Belle Vue Clinic, Preventable Medical Disasters, and Stoic Lessons

(Photo: Dirty Bunny)

[Warning: This post is one of my rare rants, perhaps my only rant, written last week when the reality-bending fury was fresh. Almost never seen, like a snow leopard, my angry self has come out to stretch his arms a bit, perhaps punch a few deserving people after warming up. The reasons — primarily the safety of other people — will become clear shortly.]

SEPTEMBER 25, 2011, CALCUTTA, INDIA

SAFE AT THE OBEROI HOTEL

Earlier today, a hospital superintendent snickered and offered me a feedback form if I had complaints. I declined, as I figured this blog would be a faster way of getting the message to the CEO in question, P. Tondon. Mr. Tondon, nice to meet you.

Forthwith, our promised programming…

The Power of the Checklist

Atul Gawande is an outstanding surgeon, Associate Professor of Surgery at Harvard Medical School, and author of “The Checklist Manifesto,” which details the power of checklists to prevent catastrophes or simply improve outcomes.

From the prevention of airplane crashes to decreases in hospital-based bacterial infections, having a clear, repeatable process is key. I read his book while flying to Amman, Jordan, and I ensured beforehand that I knew exactly where the best hospitals were close to our hotel, the fantastic Evason Ma’in Hot Springs. It’s as simple as calling the US embassy or consulate (if that’s your nationality) via Skype before you land. Here’s a list for your future use.

This week, I violated my own process: I didn’t check on hospitals before traveling.

“Ah… but where to?” you ask.

To Sweden? No, sir. To Japan? No, ma’am. I landed in Calcutta (Kolkata), India. Home of Mother Theresa and pathogens galore.

Ultimately, I ended up spending 3.5 days in two ERs and hospitals.

Before I explain the comedy of errors that led to this post, a few caveats to flavor the haterade for the anonymous ankle biters we affectionately call “trolls”:

– After 30+ countries visited, I don’t believe I’m a spoiled American. Puking on the floor of Chinese hospitals? Check. Getting probes and pokes (not that kind) in Argentina? Done. I’ve roughed it plenty of times and know the world isn’t covered with linoleum.

– I’ve been in dozens of hospitals and ERs around the world, had multiple surgeries, had food poisoning 4 or 5 times, and spent hundreds of hours with MDs for The 4-Hour Body.

– There were a few heroes in the following story, so this isn’t “us versus them” nonsense. Among the heroes: Pawan, our guide; Dr. Gunjanrai from Belle Vue, who saved our asses; and all of the friends I traveled with, especially Dr. Kareem Samhouri.

The Avoidable Pain of Poor Checklists

Preamble complete, here’s an abbreviated version of what happened:

– I ate a usually delicious local Bengali fish, Bekti, at the Tollygunge Club’s Belvedere restaurant, which my girlfriend Natasha later dubbed The “Tollygrunge” Club.

– Diarrhea and vomiting ensued through the following morning, as did fevers. I hit 101 and Natasha passed 102. I made the executive decision to go to the hospital for, at the very least, intravenous (IV) fluids.

– To stabilize my girl, who was incoherent, and avoid 1-2 hours of traffic, we first visited the closest hospital, the name of which I can’t recall. Now things get interesting.

– Enter war zone — Dr. Sumon and Dr. Chatterjee admit us to the ER. Natasha is wheelchaired in and put on a cot. No vitals are taken besides blood pressure. One of the doctors then alcohol swabs the arm, to prepare for IV insertion, following by slapping her forearm with the bare hand he’s just coughed on. I stopped him to correct course, as I had to do so with both doctors multiple times. Eventually, once her IV was delivering saline solution and lost electrolytes, I had to lay down, as I’d declined an IV and could barely stand. My only choice for rest was a cot with dried urine all over it, which Kareem covered with a towel. Who says chivalry is dead?

– The good news: when we leave, the grand total cost is 150 rupees for both of us, or about $3 USD.

