Wednesday, August 23, 2017

Surgery

In this temple scene the artist has included people with cellphones taking photos

*Creaks open door, turns on light*

Well... back in business.

I took the last two weeks off because I had surgery. In July I went to a favorite swimming hole in Miaoli on my bike. You have to climb down to the creek. After lolling about in the water for a while, we climbed back up to the road. As I was climbing, pulling myself up with a tree branch, I had one of those you're not 23 anymore moments: pulling myself up, my foot slid down off a rock, yanking my core muscles in two opposite directions. Pain.

I got back to the house and realized it must be a hernia. So the next day I went to the doctor. Doc couldn't find the hernia by touch, so he sent me off to get an CAT scan, which revealed a very tiny hernia that eventually healed of its own accord. But the scan found a ginormous gallstone which had destroyed my gall bladder. The doc recommended removal.

I had never had surgery before, and hemmed and hawed. But if the thing, which caused me very little pain, became acute during the semester, it would knock me out for a couple of weeks, and possibly out of a job. So I scheduled surgery for early August.

Care was on the whole good. I was in the hospital near my house, for convenience' sake. I was in the hospital for two nights, then sent home. Healing is going well.

For those of you who are wondering, total cost to me was NT$22,000. 13,000 of that was elective costs. If I had gone the cheapest route, I would have paid only $9000 NT, or about $300 US. Frankly, if you are not a supporter of universal single payer health care, you're either a fool or malicious. The high cost of health care in the US has two key functions: (1) it transfers wealth to the already fantastically wealthy and (2) it helps convince people that health care must be expensive and the nation can't afford it. In reality, US health care costs are incredibly inflated, because there are incredible profits to be made.

That said, the experience also highlighted many of the Taiwan system's problems. There are not enough nurses, so patients subsidize the system by providing family members who care for the patient. My wife slept in the hospital in case I needed help, and my kids came in rotation to stay with me for a while.

The lack of nurses -- because hospitals regard nurses as costs but doctors as profit centers -- has many pernicious effects. Care is brisk yet the nurses are shockingly kind considering how overworked they are, but they make numerous small errors, since they are tired from lack of sleep and overwork. At one point I ambled out of my ward to ask for painkillers and the night nurse dialed up my case on her work station and handed me some medicine. Except she clicked on the wrong name and gave me the wrong medicine. Fortunately I watched her do it and gently told her it was the wrong name. Hospitals in Taiwan are basically administrated the way factories in Taiwan are: production is maximized, costs are minimized, and the labor force is exploited to the extent possible. The result of overworking nurses is that Taiwan has a persistent shortage of them despite graduating more than the island needs, because so many trained as nurses don't go into nursing or eventually make their way abroad.

Perhaps the worst part for me was the recovery room. I awoke completely disoriented and in fear. I had no idea what had happened or where I was. And nobody said a word to me. Did the surgery go well? Was I ok? The nurses there ignored this particular need of mine for focus on the technical tasks at hand. That is well and good, but it would have been great to have had this small human need of mine addressed...

UPDATE: Tobie Openshaw's experience of being bitten by a venomous Habu and the treatment and costs.
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12 comments:

Anonymous said...

Take care and get well!
--lin in Taipei

Anonymous said...

The difference in cost between Taiwanese and US healthcare is easily calculated/converted by simply replacing the "NT" with "US".....

$22,000 US instead of 22,000 NT.........

Domenic said...

Well- glad to hear you came out the other end okay. And what swimming hole were you at? How come I do t know about it. Show me! Soon!

Anonymous said...

I can't believe you had the gall to post such bilious nonsense!

Get well quick!

Anonymous said...

Take care, get well soon! Been waiting for your next blog entry!

Anonymous said...

Guess no salty pork for a while, eh?

Get well soon!

Cary Allen said...

Glad you are through it, and recovering!

Aaron Wilson said...

早日康復!

TCasanova said...

Wishing you a speedy recovery! Take care!

PeterW said...

Glad to hear you're on the mend.

B.BarNavi said...

Taiwan should recruit Philippine nurses already!

Carrie Kellenberger said...

Hi Michael. It has been a while since I've stopped by, but I wanted to say hello and wish you well after hearing you were in the hospital. First of all, I'm very sorry to hear that this experience caused you so much stress. It is very scary to be in the hospitals here, especially when you realize just how short-staffed hospitals are around the island.

It is not unusual for doctors at all hospitals to see 101+ patients per day in most departments, and I often wonder how doctors and nurses keep track of their patients. Sometimes I have to remind my doctor what we talked about two weeks ago, but now he knows I am taking notes and we are working together, which is great. I don't often see that kind of mentality with doctors here in Taiwan. (Most doctors I've met here like to tell you what to do, not explore options together with you.)

I am very grateful for the health care I receive here and your comments about nurses being overworked, yet still remaining incredibly kind, are spot on. I bring food to my doctors and nurses now because they have done the same for me on many occasions over the past four years that I've been a 'frequent flyer'. I take special care to learn the names of my nurses and blood techs and I try to support them as much as possible to show my thanks since I am there so much.

Your comments on what needs improvement are excellent, but I don't see any solutions on how they can be improved in the immediate future. I'm interested in hearing others comments and hearing about their own experiences and thoughts. I'm not trying to initiate any negativity here. I'm just wondering what can be done to improve upon an excellent system that is very overburdened. I see a lot of people at hospitals here that just don't need to be there. (Colds, flu, etc., can all be treated at local clinics.)

Wishing you continued good health, Michael.