Healthcare

**Long read, you've been warned**

Well my wrist is still broken. The fracture occurred approximately 80 days ago. My wrist has been immobilized for about 78 days. For those interested in how I've dealt with healthcare in a country where English is not primary...

Saturday September 12 11:30pm - fracture occurs

Monday September 14 - Convinced of a fracture, I reluctantly ask the assistant principal to escort me to the nearest x-ray facility/doctor to confirm my suspicions. Graciously he meets my request with a same day appointment. He accompanies me to a local clinic/standard Doctor's office and tells the receptionist/nurse of the condition. After collecting my government issued ID and confirming my national healthcare membership I wait a few minutes before meeting the doctor. This doctor (don't know his name : / ) speaks decent English and the second question he asks me (after what happened?) is what medical allergies I have and what medication I'm currently on. This may seem very routine, but when you are in a foreign country this sort of question gives you more comfort than you can imagine. Anyway, the x-ray shows a hairline fracture (note: no lead vest...hmmm) which the doctor is very pleased with because he insists a scaphoid fracture is typically awful to heal and a pain to say the least. He applies a splint and gives me a prescription for ????? (he says medicine for minor pain and to reduce the swelling). A couple of minutes later I am on my way to the pharmacy with my assistant principal (pharmacies literally line the streets, quite convenient). The pharmacist takes a quick look at the paper, disappears, then reappears with 12 individual plastic packets with three pills in each. Through translation with the assistant principal: Take these 3 pills (again, who knows?) thrice daily for three days. Easy enough. Mildly pleased with my first experience with foreign medicine. Paid in Korean won, but will give approximate USD. Out of pocket: $18.00 (xray, dr. visit, splint, drugs).

Thursday September 17th: Return to original doctor. Splint removed, hard cast applied. Told to return in 3 weeks for x-rays (went alone this trip, fortunately front desk recognized me right away...American with a broken wrist, probably not all that common). Out of pocket: $4.00 hard cast.

Monday October 5th: Return to original Dr./clinic for x-ray check-up (accompanied by assistant principal). X-rays (lead vest? of course not) show fracture much worse than original x-ray showed. I actually assumed this as I had experience before with getting x-rays while still being swollen. It appears from my experience that when the injured area is initially swollen, the bone appears via xray to be perfectly aligned/having only a hairline fracture/no problem at all. I asked the doctor to remove the full hard cast out of comfort and give me a half cast splint for the remaining three weeks (his initial diagnosis of 6 weeks to heal). He obliges. Out of pocket: $9.00 (xray/splint).

Monday October 26th: Return to original Dr. by myself excited to see my wrist, begin writing legibly, wearing shirts/sweaters with sleeves, etc. X-ray (again, no lead vest) shows no improvement from week 3 x-rays (and obviously still decline from original x-rays from 9/14). Dr. is pretty disappointed as am I. He recommends 4 more weeks of immobilization. Out of pocket: $4.00 (x-ray).

Monday November 23rd: Return to original Dr. by myself excited to AGAIN see my wrist, begin writing legibly, wear shirts/sweaters with sleeves, etc. Hooray! X-rays (sans lead apron of course) show improvement! Not enough. Dr. tells me he is encouraged but not convinced that it is time to remove the cast and begin rehabilitation. He offers me two options: 4 more weeks immobilization, or run down to the clinic down the street for a CT scan. Vexed, I opted for the CT scan as long as it was reasonable cost wise. He tells me $50 with insurance (me), $160 no insurance (...not me). Ok, 50 is reasonable. He writes up the recommendation letter and draws a modest map. Seems simple, walk 10 meters north, take a right, head 100 meters East. Well, 100 meters was a conservative number. 15 minutes and wild pointing/broken Konglish later I spot the sign (thankfully I've studied my 한글). I hand the "recommendation" (who knows what it says?) to the front desk and they point to a chair. A few minutes later I'm ushered into a room and asked a couple of broken English questions like "what hurts?" and "how?". Then escorted back to the waiting room. A few minutes later I'm shown into the CT scan room. This nurse/Dr. speaks zero English. This was probably a hilarious scene. Picture the patient trying to lay awkwardly on the table taking directions from the doctor in an unfamiliar language (with one or two English words thrown in such as "prone"...really prone?) to position themselves appropriately for the scan. CT scan complete, I'm escorted to the elevators and up to floor 5 to meet with a doctor. This Dr. knows a wee bit of English (less than my original Dr. but more than any other medical staff I've met). Through mostly pointing, nods, and a few English words I discover the news that the scaphoid hasn't healed (X-ray fail, don't tease me with your blurry pictures). This doctor says verbatim "Elevator down 1 give CT picture". Alright will do. Headed down 1 floor.