Round Two at Belle Vue Clinic

– We leave for a reputedly much-better hospital, Belle Vue Clinic, where we’d be meeting an expat specialist named Dr. Ghosh. Sigh of relief. Natasha is still delirious and nonsensical, so I’ll be the only one coherent for our first day there. The pamphlet for Belle Vue Clinic is seductive:

Equipped with the finest resources of medical science, the clinic’s emphasis is on relief, reassurance, recovery and rehabilitation.

At Belle Vue Clinic, a patient is not a bed number. He or she is consider as a member of the Belle Vue family. A scrupulously clean and homely ambience is provided. There is always service with a smile.

– Without further ado, here are a few highlights from our slapstick treatment. Keep in mind, Belle Vue has good materials and drugs on hand. Their “Rules and Information” brochure reads “44 years of proven and trusted medical care of international quality.” In retrospect, I realize that “international quality” could mean “From St. Lucia to Somalia, we combine the most preventable mistakes possible.”

The following are process fuck-ups:

* Upon being properly admitted, a “sister” — or nurse attendant — takes my armpit temperature without paying attention. It’s half in contact with my shirt, resulting in a 98-degree output. “Fever, ne,” (“No fever”) she says and starts to walk away. I yell for her to wait, pull an electronic oral thermometer out of my pocket and repeat the drill: almost 102. “Fever, yes.” She later insists twice that I have no fever, until the doctor puts a hand on my forehead and settles the matter in my favor.

* Natasha had a terrible reaction to pain medication they administered, Drotin® (drotaverine), and collapsed on the floor that night after going to the bathroom. No one was watching her properly, so I had to leap out of bed with my IV and help her get up. They administered it the following day and Natasha’s temperature skyrocketed and she began to shiver uncontrollably. I called Dr. Ghosh, got no answer, and did what I could: tell all staff to absolutely NOT administer any more Drotin. When Dr. Ghosh arrived around 7pm that evening, I told him the same, which he said he’d note and convey to all staff.

That evening, as Natasha was falling asleep and I was going to bed, a nurse comes in with — guess what? — a syringe of Drotin to give Natasha. Fortunately, I wasn’t in the bathroom and intercepted it.

* Natasha ran out of toilet paper — as we did several times, which diarrhea will do — and rang the call button. The sister who came in asked her to use water instead to wash off. My girl, as I would hope, refused. The sister then took a dirty towel she’d used to wipe Natasha’s feet and offered that. Again, no dice. Eventually, we got the toilet paper with a chuckle of “fussy” in English. Bonus anti-hygiene points: The bathroom featured a used bar of soap from the prior occupants and nothing to dry your hands with.

* The second or third afternoon, Natasha’s feverish temperature was put in my chart, resulting in them attempting to switch our medicines. I had to make the correction.

* Critical requests for water (we’d been instructed to drink a certain number of liters per day), IV bag changes, IV blocks, etc. often took 10+ call button rings over 30 minutes. Calling Dr. Ghosh, as he encouraged us to do “anytime” did little or nothing, as he didn’t pick up 90%+ of the time. If he did, he said he’d speak with staff and then nothing changed. This meant we had no reliable English or supervising physician at the hospital until Dr. Gunjanrai rescued us by sheer good luck. Achtung: there appear to be quite a few people who speak English at Belle Vue. I’m not being an uppity entitled American; they had the capacity to triage this, even if it meant making the dietician, who was outstanding and spoke excellent English, our point person at additional out-of-pocket cost.

* Dr. Samrat Chatterjee (I ALWAYS write every doctor’s name down when being treated) enters our room to tend to us: a blood draw for me and a new IV for Natasha. He points to Dr. Kareem Samhouri, my friend who was visiting during proper hours, and says brusquely without looking at him, “You can leave,” while pointing at the door. I make it clear that Dr. K is my physician on the trip and listed as next of kin: he’s staying. Dr. Chatterjee then starts taking my blood sample and refuses to answer any of my questions, which focused on an odd yellow liquid in one of the collection tubes that mixed with my blood. Then to Natasha: Dr. Chatterjee rushes into the new IV insertion as Natasha screams in pain. He laughs and tells her she’s overreacting, repeating “fussy” with shake of the head. Later, when Natasha’s forearm skin swells up like lemon holding liquid, Dr. Gunjanrai will try and aspirate (draw out) blood from the IV — nothing. If you can’t get blood out of an IV, guess what? It ain’t in a vein. It’d been pushed into the tissue and several liters of fluid had been forced into Natasha’s worthless sham IV.

