I might start by saying that I gave up trying to talk the wife into seeing qualified doctors a few years ago, she could never accept that the ones that she had been seeing were hopeless – I think the penny may have dropped now…

Saturday night before last the wife spent the night with a fever and tossed and turned until morning. Come morning she was still > 38c so I said you’d better go and see a doctor. So she went to go and see one of the “Jab em, Bag em and Bill em" doctors around Psar Kandal, arriving home by motodop, carrying the IV drip bag, less $15. I no longer go with her when she’s sick, as when they see me you can see the glint in their eyes and hear the cash register ringing.

She spent the next few hours lying down and her temperature went back to normal. Mid afternoon she was getting worse, fever back over 38 degrees and writhing in pain, complaining of abdominal pain and difficulty breathing. Two of her sisters had come to help her by this time and I suggested that they go see another doctor and get an ultrasound of her abdomen to see if there was anything indicated. She had great trouble in standing and I began to wonder if she may have an acute appendicitis.

So she went with a sister to an ultrasound place across the road from -I’d better not name it. Soon after, I got a phone call asking me to come as they were saying she would need surgery. I went straight away and was told that she did indeed have appendicitis and they wanted to give her a local anaesthetic and operate on her there immediately. However, the wife and sister decided that they should go to a hospital and get an opinion there. $5 for the ultrasound.

They got a Tuk Tuk and headed to - Better not name it. I didn't go with them for obvious reasons. Later that evening, I got a call from the wife asking me to come and see her, as she was going to stay the night and had already paid. I turned up and she’d, fortunately, not had any surgery. They had apparently taken some scans and felt that she had appendicitis, then later changed their mind, saying she had ‘burned’ her stomach. She decided to stay the night to be monitored in case she got any worse, sister stayed with her and I came home to look after the kids.

Next morning she called me and said that they had changed their mind again and that she had appendicitis and needed surgery. I told her to "get the hell out of there and get home now" and that she needed to see a real doctor. Later, she told me that she’d overheard the doctor saying to a colleague that "she didn't want to spend much money". Cost $100 – I’d told her to make sure she had copies of all the scans and any paperwork – they flatly refused to provide these.

When she got home we got on a Tuk Tuk and headed to a clinic near Olympic that I’d heard of with a Western trained Khmer doctor. They immediately took a blood sample and sent it off and sent us for a chest x-ray. X-ray place was nearby and in about 30 mins we were back at the clinic - chest clear but evidence of a build up of faeces. Cost $12. They put her on some IV antibiotics and it was pretty clear she was going to be staying for the night. Blood sample showed that her white blood cell count was redlining. Although she still had trouble breathing and was in severe abdominal pain the doctor was leaning towards a GI infection somewhere, not appendicitis, but said it was difficult to pin down because of the medicines she’d been given previously. She spent the night with a duty-nurse monitoring her and pumping her with IV antibiotics.

Next morning I went back and the doctor said he felt that she had an abscess on the diaphragm that was likely caused by a parasitic infestation. This, of course, helped to explain the fever and the breathing difficulties. Doctor said that he could prove it with a CAT scan, but that the treatment would remain the same regardless. We opted out of the scan. By about 2pm although she was still quite ill, there was a noticeable improvement so we needed to decide on staying another night and continuing the IV antibiotics or heading home with a bunch of oral medicines. We opted for the latter.

She had a slow but steady improvement over the next few days, and a follow up blood test showed that the white blood cell count was normal, and a pelvic swab taken at the first consult showed no abnormalities. She still has a few days of meds left, but is no longer complaining about the difficulty breathing that had gone on for a long long time. Costs – $515.70 – not cheap, but you get what you pay for, that’s for sure.

So, here’s the rub – had she gone along with the initial doctor’s assessment and had her appendix removed –

a– there was nothing wrong with it.
b- she would still have had the abscess.
c- I’m certain she’d still be in the damn hospital or at the Wat by now had she had surgery.

I do not believe that the clowns at the hospital would ever have found the abscess.

Also, about 18 months or so ago she had a blood test at a provincial health place. The results which we still have somewhere said that she had Hep B and Typhoid.
The doctor at the clinic told me that she had no markers for Hep whatsoever.


I wrote this yesterday but didn’t post it as the wife is a bit paranoid about openly criticizing doctors here so I’ve deleted the names.

PS.
She had a long conversation today with a neighbour, a woman, who had been operated on at the same clinic that did the ultrasound. She had presented with abdominal pain, had surgery there, that sounds like an ectopic pregnancy, something to do with her ovaries anyway, but is now still suffering abdominal pain and rues the day she had the surgery.

just never ever think, these things only happen in SEA.

never.

its the same back home.

Good point Potty, I'm well aware that doctors bury their mistakes.

A great post JP; your wife is lucky to have an informed and caring husband. Yes doctors in our countries make mistakes but I doubt if any have infected over 200 people with HIV> Also, it is not without reason that most carry malpractice insurance. How many in Cambodia do? Yeah it can happen anywhere, BUT your chances are greater here than back home.

Thanks taabarang!

I worked at a hospital trust in the UK for a while and as part of my role I attended CPOD meetings where the surgical teams would discuss what went wrong - changes one's perspective a little. Not suggesting anything untoward, but mistakes do happen.

I can't imagine such meetings taking place here.

Had a similar experience with my missus last year, first 3 clinics instantly diagnosed appendicitis and she needed an op BEFORE they even examined her! All 3 clinics told her that she would have to remain at the clinic for 7 days after the op...f**k off money hungry rip off c**ts!

As I was extremely skeptical, I contacted Dr Scott and asked him if he could recommend a reputable clinic/doctor for her (it was after hours), which he kindly did. I took her to the recommended clinic (can't remember the name sorry), who carried out a comprehensive examination including blood and stool samples...result - 3 day prescription of meds and she was on the mend within 12 hours, no drama whatsoever and no more problems since.

Appendicitis my ass!

"Appendicitis my ass!" Yep, that' probably where they would make the first incision for an appendectomy.

Thanks for sharing. A stark reminder of healthcare for most locals...

FYI,

Chenda Polyclinic near Wat Phnom is excellent and reasonable. That is where the US Embassy sends it's Khmer staff when they have problems. The dodtors in Cambodia can be very scary. It is worth it to go to doctors who you know are competent.

picooie