••• The International Writers Magazine:Going to the Doctor Abroad

Doctor's Visit • Andrea Cox Christen It was the jarring shock and having to hobble a bit in the mornings that made me do it. And that I kept hearing how everything was covered by insurance.

My insurance in the States would skim a few hundred dollars off the top, send me loads of mail, and then dump the rest of the payment in my lap with their fairy dust idea that once I reached my deductible I wouldn’t have to worry about anything. So, it was the miser in me that made an appointment at the hospital, that and that everyone else had been there and I hadn’t gotten a chance yet. Freebies and peer pressure. Why not go to the hospital on a Wednesday night in Indonesia and have a doctor look at the lump on the underside of my toe?

When I made the appointment I was given a number. Number two. One other patient would be before me. I was told to sit in front of room 2080 in a large waiting area and listen for the doctor to call my name. A screen next to the door showed who was next while a slideshow informed the waiting. Vaginoplasty, HPV, cervical cancer, endometriosis, all of this was explained. One wouldn’t have guessed that I was in Indonesia, the world’s most populous Muslim country, and that this was the general surgery ward.

After seven months in Indonesia my pre-conceived notions were starting to shed, but this openness surprised me. The students at the high school where I taught didn’t hold hands even if they were dating, so to be so openly discussing pregnancy wasn’t what I expected. Plus, this would be something only shown in an OBGYN’s office in the U.S. I looked around at the other patients, but none of the men or women seemed surprised or embarrassed. No one was taking notes either, paying more attention to their phones than the PowerPoint, but it made me wonder why women’s health issues wouldn’t be discussed more openly in the U.S. than Indonesia. Our pop culture is cluttered with sex, but discussing women’s health issues doesn’t even happen in the general wards of a hospital.

I was called in, so I had to stop taking pictures of the slideshow and go into the bright, cold office. I’m rarely cold in Indonesia, but this office was freezing. Maybe it was a quick way to get rid of someone’s fever.
“Do you speak Indonesian?” the doctor asked. Being a buleh, a Caucasian foreigner, this was a common question.
“Sedikit,” I said. “Very little.”
He then turned to his nurse and spoke in rapid Indonesian.
“What is your problem?” he asked me.
I lifted my foot onto the table, but he interrupted me. “Please, let’s go to the bed.”

Once I was on the examination table, I explained that the lump under my second toe on my left foot hurt when I stepped on it occasionally. “It hurts when I walk sometimes,” I told him.
The doctor peered at my foot and moved the lump around with his gloved hand.
“Ah, this is what we call a gangleeeon,” the doctor said. About twenty years ago my mom had told me that’s what it was too. I knew she’d be proud of her diagnosis having gotten all her medical training from Prevention magazine.
“We will have to cut this out. Local anesthesia.”
“When?” I asked.
“Tonight. It will only take an hour.”

I couldn’t help but smile. It would have taken weeks to get in back home but here at six o’clock at night I could get a surgery in less than an hour.
“Do you have ahlergee?” the nursed asked as she took me to the surgery ward.
“Me? Nope. No allergies,” I said. That was the only question I would be asked about my health history. I only filled out one short form, in Indonesian, that said, according to the doctor, that I knew what the surgery would be.
“Follow me, please.” We walked down an empty corridor and took a right. Before a set of double doors she waved her key badge. “Please, no shoes.” A sign said this was a sterilization area. The room was painted in hospital green, echoing large and empty except for two gurneys in the corner. She gestured for me to sit on one of them. I swung my feet upon and down looking at my toe.
“Do you speak Indonesia?” A young man in green scrubs was looking at a chart with the nurse.
“Sedikit.” The nurse shook his head at him, reducing my “Little” to “None.”
“Take this and change there,” the man said, handing me green scrubs. The room he gestured too had a hamper filled with scrubs, a toilet with bed pans next to it and a sink. There were two doors on opposite walls which only after I was undressed did I wonder if they were locked.

When I returned to my gurney, they had me lie down and then tucked me into bed like a child. “Do they know this is just a small foot surgery?” I thought as they rolled me through another set of double doors. “Tidak, tidak, tidak,” I reminded myself how to say, “No,” in Indonesian over and over. If they started to put any needles attached to machines in me, that was what I’d shout.

Once in the surgery I was glad for the blankets because the room was cold, 19.5 Celcius according to the digital display on the wall. An older woman and two men in their early twenties slid me from the gurney to the operating table on a hard, plastic sheet as if I couldn’t move myself. I was working up the courage to ask if all this was just for my toe, trying to recall more from my Indonesian lessons, when my doctor arrived.
“I will give you a few shot of local anesthesia. Then we will see if you feel anything. Let me know if anything hurts when we do this.”
“Can I watch?” I asked.

When I was a kid, my mom had a mole removed from her arm and she told me all about the surgery. I had thought she was so brave, and I wanted to be brave too, to be able to say that I’d watch a surgery and not felt scared and nauseous. My mom died suddenly twelve years ago, but, like I often do, I was thinking of how I’d tell her what I’d done – how I was just like her.
“Of course, but your back might get tired.” The doctor gestured at one of the young attendants, and I felt my head elevated and then I could see.
“There will be some pain now. Take a deep breath.”