This is Natasha’s sham IV arm one week later.

Dr. Chatterjee, you’re a motherf*cker and should have your medical license revoked. Hopefully this post gets you part way there. You’re welcome.

* The next day, my IV clogged at least a dozen times. Somewhere between 6-12 times, I was therefore given “Hep-Lock,” named after it’s principle ingredient, heparin. Heparin can be quite dangerous, fatal if you overdose, and neither the nurses or Dr. Ghosh were remotely concerned. The blocks were blamed on me getting up to go to the bathroom or on me bending my arm. My left arm was so swollen and red from heparin that I had tingling in my fingers and couldn’t straighten my arm.

Dr. Gunjanrai, our repeated savior, replaced my IV when she removed Natasha’s sham IV. Problem fixed and perfect flow. No blocks. The only issues that cropped up were, again, process-related. On two occasions later, there was no drip; the nurses wanted to use more Hep-Lock (not a chance), so I used sign language to show they’d forgotten to put an additional needle in the IV bottle to create necessary vacuum and flow.

* On our last morning, we were to have fasting blood draws for follow-up testing. Natasha’s blood was drawn but mine was not. Since Dr. Ghosh had told us the night before we’d both be tested, I asked the sister, who replied with “Not you.” But yes! About 30 minutes after I’d finished breakfast, I was told that I’d have a sample drawn (we also had our temperatures taken right after we’d downed water). “Doesn’t it need to be fasting? Typically 8-12 hours?” No problem, I was assured.

Now, I’m no MD, but I’ve had compared hundreds of my own blood values. Blood readings taken 30 minutes after eating are not the same as from fasting. Not even close.

The End Result

We survived.

Even though I was more coherent than Natasha, I was a mess of delirium. My diarrhea was about three-times worse that hers (by frequency), I vomited more, and there were some episodes I won’t describe here, as they’ll make you nauseous. To maintain hawklike spider-sense while incapacitated, quality-controlling everything to avert disaster, is taxing beyond belief.

No one should have to do it when such simple measures can fix it. All of the above issues can be fixed with proper protocols and checklists. This is not the first time Belle Vue has had serious process screw-ups. Read this appalling news flash of a newborn baby declared dead, only to be later found alive.

But perhaps Belle Vue is too poor to make things work? Not likely, at least not based on my bill.

Cost: about $1,350 USD per person.

Dr. Ghosh’s fee? Almost 50% of each bill. Extortionary. He’s an outstanding ER physician, and he’s saved many people with horrifying injuries and infections. That said, if he’s almost never available to his patients (us in this case) and can’t manage staff to follow his life-saving directions outside of his 7-8pm visits, his expertise does next to nothing. I suspect he’s amazing when on the case 24/7. In our case, it was as if he weren’t there. 50% of the bill is an insult.

Dr. Gunjanrai’s fee? Less than $20. Give that woman a raise. She’s a superstar. I know she doesn’t have Dr. Ghosh’s credentials, but she fixed every problem she encountered, undid the messes created by others, and did it all with a Zen-like calm that made us calm. That’s a good doctor.

P. Tandon, fix your hospital. If you didn’t know already, now you do.

If you choose inaction at this point, you should be charged with premeditated homicide.

Here’s your feedback form:

The Bright Side

Experiencing pain allows you to appreciate pleasure.

Looking at the creature comforts of San Francisco, the world-class medicine I perhaps took for granted, my experience in Calcutta was a useful recalibration.

