musings on music, travel, books, and life from Southeast Asia

Nursing Home Blues

It’s been almost four full months now, and one of my best friends, an American who I will refer to as “H”, is still hospitalized in Bangkok. The long story short; he collapsed and was unconscious for a few days and was put in ICU, some tests discovered “masses” in his brain, he was treated with heavy-duty antibiotics, a biopsy revealed no tumors but instead a very serious brain infection, more treatment, more tests, but no improvement. At one point his doctor told me frankly, “The damage has been done.” Even if my friend survives this infection, and isn’t struck by a secondary infection (he’s also had breathing problems and is using a tracheal tube to breathe), he’s going to need round-the-clock care for the rest of his life.


So, it’s a pretty depressing scenario. This guy is in his early 70s, but until very recently he was teaching full-time at a school in Mandalay, riding a motorcycle around town, and generally living a pretty full, healthy life. And then, wham, bam, boom; he’s in the hospital, and within a few weeks is not able to talk or communicate, or seemingly aware of who’s been visiting him. At this point, he’s maybe never coming out, and most certainly never coming back, at least in terms of his mental capacity. In a situation like this, you almost hope for a quick end to it all.

And then at the end of January, his health insurance policy expired. Uh, what now? Since I’m his closest friend in Bangkok, I’ve been acting as a go-between between his closest relative — a cousin in Alabama — and other participants in this drama; the hospital (we’ve also had to arrange with Thai Immigration to get his Thailand tourist visa extended every month, now every 60 days), his school in Mandalay, the insurance company, and his bank in Bangkok.

And that’s the catch. He had a considerable amount of money in two separate savings accounts in Bangkok, but how could we access those funds to pay for either a renewal of his insurance policy or to pay for his medical care? I discussed the logistics with a local law firm, and then we contacted the bank who in turn got in touch with the hospital. The bank agreed to pay the hospital for any additional charges after the insurance coverage lapsed.

Which was good news, expect for the fact that the daily charges at Bangkok Hospital Medical Center, where “H” has been most of the time, are quite expensive. He eventually was moved out of ICU but still needs special nursing care. The hospital called me and suggested moving him to a private nursing facility in Bangkok that was managed by one of the hospital’s doctors. The monthly rates, including medicine, would be a fraction of the cost of keeping him at the hospital. Great plan!

But then there was another catch. The bank’s head office said that they would authorize payments to the hospital but not to the nursing home. Urrgghh!!! The hospital then came up with the idea of the bank billing the   hospital and then the hospital would bill the nursing home. Sort of a roundabout way of doing it, but perhaps that would work.

On Thursday this week I got this e-mail from the hospital:

Good news! The bank manager has just confirmed to me this afternoon that the hospital could be the mediator between the bank and the nursing care facility. We are preparing to move him to his new place within tomorrow.

And indeed, it finally happened. I never thought that moving to a nursing home would qualify as good news, but in this case it certainly is a positive thing. However, I’m still concerned about how much money is remaining in my friend’s bank account. Between the time when the insurance expired and when he was finally moved to the nursing home, nearly two weeks elapsed. Using the figures that the hospital quoted me on the phone, that two-week total is the equivalent of about six months at the nursing home. Ouch!

Obviously, this whole situation has been very depressing. But everyone I’ve talked to at the hospital — the nurses, doctors, and administrators — have been extremely kind and helpful. “H” was never a very social person and didn’t have many friends. I wouldn’t exactly call him a misanthrope, but he didn’t care for the company of most people and was pretty much of a loner. And yet teachers from his school came to visit him a few times, as did a few guys from his apartment complex. I also got really sweet notes from a childhood friend of his now living in Georgia, and a woman who used to teach with him, now retired in Spain.

Friends and strangers, living in faraway places, connecting and sharing memories, trying to help a friend in need. It’s been both agonizing and comforting. But hey, such is life.


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