Monday, 11 February 2013

Emma Admitted

Last year I noticed some pain in the gum near a tooth in my upper jaw. Like anybody who continues to live in the mindset of a poor student in a country where dental care is prohibitively expensive, I ignored the pain and it went away. Despite a rigorous mouthwash regime the swelling continued however, and in September I eventually saw a dentist. The following is a detailed look at my experiences with Korean dentists and hospitals.

Doctor Ko had been recommended by other foreigners in the area. Like most professionals in South Korea he spoke decent English, definitely enough to discuss my dental situation, and he and his staff were very accommodating and kind. Going to the dentist was more like visiting the hairdresser, as Doctor Ko moved between three patients all sitting in a row, relying heavily on a number of dental nurses to do the more routine parts of each appointment. Everything appeared very clean and modern, and I especially appreciated the dentist being able to show me my x-rays almost immediately on his iPad.

The most important thing to note about the dentistry was the cost. We are lucky to have public school insurance which covers 50% of the cost of most medical and dental treatment, though even without that Korean service is still a bargain. My initial visit, when Doctor Ko had a look around, took an x-ray, established that I needed a root canal, and began the cleaning process, cost around $18. The next session was about $12, then $5, then $3.80 (rounding to approximate NZD value), and on the final session which ended with him telling me I needed to see a medical doctor, there was no charge at all. Over these five visits I had multiple x-rays, temporary fillings, and medicine applied directly to the tooth. The practice accommodated my teaching schedule, offering appointments after 5pm on weekdays and early on Saturday mornings.

Doctor Ko cleaned out the infection in the roots of my tooth, but he was bothered by a dark smudge in my jaw that appeared on an x-ray. He suggested I see an ear, nose and throat (ENT) doctor to get it sorted out before he continued with the root canal. In Korea there are two types of hospitals. One is the large city or university hospital you are probably acquainted with which deals with all kinds of illnesses and is often run by local government or a tertiary institution. Then there are smaller practices which are called hospitals because they admit patients and have a fairly large staff, but they are privately owned. I opted for the biggest hospital in our city, Gunsan Medical Centre, for two reasons. One is that it is easy for a foreigner to get there by taxi, as it is the main hospital, while the smaller centres are numerous, often located down side streets, and will have a complicated name which you may or may not remember and which the taxi driver may or may not know. The second, and most significant reason, is that the larger hospitals in Korea employ full-time English speaking liaisons, who escort you around the buildings, manage your paperwork, translate or clarify what the doctors say, and even hand out their personal cell phone numbers so you can contact them any time you have a query or need to make an appointment. So far I have dealt with five different liaisons at two hospitals, and they have all been kind and patient, with an excellent level of English (one was actually a charming Mongolian woman who speaks at least four languages). The liaisons at Gunsan were also trained nurses, and though I didn’t ask the women who helped me at Iksan I suspect they were too.

The ENT doctor at Gunsan Medical Centre sent me off for two CT scans (~$90 total). After examining these he explained that I had a cyst in my jaw which needed to be removed, but he did not have the right equipment and so referred me to Doctor Lee, the sinus specialist at Wonkwang University Hospital in nearby Iksan. The next week I had a consultation with Doctor Lee in Gunsan, where he conveniently has hours every Wednesday. He explained the surgery process to me and together we worked out when I would be admitted for my week-long stay at Wonkwang. I was never put on any waiting lists or forced to experience any kind of delay - like the dentist visits the surgery was worked around my schedule and in fact I could have had it sooner than the three weeks I chose to put it off due to work commitments.

I was admitted to Wonkwang University Hospital on Sunday the fourth of November, with surgery scheduled for the following morning. I was put in a six bed pre-op room (I had the option of a single, double, four person, or a six person room. This was the cheapest). That first night was the most uncomfortable time of my entire stay. Korean hospitals differ from Western hospitals in that the family is expected to stay with the patient around the clock, seeing to their cleanliness and any other help they may need. There is no such thing as visiting hours, rather there are multiple visitors going in and out of the room at any time of the day or night, and cots are provided because it is a given that somebody will be sleeping on the floor beside you during your stay. The rooms are mixed gender, so there were male patients in the beds around me. This was not an issue because they seemed to all be old and bedridden, but there were also young male family members moving around freely. When I first arrived at the hospital it took some time to get all of my admittance paperwork sorted, so for a few hours we had to leave the curtains around my bed open as nurses popped in and out to talk to me. Two men, presumably family members of patients in my room, stood there staring quite openly at us. Sometimes the nurses would appear and ask me things for their forms, personal information such as age and weight, speaking in English to me and Korean to each other, and still these two men just stood there, clearly listening and gawping at me. I know that foreigners, particularly blonde foreigners, are interesting to many Koreans. I do not believe however that these two men, living in a decent-sized city with many English teachers, had never seen white skin before. Even if we were their first foreigners, they would still have recognised that we were human beings and presumably should be granted at least basic courtesy and the illusion of privacy in this very public setting. That said, I don't believe it was entirely a 'foreigner thing' that made these men feel they could stare at me - later during my stay a young girl was admitted who had clearly been in some kind of major accident that had broken many bones. As she came in many of the (female) family members hanging about in my room very openly walked over to have a look at the new arrival, also listening in while the nurses spoke to this patient's parents. I suppose it is a cultural thing, but I found this behaviour of staring at sick people in hospital, who are already feeling uncomfortable and vulnerable, rude and somewhat threatening.