I probably should have read the signs to the entrance of the offices on this floor to see if they resembled anything medical. This created a fun situation of me saying "CT scan pictures" to the receptionist while handing her my recommendation paper from the Dr. Would have been great if she wasn't a receptionist for "Rabbit Advertising". Whoops, what that dr. had intended to say was go TO FLOOR ONE, not ELEVATOR DOWN 1.

Anyway, my red face arrives back at the front desk to retrieve my pictures/cd of pictures. They hand me the calculator with 165,000 typed out (calculators are incredibly handy tools for merchants who serve a community who doesn't speak the native tongue). I give them an awkward look, say "ah-nee-oh" (no). "ah-nee-oh, insurance" then I gave them the ol' X crossed forearms with fists in the air. The three people standing at the front look awkwardly at each other then back at me. I hand them my alien resident I.D. card and repeat insurance a few more times. I'm directed to a seat. 15 minutes later I'm summoned to the front. Summoned of course the Korean palm down way. This comes directly from the Official site of Korea tourism:

When you beckon to a person, do so with your palm down, and then flutter your hand up and down with your fingers touching together. It is not polite to beckon with your palm up ― especially using only one finger, because Koreans do that only to dogs.

The nice people at the front smile at me and show me a calculator now with 44,000. I smile, hand them my money and bow as low as I can to show them respect/thankfulness. I walk back to my original Dr. and give him the CD with the CT pictures. He views them and says "ah, you see CT scan is a good plan! X-ray was not a good picture and this is better to say your wrist is not healed". Bittersweet...very bitter. At this point the Dr. recommends I head to the big hospital to see a specialist regarding surgery. He writes me a recommendation letter that has to be used within one week if I want to see the Dr. at the hospital. I thank him and head back to school and ask my assistant principal to call and schedule me an appointment. He is great. Out of pocket: $45.00

Tuesday November 24th: The assistant principal (Mr. Kim btw) and I take at taxi ride to Gangnam Sebarentz<-- Korean pronunciation of severance. I thought hospitals were a tad confusing when you spoke the native language...oh my word I would have been here for 4 days without Mr. Kim's help. Shortened version: Find main front desk hospital, directed to the Orthopedic front desk, directed to the cashiers desk, back to the Orthopedic desk, directed to the area/desks that takes the CT scan images from the CD and loads them into the system, then back to the orthopedic desk where we wait to see the specialist. This is where the frustration begins. This specialist speaks no English. He looks at the CT scans, talks with Mr. Kim for about 6 minutes. Then we leave the office and Mr. Kim tells me that the Dr. says the bone is still broken but they need X-rays. I'm thinking why would they need an x-ray when you just looked at a CT scan from YESTERDAY. Ugh, I take the x-rays (oh a big hospital, definitely lead apron...nope) and schedule to meet the next "specialist" in two days. Out of pocket $19.00 (x-ray, initial visit)

Thursday November 26th: Arrive with Mr. Kim back at the hospital. See the next specialist. He speaks a bit of English...less than the original Dr. from the beginning, but more than all the other people so far. He looks at the X-rays and says (paraphrase): These appear inconclusive, I think we need a CT scan. I tell him, no, we have those in the computer. Then Mr. Kim (I'm assuming) explains in more detail. He pulls up the CT scan and then says "well, the bone is lined up, but hasn't healed, I'll be right back". He goes and speaks with what he calls "the head professor" and says "lets do 2 more weeks immobilization and then reevaluate. In two weeks you will meet with head of the orthopedic department". Really? 10 and 1/2 weeks have gone by and you want just 2 more weeks? I'm then walked into the room where a hard cast is applied. Out of pocket $40.00 (hard cast, etc).

Present.

I'm hoping the head orthopedic Dr. has got some great news/great ideas/speaks great English. I just hope he/she is great.

Couple of overall thoughts. I am pleased with the cost of healthcare and the care itself. I can't say I'm frustrated with the barriers because they are expected. I cannot presume that somebody in another country will speak the language I speak. I find that thought, to me, to be close-minded and naive. On the contrary, I'm extremely thankful for the Dr.'s who can use English (even if just a little), and abundantly thankful to Mr. Kim who may not speak perfect English but is doing all this work for me. I mean what does he have to gain by putting in all this time and effort? It is a blessing.

Scaphoid fracture