Lisa's Korean surgical adventure (can you hear the difference between "bed pan" and "bad pain"?)

Here I am, holding the stuffed animal (a cat made of recycled materials) sent to me by my wonderful friend Rachel and her equally wonderful daughters, Ruby and Ellie. They were sorry to hear I couldn't bring my own live kitties to the hospital with me, so sent me this one as a temporary substitute.

The "back" story

After 6 months of increasing back pain due to a severely herniated disc in my thoracic spine, and multiple medical appointments and consultations, I finally had surgery on January 12 at Seoul Wooridul Hospital. I both dreaded it, as someone who's extremely squeamish around medical stuff (I've been known to pass out when *other* people have blood drawn), and looked forward to it as a way out of the pain that had been seriously interfering with my ability to just live my life normally (I'd almost stopped going out if I didn't absolutely have to do so, had canceled several classes, was having trouble sleeping because of the pain, and getting increasingly depressed about the whole situation.)

One thing that helped me get through the stressful experience of having surgery in a country where I don't speak the language or have a strong support system, and being hospitalized for two weeks, was keeping mental notes of things to talk or blog about later, especially comical misunderstandings, or incidents that didn't feel funny at the time but I expected would seem so in hindsight. In no particular order, here are some of those incidents and observations.

Hospital culture

Korean hospitals, though very modern and high-tech (at least in major cities), are different from American ones just because the cultures are so different. One big difference is that patients who are admitted to the hospital are expected to have family members stay with them and take care of their basic needs. Patients without family members who can do this usually hire full-time caregivers, which is what I did (more about that later).

There aren't set visiting hours or a limit on the number of people who can visit at one time, as long as they can all fit in the room. "Fit" means something different here than in the West, as people are used to sitting on the floor and having less personal space. Visitors just show up and hang out, which didn't really thrill me my first week after surgery when I had a daily severe headache and my roommate had daily loud visitors. "Loud" has a different meaning here too; Koreans typically speak more loudly than Americans (even your average New Yorker) and, after three and a half years, I've mostly gotten used to feeling shouted at much of the time here. Also, though this may be an over-generalization, Koreans typically do things in groups compared to Americans (the collective vs. individualist culture dichotomy). Again, it's something I've mostly gotten used to here, but would have wished were otherwise when I was in the hospital and multiple visitors came to my shared room simultaneously. One nice thing about not understanding the language, though, is I find it easier to tune out conversations around me.

Enough complaining about cultural differences for now.

Well, one more thing, though it's more of a bemused observation than complaint....I think there's less of a sense of privacy here, and other foreigners and I have laughed in the past about seeing Korean hospital patients in their pajamas sitting around outside and even smoking cigarettes while pulling IV poles. While I didn't venture outside during my hospital stay (it's January, after all) or smoke, I did find it convenient to be able to go to the convenience store in the hospital lobby while still in my jammies and slippers. But I was less keen on the prospect of being in public space while still in hospital garb on the day of my discharge, when the hospital administrator offered me a parka and suggested we go together to the bank across the street while I was still in my p.j.s. I balked and she had to wait while I went back to my room and put on normal clothes.

About language

At first it was mostly frustrating because in addition to being in a lot of physical pain I had the extra challenge of trying to figure out what people were saying to me and make myself understood to them. Sometimes I felt like I just didn't have the energy (mentally, emotionally, physically) to bridge the communication gap. But I also didn't have a choice so I usually muddled through. Sometimes, if the stakes weren't especially high (say, explaining that I wanted yogurt instead of jello, rather than communicating that I really wanted another painkiller injection) I just let it go. Other times, though, focusing on language was a good distraction.

It started with the first night after my surgery, which I spent in the ICU. I couldn't understand why the nurse was repeating "depression, depression" to me. When she demonstrated, I realized she meant "deep breaths in," so I tried to take some, and filed the pronunciation lesson away in my memory. A side note about the first hours after surgery--I was incredibly thirsty, not having been allowed to eat or drink anything at all for the previous 2 days (one day was a slew of tests before the day of the surgery). The nurses put damp cloths on my mouth and I immediately sucked all the water out of them, until I was told (through gestures, not words) I shouldn't swallow and could only get the relief of having something cool and damp on my mouth.

