parents. Women in the LADIES line stare at my wife’s western clothing. Men in the GENTS line also stare at her, most of them scowling. Everybody tries to ignore me, the tall, bald white guy in Eddie Bauer pants and Ecco sandals.

We have no idea what to do. I look around at the dark buildings for clues. Each sports a dizzying array of blue signs, most in the flowery Sanskrit of the local Malayalam language. A few were in English:

Eye Examinations

Lab (along with a huge board that detailed every single lab test with a price in rupees)

X-RAYS

Transplants. (when I saw this one I turned to look at my wife. Transplants?)

A beautiful little girl peeks out at me from behind her mother’s sari and gives me a little wave. I smile back at her, and wave. Her mother sees the interaction, and she smiles and waves at me too. This small little friendly contact makes me feel a little less awkward.

One of the buildings is marked SURICAL OPERATING THEATER. The grimy windows are open, and I can see what looks like an iron bed inside. I look at my wife.

I prefer to have my surgery in the United States, she whispers.

The jest is no longer funny. The waiting area (the dusty courtyard) has no chairs. The sick and wounded stand in the long lines or mill about in front of each of the other buildings, occasionally parting to let a scooter pass through. To an American accustomed to an ER waiting room, this is completely alien, like a scene from a dystopian science-fiction movie. These people don’t have the option of going to a clean, modern, high-tech hospital. I don’t know what quality of health care they will receive here, but based on the conditions in the courtyard waiting area, it probably isn’t state-of-the art.

We move to the back of the GENTS line. It’s a very long line, likely the result of it being Monday morning. Every person from the surrounding hill farms and tea plantations who became sick or injured over the weekend is here. These people are farmers and laborers and tea pickers and the men who run the rollers and sorters and dryers in the tea processing plants, their faces and bodies worn by difficult lives. One man is missing a hand, another hobbles on ancient, well-used homemade crutches, his leg gone below the knee. A few wear the filthy rags of beggars.

I spot a sign at the edge of the courtyard. Parking for Doctor Only. There are two cars. Only two doctors, for this huge crowd? One is a dusty Hundai sedan, the other an old-model Suzuki. Apparently government ER doctors in rural hospitals don’t make the same salaries as their American counterparts.

Everyone is still staring at us. I jump when somebody touches my shoulder. It’s Kal. “I will go inside and ask what to do,” he volunteers. He pushes through the line to the GENTS window. Everyone watches him go to the front of the line. He shouts into the window, then vanishes inside the building. The crowd’s eyes return to us.

To be completely honest, I’m pretty freaked out. I’ve always considered myself to have an open mind. I enjoy learning about and experiencing other cultures. I travel to learn, not judge, because I firmly believe that my American way of life isn’t inherently superior to anyone else’s; just different.

But then I look up at the red hammer-and-sickle communist flags and graffiti  (which is everywhere in Kerala) and at the woman standing next to me who is wearing a black, head-to-toe burka. All I can see are her eyes. Despite my best intentions, all my childhood xenophobic Cold War conditioning is kicking into high gear. I am inside Donald Trump’s worst nightmare, surrounded by poor, dark-skinned foreigners, Muslims and Commies.

I force myself to relax: politics aside, these people are just like the ones I grew up with in Georgia. They are farmers and laborers, mothers and fathers who love their kids and who work hard to provide a life for their families. They are poor, hard-working people. They don’t want to be in this line any more than I do. I give what I hope is a friendly nod at the woman in the burka. I can’t tell if she’s 19 or 90. She nods back at me and gives a noncommittal Hello. The little girl she’s holding grins and gives me a shy wave. I wave back and her grin widens and she buries her face in her mother’s robe.

A couple of minutes later the crowd parts again, and here is Kal with the car. He motions to us. “There is a private hospital nearby. We should go there.” Everyone watches as we get back in the car. What must they think? Kal drives through the crowd like Noah parting the Red Sea. Nobody is staring anymore; we were a momentary blip in their existence, and then we were gone.

To see all the posts in this series (Seven Weeks in India), click here and scroll through the post listings.