Chiang Mai Emergency care

It’s good that they make you buy insurance when you buy a motor scooter here. They must have lots of experience with inexperienced drivers, like me. Last Sunday afternoon I tried to cross the street and turn, while merging into fast-moving heavy traffic. That was more than I was ready for. As a result I got a first-hand look at Chiang Mai’s emergency medical care.

Getting up after crashing into the curb, and noticing my left arm was weak, I felt a pointy bone poking up near my shoulder. That point made me realize I didn’t have the choice of going on to church with my dirty shirt. A lady had stopped to help me. When I showed her my shoulder, she called an ambulance. I wondered how much that was going to cost, but felt unable to do anything else. Gary had taken our visiting daughter to Cambodia, so I called my resident “mother”, our housekeeper, Hok. She had given me her number on Saturday in case of this kind of event.

Hok spoke to the Thai lady who had stopped to help me. Then she came, arriving just before the ambulance. This was all near my house, so Hok was able to take the motorcycle there and then join me at the hospital.

The ambulance was a pick-up truck with a high cover over the bed. It didn’t have as much medical equipment in it as ambulances I’ve seen displayed in the US. I sat on the tailgate and then moved backwards to the stretcher that was its bed. That was good enough for them, since Thais are used to hard beds. Because of my injury, they let me sit up for the ride. It was kind of cool seeing how we drove around the traffic with the siren on. It probably wasn’t as different from a regular ride as it would have been in the US, though, since most of the drivers here ignore sirens, and many of them do what this driver was doing anyway.

At the hospital they made me lie down after I moved myself onto the gurney. Then they rolled me to just inside the door of the emergency room. The checked me over, took my blood pressure and temperature (BP & T) and decided they needed an x-ray of my shoulder. It was good we had seen doctors there before because our registration was in their system. All they needed was my name to find it. They washed and bandaged my road rashes and then rolled me to the x-ray room. All the equipment was the green kind I’d seen in the US 20 years or so ago. This was the oldest hospital in Chiang Mai, after all. Everything seemed to work fine, though.

Soon after I was back in the emergency room, Hok arrived. She made sure all my things were together and safe, including the necklace I had to take off for the x-ray. The emergency room doctor looked at the x-ray and asked if I could stay in the hospital. I thought that was kind of strange. In the US they don’t give you a choice, they decide. Since it was about 5 pm by then and I didn’t know what else I was going to do, I said, “Yes.” A few minutes later they brought a form and asked more questions.

“Do you want a shared or a private room?”

I tried to ask how many people would be in the shared room, but they just took that as a private room choice.

“Do you want a fan or air conditioning?”

“A fan,” I answered. We hadn’t used the air conditioner at our house for a few months. They were a little surprised, though, and asked again to make sure. Then they had me sign the admission papers. They took my BP & T again and gave me a sling for my arm.

Before too long they were wheeling me to my room. It was up a few floors, so the orderly rolled my gurney up several ramps to get there. Then we went down a bare hallway to the room. It had a bed with hand cranks, a couple of folding chairs, a cushioned bench seat with a back, a fan on the wall, a rolling tray table, a nightstand table, a refrigerator, a TV, and one other small table with drawers. The cushioned bench seat had a pillow and a blanket on it. Some nurses took my BP & T again and gave me some loose pants with a drawstring and a shirt that crossed over and tied. After they left, Hok helped me change clothes. In that process we found that I had a large lump on my left hip. We joked, in Thai, about that being black, purple, and green soon.

Hok began to ask me if I wanted her to stay the night with me. I wasn’t sure because I didn’t know what they were going to do with me yet. My Thai and their English weren’t quite good enough for me to understand everything. Then Chiang, another friend I called, came with her husband and son. They used their Thai and English skills to help the hospital staff and me understand each other. All of us together got the accident report filled out accurately. We also learned that the orthopedic surgeon had not made his rounds yet and he would be the one to decide my treatment.