In the days after the surgery I had multiple chest x-rays. The first time I was still too weak to sit up, much less stand and walk, by myself (I had been wheeled on a stretcher to the x-ray lab), so the technicians helped me to a sitting position. Apologizing for being in pain (though I don't know why I felt the need to do so), I said "I'm sorry" and one of them responded, "You're welcome" which made me smile, at least inwardly. Subsequent times I was able to sit up for the x-ray on my own, and later to even walk to the lab and stand up while the x-rays were being taken. I became familiar with the technicians' mantra, "breathe in and hold" and started listening for the variations in pronunciation (and errors), like the teacher I am. Usually, it sounded like they were saying "breeze in and hole" but sometimes it ended in "holdah". Occasionally someone pronounced the whole phrase correctly and I wanted to give them a gold star or pat on the back, but thought that might be too condescending. The hospital staff were unfailingly kind and helpful and I don't mean to mock them. These are just the things my brain focused on at the time.

"Ooond pain" was another mystery phrase at first, until I remembered that Koreans typically don't pronounce the "w" sound at the beginning of a word if it's followed by an "o" or "u" sound. For example, I couldn't understand why my students used to say "ood" when they meant "wood" (or "would") until I studied Korean and learned its system of pronunciation. All of which is to say "ooond pain" means "wound pain" and someone using the phrase wanted to know if I had pain around the site of the operation.

The most comical incident has to have been "bed pan" vs. "bad pain" though. I'll skip the potty details here but just say that the nurse and my assistant had no idea what I meant when I tried to ask for a bed pan (she kept asking me where I had bad pain) and I discovered that really really really needing to get to the bathroom was the motivator that got me out of bed for the first time several days after the operation. An interesting note, though--the nurses did know the phrases "number 1" and "number 2" for bathroom functions.

Ajjumma caretakers

There's a Korean word, "ajjumma" that literally simply means a married woman with children but actually suggests a strong, rather bossy, aggressive and pushy, no-nonsense middle-aged woman. You don't want to mess with an ajjumma. They are the ones pushing to the front of the line, or haggling for the best bargain, or loudly hawking their products in the street or shop. I read an article by another expat awhile back that said that ajjummas run Korea and I think it's true. The government and businesses are controlled by men and it's a sexist culture, to be sure, but the country wouldn't function without these powerful pushy females.

Not surprisingly, the caretakers I hired to help me in the hospital were ajjummas. Not that I requested them, but that's who was provided by the agency that the hospital uses. Being taken care of by an ajjumma was like having a kind but strict mother as a helper and taskmaster living in the same room 24 hours a day.

The first woman who took care of me was probably in her 60s. She did everything from putting cold cloths on my forehead to cutting up my food and propping a pillow between my legs. She even wheeled me into the bathroom on a stretcher that had a special kind of drain on it and washed my hair for me. It was like having a substitute mom, but one who spoke not a word of English. We relied a lot on sign language.

The phrase "no pain, no gain" could have been coined here in Korea. This is not a culture of doing things slowly, gently, or easily, whether you're talking about studying, drinking, working, or exercising. Or, in this case, recovering from spine surgery. It took me much longer to be able to get up and walk than my doctor had expected. Even though I felt a bit better each day, it still took almost a week before I could walk farther than the bathroom. I was just in too much pain and too weak.

