Sunday, January 8, 2012

Korean Christmas Surgery

What started as a regular weekend of going out with friends while hosting another couch surfer quickly turned into an early and unanticipated Christmas present. Saturday I noticed a small red spot on my leg, which for most is nothing out of the ordinary. Myself however am far from ordinary and having had more than ten STAPH infections in the past six years, I suspected this was yet another so I commenced my pre-prescribed antibiotics regiment. This particular infection however grew virulently out of control in a 24 hour period, growing to the size of a grapefruit on the back of my leg and making walking an unbearably painful task.

Upon noticing the severity of the infection I explained to my best friends and support system in Korea how to go about cutting it open to drain, as it was in too awkward a location to do myself. The idea was simple and my friends were prepared to make an incision in my leg to relieve the pressure of the fluid within. Due to the depth and speed of the infection however a last minute decision was made and I reluctantly took the subway and limped to the nearest hospitals around 8PM Sunday.

I checked in by leaving my identification card at the desk and proceeded to an ER bed, surrounded by screaming babies and crying families, which is always the worst part about being in a hospital. It's not about the pain that you are in but that of watching others in physical and emotional pain. I waited on the bed until an English speaking doctor could see me and show her the infection and explain what it was, unfortunately it went in one ear and out the other.

I underwent standard blood and urine tests as the doctor consulted with other doctors returning one by one with them, as each new doctor took a picture on their phone. They told me I needed a chest x-ray and I disagreed but they insisted it was hospital policy for all patients to receive a chest x-ray.

After the x-ray I was rolled on a gurney to the back of the hospital next to a teenage boy who for no point in my time in the hospital stopped screaming and crying. As I lay in the bed, now connected to an IV, I counted the dots of dried blood splatter on the ceiling above me pondering possibilities of how they got up there. In the meantime doctor after doctor came up to see the infection and take a picture, and each time I explained that all I needed them to do was to cut it open and drain it.

After 2 hours of this repeated cycle I began to lose my patience and was about to pull out my IV when an attractive young female doctor came over to me and I explained everything to her as a team of surgeons descended upon me. They decided to take an unnecessary leg x-ray and then left me in the bed for another hour as the team discussed a plan in Korean, clearly still not understanding what needed to be done.

With an unknown painkiller being fed through my IV and filled with frustration was fighting the medicine to stay awake. One of the doctors approached me and asked if they could take an MRI to see where it needed to be cut. I unconsciously agreed and signed the paper as contrast dye began circulating throughout my body. Struggling to stay awake I asked them if my insurance would cover the MRI.

Upon receiving the answer of a $500 cost I instantly gained consciousness in a fit of rage. I jumped from the bed and said HELL NO, screaming and yelling at them to stop the dye and that if they did not perform the surgery immediately as I instructed I would rip out both IV's and walk to another hospital. With the threat of violence the team of surgeons reluctantly rolled me to the operating room.

With a body pencil I drew a line where I wanted them to cut. They brought in anesthesia and told me I would be asleep for roughly fifteen minutes but I demanded to be awake in order to oversee the procedure. The three young surgeons, now terribly afraid, photographed my leg and reluctantly prepared for surgery. They covered the wound with blood splatter sheets and turned on the light as I arched forward lying on my stomach to watch behind me through the mirror they provided upon my request. Alcohol swab, iodine swab and four injections of lidocaine and we were ready.

I gave some last minute encouragement to the currently petrified young doctor as he hesitantly picked up the scalpel and nervously moved into position. With the first small incision the wound erupted like a bloody puss filled Vesuvius. The assistants panicked and grabbed towels to begin wiping away the fluids as they ran down my leg like a slow flowing river.

Once cleaned and cleared the surgeon continued cutting down the line I had drawn straight through the skin and then clamped it open. He then ordered a surgical vacuum to be brought to the room as he continued cutting into the muscle towards the bone breaking into more pustules along the way. He then internally probed up and down to drain but both of these cuts sent a surge of pain throughout my body and I stopped watching through the mirror and buried my face into the pillow.

Luckily I looked up in time to see the assistant handing stitching thread and a needle to the surgeon. I yelled as loud as my weak body could to stop! With my leg tied down and clamped open bleeding, I had to explain to them that the wound cannot be closed and needed to stay open to continue draining the infection throughout the week.

