Gareth+-+Memo+-+27

I can imagine a long list of people who I would be interviewing, and who would provide analytic insight: Patients, Health Care Providers, Health Policy Advocates, Legislators, Ruben Toral (Bumrungrad Marketing Director), Rudy Rupak (Founder of Planet Health), the folks who run websites or write books promoting/about the industry… For the following I focus on a patient because it is the part of the project I have already undertaken, and I would rather write up something non-fictive. I used to start my HASS proposal with a collection of one sentence stories, with patients whom I had already spoken to. When we study a subject for a long time, and mention it often we collect the stories of those connected to it, especially when friends and their associates have experiences. Last year the proposal begins “Newlyweds extend their honeymoon in Johannesburg, South Africa, for the day following their safari so that the bride may receive Lasik eye surgery at a lower cost than home. An Israeli grandmother living in the United States, travels to Turkey after visiting relatives in Israel and has a new kidney surgically implanted, unconcerned about its origin she recuperates in a hospital looking upon the Historic Blue Mosque in Istanbul.” This year, I switched it to add “A father of three is offered a referral to an Indian Hospital for routine heart surgery by a doctor in Kentucky; the doctor has read about Medical Tourism to Chennai” replacing my friends grandmother and her trip to turkey. But in some ways, the story of this woman, nearly seventy more explicitly exemplifies the sort of disregard for the destination that I find so fascinating. Much like a Columbia university professor who recently stopped me at a conference to ask if Bangkok was a good place for his grandson/son (I can’t remember which) to have had a sex-change operation. The professor wasn’t concerned about the scenery, or the culture, but was curious whether I could offer justification for the choice of this site from a medical perspective. I offered half hearted theorization and apologized that I hadn’t completed my fieldwork. But back to my friend’s grandmother. She was nearing seventy, young to have a twenty five year old granddaughter, but she had been young in the early days of the Israeli state when rapid production of offspring, was like working hard in a factory, an expected duty to her people. She hadn’t had surgery in years, but the kidney disease had been getting worse throughout her stay with her daughter’s family in Maine. She had intended to wait to treat it until she returned to living in Israel but found that there was little her American doctor recommended, and in consultation with her primary doctor, still in Israel, she planned a trip home. In the consultation with her Israeli doctor, she was told that the kidney transplant was the best option, and that Turkey was the place to go for a kidney. He made the arrangements, and she assumed, though she didn’t ask, that it was not his first time arranging such a trip. The hospital, she forgets the name, was downtown in Istanbul, and her trip there was the first she had ever taken to a country in the Arabic world, having lived her whole life in Israel and the US. She didn’t think of it as a trip to Istanbul, she went there as if to a hospital in her home country, home country being a mix of the two. I spoke to her on the phone, and she pauses after I ask whether she knew who’s kidney it was. She replies that a kidney is a kidney, and she hadn’t been told. It is implied that the question is so uninteresting as to not have been asked. She implies later that it would be like asking where the pills she took, or the scalpel used, were manufactured. It isn’t part of her interest, which is to have gotten well. And she has, the trip a success, I am speaking to her six months after the fact, while she is again visiting Maine, now living in Israel full time again. I had told her I had wanted to see the Blue Mosque since my Brother described it to me, and she mentioned having seen mosques before. I hadn’t pressed the issue, but thanked her for talking to me.