I felt a prick and then a sharp pain going down into my foot and then racing up my leg. In, out, in, out. I reverted into my La Maz breathing. Each of my daughters had been born through planned Caesarian, so I’d never gotten to field test all the pregnancy class practice, but the breathing technique seemed to be working. I wasn’t screaming like I wanted to with each needle in my toe.

After checking that I had no feeling, the doctor slid open my skin. He and the woman leaned over my foot, my toe nail polish matching their hairnets. A fat ball of fluid clung to my toe’s muscle, looking like a piece of lychee fruit. Seeing metal prying open my body and revealing me, fear coursed through my body. “This is my first surgery. What am I doing here in this cold room with people I can’t talk to without telling my family or friends what I’m doing?” I thought. And then, bemusedly, I realized I’d already had two surgeries. My daughters were taken out of me by people with metal too.

Metal and skin. They seem antithetical but my daughters came out of me that way, my mother got rid of her skin cancer that way and my brother was able to save his sauve-good looks and have an awesome, “ I-was-surfing-on-Bali” memorabilia sewn on his face thanks to metal and skin. My tattoo that the cheap Greece price led me to get was done by metal digging into my skin while drops of ink came out of the needle and pressed into me. However, it was also metal slamming into my mother’s head and snapping her neck that killed her in the car accident. It was metal that caused islands in Indonesia to be ravaged by companies that claimed to help the country while the workers were barely able to live off the wages and the managers had luxury homes. It was metal that was cutting into the few rainforests left in Indonesia leaving orangutans, the Indonesian elephant, and the Sumatran tiger homeless.

It was metal instruments that were digging through my skin, trying to remove the growth from my foot that caused me some bits of pain, but nothing I couldn’t handle. And it had been my mom who was the one to diagnose that it wasn’t anything dangerous but just irksome. Now I’d had it removed on a whim to test out my healthcare guarantee? And I was in the basement of a hospital where three of the attendants were more interested in bumping into each other and joking at each other behind their masks?
“See it looks like a jelly, like a chicken eye,” said the doctor as he removed the cyst. It was so anti-climatic compared to getting a slimy, screaming baby. My cyst sat on its square of gauze and didn’t say much. I began to worry that they’d offer it to me. Was it considered rude not to take your tumors home with you when removed so gently? They’d already taken pictures for me of my foot; how far would hospitality go in this hospital?
“Now I’ll stitch up the skin. Maybe five stitches,” the doctor told me. The curved needle was pre-attached to the string. I’d always imagined them using a needle from a sewing kit
A bit of red stickiness stuck to my toe, but the doctor push it inside me and pulled the skin together with thread and needle. “Six stitches,” he said. He began to wrap gauze and tape around my toe and then across the arch of my foot. “Be sure to take the pain pill right away when they give it to you. The pain will come when the shots stop working,” he said, gesturing to my foot.
“Terima kasih! Terima kasih!” I gushed. He nodded at my thanks and left.

They rolled me back to the empty sterile room next to the other gurney. I lied on my gurney looking around at the empty green room. I had lots of questions that I couldn’t put into Indonesian. Can I walk on this? What will my husband think when I come back with stitches? When will I get my clothes back? If I tilted my head I could see between the doors to where people sat filing reports and tapping into computers. A shoeless man came into the sterile room carrying a plastic tub, nodded at me and then left again. A shoeless woman came in, talked to the typing people and then came to me.
“Do you speak Indonesian?” she said.
“Sedikit,” I replied.
“Okay, here is your medicine.” She gave me a pile of pills in plastic bags, the pills individually wrapped: pain pills, antibiotics, pills for stomach pains the other pills might give me. I took the pain pill right away, and then she left. The pills had no instructions other than on the antibiotic. When I googled one of the pills, the top sites said, “Clavamox – Pet, Dog and Cat Medications,” “Clavamox Tablets for Animal Use” and “Veterinarians operating for over twenty-five years.” The FDA website said, “Provides for additional claim against canine periodontal infections due to susceptible strains of aerobic and anaerobic bacteria.” WebMD’s entry about the pain pill said to not lie down for ten minutes after taking the pill, something I was doing as the woman watched me take the pill.
One of the attendants came over to me. “Hari ini anda come rumah sakit.” He was gesturing at a date on the form, but didn’t bring it close enough to me that I could see it.

Should I tell him I don’t speak Indonesian? Does he think that was English? What is the word for Monday? I nodded my head and smiled. At least I will be the polite girl who spoke no Indonesian.

He gave me my clothes. I shuffled off to the bathroom/changing room/bed pan storage room, walking gingerly on my foot. All the wrapping made it difficult to walk, but I didn’t feel much. I put my scrubs on top of the others in the hamper, unfolded my hair from the net and went back to my gurney. I looked around. The man nodded to me, and gestured to the double doors. He helped me with the door and then I was standing alone in the hallway looking for my shoes, knowing that my flip-flops wouldn’t work with this bandage.

© Andrea Cox Christen June 2016
Surabaya, Indonesia
andreacoxchristen at gmail.com

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