Chiang told me it was Thai tradition for a person to stay overnight with someone in the hospital. They helped me tell Hok that I thought I could stay by myself unless the doctor decided to do surgery. The nurses had left a sign in my room saying, in Thai, no food or drink for me. That indicated they thought surgery was still a possibility that night. Hok decided to stay until the doctor came and made his decision. Chiang and her family left to get dinner and their other son.

Hok told one of the nurses who came in to get my BP &T about the lump on my hip. One of them must have told the doctor because he looked at it without my saying anything. He also ordered an x-ray of that hip and showed me an x-ray of one that was broken in just a fall. I guess that was because I moved my leg around to show I didn’t think it was broken.

I thought they would take me back down to the x-ray room, but instead the technician brought the x-ray machine came to me. Hok helped me stay in the right position for the first shot. On the second, the technician made her move toward the backside of the machine. I guess one shot of x-rays for her was enough.

The doctor came around again to say my hip wasn’t broken and my collar bone could be fixed with a brace. They would put the brace on in the morning and I was to sleep sitting part way up. Then a nurse took the “no eating” sign down, pointed toward the nightstand with the hospital phone and my cell phone, and said I could call “the woman” to get some food. I didn’t understand what woman to call on which phone, so I waited for Hok to come back from getting her own food. When she returned, a few minutes later, I told her what I could. Then she went to check on the hospital kitchen. It was after 9 pm. She found it closed.

Hok volunteered to get me something, so I gave her some money. She came back with some mystery sandwiches, sweet rolls, milk, and water from 7-eleven. Even after eating one of the mystery sandwiches, I couldn’t say what was inside the bread. It didn’t make me sick, though. Some of the milk and rolls we put in the refrigerator for breakfast. I said goodbye to Hok, assuring her I would be ok. She said she’d be back at 9 am.

The room was very quiet. No sounds came from the hospital except the nurses who took my BP & T a few times. The few other noises came from the apartments across the alley from my room. We had found a Gideon Bible in the nightstand with both Thai and English in it. I read that before I tried to sleep and again in the morning. My shoulder ached some since they hadn’t given me anything for pain. They had given me an antibiotic.

A nurse brought me a pill for pain at about 6 am. She said something about taking it before or during breakfast, so I took it with some of my milk. Breakfast came about 6:30. It was rice in a brown broth, some mild spices and onions to sprinkle in it, and a small carton of chocolate milk. I was glad I still had milk and rolls left from dinner.

At about 8 the doctor and some nurses came to put on the brace. They had me sit on the edge of the bed with some of the women nurses in front of me and the doctor behind me with the other nurses. They said, “Sorry,” as they took off my top to put the brace on. It is a thick, padded, cloth-covered strap that goes around the front of my shoulders and crosses in the back. Velcro holds it together in the back. The doctor said not to take it off for anything and to see him in three weeks. He also said not to lie flat or to lift anything heavy. He did want me to let my arm out of the sling to exercise the lower part of it, but not to lift the upper part away from my body. He didn’t say anything about changing the gauze pads over some of my scrapes.

Hok came at 9 with a change of clothes for me. She also had the documents about the motor scooter insurance to show the man from the hospital business office. He wanted a copy of my passport too. Since I only carry copies, Hok had to go get it from the house.

In between the visits of the business office man and the nurses taking BP & T and giving me another antibiotic, Hok helped me put on my clothes. Everyone was gone when the orderly delivered my lunch. It was rice in a thicker broth with bits of meat in it and a bowl of steamed greens. The lady poured some water for me to drink. It tasted good, but I added another roll and the cookie left from dinner to the meal.

Some other friends came to make sure the hospital bill was covered and to take me home. The insurance ended up covering all but $10 of the hospital bill.

I was surprised that they didn’t come with a wheel chair after I was cleared to leave. In the US, hospitals don’t let their patients walk out, as far as I know. My friends suggested I ask for a wheel chair anyway, so I did. It was kind of a long way down the ramps, or the stairs, after all. Soon I was on my way home with another piece of my Chiang Mai experience over with. Now I can’t wait for the brace, the sitting-up- sleeping, and the sitting around at home experience to be over too.

