On Thai Medicine (and Science vs. God)

Bangkok, Thailand, August 2011:

The Greek Demetri, my de facto housemate, rolled a cigarette for me downstairs under the gaze of Tanawat’s dead sister.

While he fingered the tobacco and paper, I lamented my now-lost faith in the Thai medical system after my appointment earlier that day. The hospital had taken an x-ray of my ankle and leg, the attending physician had looked at it for about four seconds and said some stuff I didn’t understand to Tanawat’s cousin (or whoever she was to him) who had gone with me to the appointment.

Most of his sage advice I didn’t catch, but I did understand “mai pen rai” — “never mind” — accompanied by a dismissive wrist-flick. Not that I needed to hear those words necessarily; his lack of urgency for my broken ankle radiated through his nonchalant body language.

(A year later, back in the U.S., a podiatrist would confirm that, in fact, I should have had surgery right when the break had happened because some of the bones were misaligned. By the time I saw her, the bones had already fused back together and so, she informed me, the only solution would be to re-break them, set them back right, and then wait for them to heal again — a process which itself carried risk that might outweigh any potential benefit.)

“These people don’t know anything,” Demetri said.

“Who?” I asked, assuming he meant Thais in general.

“These scientists.”

“Scientists don’t know anything?”

“They think they’re God. They’re not.”

We went on like this via the Socratic Method for some time.

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What took me a while to parse through — separating the wheat from the chaff through his thick accent and Greek-style English — is that he didn’t not believe in science per se, but rather that he had no faith in its human practitioners.

Perhaps, being the Third World veteran that he was, Demetri had seen too much of the corrosive power of corruption up close to trust in the authorities of any domain, including the medical.

Life in the opaque Southeast Asian jungle is transactional. Extortions are done out in the open and positions of authority are leveraged for personal gain.

In this sense, the people of the Third World understand the precarious veneer of the social contract better than the Westerner who clings to the notion of civilizational rule of law — a quaint and laudable, but largely manufactured, vision of how the world operates.

In short, all of the graft believed to have been purged in the West really just went underground. Democracy and public accountability have failed, Demetri understood, in reshaping human nature — a fact lost on the comfortable masses of the middle class.

In 2018, seven years later, my Filipino worker at the university would introduce me to his doctor operating out of a dingy office in a back-alley (“soi” in Thai) on the outskirts of Bangkok.

Once again, as in 2011, I would need documentation of a negative syphilis test as well as a physical exam to get a work permit. Four of us foreigners — me, the Filipino, a Ugandan girl, and a Chinese professor who left shortly thereafter for higher-paying work in an international school — filed in one by one and paid our 500 baht. In exchange, we each received a clean bill of health with a negative result for a phantom syphilis test that never existed.

No needles, no blood, no waiting — just cash on delivery for fraudulent exam results.

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Alex Jones pounded the desk in his Austin, Texas, InfoWars command center and ranted with his guest, another internet activist on a warpath against big pharma.

Related: Do You Trust AI With Your Health Care?

Around the turn of the 20th century, Jones and his guest explained, John David Rockefeller, in cooperation with the Carnegie fortune, centralized and standardized the practice of medicine in the West to focus on allopathic care — i.e., surgery and pharmaceuticals — as a means to generate profit and consolidate control over the industry.

And generate windfall profits and consolidate control they did.

Between Alex and Demetri, I had started to come around to the nobody-knows-anything-we-are-just-monkeys-with-nukes-playing-god worldview, one that has stuck to this day.

I had seen too much to still believe in benevolent humanity.

Thailand needs God, I concluded. So does Austin, Texas, and so do I.

This article was excerpted from Ben Bartee’s recently published expat memoir, “Broken English Teacher: Notes From Exile.”