Getting the Belle Vue treatment is not necessary to increase your appreciation of what you have. This should be a principal goal in life, of course, as gratitude will determine your happiness more than achievement. In fact, Stoic philosopher and master statesman Lucius Seneca encouraged his students to practice poverty for precisely this purpose. From Martin Frost’s excellent introduction:

The second type of apathetic training proposed in the Moral Epistles is practical training, which is essentially a Stoic modification of a common Epicurean practice. In Epistle 18, Seneca informs Lucilius that Epicurus frequently set aside a number of days in which he satisfied his hunger with cheap food. The goal of this exercise apparently was to develop enough self-sufficiency that he would be able to remain happy, regardless of what his circumstances might be. Using this example, Seneca similarly advises Lucilius to practice extreme poverty for limited periods in order to test the ability of his mind to withstand the loss of his wealth in the future.

Although Seneca does not expect this type of practice to go on indefinitely or to be too severe, he makes it clear to Lucilius in Epistle 13 that it should be more than just a “mere hobby” that rich young men might play to “beguile the tedium of their lives.” Even though it is meant to last for only a few days at a time, the method should be harsh enough that it can prepare the subject for the most extreme reversal of fortune—the possibility of utter destitution.

Rehearse worst-case scenarios and they lose their power over you. Practice what you fear and ask all the while: “Is this the condition I so feared?”

You’re more resilient than you think.

The Tim Ferriss Show is one of the most popular podcasts in the world with more than 500 million downloads. It has been selected for "Best of Apple Podcasts" three times, it is often the #1 interview podcast across all of Apple Podcasts, and it's been ranked #1 out of 400,000+ podcasts on many occasions. To listen to any of the past episodes for free, check out this page.

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278 Replies to “Belle Vue Clinic, Preventable Medical Disasters, and Stoic Lessons”

  1. Hi Tim,

    Glad that you and Natasha are recovered now but what a horrible experience for you to go through. It is amazing to read that despite your delirium and debilitating symptoms you were able to advocate for Natasha and yourself when Dr. Gunjanrai was not present. From my own work as a nurse I am sad to say that I have seen examples of patient mismanagement and neglect in hospitals I have worked at in North America. A book I thoroughly recommend if you have not read it is Norman Cousins’ Anatomy of an Illness which essentially describes how the author who has a devastating illness advocates for himself in guiding his treatment and works in partnership with his doctor.

  2. Are you back in SF yet? Let’s grab a beer and talk about the Top 10 Places to get Food Poisoning in the Tenderloin, and then I’ll tell you what I think of your book if I’ve finished it. No Jamiroquai allowed, ya space hippie. Jesus.

  3. [COMMENT MODERATED]

    I’m sure the post made some people uncomfortable, but it needed to be said, and in my view, this harrowing experience was presented in quite a balanced way. As you say, it wasn’t “Indian medical standards” that caused this problem. It was the laziness and incompetence of a few select members of staff (while other performed admirably).

    As such, all indignant comments to the tune of “you have not seen real Indian service”, “this is an unfair representation”, etc, should be duly ignored. As should any that try to extrapolate this into a general argument against socialized medicine.

    I have lived on three continents, and experienced extremely high-quality, AND lazy and negligent service in British, Japanese AND American hospitals (where apparently you have “the best healthcare in the world”). On balance, the average quality of service I have experienced on all three continents is the same. The only difference is that I paid approximately 200% more for treatment in Japan, and 2000% more in America.

    If I’m going to have incompetent doctors, they should – at the very least – be cheap.

  4. Got similarly sick in India myself but didn’t visit a hospital, which on hindsight was a dumb move until I read this post. However the illness lost me weight faster than the slow-carb diet, for which I’m grateful.

    Most people would not have the medical knowledge you applied to save yourselves from extreme danger. We had a similar experience of so-called professionals doing things blatantly wrong.

    I travelled India by motorcycle, which kept breaking down. A mechanic decided to replace the fuel pipe with a new one, which was unfortunately too narrow, so whad did he do? Tried to melt it with a cigarette lighter so it would stretch.

    Yes I said fuel pipe, which was at this point connected to the fuel tank of the motorcycle. The whole thing went up in flames, but fortunately it was quickly extinguished and nobody was hurt. I was even able to ride the machine away from the scene but when I tried to leave without paying in protest at the mechanic’s stupidity, a mob surrounded me until the wallet was opened.