A two minute debate began, and I believe that an angry, drugged and bleeding foreigner might be a Koreans worst nightmare. I had to explain to the surgeon how to slowly fold in packing gauze back and forth into the now gaping empty hole in my leg. It took nearly a meter of gauze to completely fill the hole before the clamps were removed and the job was done.

I congratulated and thanked the team of doctors as they rolled me back to the ER with a smile on my face. A doctor then entered with a cart of what appeared to be miniature empty beer bottles. The cute doctor with whom helped me earlier injected yet another needle into my arm and my blood began pouring into bottle after bottle until they all were full for reasons unknown.

Confused by the situation and now lacking blood with two IVs pumping my body with fluids, antibiotics and painkillers my surgeon returned with paperwork for hospital admission for three days in which time the blood tests and cultures could be analyzed. Quickly I lashed out and said I knew it was Staphyloccocus aureus and that I wanted to go home now. He walked away embarrassed and sent the next doctor to explain that I needed to stay. Again I denied him.

This process was repeated by two more doctors and I once again in a near unconscious state yelled at the fourth doctor that I am not staying and that I would rip out my IVs if they did not take them out. I gladly signed release papers and papers labeled 'Refusal for aftercare'. My cute dream doctor once again returned to remove the IVs as I apologized to her for being such an asshole but knew what was best for my body.

At 1am I was given antibiotics and painkillers, paid the exuberant hospital bill and slowly limped out of the ER doors and down the road to find a late night taxi home. With all the stress of the night I quickly Skyped my parents to inform them I was alright, and thankfully was able to sleep in my own bed until work the next morning. The experience although extremely trying, gave me great insight into the health care system of yet another country; as well as another outlandish story.

Saturday, January 7, 2012

Korean Kings of the Past

After nearly 20 months of living, working and traveling around Korea, the major cities seem very cut and paste, with an endless craving to achieve a westernized look. The city of Gyeongju on the eastern coast of the peninsula however, has a very different atmosphere. Lacking in high rise buildings and the speed of most Korean cities, Gyeongju stands true after the trials of time, war and industrialization.

My trip began in the early morning hours of a cold winter day walking through frost covered fields. The tranquility of slowly passing through the country side with nothing but the bag on my back, was in itself an awe inspiring moment. I arrived at Bunhwangsa temple as the sun was breaking into the dark sky and crisp morning air. The site, to a casual onlooker feels lack luster, but it provided me with a sense of solitary peace.

As I continued on in the morning light the frost covering the farm fields began to recede as students dressed in their school uniforms emerged onto the empty country road, walking in the same aimless direction as myself. Upon arrival at the Anapji Pond the gates were only just opening and I found myself as the only individual seeking entry.

Having the park to myself I truly gained an appreciation for what the ancient Silla Dynasty was able to accomplish. The beautiful man-made ponds surrounded by what once was once an eccentric series of lavish, nearly 1400 year old temples, still remained in their grandeur. The adjacent Gyeongju National Museum, although overly sized for it's limited contents, did give excellent insight to Korea's past, packed with a wealth of historical knowledge.

The next stop several km away was the famed Cheomseongdae Observatory. Although it appeared to be nothing more than a windmill tower without fan blades, this building holds its importance in being the oldest observatory in East Asia. A disappointment to trek it for just a quick glance, it's historic significance is certainly something to ponder. In the minds of Koreans who ever so hard look for things that can be uniquely claimed as theirs, this site holds testament to their accomplishments.

I continued on for about 20 km visiting tomb after tomb of kings and mighty generals past. Although from the outside all the tombs look like miniscule hills build for winter sledding, inside the hold a plethora of wealth and ancient secrets similar to the famed pyramids of Egypt.

Although Gyeongju by no means shows up on one's top list      of travel destinations, it is certainly in my opinion the most historically rich place in Korea. It is well worth a visit while in the region and certainly a place I will frequent in the months to come due to its proximity to Daegu. It justifiably is an obscure location packed with UNESCO sites and ancient treasures, that should be observed and respected not just by Korean nationals who at times seem extreme, but by all those attempting to experience and understand the culture that is Korea.