A Foreigner’s Introduction to Korean Healthcare
In the span of my thirteen months in Korea, the two most unsettling times I have been through were my two medical “events”. While picking up and moving to a foreign land is full of adventures – both intended and unintended – it is clearly understood that a nontrivial fraction of those adventures will involve some level of miscommunication. Miscommunication can often lead to amusing experiences at restaurants and subways, with the greatest risk usually having the ultimate consequence of being served an unintended animal or being looked at disapprovingly by a local for breaking a clearly-posted rule. However, when one is confronted with a potential medical emergency, vague pantomimes and poorly-constructed Korean sentences using sentence fractions can have slightly higher stakes.
My first dabbling in the Korean hospital system occurred about three months after my arrival early last Fall. It was a Sunday morning (key detail) and the wife had left with a friend to go hiking about two hours away from Seoul. As per typical, I spent the first couple hours of the morning deciding how I would make the world a better place, or at the very least find several hours of non-destructive amusement.
Around 11:00AM and completely out of nowhere my stomach began to have a small, but alarmingly escalating pain. As the pain increased, nausea and other discomforting sensations appeared to keep the pain company. These sensations led to an urgent bathroom visit, which I will describe as “multi-purpose” to avoid treading too far into the realm of icky. There were then chills, intense sweats, and a pounding headache. In summation, it ended up being an action-packed twenty minutes. (This seems like an appropriate point in the story to mention that a friend of mine in the US had recently had their appendix burst and as most people do, I passed over any likely simple diagnosis and raced straight to the most catastrophic.)
Obvious contributing factors to my anxiety included the fact that I was alone, the only people I knew to contact were hours away, and the tiny bit of research I could do on my own was showing that none of the English-specialty clinics in the Seoul area were actually open on Sunday. As the pain re-established its dominance over my other symptoms and increased to the point of near-functional incapacitation, I knew I wasn’t going to have much choice but jump into the deep end and hope for the best at any hospital. The closest hospital I could determine to be open was across the river in Gangnam, so I staggered down the hill on which I lived in pursuit of a taxi.
Itaewon has plenty of foreigner-only taxis, but they were conspicuously absent from the main street that morning. I frantically attempted to flag down anyone who might be willing to transact transportation for currency, but there must be something about a guy basically doubled over on the side of the road that is counterproductive to initiating those types of transactions. I could certainly believe that when I had the strength to raise my eyes, those eyes were communicating something to the effect of “icky fluids may erupt from me at any time, and from any orifice, but – can we be friends?”
After a seeming eternity that was likely no longer than about four minutes, a taxi willing to risk a horrific cesspool in his backseat for a few thousand won had the heart to pull over. Somehow I kept things together during the ride, and I was dropped off at the foot of St. Mary’s hospital. I staggered in and immediately found the front desk. The personnel working the desk and I quickly established that we would never have a meaningful conversation, but I’m sure it was quite clear that I wasn’t there looking to order pizza.
They grabbed a clipboard which contained a series of forms to fill out at my convenience and thrust it in my direction. I began filling these out promptly as they were clearly the key to getting more substantial aid, and only twice was interrupted by the need to scurry off to the restroom to erupt as the entire waiting room stared at me with a bemused curiosity.
With the forms filled out, a gesture was made to me that thenext step would include waiting amongst the afflicted yet undiagnosed masses. I had enough lucidity to determine that the corner near a trash can would be a strong location choice for me, a decision that was validated about 90 seconds after I sat/hunched/curled. A few fellow waiting-roomers clearly re-calculated a safe radius from the guy who seemed as likely to perish as to recover, and adjusted their seats to a new location outside of said radius.
After a surprisingly short period of time, a name was called and the simultaneous turning of heads in my direction led me to believe that it was probably mine, or at least something reasonably close. I staggered towards the nurse who led me into a room where it was fairly clear that my vitals would be taken and blood would be drawn. Miraculously, this was almost done without further incident, unless you count shoving my head into a trash can lid to expunge a little more stomach bile as I stumbled back out the door.
I was then pointed to a direction towards the back of the hospital, which I assumed meant they wanted me to escort myself to the morgue and forgo the charade that I might actually survive the afternoon. However, my trudge was interrupted by a male nurse who had a much stronger command of my native language than I did of his. Thankfully, he was able to guide me to the actual emergency room and had me lay on a cot. I was given the opportunity to explain my situation, which he either understood or just listened and smiled reassuringly.
At the time, it seemed very important to me that I express that I was not just hungover, a message which may or may not have been successfully delivered. He then gave me some water, a few pills that I swallowed without inquiring about their identity or function, and hooked me up to an IV. Given my newfound propensity to eject fluid at inopportune times, it seemed ill-advised to tether me to something that would limit my mobility, but I’m sure the waiting room stories had probably gotten around the hospital by this point and he was willing to take the calculated risk. The nurse then left for a period and I again sat and contemplated what I assumed was an imminent abdominal surgery.
As I laid there and considered how my US medical insurance would feel about my hospital choice, a funny thing began to happen. For reasons I still do not entirely understand I began to feel marginally better. Over the next couple hours, my life took a decided turn back towards the uneventful. My wife eventually made it to the hospital and was led back to me either because they understood that we were together or they just wanted to group all the foreigners together. Near the end of my IV, a doctor came in and delivered the news that my appendix was still intact, and probably either explained what was wrong or simply told me that they didn’t know.
To this day I have absolutely no idea what caused my issues that morning. Regardless, I was then given a series of pill packets as a parting gift and sent on my way after paying about 10-20% of what I would have paid for a similar hospital visit back in the US.
I am still wildly thankful and possibly very lucky that the first dip of my toe into the foreign medical system waters didn’t include the aforementioned abdominal surgery. As scared as I was that I had no idea what was happening and had no idea how to even tell anyone what my problems were (although some of those pictures would have been worth at least 2000 words), I was amazed at how professionally they were able to deal with someone who had the communication powers of an infant. Even though I will never know what was actually afflicting me, or really what any of the treatment was, all I really care about is effectiveness. And they were damn effective.
Advice on Emergency Medical Situations in Korea
Looking back, being completely unprepared for a medical emergency kept my excitement level high, unfortunately this was one of those special situations where excitement=stress=bad. Enacting the power of 20/20 hindsight, I think the following advice could be gleaned:
1. Look up the hospitals that have foreigner-specific services in your area. There are several, and they are actually all around Seoul and not just clustered in Itaewon. Equally as important: KNOW WHEN THEY ARE OPEN. A lot of the foreign clinics are 9-5 weekday operations, with some having limited hours on the weekends. Korea4Expats has put together a pretty good list for the Seoul area:
2. Have at least a cursory understanding of how your medical insurance works. I happened to be working for a foreign-company and had foreign insurance. I knew that my insurance was valid, but had zero understanding logistically what to do when I was in the hospital.
3. I really had no reason to be so anxious about my inability to communicate. Specifically, expressing that I had extreme stomach pain without the aid of language wasn’t exactly (ahem) brain surgery. Expressing the just of most symptoms isn’t much more complicated. Many medical situations are pretty prescriptive and follow well-tread processes. Between my stomach pain, fever, etc., they were of course going to do a blood test and other diagnostics to rule out a burst appendix. The fact I couldn’t tell them all about my friend having similar symptoms and my internet self-diagnosis wasn’t going to alter their professional response. Speaking of which:
4. Don’t ever type your symptoms into a search engine unless you want to be told a tortuous and painful death is imminent. This one has nothing at all to do with the rest of the story, but it’s something I will continue to do and instantly regret until either I or internet perishes.