  5. Having had a somewhat similar experience in China, that and Tim’s shows that it pays to know a little bit about medicine and hygiene, even in the US. Self advocacy can make a huge difference in medical outcome.

  6. Thanks for this piece, Tim. My boss suggested I might like to do some systems development in India with our in-country consultants in November. I think not.! Sometimes I have my reservations about this geoarbitrage business.

  7. This is an awesome article for people in my business (executive security). If my principles ever wonder why I am humping a med kit full of clean needles, IV starts and meds to every corner of the earth, I’ll refer them to this tragic set of events.

    Glad to see you and the GF made it, Tim.

    Checklists save lives…couldn’t agree more.

    -Josh

  8. I’d love to read the first draft of this post. I bet it is a lot more R rated and full of vitriol.

    I admire your writing, Tim, and your ability to take this totally f*&ked-up situation and so clearly lay out your grievances based on fact and not emotional distress. I’m glad you and Natasha are feeling better.

    This post can also serve as a reminder of what can go wrong when traveling. Spontaneity is fun after you’ve made preparations for it.

  9. First rule: don’t eat meat at India, specially fish. I was there years ago, so I can tell you. Option: Be veggie temporarily.

  10. Hey Tim,

    Many things come up for me as I read your post. First, I am grateful you both lived to tell the tale. Having taken care of more than one ill relative spending a fair amount of time in (wonderful) US hospitals, I am struck by the conditioning that keeps most people from speaking up on their own behalf. Even under the best of circumstances, advocating for one’s own care, being committed to paying attention to what’s going in is essential. Many don’t, can’t or simply won’t speak up for themselves, or trust their instincts if they feel something is wrong. Too many are used to handing responsibility and power over to medical, (or any) authority figures.

    Just a couple of weeks ago, a woman died in an Oakland, CA hospital because she was given liquid food designed for her belly feeding tube via IV, by mistake. Sadly, she was being cared for by a nurse brought in temporarily, during a strike.

    Speaking of striking, I appreciate your willingness to display the vulnerability and fear beneath your anger. It means a lot that you would share such an intimate story with this audience. The outpouring of concern for the two of you here was remarkable to see. I wonder how it feels for you to witness that?

    Remarkably striking, too, is the stunning lack of an outpouring of concern for the people who live in that city, everyday, humans who cannot escape those conditions, who probably have a much lower life expectancy, bury their children, and loved ones much too soon.

    Its almost as if, as westerners (mostly, here-my assumption), we are only able to feel the pain of those we identify with. Others seem to disappear into the scenery. They become the background in a cool photo of our journeys, tweeted back for the admiration of our friends and followers.

    I am grateful for the brilliance and ingenuity I see displayed on this site on a regular basis. I find myself inspired by something every time I visit.

    So, in the true spirit of this blog about creativity, passion and action-taking, I invite ideas as to how we could help improve conditions both for adventurous travelers like you and those whose daily life is an adventure by accident of birth.

    Here’s some juice to get us going. I love this story about how game designers have been enlisted to help find a cure for HIV. I hope its ok to place the link here. Remove it, if its not ok. I have nothing to do with these folks, at all:

    http://www.topnews.in/health/computer-game-may-help-find-cure-hiv-22438

    Following up on some comments in the thread above, how about a checklist app for travelers with the proceeds going toward local health care in some of the exotic locales that magnetize adventurers? I’ll bet there are tons of wonderful solutions waiting to be born. Perhaps some greater good come from the awful experience you had. Maybe your willingness to tell the story could help others in a tangible, long-lasting way. Any ideas?

  11. Honest concern here. What are the chances the doctors and nurses were (knowingly or not) using used needles? Wait 3 months and get tested. HIV in India is no joke.