:J

What is in your hand?

A pastor recently quoted what God said to Moses in Exodus 4:2 to sum up his message; "So the Lord said to him, 'What is that in your hand?' He said, 'A rod.'" God used that rod to display Himself to the Israelites and to Pharaoh. The pastor's message was that God wants to use what He has given us to do His work in the world.

When I saw Beth Moore's story again recently about the Lord's direction to her to brush an old man's hair, that message was reinforced in my mind. The old man in the airport had long matted hair and he looked too weak to brush it himself. She at first resisted the Lord's prompting, thinking, "I should witness to him. Tell him about Jesus," but she felt Jesus insist that she brush his hair. Finally she did. As she began working carefully through the tangled hair, she thought, "I can DO this. I've raised three daughters." When his hair was smooth again, she asked him if he knew Jesus. He said he did. Her brushing his hair didn't bring him to Jesus. Yet the stewardess taking him to the plane was crying after seeing this display of love for a stranger. She asked Beth what made her do it, and that was where the witness happened. Jesus was glorified in what Beth did, so her presentation of Jesus to the stewardess had greater impact.

This is how I see what we are doing in Thailand. The Lord has given us health and healthy independent children. He has given us the ability to enjoy a foreign environment and adapt to it. He has given us a source of income so we can be here without having to be paid. He has given us some ability to learn a new language and has given us experience and training that He can use here. Gary has knowledge from his Masters in Business degree and through his work as a business owner for many years. I have some knowledge from my Masters in Teaching degree and from years of experience working with children.

I'm not saying I am the most qualified person to be the head English Teacher at this new school. There are many people with much better teaching experience and ability than I have, but they are not here. All I am doing is giving what I have to teach English to the Thai children in my school and trusting that God will work through me and in me to use it for His glory.

We don't know exactly how God will glorify Himself in this, but these are some of the possibilities we, and others, are hoping for. First, we are trying to help the children in the school to know Jesus and English well so they can become an influence for Him in their country. As I teach, I sometimes I get to say something about God in the classes. Sometimes I reinforce the faith they express. Other times I pray with them in English or join in their Thai prayers. Sometimes I encourage the faith of the Thai teachers, and they mine, as we share about our faith with each other.

Gary and I also meet and talk to other Thai people in our neighborhood and our community. Sometimes we get to say something or demonstrate our faith to them also. We don't know how God will use any of this, but we are expecting that He will. We went to a seminar last week where the speakers explained that the biggest impression we can make on the people in the Buddhist culture is through our demonstration of Jesus' love. That kind of love is missing in the Buddhist faith. Still, we need His help to truly show His love, and we need to give Him the credit for it at the right moments. Please pray for us to be able to do that.

Thank you.

:J

Eating Weeds

One of the amazing things about Thais is they will eat almost anything green which grows in the ground. From an early age they seem to be taught what is edible, and most everything is edible, if not tasty.

This morning I went to inspect the hedge surrounding our yard. I look for weeds. Ok, what I think are weeds. My definition of a weed is: Anything that is not the same as what was planted there originally. A reasonable definition. So I picked out a “weed” I encountered and threw it on the street. Then, I walk to the ATM machine to get some spending money, and when I get back, guess what? I was gone maybe 10 minutes and my “weed” is gone.

I suspect an elderly lady who walks the streets. Why her? I have caught her inspecting the neighbors’ plants around their houses. If they see her and talk to her, she seems to be lecturing them on what they have that can be eaten. I don’t understand Thai but it sure looks like that. I have even caught her picking out “weeds” from the neighbor’s yard across the street. I don’t know how these “weeds” get in our yards but I do suspect the old lady.

Why her? When they were remodeling the home across the street, she took over the front hedge area. Not to plant a hedge, but other edible things. I don’t know what they call that stuff, but she’s there every morning, tending her garden and gathering her rewards.

