Putting your money where your mouth is..

or more accurately, less money – more like putting your health in the hands of the people I’ve spend the last year writing and talking about.

Many people have asked me that question – “Gee – but would you go to Colombia and have these physicians take care of you?”  And, it’s a legitimate question, after all – it’s all well and good to send other people to far off places (foreign countries!) when it isn’t your own health and well-being at stake.  But what would the writer do in a similar position?  So I’d like to answer that question here.

Yes, Yes, I would and yes, I have.  In fact, this very question is what prompted my investigations into health, medicine, surgery and surgeons in Bogota.  I don’t usually disclose this information because I don’t think it is germaine to the majority of the discussions (it is briefly mentioned in the book) – since most of my previous posts have been more on the basis of rational inquiry then personal accounts.  It’s also difficult for me to talk about private matters – but today, for the purpose of legitimacy and credibility, I’ve decided to set my privacy aside.

I usually omit the ‘personal experience’ because I find it less than helpful for patients since our experiences are not objective, but are rather colored with previous experiences, our culture and upbringing as well as our expectations.  I don’t believe in “patient testimonials”, per se because I feel it gives a false representation.  After all, a charismatic individual may not be as skilled or talented surgically as someone who is less loveable, so to speak.

But, I do think that it’s important in this instance for me to share some of these experiences with readers, because it speaks to the validity of my research – I have interviewed and been in the operating room with these individuals, and have knowledge that many of you (the readers) are not always privy to.  And knowing all of this, I elect to return to Colombia to see my surgeon here.

This week, I am having another CT of the abdomen to follow-up on a medical ‘issue’ I experienced while living on the island of St. Thomas.  Immediately after being diagnosed with this problem – when I had the choice of seeing doctors in nearby Puerto Rico, or Miami (where Caribbean patients often seek care) or going home to Duke – I chose to come to Bogotá.  I didn’t do it for cost – though as a person with very poor health coverage, that was certainly a factor, I did it as both part of my research and because of the absolute confidence I had in one of the surgeons I had met during the writing of the first book, in Cartagena.  (Dr. Hector Pulido).

After a month of worry (okay, to be honest – terror) while I wrapped up my life in the Virgin Islands – my first peace came as our plane landed in Bogotá.  I still had worries about my health, but I felt calmer than I had in weeks – since the first, fateful CT scan showed a rare abnormality.  This sense of security and well-being only increased with my interactions with the staff at Santa Fe de Bogotá, and under the care of my surgeon, Dr. Roosevelt Fajardo.  He had already communicated with me prior to my arrival by email, viewed my medical records and conferred with several other specialists.

Now, admittedly, my experience is colored by the outcomes, and I was extraordinarily lucky, for someone in my position.  I had been tentatively diagnosed (at my home hospital) with a serious malignant illness – and was gifted with a new diagnosis of a rare, but benign condition instead, which has made no impact on my daily life.  I take no medications, there is no sequelae or complications – and it appears that it is just a variation of ‘normal’ that woud have never been discovered if I hadn’t originally become ill in St. Thomas and had a CT scan*.

But, I know, in my heart of hearts, that had the outcomes been different – I still would have been in great hands – with caring, compassionate individuals who understood my fears and concerns.  That is worth its weight in gold – but being in Colombia, the entire experience cost considerably less than that.

I can also say – that if I ever needed heart surgery, lung surgery or any number of procedures (who know?  plastic surgery may be in my future..) that I wouldn’t hesitate to place myself in the care of any number of the fine surgeons profiled in my book.

* Transitory illness, now fully recovered and unrelated to current care.

Now in today’s litigious society, I probably need to put some sort of disclaimer that my results are not typical – usually people turn out to have the maladies they were originally diagnosed with.  But as I said – it’s a rare circumstance, and I had the benefit of having multiple specialists confer in my case – so as I said, I was lucky.  I also probably need to make a statement about safety and surgery, such as surgery always carries risk – and that bad things can happen no matter how great your surgeon is, or how good the facility is.  I hate having to put this stuff because people comes to me for answers, but unfortunately, there are no guarantees when it comes to things like this.  I hope I haven’t offended my readers, and I apologize because I feel that having to make these disclaimers cheapens the message.

Update:  18 August 2011

Dr. Fajardo contacted me this afternoon a few hours after my CT scan.  Results of my follow up CT scan show everything is indeed unchanged and remains a benign, if uncommon variation of normal.   This is greatly relieving, but more than that – part of a consistent pattern of genuine care and excellence in medicine.

Sorry to my friends at the paper – whom I had promised an in-operating room exclusive, if the situation had changed.  (Sorry for them, not for me!)

I hope that by sharing this more personal experience, I have been able to give some of my readers a little different perspective than what they are used to seeing here at Bogota Surgery.

5 thoughts on “Putting your money where your mouth is..

  1. I think that your story actual helped me feel as though you knew personally what an incoming patient might be feeling and that you understood this first hand. I know that Healthcare professionals are the some of the toughest critics of providers of care. So for you to feel that confident…made me feel confident in your statement to others.

    • Thank you, Lynn.

      There are just a few times in my life when I have experienced such fear – even though everything is fine (now) – it was a life-changing event, and having the trust that I have in these providers made it possible. (And yes – I had been very disappointed by others, and yes, probably because I am in healthcare/ because they lacked compassion, and did not include me in their plan of care.) When you are shivering in a patient gown – you feel tiny, small, helpless and it reminds you of what your patients are experiencing.

      I think it is important to recognize people for these things – because too often excellence and caring go unrewarded.

      • I am a nurse. Worked in cardiothoracic sreurgy for several years1. I totally agree with the notepad and pens for questions. Docs come in for about 5 minutes out of the whole day. You will never remember all your questions.2. Many times, pain medications are written on an as needed basis meaning the nurse cannot legally just give you pain meds every 4 hours or whatever. It is up to YOU to ask for you pain medication when the the pain STARTS. You will have to rate your pain on a 1-10 scale. Ask for pain medicine when pain is a 3/10, not an 8/10. It is much harder to get pain under control when it gets higher.3. Bring some books or laptop. You will get bored4. WALK when they tell you too. It is for your health and so you don’t get pneumonia.5. Deep breathe and cough at least 10 times every hour right after sreurgy. Same pneumonia issue6. Trust the nurses we mean the best for you.7. If you get nauseas, try putting an alcohol swab under your nose I don’t know why it works, but it does sometimes8. Ask all kinds of questions at discharge so you don’t get home and get confused. We don’t mind9. Tell your friends and family that you WILL NOT BE AVAILABLE for the first 3-5 days. Major sreurgy needs rest. Unplug the phones in the room and ask people to call a designated family member or friend for updates. I see WAY too many patients become completely exhausted because they will not say no to visitors. If you are ready to see people earlier, you can call them.10. Stay calm. Anxiety will only make everything worse. If you find you are very anxious or have trouble sleeping, ask the doctors if they can prescribe you something just for the time you are in the hospital.Good luck!

  2. You are most welcome.

    I can relate to your feelings as a patient because I’ve been one, a time or two myself. It is good that you recognize the really good doctors. I’m sure that your experience as a patient made you more aware of how you treat your own patients.

    Have a great one!

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