  12. I’ve been traveling far and wide since I was 17 and haven’t had any serious medical challenges. Once we starting going to foreign countries with a toddler, however, we realized it might be best to update our “checklist.” The toddler is now grown (but so are my husband and I) and we have two recommendations we follow: l. We subscribe to a global rescue service when we are out of the U.S. There are several services, depending on your requirements. They’ll come and get you with a medical jet if both parties agree; they also provide telephone access to a team of screened doctors at reputable hospitals 24/7. Traveling several years ago in Morocco’s High Atlas Mountains, that service and a sat. phone provided a lot of assurance–especially since the number 1 health problem Americans face in foreign travel is auto accidents. (think: blood transfusions.) And second, a good overall primer is “Shitting Pretty”, (Travelers Tales, 2000 San Francisco.) Amazon should have it. It’s by Dr. Jane Wilson-Howarth, fellow of the Royal Society of Tropical Medicine and Hygiene…and she has good tips on how to stay healthy and what to do if you get sick.

  13. I have a very close friend from India. The primary reason he has chosen to live in the USA, rather than there — even though he and his wife both come from rather wealthy families and would not have to work, is because of the medical care. When he first came to the states as a student, he suffered a collapsed lung. Here it was dealt with and he survived with no long-term problems. He’s quite sure, even though one of his uncles is a doctor, that he would never have received treatment in time and would have died. Even if you have money to spend, the medical care is bad. He doesn’t want to risk it.

    So, his trade off, rather than living a life of luxury in India as the sole heir to his family’s fortune, he works a 9-5 job in the states. All because he wants access to quality health care.

  14. HI Tim, glad you are ok now.

    Quite frankly, you were in the wrong city if you were looking for decent hospitals. Chennai/Madras is the city you need to go to for this, if in India. Unless you landed in Calcutta/Kolkata as a tourist and then fell sick, in which case you should have gone to the Apollo hospital.

    Nevertheless, glad you and Natasha are better now.

    PS: welcome to the Indian medical system.

    Cheers Anish

  15. I’m glad you are both feeling better. Food poisoning is no joke. I have had it from eating fish at a reputable restaurant in Clarendon VA. I am heading to India next week and have heard so many scary stories about getting sick out there from either food or drinking the water. Prevention: I had my brother prescribe me some antibiotics to take with me and reading this just reminded me why i will not be eating much. I will hate to get sick.

  16. hi tim,

    am from pune, city very close to Mumbai.

    Being an Indian i apologize for the treatment yu recieved in calcutta…

    But that is the harsh reality in iur country..

    Though most of the world feel india is progressing..this is the harsh reality…

    Any ways get in touch when yu come next time and i will make sure yu get to experience a better india.

    cheers,

    sameer

  17. Hey Tim glad you and the lady friend are okay! Sounds like an awful experience, my guess is it happens around the world far to often. Have you ever thought about taking your practical, best-practice, DIY knowledge and creating a Medical Care Urban Survival book? Something of a guide book for the in-the-know patient or traveler..

    As I was reading through your story, a thread that came to mind several times, was “Dang good thing he knew about the IV drip” or something like that. I think many of us in that situation would end up in much more pain or worse. Thanks for all you do!

  18. Dear Tim,

    I am from city of Calcutta where you had this terrible experience. I am very sad to hear the terrible experience you had to go through.

    Medical negligence is a reality that haunts India. even the rich do not have access to safe medical care. the laws are so underdeveloped and anti patient that doctors and hospitals get away very easily almost with any malpractice.

    My dad had two surgeries last year, the first one at belle vue. He paid a lot more than what he would at other cheaper hospitals hoping for a safe surgery. He developed an infection on the surgery wound that is yet to be completely cured. He had another surgery on his heart 6 months later in another ‘reputed’ and costly hospital, following which he developed hepatitis B, and he believes it happened due to blood transfusion during the 2nd surgery. he spent most of his savings in the last 10 years on these surgeries.

    We need to break the situation where doctors and hospitals know they can get away with negligence and careless attitude towards well-being of patients. I am living in Mumbai now, and I find the situation to be the same here. With help of a few friends, I have started a blog called medicallaw.in, and we are trying to organize a group of lawyers and doctors who will try to address these issues at a policy level.

