We’ve all seen it on the big screens and the small ones too. A novel disease emerges. Often, as in the case of zombie viruses, it has a 100% lethality, with very few graphic exceptions usually involving, say, cutting some infected persons limb off immediately after exposure. It affects everyone equally from young and old to the attractive to the unwell. Some beautiful movie stars emerge who are going to put a stop to this deadly pandemic. Those actors, you see, shall live. Well, most of them, anyways.
The rest of us? Not so much.
Of course in watching the images on the screen you are supposed to align with the protagonist and his family. That is you! You are smart enough, advanced enough or whatever, to have the skills necessary to survive the apocalypse. You’ll live, you see, through your sheer merit.
The idea that the vast majority is slated for destruction never enters your mind. That won’t happen to you, dear soldier. That’s for the rest of them. You watch the show, thoroughly engrossed in their manufactured reality.
Do we have any diseases that really do that in the real world? I’m trying to find out. At best they seem to be mingling with multiple other causes all circulating together in a complex dance. Overwhelmingly the old, the sick and the immunosuppressed are most targeted. Some people do not seem to get sick at all despite obvious clear exposure. In other cases the pathogen seems to emerge out of nowhere like it was latent in their body.
Of course you are also expected to believe that the illness or disease in question is always progressive, meaning it will result in your death without treatment. Little consideration is given for environmental contaminants. The relationship vaccines have to ill health later cannot be mentioned. Even less interest is given to how your thoughts might have shaped this reality. There’s no money in looking for solutions to those things.
So testing becomes an odd dance regarding following the money on one hand and genuinely trying to find solutions for an illness or ailment on the other. Here are some rules of thumb I go by:
I am immediately skeptical of any medical results which were obtained in the complete absence of an illness or ailment, or at least one which corresponds with said disease. This would include say, an incidental scan for a sprained ankle showing the presence of ovarian cysts or any type of routine wellness check coming up with abnormal results. I do not assume that such results are false, but I wonder if they will amount to anything, as many conditions clear up without medical intervention. In these cases I would always want a second opinion blind look (I.e. a completely different unaffiliated medical practitioner, who does not know about the first results, also finds the same results. Or does not). I also would want a waiting time to see if whatever abnormality was found clears up on its own, or begins to show symptoms.
Now if there are actual symptoms of something this changes the calculus. Whether I would want a second opinion depends on how well their diagnosis fits with what I have going on, if their treatment plan seems to be working, and analyzing any blind spots of conflicts of interest on the doctor’s part. Sometimes they see things they are paid to look for and other times they don’t see things they are free to ignore. Environmental contaminants are a big issue but because big corporations are the ones doing most of the polluting, most doctors ignore it.
Hopefully the problem goes away. The end.
So we have a problem. In order to make my husband’s visa to come to America, the US Embassy needs the records from the panel physician check in May. The panel physicians would not release the records because Ka’s chest x-ray supposedly showed pulmonary nodules and they wanted to check for tuberculosis using a sputum test and waiting 8 weeks to see if the culture grew. My husband is not and was not sick, but I decided I wanted a second opinion about this.
Being back in Phuket we chose Thalang hospital, where routine medical care for a Thai national costs 30 baht (as compared to the $300 for the sputum test alone at Bumrungrad). Ka’s BMI is normal and he’s even picked up a few kilograms since last time. He’s thin, but not wasting away:
Nothing about my husband’s blood pressure and resting heart rate readings should be raising any alarm bells.
A temperature gun was pointed at Ka’s head. No fever. His O2 saturation levels were given as 97% from somebody listening in with a stethoscope, which is not great, but not alarming either. Then my husband was given a new chest x-ray and he saw the doctor to talk about the results. She seemed confused.
“Everything okay! So why you come here?”
I explained then that my husband had had a medical check for a visa in Bumrungrad and he had a bad chest x-ray. She scrutinized the lung results more closely with me. I took this picture since I am the farthest thing from a radiologist. I don’t think I’d given a sideways glance to a chest x-ray before this.
“Okay maybe problem a little bit.” she said, centering the mouse in the middle. Now she wanted to consult with Bumrungrad.
The doctor proceeded to order a CT contrast scan and blood work. I explained that my husband had been working at a construction site and that I thought this might be from inhaling cement dust (silicosis). I also explained that he had no symptoms of anything.
We had to wait a few days for the results of Thalang Hospital's very thorough testing. The doctor had us sitting down for the results.
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