DR Johnson

Martin Johnson found himself at a crossroad. When one reaches a crossroad, one has to take a look at the easy path. A continuation of the path that you have known all your life. The nine to five office job; working as a team with a group of individuals whose collective aim is to form a pyramid above you using deceit and treachery as the common currency to make sure you stay routed to the bottom of the pile where you belong. The car on hired purchase, you can’t sell the bloody thing because you have to pay back three times what it is worth and it won’t start on a freezing January morning and you swear at the bloody thing every time you turn the flaming key. A wife that grows fat, lazy and bitter and blames you for the way the tides of the sea effect the moon’s gravitational pull and in turn dictate her own personal bloody menstruation cycle. Everything, you must understand, is your own fault. Unless, that is, something good happens, and then naturally the credit is placed elsewhere. Then the wife (with your help of course) decides to squeeze out a couple of puppies at first to be loved as an extension of herself and then to be used later as a bargaining tools in a tit for tat power struggle eventually escalating into a matrimonial explosion of young lives, bricks, mortar, furniture and a Golden Retriever named Max.

Is Johnson cynical? You bet your mortgage he is. He likes to tell folks, “You see; marriages are like a tornado; they start off with all this sucking and blowing and you end up losing your house and all your belongings.”

Johnson took the other path, a road equally treacherous, but certainly a road a lot less bloody predictable. A road that has been travelled by us seemingly developed westerners ever since the first ancient mariners built themselves wooden vessels and sailed for warmer climes.

Many of these travellers became settlers. And this is what Johnson has done.

He gave the home, the kids and the dog to the ex-wife and he flew to Thailand to become a doctor.

Johnson first became fascinated with becoming a doctor through a profound interest in medication and particularly in medical fiction and text books. The author Robin Cook taught him more than any real doctor, and thus rather than take the more orthodox and lengthy route of qualification Johnson decided to leap frog academia and apply for his degree certificate online. The certificate, bought from a US University, hangs framed above his desk on the ground floor of Surin Hospital. He has never practiced in the West. In fact Johnson used to work for an insurance company until he tried to sue his employers and lost the case. You could say that forgery is in his blood.  

The Thai’s at first took Johnson’s sloppy approach to work as an example of a maverick cavalier approach to medicine that was practiced throughout Europe. He claimed to specialize in psychiatry on the basis that the language barrier would camouflage his ineptness. It worked. That was five years ago and the gig is still going strong.

Dr. Johnson, they call him, Dr. Johnson.

Surin is in the Northeast of Thailand not far from the Cambodian border. Most of Johnson’s patients are of Khmer peasant stock. Cambodians by decent who have become Thai nationals through either border changes or political migration. His patients rarely question his diagnosis, recommendations or prescriptions. A doctor in this part of the world is to be trusted and not questioned.

Johnson first came to Thailand in the early nineties and did the tourist thing – Bangkok, Ancient City, Wat Phoo, Kancanchiburi, Chaing Mai and then Ko Samui. He remembers Chawang without a proper road and only a handful of bungalows. Now it’s all five star hotels and Starbucks, apparently they have a Tescos on the island now.

He has put in a transfer request; the Isaan region can be bleak and lonely. When He had first come to the Isaan he felt that he had landed in the real Thailand. Rickshaws and dirty open air restaurants, old wise women spitting betel nut juice on the dusty roads. Take a walk with Johnson through the open air markets, live fish flap around in plastic buckets gasping for water. Toads climb on top of each other, trying to escape the confines of their plastic bucket prison. An old blind man sits on the floor playing a strange two stringed instrument with a bow and a sad knowing expression. His song is tuneless, but receives some coins despite his lacklustre composition. The Elephant lady who sells the fat from the elephant’s leg as a beauty product, the women here cover themselves in this cream to prevent aging. But the Elephant woman looks much older than her customers. Enter the meat market where old women sit cross legged on high tables with the meat laid out in front of them, a pigs head here and the offal sitting next to it. She has a piece of plastic tied to the end of a stick, which she uses to swat away the constant swarm of flies that hover above her produce.

Johnson likes to walk around the market stopping here and there to buy something or just to talk with the vendors. It is here that he learnt to speak most of his Thai.

The hospital is clean and efficiently staffed by well educated young doctors, friendly orderlies and nurses who have been trained from an early age and weeded out from their less aseptically pleasing fellow students at a school of Nursing excellence. The ward is busy. There are no restrictions on visiting hours or on the number of visitors a patient can receive. Family and acquaintances are permitted to come and go as they please, they bring straw mats which they lay out in front of the wards TV set. They sleep under beds in twos and threes. Back in the UK Johnson would be lucky to get a single visitor at his death bed. These rural people stick together like glue through thick and thin and he loves them for it. The nuclear family is approaching fast, but has not reached this region. Generations stick together and help each other out. That is why there are no real cases of anxiety or depression in this part of the world. These people have been taught by religion and the concept of family values that one must not become wrapped up in oneself. One must consider family foremost. The mental patients that Johnson does see are at the stage where in the US they would be sectioned under the mental heath act. Out here there is no such legislation and nowhere to put them anyway. Care in the community, in the truest sense.

The first patient on Johnson’s round however, has no visitors. A Thai youth sits up in bed, knees up at the chest in a hypertensive delirium. His left hand clutches the back of his neck whilst his right hand fondles his crotch area. Substance abuse is his immediate diagnosis, probably methamphetamine. The youth is gibbering something about his family and incapable of answering any questions. Probably an overdose of Ya Ba, but he could also quite easily be displaying withdrawal symptoms from that drug or another or perhaps symptoms of alcohol withdrawal. A urine or blood test will assist in determining the nature of his state, but there is no time as the boy needs to settle down. All the major signs are normal except for the heart beat, which is dancing like a ballerina. Johnson prescribes two 5 mil Diazepam tablets to act as a sedative and no doubt he will be ready to go home once the tablets take effect.

The next bed is a lot more serious. A middle aged rubber farmer from Prasat is recovering from a stroke. His entire left side is paralyzed and his jaw slacks to the left in an ugly grimace. His wife and grandchild sit beside the bed. His daughter is currently working in Pattaya, desperately pedalling her body to keep up with the hospital bills. Johnson repeats the medication and admits him for one more week in lieu of the next down payment as per hospital regulations. It is all he can do.

Johnson retires to his office, and mixes a Scotch and Water and throws in two chunks of ice washing it down with a sleeping tablet. He finishes the scotch and turns on the buzzing device, which will no doubt awaken him the moment he falls asleep.

He sleeps in his clothes so there is no need to get changed. It’s just a matter of some mouthwash and a stumble down the stairs, past the screams of the paediatric ward and into his consultancy room adjacent to the main entrance. An old lady is already in the far corner of the room. At first it looks as if she is sitting down; a hunch on her back the size of a watermelon weighs her down in a half crouch. She must be a hundred years old if a day.

“Doctor, it’s my back,” she says.

“Yes,” says Johnson, “I can see.”

 Doctor Johnson had seen it all.

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