    Since you have suffered this traumatic experience Tim, you may now understand what my countrymen face every time they go to hospitals. I have made it my mission to change this, and find myself facing a very uphill battle. I have not even identified a very effective way to make a difference yet. Would you like to help?

  19. Hi Tim,

    Great to read that you are not only an amazing self-promoter, but also great at taking care of others, in this case your girlfriend.

    Natasha was lucky to have someone like you at her side throughout this ordeal, a “mere mortal” would not have had your knowledge and things might have ended up much worse.

    Cheers,

    Greg

    PS: your copyright notice still says “-2010”, might not be worth to change this anymore for 2011 though 😉

  20. Hi Tim,

    I just read your post regarding the Belle Vue Clinic. Nasty experience! I’m glad to hear you both survived and made it back to where you can get proper medical care.

    I’ve really enjoyed your “4-Hour Work Week” on audio. I’ve started my own company, while working full-time to start the process of redesigning how and where I work.

    Thank you for the inspiration!

    Joe

  21. It’s a good idea to carry antibiotics with you when travelling in India. These can be bought *without* a prescription at a local chemist’s.

  22. I lived in India for a year and can totally relate to your story. Accepting cultural differences is one thing, but being negligent and irresponsible is something entirely different; these people deserve this rant. I applaud your commitment to quality and your appreciation for the people who actually helped you. Thanks for sharing Tim, it´s appreciated.

  23. You got out alive! 😉 Anyway, next time you visit India, you might want to try Kerala or Chennai for a change.. Compared to the rest of the country, I guess the South Indian states are better wrt medical tourism.

  24. Tim,

    Welcome to the club of “man up.” 🙂

    This sounds like one of my ordeals in Iraq a few years back when living on the local economy. It’s amazing how excellent any sort of health care seems after ordeals of this nature.

    Good on you for watching out for your girl!

    Best,

    Jason

  25. My husband and I were just talking about the issue of foreign hospitals (in developing countries) this evening. We’re serial expats and could possibly end up in the Middle East next year. Stories like this really make me nervous about the possibility of needing care…it’s good that you were able to be diligent and monitor your own care – you probably saved your own lives!

  26. Dear Tim, I’m a big fan of yours…and was quite concerned, naturally, to read this post of shocking negligence, indifference, hygienically-challenged (to be polite here) medical facilities and so much more. I’ve had several brushes with incompetence, fatigue and general malaise working with many in the profession here in the States, who feel over-scheduled, blamed, misunderstood and the like..and we’ve seen numerous cases- in my wellness work and training experiences- (and personal ones) of the danger of oversight, burn-out, etc. BUT- I think you story has topped all others. If your humor returns, do read or-read, Troost’s “The Secret Lives of Cannibals- Adrift in the Equatorial Pacific,” it sounds like you could use some cheer. Be well, Michelle

  27. When I first read your post, I was like YIKES! I’m an expat living in Mumbai and I got ill around the same time that your post came out. Lucky for me, I had a very pleasant experience being treated for the illness. It appears that yours and mine were two extremes, and of course, India being India, there’s everything in between as well.

    I will say this: If I had had a similar experience to yours, I would leave this country and never come back. That’s scary.

    Luckily, there are options. Unlucky for you that yours was such a bad one!

  28. Oh My God! You have inspired me to think my family and I really can get this 4HWW thing together and travel, but I think I’ll skip traveling with my toddler to 3rd world countries for quite a few years.

    Maybe I’ll also insist we eat vegan…

  29. Tim,

    If you were staying at the Oberoi, it would have been simpler to ring up reception and ask for the in-house doctor to come up and do a check-up. You would have saved yourself all the trouble.

  30. I am from India. I have seen episodes like these and even much uglier ones. I am really lucky that whenever sick i got the best doc/hospital around. Like you said there are really really good ones and the bitch ugly ones.

    I am glad now you guys are ok.

    The bathrooms anywhere in India(except our home and maybe star hotels) give me the creeps. The scum scaled tiles, moldy damp smell, ugh.

    One a curious note – Did the hospital bathroom have a ‘health faucet'(the thing with which you spray water at your butt) or a large mug?