When we have dinner at night in the neighborhood restaurant, I always get some green leaves in my soup. I have often wondered if any of those came from my neighbors’ yards. Now, when you pull those weeds out of your garden, you should stop and pause a minute. Could this be feeding some starving kid in Thailand?

GP

Advice

Have you noticed how some people love to give advice? Some just say it. Others disguise it. They write a lengthy, scholarly article, book or paper. Usually, you’re considered intelligent if you give advice. It doesn’t necessarily have to be good advice. A lot of bad advice gets published.

What is it about giving advice that makes us want to dispense it? There must be some reward in it for us, whether people take it or not. My father never gave me much advice when I was growing up. Sure, he said change the oil in the car. Take a bath every once in a while, but not the important philosophical truisms that you can live your life by. I guess he thought experience was the best teacher. Although later in life, perhaps in his 80’s, he

tried to dispense some wisdom. Problem was, by then I had already made most of the mistakes he thought he was saving me from. The “strong, silent types” will say their lives are their teaching tool. I was always afraid for them because I don’t see many people paying attention! So, like my father I’ve chosen not to give much advice. I really don’t need to. I’m married and that’s being taken care of! (Thanks, Jean)

I’m not saying you shouldn’t give advice. A big reason I came to Thailand was to give advice. My kids left home years ago and I’ve been married 30 years so I didn’t really have anyone to give advice to there. I thought the Thais might want some of the wisdom we Americans have accumulated because of our great economic success. After nine months, other than wanting to learn English, I haven’t found a single Thai looking for advice. What I discovered was, they think they know it all too! Then, last Sunday, my opportunity, my big break you might say, presented itself. It was a white person, but at this point I am not going to be choosy. I was sitting alone, minding my own business, which is very American, and a young white man approached me. After hearing his question I knew I had prepared well. I told him the bathroom was down the stairs and to the left. Sigh! When giving advice it’s probably better to start out small anyway. I did feel important. After all, knowing where the bathroom is located is very important in Thailand! I bet some of you are saying, “That’s not advice, that’s directions.” Well, that’s easy for you to say, you’re not in Thailand trying to find someone who wants advice. I don’t want you to think I’m discouraged, because I’m not. I know it’s going to take time for someone to ask me the answer to the bigger questions in life. I hope I’m as prepared to answer those questions as I was with “advice” on the direction of the bathroom. Life can be so simple sometimes.

Gary

Patience

Did you ever wonder why “patience” is a virtue? It seems as a virtue it doesn’t have a lot going for it. For example, it seems inefficient. Waiting for something gives the appearance something is not getting done. Patience doesn’t seem to get much credit. People don’t re-mark, ”he/she was a great man/women, he/she was so patient”. Patience doesn’t seem to make one great. Patience might have been used in the creation of greatness, but they are usually remembered for something else. Like, the light bulb.

The old tale of the Hare and the Tortoise doesn’t seem to fit in the world I’m in. Getting things done, taking command and being decisive are more desirable attributes. Patience also seems to be a luxury. You can afford to have it, when you need it the least. When you’re wealthy there’s no reason to rush after riches. You can be patient when you’ve accomplished everything you set out to do. You can be patient if there’s no pressure to get something done or be somewhere. Patience is in distain, old fashioned, lightly appreciated and seldom practiced.

And then you have the problem of definition. Everyone has their own definition of patience. To some waiting 10 seconds for something to happen is patience, to others, 10 minutes, or 10 hours, or 10 days. When a person is impatient what does that really mean? They aren’t living up to your definition of patience?

I don’t think people consider it the most important virtue. People just say it’s “a virtue”. Does it have a rank? How high should it be? Then, it's like a game. You need to practice, to get good. Not only do you have to “have patience” you are to keep practicing. If there is something most people don’t like it’s practicing. Why do you think so many exercising and dieting programs fail? Well, that may not be a fair analogy. I think you get my point. In some odd way we admire people who we consider to have patience. Although none of us seem to be satisfied with the amount we have. Nor, do we know how much we’re supposed to have.

