The Bryants in India: discovering the cost of healthcare

Brad Bryant finds out more about the Hyderabad medical system

In last week’s installment of the Bryants’ travel journal, Brad broke his tibia after an incident on his scooter. He was taken to hospital, where the doctors and the hospital accountant began discussing the bill…

The surgeon asked the accountant (who, by the way, was carrying a large ledger book and pen rather than a computer) what the surgical procedure, three nights stay and medical supplies would cost.

Gwen and I held our breaths as she threw out 2.5 Lak or 250,000 rupees. Under the influence of painkillers, my math was not real sharp, and my first conversion to Canadian dollars was $50,000. Suddenly my nausea was back. The surgeon, however, was wielding a calculator and had a clear head. He quickly converted it to about $5,000 CDN.

Now this seemed way to low, and I was concerned what I would get for such a small amount of money at a private hospital. At this point we had no choice. It was agreed we would move forward with the care.

The surgeon told Gwen and I that based on the sips of water (enough to wet my lips only, because the driver had it in a used pop bottle and I knew it was local water) I had on my way to the hospital, they would wait another two hours so there would be no complications with the anesthetic.

The group of professionals dispersed as quickly as they had formed around my bed, with the exception of the emergency doctor, who stayed behind to ensure I understood everything.

Someone took Gwen up to the billing department to prepay for my stay. I was moved up to pre-op to be prepared for surgery, which meant another trip through the lobby with all the looky-loos staring.

I informed someone that I needed to empty my bladder prior to the operation and they sent a young orderly, or “boy”, as they are called, in with a bed pan, who peeled back my covers and assisted me with getting it under my body. He took a step back and then stared at me while he waited for me to complete the task. Stage fright set in and after a minute or so he started tapping on the bed rail with a look of, ”Come on, go go,” on his face. Eventually he got the idea and left me with some privacy for a moment.

I was again visited by the anesthesiologist who discussed the two alternatives for sedation. I chose to stay awake and have just an epidural to freeze the lower portion of my body. She agreed this was the better choice.

By 5:30, the crew was back and rolling me in to the operating theatre. The procedure was explained again and then the wonder drugs were pumped into my lower back. My legs began to get heavy, and soon they felt as though they were a part of the bed, and away we went. I could tell they were moving stuff and pushing and pulling parts but felt nothing. They took pictures all along the way that they used for explanation later.

Before I knew it, I was in recovery and the nurses, or “sisters” as they are called here, were very attentive. My anesthesiologist stayed for an extra two hours during my recovery because she knew the sisters did not speak English well and she wanted to be able to translate any of my needs.

During recovery they told us that I would be in a private room with a couch/bed for Gwen to spend the night. Her employer had already told her to take the next day off to spend with me.

The surgeon, family doctor and the emergency doctor all visited me in post-op to check on me and make sure everything was good. The surgeon explained that I had sheered off the top front edge of my tibia and because it is integral in the tight operation of the knee, he had placed a metal plate inside my leg to hold it in place, as well as a whole box of screws. No more waltzing through mall security now.

His only concern was where both the break and the tear in the skin were in relationship to the knee joint. Therefore, he informed me, I would not be able to bend my leg or place any pressure on my foot for four to six weeks. That was a tough pill to swallow, but if it meant I would walk and possibly run again I was OK with it.

We were soon moved to our private room and introduced to all the current staff members. The sisters were all giddy about having white people to care for and they stared and smiled and I thought they would never leave. By 6 a.m., the cleaning staff were in and we had only been in the room seven hours. They swept and mopped the room three times a day, and every day someone came in with a ledger book and asked about the service of the cleaners or the sisters and then had us sign our comments. They all had a great laugh when they saw my signature.

At shift change, both crews came in and introduced the next shift. All the doctors visited and talked about the surgery and how well it went and then the head nurse came and introduced herself and told me her name was Lahamel. She offered her services if anything was not exactly as we expected and when she was leaving I said, “Good bye Lahamel.” She stopped at the end of my bed and smiled, waved and said, “Goodbye.” She took one step and repeated the smile, wave and salutation. Took another step and did the same again. Each smile was a little bigger. She absolutely loved that I took the time to remember and address her by her name.

Morning two, the family doctor changed my dressing and things looked great, so the surgeon agreed later in the day as he was doing his rounds that we could leave that night. They had been having me do my walking with a walker so there was no chance of putting my foot down. I asked about crutches but they were worried that they are too easy to loosing balance and stepping down. So Gwen went on a mission to buy me a new walker. We were given the green light to check out, so Gwen went up to billing to settle the final balance and it turned out that they gave us a credit of 40,000 rupees, so our actual expense was closer to $4,000 Canadian. Pretty amazing for the attentive care that I received. Except for the injury, this was a better stay than the “bare bones” hotel. Great Indian food for meals, the finest medical care I have ever seen and the sweetest most attentive sisters.

I cannot say that this is typical Indian health care. I do know that there are many private hospitals that cater to the many employees in the hi-tech industry here who have extended health coverage, or the tourists who are smart enough to buy coverage. What I need to investigate further is who is using the small government hospital I stopped at first. I will hopefully be using a different journalistic tactic going forward: maybe some questions and answers rather than injuring myself.

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