Day 1, Admission
Sandra writes most of this.
Yesterday was an eye-opening experience into the differences between Indian hospitals and North American ones. We were seen off at the gate of our apartment by Mala, our landlady, who gave us her cell phone number and her son’s, and told us to be SURE and call her, for any reason, day or night, and that she was going to church to light a candle for Bill, which was so sweet of her. She waved us off, and we made the long, bumpy, bone-jarring trip by auto-rickshaw along the rutted roads out to the hospital. The driver took us the longer way, but we didn’t concern ourselves about it too much — we had more important things on our minds at that point.
Upon arrival, we were ushered in to see Dr. Thomas and two of his assisting doctors, and last-minute loose ends were tied up. He told Bill that he was making arrangements for him to be given only bottled water to drink during his stay, to prevent any chance of infection from unfamiliar water, even though the hospital water is so-called “filtered.” He also conveyed to the dietitian that Bill’s not supposed to be fed any tomato, oil, ghee, or sugar. Then we were taken to the cashier, where we had to pay half the price of the surgery in advance, in cash (about $1,000 Canadian-worth). That doesn’t include the cost of any extras, such as X-rays, EKGs, antibiotics, or drugs — those things can be paid for when Bill checks out, along with the other half of the cost of the surgery.
Next, we were ushered by the nurse into the X-ray room, where Bill received a full chest X-ray (even though he had one at Vikram Hospital only a month or so ago). After that, we went into another room where he was given an EKG. I had to wait outside in the men’s “poor” ward, where some very sick-looking men were lying in their beds, one of them groaning. Even in this ward, although the beds are fairly close together, it looked clean and very airy — quite different from the closed-up hospitals at home.
Finally, we were taken up to Bill’s “deluxe” private room on the 2nd (top) floor, after which time there was a steady stream of nurses, social workers, and other staff popping in and out with various questions, forms, instructions, and requests for information. Bill was given oral antibiotics, to put away in a drawer “for later,” and another time a nurse came in and gave him a stinging injection in the bum of the antibiotic Cypro.
But, things really got weird when she came in with a form that gives our consent for surgery. We thought all we had to do was sign on the dotted line, but, no….turns out I was expected to hand-copy the entire, one-page typed form onto another piece of paper I was provided, and then we were to sign both the original typed form plus the one I had written! THAT took a long time, and I had writer’s cramp afterwards — I haven’t had to hand-write that much in years, since the advent of the computer. I’m sure they could have either typed or Xeroxed a copy instead, but I guess the idea is, if you’ve gone to all the trouble of handwriting it, then for SURE you’ve read it thoroughly and there’s no question that you’ve agreed to the terms. The number of typos and turns of phrases, however, was laughable, but I copied it all exactly as-is.
We took a little walk outside the hospital after all that (which freaked out the nurses, because once you’re checked into the hospital, you’re not supposed to leave the grounds), and they also couldn’t understand why in the world we’d want to go for a walk outside in the heat of the day; we might get heat-stroke! We explained that we LIKE the sun, and we truly weren’t going to go far — we just wanted to buy some fruit for Bill, and maybe find a little place to eat lunch. They reluctantly allowed us to go for about a half hour.
As it turned out, there really was no place to go after all, because the hospital is so far out of town, there’s nothing out there except the highway, some factories, a grubby little tea stall, and a lady selling sweets and expensive bananas. We bought a few bananas from her, and then walked back to the hospital, told the nurses we were back again, and walked downstairs to the hospital “canteen” to try and find something edible for lunch.
Inside, the dietitian has her office, and there are tables and chairs where the hospital staff and any ambulatory patients who want, can go up to the cashier, order food from a very limited vegetarian menu on the wall, receive tickets for each item ordered, and redeem the tickets at the food counter for whatever greasy slop you’ve decided upon.
South Indian cooking has to be the unhealthiest cuisine in the world, especially when it’s cheap food — everything, but everything is fried in rancid sunflower oil, and what little can’t be fried, like soup, is cooked absolutely to death, and fiery spicy with chili. They also sold sickly sweet tea and milk coffee, and behind the counter were packages of fried snacks, candy, packaged “pickle,” and bottles of soda pop, the more colorful the better, so there was a good supply of brilliant orange Fanta Orange Soda. I finally settled on an onion dosa with dipping sauce, and Bill ordered a “bread and egg” — NOT a good choice (some kind of gummy white bread dipped in an egg batter); the dosa was greasy and not much better, and I left most of it.
After our repast, we went back up to Bill’s room. Two beds are provided: one for the patient, and one for an attendant or the wife, if she wants to stay in the hospital with the patient. The room looks more like a cheap Indian hotel room than a hospital — two stark beds with no sides on them, a plastic chair, a cupboard, and a little tin end-table. There’s a bathroom with a toilet that can either be used as an Indian type (with places to put your feet when you squat), or you can put the seat down and use it Western-style. A tiny cake of carbolic soap (cut in half to conserve) is provided on the sink, unless the previous tenant hasn’t used up his piece, in which case that’s left behind for the next person. There used to be a shower fixture, but it’s not there now; just the broken fixtures. But the usual spigots are on the wall to run onto the floor, and a bucket is provided in which to run water for bathing, and a cup for pouring water over yourself. Afterwards, you just dump the water onto the floor and give the floor a wash, and it drains into a large drain in the floor. A small bucket and cup are positioned under a smaller tap next to the toilet, and that’s for washing your left hand after you’ve wiped yourself. Toilet paper, of course, is not provided — fortunately, we remembered to bring a roll. A typical Indian bathroom, all in all.