Needless to say I was over the moon when I was moved across the hall to an outpatient room the following morning. By good luck this room was entirely full of women, with just the one young man who sometimes helped his grandmother, though he appeared to be studying and stayed in the corner behind a curtain most of the time. The other patients were clearly interested in me in a friendly way, though none of them spoke English so beyond encouraging smiles they left me alone. There were also fewer visitors and they mostly kept to themselves, so I was altogether more comfortable. Around 8am on the Monday morning I was fitted with a drip, and I think it was about 11am when I was wheeled off for surgery.

When I got to the operating room I was greeted by Doctor Lee and a very handsome younger doctor who asked me what music I wanted to listen to. One-and-a-half songs into The Moon & Antarctica I remember saying dreamily "oh, that's the drugs" and then I drifted off to sleep.

I think it was 4pm when I floated back to consciousness in the OR, and by around 5 I was being taken back to my room where Stephen was waiting. Over the next day or so I was weak from the effects of the anaesthetic and I discovered deep mysterious bruises on the back of my head (surgery involved sawing through my upper jaw, so the origin of the bruises doesn’t bear worth thinking about), but otherwise I felt good. My lower lip was extremely chapped, presumably due to whatever had forced my mouth open during the operation. I had also been given a very strong anaesthetic to my right cheek area, numbing half my nose and the side of my mouth, so eating and drinking was a little difficult. This was not quite as inconvenient as it should have been however, because it turns out that a Westerner in a Korean hospital doesn't do much eating anyway. There is only one way to describe it; the food was awful. I am not a fan of kimchi at the best of times, so being presented with this fermented cabbage dish, alongside soggy chewy mushrooms, seaweed soup and a whole fish, at 7am, was less than pleasant. An additional warning - all meals are served with a spoon and a pair of metal chopsticks as your only cutlery, so if you are not proficient with these or if your illness/injury makes using them difficult you may wish to bring your own fork along. Thankfully I did not have much of an appetite and Stephen was in every day to keep me supplied with yoghurt and crackers to nibble on between the mouthfuls of plain sticky rice that I managed to force down.

I also must say a huge thank you to my co-teacher who visited one evening a few days into my stay bearing a chicken salad and two slices of cake from a local café. What a champion.

Aside from the food and the awkwardness of that first night, I would say my experience at Wonkwang University Hospital was very positive. Although they did not speak much English the nurses were very kind and did their best to make me feel comfortable, expressing concern when they noticed Stephen wouldn't be staying overnight (I was totally fine, I think they were just worried I would be lonely) and making every effort to be gentle with the various needles involved in modern healthcare. A few times a day I would be visited by a pair of young nursing interns, one male and one female. They didn't speak much English either, but perhaps because I was their first Western patient, or perhaps because they simply had time on their hands, these baby nurses seemed happy for any excuse to come and say hello.

By Friday morning I was as rested and bored as one could hope an outpatient to be. The young ENT doctor who had been checking on my progress every morning gave me a bottle of saline solution and a large syringe along with instructions on how to irrigate my nasal passages, and then a liaison helped me to get packed up and ready for discharge. With a bilingual person in the room my fellow patients were finally able to ask me the things they had apparently been bursting to know during our five days together but which the language barrier had kept hidden from them, namely my age, eye colour, if my hair was naturally blonde, and whether or not Stephen and I were married. Koreans will be Koreans.

The bill for five nights in hospital, surgery, and continuous antibiotics and whatever else was in the drip, came to 1,300,000 won. This is the price I paid, which is effectively 50% of the total after insurance. I see Doctor Lee every fortnight or so during his hours at Gunsan Medical Centre so he can check up on the healing progress, which so far he says (and I agree) is going swimmingly. For a while after the surgery much of my face was still numb, and for a couple of weeks there was a tingling sensation. I still don't have complete control over part of my lip, but I have been assured that this is normal due to the whopping amounts of anaesthetic needed to safely saw open my jaw bone to access the cyst. Thankfully Doctor Lee went in through the gum, so there is no external scar. I'm going back to Doctor Ko soon to finish up the dentistry. I've been quoted 450,000 won for a 65% gold cap, which is a great price by our standards.

In short, I would not hesitate to reassure any foreigners that they have no reason to worry if they are admitted to a large hospital in South Korea for a routine surgery.

No comments:

Post a Comment