Well, when it comes to patience, I have more questions than answers. But I have learned one thing. You don’t “make” friends! You don’t create them out of thin air. You have friendships and practice to make them better.

GP

Seeing a Doctor

“Come over here. Now wait here. Come over here. Now wait here. Come over here, now wait here.”

This was repeated numerous times as we worked our way through to see a doctor at the outpatient clinic of McCormick Hospital, the Presbyterian hospital in Chiang Mai. I wanted to ask “Tom My” many times, but felt that I wouldn’t understand the answer if I asked it. So, I let myself be in their hands trusting that really I was in God’s hands, as I often do here in Thailand.

Gary had gone to one of the local clinics before and found a very good, English-speaking doctor there. An appointment with her was much easier to get and go to. I needed a gynecologist, though, and I don’t think she did that. A gynecologist at McCormick was recommended to us, so we went to check that out. Gary also wanted some of his moles checked, and taken off if needed. He had heard they did that at a low cost. We decided to include my blood test for thyroid in our visit as well.

We went to the outpatient clinic on a Friday when we were downtown to check out how the appointment system worked. We found out that we had to fill out a form before we could get an appointment. Then we had to state exactly why we wanted to see the doctor. I didn’t know how to ask for a general female exam, so I asked for a Pap test. That they understood. Then they said we could have appointments that morning. That made me suspicious. My suspicions were confirmed when our appointments for the next Saturday morning were 8 to 11. They weren’t at a specific time. Then we tried to get our “How much” questions answered. The Pap test price was pretty clear, but not the price for checking the moles.

July 3, we arrived just before 8. A few people had beaten us there. We turned in our paperwork and watched and waited. We saw that, to get out of the first seating section, the nurses would first weigh us and take our blood pressure. When they called me for the gyn appointment, though, they took me to the women’s clinic section to get my weight and blood pressure. I grabbed my backpack and said goodbye to Gary for awhile. The rooms they led me to after that are only for women patients. (So, any men who happen to be reading this, unless you skip the next two paragraphs, you will get a peek behind some doors that are closed to you)

First a nurse took me to an office with many desks. We sat on either side of one while she took down information about my address, pregnancies, and menopause. She gave me a paper telling when the Pap test results would be available and a phone number to get them. Then she led me to another room at the other end of the women’s clinic hall. This was a large room with hooks on one side and a bench on the other side. She pointed at a bin full of white cloths and said those were clean clothes. She also pointed to some of the clothes hanging on the hooks and said to remove my lower clothes and underwear. After she left I pulled out one of the “clean clothes” and found it was a large tube “skirt”, at least ten times bigger than me. “Should I leave my pants and underwear hanging in here?” I wondered. “Who was wearing those really short jean shorts? How do I keep this skirt from falling down?” I decided I could leave my clothes on a hook in the room and folded the “skirt” over so it was tight enough so I could hold it on with one hand and still carry my backpack with the other. Then I joined the other ladies sitting on the bench in the hall in their “skirts”.

A short while later the nurse called me into the examination room. The doctor went over the pregnancy and menopause information the nurse had asked me about. Then the nurse said, “Come over here” again. This time it was to “the exam table”. The doctor took the sample and did a short exam after and it was all done. Back in the changing room I soon had my clothes back on and put the skirt in the dirty clothes bin. When I went back out in the hall the nurse led me over to the cashier section. On the way I spotted Gary so I could go get him when they asked me to pay. The price was 500 B, about $16.

Meanwhile Gary had been to see one doctor and was waiting to see a dermatologist. After the dermatologist he was sent back to see the surgeon. At every step he kept asking how much this all was going to cost. Once he asked me to talk to the nurse about it for him, as if I could understand that much Thai.

Since Gary was still waiting to see doctors, we decided I should see about having my blood test for thyroid. That meant I had to see another doctor. Gary said I should ask for a “full panel” of blood tests too, but the doctor I saw wanted me to list the names of the tests I wanted. I settled for cholesterol, glucose, and the thyroid one. That was a good thing. Blood tests are expensive compared with doctor exams. Those three cost about 1000 B. They made us pay for them before they took them too, which makes me think they know they are expensive too.

