Relief, and celebration

Most cities in southeast Asia are densely packed; buildings are stuffed in haphazardly, and green space is rare. Except for the sacred precinct of the Kraton, Yogyakarta is typical. However, when the taxi arrives at Jogja International Hospital (JIH), the scene is from another world. Broad suburban lawns surround wide, well-paved entryways. The glass front gleams as if freshly polished. Stepping into the lobby, we are greeted with the sound of sweet gamelan music—not a recording, but a live gender ensemble. (The gender sounds something like a vibraphone played with soft mallets). This is a class act, indeed. I am happy to have arrived at a peaceful, upscale place. The double-dose of tylenol I took an hour before is taking effect, too, greatly relieving my anxiety. (I only take pain-control drugs when desperate, which obviously I was).

hospital gamelan

The clerk at the check in desk speaks excellent English. Do I want to see a doctor? General or specialist? Either way, it turns out, involves waiting an hour or more. But you can be seen right away in the emergency room. Not really an emergency, I say, but that doesn’t seem to be the point.  And budget is not a concern, since my travel insurance will cover it. So, okay, emergency it is. A wheelchair is produced so I can make an authentic entrance there.

The emergency section, and everything else in sight, is sparkling clean and new, like you’d expect from a high-end first-world hospital. It is also deserted; the doctor can see me immediately.

I explain the problem, it feels like maybe a broken rib. He nods, and does some methodical poking and prodding. No, not a broken rib. He thinks its a stone in the urinary tract. We need an X-ray to check. I relax; I’m in good hands. Onward to the radiology department. The x-ray is negative for stones, but reveals some sketchy misalignment of the spine. Call the orthopedist. “Emergency” status puts me in front of the queue. Probably a pinched nerve, he says, where the vertebrae are too close, due to disc degeneration. But to be sure, we’ll need an MRI.

Spinal-alignment problems are familiar territory for me, so I’m kicking myself for not recognizing the symptoms and getting the right treatment from the start. MRI seems like overkill; even with a more precise diagnosis, how would they treat it? Certainly nothing they can do tonight or even this week, most likely. So it makes more sense to wait and do that when I’m back home in Chiang Mai—even though my insurance coverage will be gone by then.

The doctor is so clear about all this, I am impressed by his competence. This is, after all, a very poor country. Where did you get your training, I ask? Right here in Yogyakarta. Now I am doubly impressed.

Hosp bill

So we go to check out with the cashier. Here’s the bill. Rp. 381,000, of which Rp. 140,000 is for radiology, most of the rest for the doctors. I paid with my newly-recovered credit card from my US bank.

Pretend, for a moment, that you don’t know how much an Indonesian Rupiah (IDR) is worth, and just compare this to US hospital prices. If I told you the rate is 100 or 200 IDR=$1, that would be about what you would expect to pay at a high-end hospital emergency room in the US, right? (Or expect to be billed, I should say; whether you pay it is another story entirely). But if I told you 1,000 IDR=$1, total bill $381, you’d say, what a bargain! But neither of these is even close to the truth. The actual exchange rate is about 14,000 IDR=$1. The charge shows up on my bank statement as $27.69.

With this as a model, why we can’t deliver health care in the US at a reasonable price is a question for another day.

Having a manageable diagnosis cheers me up immensely, and my amazement at the pricing makes me almost giddy. Oh yes, and hungry: It’s 8 p.m., past time for dinner.

I guess now is a good time to talk about street food. The busy streets in the heart of town are full of night life–not clubbing, but shopping and eating. Some blocks seem to have nothing but little eateries, maybe 4 or 6 in a row. One we visited even had space for a prayer room. Most of them serve various combinations of nasi goreng (fried rice), noodles, and/or chicken. That’s for the storefronts–meanwhile, at curbside, entrepreneurs set up little stands to cook fresh satay, i.e. barbeque.

But when we get out of the taxi tonight, it’s in a relatively quiet area.  Only a couple of street vendors. One has just run out of chicken for grilling. The other offers a steamer pot full of unappetizing-looking chunks of, what, exactly? I recognize potatoes, tofu, and cabbage. Take what you want, pay by weight. Well, we’re hungry, it’s food. Doesn’t look like much, but after it’s chopped up and served with sauce, it’s delicious. And very cheap, of course.

We are here on this quiet street because I’ve learned that there’s a jazz jam session that is held here every Monday. This is not in a bar or concert space, but an art gallery (as far as I can tell). No admission charge and nothing for sale, and the seats are filled with mostly young, enthusiastic locals. I say enthusiastic, but in this culture, applause is as restrained as in classical venues of continental Europe. The young musicians are excellent; the pianist for the house band rolls out a carefully-crafted solo worthy of Tommy Flanagan. The bassist, departing from a steady walk, shreds a melodic solo like a rock star. Where do these guys study, I wonder (echoing my question of the doctor). This city is not to be underestimated!

When it’s my turn, I get a big introduction from the MC. I’m the only foreigner on the stage, and I get the impression that they don’t get many visitors. Inspired by the house band’s example, I happily wail on Take the A Train.

A great way to end a day that threatened total disaster.



Back in ChiangMai, after a visit to the chiropractor, I learn that I was right the first time. It was my rib that was bothering me. It took Dr. Philip about 2 minutes to find the dislocated rib, and one minute to fix it. Much better now!

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