By Cynthia Ryan
The Accidental Medical Tourist
After an unexpected encounter in India, a cancer survivor finds herself once again in a foreign land of medical care
By Cynthia Ryan
As my stretcher was rushed by foot through the busy streets of Chidambaram, India, it occurred to me that a personal health crisis wasn’t part of my assignment to investigate medical tourism for CR. Two days earlier, I had walked the pristine halls of Apollo Hospital, in Chennai, to learn why patients from around the world travel to this facility to find treatment for joint pain, heart conditions, dental problems, even cancer. Now, thanks to a sudden encounter with a temple bull—and the sharp piercing of my groin by his horn—I was headed toward a small village clinic to be stitched up.
As cancer survivors, most of us have visited destinations that we’d rather not. I remember sitting in a plastic surgeon’s waiting room in 1993 shortly after I was diagnosed with breast cancer, craving a more familiar and comfortable space. It wasn’t just that I was emotionally drained from the biopsy, the second opinions and the sleepless nights. I simply didn’t belong in this place. I was a foreigner who didn’t understand the culture of cancer: the procedures, the language, and perhaps most significantly, the inevitable changes to my life after diagnosis.
Lying on an examination table in Chidambaram, I was once again outside my comfort zone. The surgeon who treated me spoke some English but conversed primarily in Hindi. The anesthesiologist who assisted him relied on the Indian guide who accompanied me to translate his questions about the degree of discomfort I felt and whether I had any allergies to local anesthesia. While remaining focused on her work, a nurse smiled encouragingly at me—or perhaps at the novelty of tending to a Westerner who had stumbled across an animal that has roamed casually through Indian cities and villages for centuries.
Beyond the language barriers, however, I recognized in my team’s approach to addressing my injury some similarities with American medical practice. Although the physicians and nurse wore street clothes, their roles were strategically orchestrated. As the doctors discussed the best strategy for treating the wound, the nurse arranged the instruments and prepared the area for stitches. The surgeon assured our Indian guide, Krish, that the injury had not reached my internal organs. The area of the groin pierced by the bull, however, was located less than a quarter inch to the right of my femoral artery.
Silently focused on this procedure, a number of onlookers stood in the background, including a select group of fellow travelers, a bus attendant who had ridden alongside us during our first five days in southern India, a priest from the temple where I was gored by the bull, and people from the city who had run along behind the stretcher. Though a worn overhead fan whirled above me and a tiny parade of ants climbed a nearby wall, the surgeon carefully cleaned the wound and donned gloves for the actual stitching. The medical team and I continued our nonverbal exchange of smiles and nods until—sewn and bandaged—I left the facility.
I’d come to India to address the concerns of cancer survivors who contemplate traveling abroad for health care, but it wasn’t until my experience in the Chidambaram clinic that I began to truly question the many assumptions about medical tourism—both as an industry and as a personal choice. Had I not unexpectedly been thrown from the horn of a bull as he, and I, circled the grounds at Nataraja Temple, I realized, I might have left India with a different perspective on what constitutes medical treatment abroad and how tourism fits into the experience.