Falling Ill in Laos


I got the chance to visit a clinic in Laos – twice.

Does it sound like a rare experience? Well, I know at least 3 others who achieved this feat, by virtue of being on the same OCIP team. Yet for the average Singaporean, it could feel obscure. Singaporeans may frequent Thailand, but not its neighbours Laos. Moreover, clinics and hospitals must surely rank outside anyone’s travel itinerary. That said, I was glad for the chance to see how a clinic – even if not representative – operates outside what’s familiar to me in Singapore.

A trip to a private clinic in Singapore strikes me as dreary. I’d stagger in, get a queue number and wait alongside seemingly sickly people. Then I’d knock on the doctor’s closed room door, open it, and convince him (typically) to give me MC. The dialogue will not just be formal, but remarkably brief and standardized. It always ends with familiar prescriptions, with no new sense of what’s wrong with my body.

This might explain how I behaved in Laos.

After dropping out of construction work after two shifts and spending the rest of it assuring teammates I was unwell but fine, it turned out I wasn’t. I had high fever. My tongue came out with the thermometer. Whoops. “Last warning ah!” admonished one of my Project Directors (PD) out of concern. I was immediately consigned to patient status. Lie down; check temperature; take a cold shower; drink water. I felt grateful yet a tad guilty for making my buddy and PD so anxious. I obeyed, except on one count.

I refused to take Panadol.

It brought some drama, just as the debate between ‘cooling the body’ and ‘sweating it out’ did. The details aren’t important here. As evening came – I thought it was night already – I faced a grave decision. (Grave, because the entire team was back and they sure looked grave.) Do I want to go to the clinic now, or wait till next morning? They will probably prescribe Panadol or put you on drip, though. Not wanting everyone to worry further, I relented. I’d go.

In hindsight, maybe I should have just taken Panadol. So what if it offers only temporary respite? There are times when the group interests should come first, and this was one of it. Lowered temperature readings will probably calm the nerves of those around me. Yet I kept them strung up. Nonetheless, my wishes were respected. I really appreciated that.

I was shuttled to the clinic after witnessing a very touching sight: villagers of a different tongue radiating utmost concern with their eyes. I told others afterwards that everyone seemed more worried than I was. But perhaps it was the ceaseless concern I received which kept me calm.

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For a change, I didn’t have to queue. I was the only customer. The clinic door was the only door I had to navigate. Quickly, I had blood drawn from my right arm. I was told to down two Panadols, having so vehemently rejected the idea the entire afternoon. As I had lower back pains the whole day, the doc proposed doing ultrasound. It was so unexpected that I fully felt the tickles at my abdomen!

Moments later, the doc came back and told my PD and the accompanying translator, “suspected dengue”. (He speaks English.) I was taken aback. My first thought: Am I going to be quarantined? I genuinely thought I was going to be housed somewhere other than with the rest. Isn’t that how you treat dengue patients?

Well, no. I was going back right after. I’m in a village. I guess one can’t think straight when groggy. And groggy I sure was, as my PD tended almost overly to my needs.

I didn’t make much of the diagnosis. It took me another day – and conscientious care from the entire team overnight – to recover fully from the fever. I had to return to the clinic 3 days later, and unfortunately, a couple more were taken ill and a total of 9 of us had to visit the clinic. I learnt that this could be terrible for our hosts’ reputation. I’m really glad we provided no further disservice thereafter.

On my return trip, I felt more acquainted with the doc, and he too with me. I was first to take a blood test, and in a short while, was told that my white blood cell count was consistent with that of a dengue patient. So I did get it? He went on to detail 2 different types of dengue: one with persistent fever, another with fever subsiding as the virus lie dormant, but which may cause fever to return later. I don’t have the knowledge to verify his words, but for once, I felt I was learning about my body. I rarely get that in Singapore, certainly not in private clinics.

I thought about what my Medical Sociology professor shared. There was once when she fell ill, and felt body aches. She delayed a few days before seeing the doctor. Her doctor took tests for her, but dismissed the likelihood of dengue. She continued going to work. Then, her doctor called her and told her, “It’s dengue.” By then, though, she has almost recovered. She then remarked, “If I had known, I would not have gone to work, and would have felt very sorry for myself.”

I guess diagnoses can be detrimental to our frame of mind. I was unaffected though. For that I can thank the insights of Medical Sociology and, of course, the individual and collective concern that I keenly felt through this illness episode.

Perhaps the relative closeness I shared with the doc can be attributed to the Lao culture and conditions. Life moves at a slow pace. Patients are fairly rare; I saw only one local patient in my 2 trips. Or perhaps I was convinced by the ultrasound procedures; you just don’t walk-in to one in Singapore. Too many patients to deal with, or too expensive to pay for? (I should check with my PD the cost for mine…)

Lastly, I can’t help but think: Aren’t there ways to foster closer and more informative doctor-patient interactions in Singapore, despite the bureaucratic systems?

Falling Ill in Laos
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