It’s funny — sheets and pillow cases for beds are provided, and a blanket for the patient, but towels aren’t. We asked for a towel, and were told pointedly that “personal” items are not provided……how it’s determined that a towel is a personal item but a sheet isn’t, I don’t know, but I’m taking Bill a towel from home this evening.
There’s not a piece of hospital equipment of any kind in sight, which is why it doesn’t feel like a hospital room, and the door is open onto the corridor outside that overlooks a courtyard, while a back door opens onto a sunny balcony. Very open-air. The balcony looks out onto a patch of red Indian earth, strewn with coconut palms and other plants — so it’s quite pleasant, with lots of birdlife and the occasional cow. There’s a clothes line strung along one side, from which dangle dozens of freshly-washed rubber gloves (obviously they re-cycle them, although whether the nurses re-use them or they’re just re-used by the cleaning staff, we don’t know). The whole time we were there, however, we never once saw either the nurses or the cleaning staff wearing rubber gloves. Outside in the corridors are metal canisters with a spigot and a metal cup sitting on top. These are the communal water containers with the “filtered” water. Fortunately, Indians always tip the cup up and pour the water into their mouths without touching it with their lips, so hopefully, no germs are spread. It’s a trick that Bill and I have not yet mastered, however, so we’re grateful for bottled water.
I haven’t been sleeping well for the past few nights, so I lay down on the extra bed to rest before going through the ordeal of taking the auto-rickshaw home again. The beds are made of some kind of nagahyde vinyl, as are the “pillows” – ha! Guess it’s easier to clean that way, but they sure are hot and sweaty and hard.
Bill had to ask for a top sheet, because in India using a top sheet is unheard of; people just use a bottom sheet and, if necessary, a blanket on top. The sheets and pillowcases were a riot….clean, but very threadbare and pilled, with even a few holes worn through, and faded flower prints of mismatched types. Anyway, I tried to catch a few winks while Bill read his book, but we had a steady stream of constant interruptions, with nurses coming in to take Bill’s blood pressure (how often do they have to do it?!), the cleaning lady coming in to sweep the floor with her little sticks-broom, the cleaning man coming in to wash down the bathroom floor with Dettol (gag), a nurse inquiring out of curiosity what we’d had for lunch in the canteen, and a steady flow of nurses coming in and out to get rubber gloves off the clothesline (?!), as if Bill’s room is a corridor to the clothesline.
Then we were informed that Bill’s operation had been postponed till 2 in the afternoon Tuesday, and that I would only be allowed to visit him for about 5 minutes in Intensive Care afterwards, as he came out of the anesthesia (he would probably be awake, but unable to talk). So, my plan now is to catch an auto-rickshaw around 4:30, run out to the hospital, ask the driver to wait, run in and see Bill for 5 minutes, pay the cashier for the X-ray and EKG he had yesterday, run back to the rickshaw and have him drive me home again (and hope he doesn’t cheat me too badly).
When it came time for me to leave Bill for the night, he walked me out to the hospital gate where the auto-rickshaw drivers hang out. Even though there were 2 of us (it helps to have the authority of a male), they still tried to cheat us. They refused to use their meters, and wanted to charge me 50 rupees for what should be, at most, a 30 rupee ride or less. I couldn’t go with a different driver, because they’re all buddies and stick together and support each other, so they knew they had me cornered. Bill argued with them, and finally got one of them to take me home for 40 rupees, but he wrote down the guy’s rickshaw number (to make him think that maybe we’d report him to the police for overcharging). That was a mistake, because the driver was a sleazy-looking character and asked me questions all the way home. It seemed like he was trying to find out as much information about me as possible. I started to get the feeling that he was trying to find out if I was going to be alone while Bill was in hospital, so that he could come and take revenge or something. I felt so uneasy that I finally had him drop me elsewhere, away from our apartment building, so that he wouldn’t know where I lived. I shoved the 40 rupees into his hand and fled and, when he was totally out of sight, walked the short distance home.
Bill
Western hospitals seem to have a constant battle with infection which, I think, is due to the closed ventilation systems. Dr. Thomas said the infection rate is extremely low here. It is probably due to the fresh breeze constantly blowing through the rooms and wards.
Barath Hospital has a men’s and a women’s ward on the ground floor beside the grassy, well-watered courtyard. The top floor of this two-storied structure has the “Special Ward” with the ICU and six private rooms. I am guessing the total capacity is less than 30 patients.
My room was the most expensive one ($20 per day) in the hospital with A/C (not required at this time of year) and a TV with two Indian channels. The less expensive private rooms ($11 per day) have no A/C, no TV, and even harder mattresses and pillows on the beds. This is not accommodation that would suit those not used to India but, if the object is good surgical care, you can’t go wrong with Barath Cancer Hospital.
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