The caretaker who was helping me was going to have to leave for another job after 5 days, so she decided that she would make me walk before she left so she wouldn't worry about me not being able to take care of myself when she had moved on to her next assignment (or this is how it was explained to me in translation later). So, she woke me at about 7:00am on her last morning there and literally tried to yank me first to sit up for breakfast and then to get up out of bed and walk. Though she knew I couldn't understand Korean, she kept talking at me and trying to physically pull me out of bed. I was still in my 10-day headache phase and not sleeping well through the night because of pain at my "oond site" so I had no interest in trying to walk that morning. Finally, I pushed the emergency buzzer on the bed to summon a nurse, hoping that I could get someone who spoke some English to come intervene. The ajjumma even tried to pull me away from the buzzer! When the nurse came in, I was in tears and tried to tell her that I didn't know why the caretaker was yelling at me and what she was trying to say. The upshot was the nurse persuaded the ajjumma to let me go back to sleep and try walking later in the day, which I did. It was traumatic though!

The second caregiver came when the first one left and she was a little more relaxed, or maybe it felt that way because I was stronger and in less pain by then. On her last day, when she washed my hair and was toweling it off, she joked I looked like a “halmonie” (grandmother) when she wrapped my head in a towel. I wasn't looking in the mirror, but imagine she was right; the towel gave me kind of a babushka feeling.

I'm sorry I don't have pictures of both of these women to post here.


It's not like in the movies

Having watched my share of hospital dramas, I couldn't help thinking how some things reminded me of tv or movies, and how different so many things were. Even though I've sat with my brother and sister-in-law (the doctors in the family) while they mocked hospital dramas on tv, I hadn't directly experienced the difference between the screen version and reality myself.

Let me explain. For example, one of the tests I had the day before the surgery was a sonogram, which I'd never had before. While I was having it, I couldn't help thinking about all the times I'd seen a tv episode with a scene of a pregnant woman getting a sonogram. I'm still not sure why I was given one though.

And, now that I've experienced feeling and looking like crap for many days post-op, I'm never again going to buy it when a tv patient looks perky after an operation. (One of my embarrassing guilty pleasures is watching Desperate Housewives and I just couldn't take it even slightly seriously when Teri Hatcher was supposedly in need of a kidney donation yet had perfect make-up and brushed hair while sitting in the hospital bed). Personally, I'm pretty sure I looked like Medusa and smelled like a barnyard animal.

Also, I discovered that after lying in bed for 10 days, one's hands and feet get puffy, swollen and dry and chapped. And, even better, the veins get weak, which makes it harder for nurses to get an IV line in. One day it took someone 4 attempts, which just thrilled me. Although I'm still basically afraid of needles (I always want to lie down when having blood taken so I don't pass out instead, which I have a history of doing), I got pretty used to them. One nice thing--the technicians used to come to my hospital room when they needed to take blood and I was already lying down anyway, so I just had to look the other way until it was over. Much easier than a night in the ICU.

Something else I didn't expect from watching movies and tv--having sutures put in was excruciating. Fortunately, having them removed wasn't bad at all.

A few last thoughts

How cool is it that I was able to get same day on-site tech support while in the hospital? The international patients office actually sent a techie to take care of the problem I was having accessing the hospital's wifi from my laptop in my room. That's the upside of Korean culture; sometimes everyone being in a hurry works to one's own advantage.

I was given a booklet titled Spine Home Care on the day of my discharge. It has a section about sex for disk patients, which includes 7 illustrations of sex postures for people with waist problems (all heterosexual couples). For all its conservatism in some areas, Korea can be remarkably open about sex sometimes.

I do, in fact, finally have a community here. It's not the same as the one I have back home (in the US), but it exists and I value it. Friends visited me and called me in the hospital. Others came to pick me up and bring me home on the day of my discharge. And others have been getting in touch and asking if there's anything they can do for me now that I'm "home" in my new aparmtment.

Being back home for a week now has been a lot about having patience, mostly with the pace of my healing. If I can get out of the apartment for a very short walk and maybe an errand each day, I consider it a success. Ditto if I can do just one household task, like a load of laundry or unpacking a box. If I also manage to do a work-related task, like some reading in preparation for next semester's courses, then I've hit the trifecta. Most days, I'll settle for two out of those three.

The main thing is, the surgery was a success. I don't have the original pain from the herniated disk and my "wound pain" is supposed to go away over time. Plus, I now have a really cool scar.