I had all that done and still waited for Gary to get done. Finally he came out of the surgery with five large gauze patches on. He denied screaming when they cut the moles off. He got close to screaming when he got the bill at the cashier, 5000 B. Most of the expense was from them sending them in for cancer testing. He did get some money back when he refused the pain medication the doctor prescribed for him.

Now we think the clinic we went to before was a better deal overall. Next time we need to see a doctor for something we will try to go see her first.

:J

The First Puppet Show

A leg falling off, tangled and broken strings, dropped puppets, the 4th grader with the next part wandering off or climbing into the puppet closet and breaking the door, the velcro proving too strong for the many changes and coming apart, the recorded voices being too quiet to hear... that was how practice went. In [curtain call] between practice and classes I was fixing and untangling the puppets and working on the puppet stage and the transition plans.

Covering the stage framework and getting the voices recorded turned out to be major projects. Often I had to remind myself that, however it came out, it would be what God wanted at that point in time.

The play was about the silent e at the end of English words, so each of the puppets had to hold letters, and a different letter in each Act. Our classroom has many business card sized letters,

so I decided to use velcro to attach them to a belt of velcro on each puppet. That worked, but too well. The velcro held on tighter than the staples in the cards. The attaching velcro needed to be smaller. It also didn’t work to use the backing to hold the different letters on the Act list. Pockets of paper worked better.

It was another lesson in material availability to figure out how to record the voice parts for the play. Hand held tape recorders are old technology I guess. I couldn’t find any. Then I used Garage Band on our computer, but that meant I had to get the computer to school on two separate days, and make sure we got through the play on those days. When I began to work on cleaning up the recording and trying to get it to a playable CD, the program had a problem. Gary took over then and did that part. We finally figured out how to burn it as an audio CD, but the sound was too quiet. Now I know to turn the recording volume up and try to find the quietest recording spot possible.

Gary also made a wonderful frame for the puppet stage out of plastic pipe. That had to be covered by cloth, though. Pee Chee from BSF came and measured for the amount of cloth. When she took the paper with the measurements home I thought she had decided to buy the cloth instead of me. That didn’t happen. Finally she brought a blanket and one long piece of cloth from BSF. Those worked perfectly.

We needed a chair for the puppet in the last Act, too. One of the 4th graders, Nathan, is always trying to figure out how things

work, so I invited him to try to make the chair. He and Manop, another 4th grader, made this one out of my collection of styrofoam take home containers, potato chip cans, tape cores, and toilet paper roles.

Painting a title sign for the play

turned out to be a great incentive for finishing their workbook page. We finished in record time. Then they all painted some letters, except Viroon, who made pockets for the letters for the different acts. (You can see a little of the painted title in the background here) Paul designed the cover for the programs.

We tried to practice the play about 5 times. We got all the way through it only once. The Thai puppet’s leg came off one day. Two of the boys didn’t want him to be the rescuing silent e anymore with his leg off. They felt better when I brought him back the next day with his leg tied back on.

Finally, it was the day for the play. We were first on the assembly program, so I started to introduce the play once everyone was seated. Meaw, the school office manager, stopped me though. They had an introductory part to do first. Whoops!

I went “backstage” and

was untangling the Thai puppet when they started the prayer for the assembly.

After that, I went back out to finish the introduction. The play went great after that. The students did all their transitions smoothly and quietly. They were ready to go right after the introduction to each act. No puppets got tangled or dropped. The only problem was the quiet voice recording.

I have told a few students that if they can practice their English to speak it well enough, and make up or find a play to do, they can use the puppets. Already

a 1st grader, Debbie, is making up a play for them. I did notice that when they heard their voices recorded, they were much more conscious of how they were pronouncing their English words. Self-correction is one thing the past teacher from BSF noted they needed to work on, so this may help that. Now I have to learn the new sound recording program Gary found to put on my classroom computer so I can make it work for the next play!

:J