    I understand Americans don’t really like the idea of water butt method, but i think if you got used to it, there’s no going back. Just my opinion. Esp if I have a diarrhea, water feels much better than paper.

    For Indians, in general the thought of cleaning butt without water is unthinkable.

  31. Dear Tim,

    Sorry to hear about your experience at the “City Of Joy” and relieved you survived to continue sharing such insightful knowledge that has helped so many people.

    Wish I knew you were in town and could have helped. Do get in touch whenever you visit this place again, and I promise to make your next trip a most memorable one.

    Cheers to life!

    Avinash

  32. Somalia! The doctors there are decent. not a joke. The doctors are well trained, mostly in Italy and I found them to be be practicing good gygiene… I got an emergency surgery ” removed an appendix” and it all went well…the doctor’s name was Dr. Nur. He spoke fluent Italian and English, He did the operation under a tree with Mosquite net and plastic bag to make sure no flies or pathogens get there….. he must operated 20 others on that day. Thinking about it, he was experienced and he was nice and seemed really concerned about my situation. I did not call him, he actually called three of four times to check on me when he was not there. That was my experience and there were so many people with bullet wounds, misile and sharpnells showing up at his hospital called Martini. At the end, I did not pay anything, it was free. Hugo, Spain.

  33. Hey Tim,

    You mentioned your girlfriend a few times in this post. I wonder if she would be interested in giving a fellow lady-traveler/entrepreneur some advice.

    1. Tim has posted packing tips for his adventures in the past. After reading them, I’m always left thinking how men are lucky because one outfit is socially acceptable for 90% of situations, while it’s not for women. Also, most of them don’t have long hair to contend with. What’s your go-to pack list look like? How do you bring outfits that fit into everything you plan to do?

    2. Have you traveled solo before? If so, any tips on staying safe and/or dealing with the cat-calling that goes on in lots of countries? Any tips on things to avoid while traveling solo? Or, tips on meeting a semi-normal, trustworthy travel companion?

    Thanks!

  34. Sadly, good and bad doctor or hospital experiences are not limited by geography. One of the things in Tim’s story that is really important not to miss is being informed and being your own advocate. Whether you’re going in for a routine physical or are needing emergency treatment, being prepared, asking questions, insisting on answers and refusing to defer simply because someone is an MD are all critical components of receiving the care you need. No one knows your body better than you no matter how smart or experienced they are.

  35. My arm looked like that after leaving a hospital here in the US of A. I have entered ERs here with terrible food poisoning only to be ejected without any fluid treatment at all. I have left after being treated for a broken back with a kidney infection because all the nurses gave me to drink was Sprite, not water, even though I asked for water. It’s as hard to advocate for yourself here when you are sick, perhaps moreso: the nurses feel their “top-notch” education equates to know-it-all status.

    Good for you, however, for advocating for your gf. My husband is a total wimp . I wouldn’t travel with him anywhere. 🙁

  36. Oh my god. As an Emergency Room employee, this story made me cringe ten ways to Sunday. What does that phrase even mean? IDK but it sure feels right in thins instance. Gads. 🙁 So glad you two made it out OK! I wonder if the good doctor ever made it to a better facility?

  37. If anyone is still following this thread, please give me some advice! I will be traveling to India (likely New Delhi and vicinity) for 10 days in December as part of my business graduate program and Tim’s post (and so many others here) are beginning to weird me out. I’ve traveled to Europe several times and have a healthy body and an adventurous spirit, but man, things aren’t sounding too good over there. What drugs should I be packing in my suitcase?

  38. Thanks Tim, I caught a strange bug in India but luckily it lay dormant then surprised me two weeks back to London. One night in hospital and several more nights at home doubled up in agony. What a hellish week. Just about to set of for a trip to an Indonesian island without so much as a chemist on it. Anyway what I really wanted to say is Four Hour Travel Book must be on your list. It know it would be a blockbuster. Everything from advanced travel hacking, air miles, upgrades, hotel all the way through to how to survive those inevitable medical situations.