Immigration control exists in every country to keep out undesirables or in some cases to keep in one’s own citizens. In America, we don’t need immigration control to keep our citizens inside our borders; the fear generated by State Department travel warnings relieve immigration officials of this task.

Some countries nurse loopholes into existence to help both the local economy realize the benefit of continued tourism, and to help the traveler continue to enjoy their travel experience. In Thailand, an industry has sprung forth in the form of the ‘visa run.’

We experienced visa runs on our round-the-world sailing journey chronicled in my book, Sailing Faith: The Long Way Home, both while living in Malaysia during Faith’s prolonged repair, and again after sailing to Thailand.

Emily and I lingered in Thailand a duration sufficient to require visa runs; my medical treatments were to take longer than the thirty-day visa Thailand granted me on arrival, and Emily’s student visa was due to expire on June 1.

Emily’s school, the International Sustainable Development Studies Institute, or ISDSI, provided a van to travel to Burma. The purpose was to provide the ‘visa run’ for students staying for internships beyond the expiration of their student visas. Emily and I, along with several other students, found ourselves making that journey for our two hour visit to another country.

Entrance to Burma

I had never been to Burma, but to suggest a visa run has much to do with actually visiting a country is reaching. True, it is another stamp in the passport, maybe two stamps—one for arrival and one for departure—but that is the extent of our visit, plus a couple of hours of free time to explore the large market on the border for people like us making visa runs.

Once we have officially departed Thailand, and officially entered and exited another country, any country, we will again be qualified to receive another thirty-day visa on arrival into Thailand. This was my understanding at the time, but it was wrong. My original visa on entry at the airport was until June 4. Because the thirty-days is available for ‘walk-in’ travelers, which we were by walking back into Thailand from Burma, who are of student status, and because only fifteen days are available to those of tourist status, I ended up receiving a fifteen day visa on arrival, extending my original stay two days—until June 6. Oh well, at least I received stamps from Burma in my passport.

Wat Rong Khun courtesy of One Inch Punch

On our return to Chiang Mai, as we passed through the province of Chiang Rai, we stopped to visit Wat Rong Khun, The White Temple–an incredible work of art by artist, Ajarn Chalermchai Kositpipat. Beautiful and eerie, one walks a bridge over a well containing hundreds of sculpted hands reaching up depicting a struggle to escape their hell (I think). Inside, among many murals is a full wall representation of a demon. In the demon’s left eye is a depiction of Osama Bin Laden, in the right, George W. Bush. According to the artist, “I want to show that eyes, as important organs, should look at each other with kindness and not with hate that can lead to war.”

(Near the parking lot for the temple stands the building for necessaries. One source of enjoyment for me during my time in Thailand was the graphics used in signage. I sidetracked into this discussion of the White Temple, interesting as it is, to afford myself the opportunity to include a picture of one sign in particular.)

During our journey on Faith, we attempted to make a visa run from Australia, whose immigration control required we leave the country for twenty-four hours, but when I suggested we could just sail into international waters for a day, the woman informed me that in addition to leaving the country for twenty-four hours, we must have entered and departed another country and have such recorded in our passports. That kind of shot that idea apart, as sailing to another country from Sydney, Australia, is somewhat of a chore; here in South East Asia, proximities to borders are different, making the visa run a great option if one times it a bit better than what I did.

Tuk tuks in Thailand

As time passed during my surgery follow-up and dental care, June 6 approached and arrived. This particular June 6 happened to fall on a Saturday, and I hired a tuk tuk to take me the two miles to immigration. We arrived to find that Immigration was closed on Saturdays.

Emily was a great assistance to me during my time of healing but we both determined that her presence in Thailand was not as important as her moving on with her life and returning to the states. She left Sunday evening.

I was well accustomed to walking by this time, and on Monday, I again made the office of Immigration–this time on foot. I arrived in time for the office to close for their one-hour lunch. That allowed me time to fill out the required paperwork, have my photo taken, and have fifty-three minutes to spare before the queue machine would be plugged-in again to issue queue numbers.

I received the first queue number of the afternoon because I waited-out lunch in the seat closest to the queue machine. My number was called immediately on the expiration of those fifty-three minutes and I was helped by a pleasant man. (The key to officialdom, nearly anywhere my travels have taken me, is to be pleasant to the official with whom I’m speaking–people are always more pleasant, thus more helpful, that way.)

He took my passport, application, photos, and 1,900TBt to process the seven day extension and instructed me to take a seat. I do not know what I was waiting for, probably the processing, but everybody else was waiting too.

In Thailand, not unlike many parts of the world, waiting is an integral part of the Immigration process.

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My fourth morning in Thailand, Monday, found me visiting a pathologist, referred by Friday’s ENT doctor, to take a sample of the lump on my cheek. She said it would hurt and the sensation I experienced confirmed that statement; her work was not unlike a bee angrily screeching its wings in reverse to inject its venom as deep as possible into the subject of its ire, me.

Dr. Supranee, the ear, nose and throat doctor that I saw on Friday made room in her busy schedule to see me again on Tuesday; by then, the pathologist would have seen me, and perhaps the results of the biopsy would be known. Those results were not yet available, but Dr. Supranee concurred with my doctor at home in Michigan that the tumor required removal, and a plan was set in motion to excise the slow-growing, presumedly benign tumor on my cheek.

I was instructed on making this appointment to call early in the morning to obtain a queue number for my scheduled time. Because neither could the woman answering the phone understand my English, nor could I understand her Thai, I instead arrived especially early for the appointment–two hours early.

My time in Thailand possessed a definition different than that learned elsewhere. Emily was yet to return from her last study in the field, and I was not too excited about seeing sights or otherwise acting the tourist until she returned, so I read books. I can read nearly anywhere, and the air-conditioning of the hospital waiting room, plus all of the activity, made this as good of a place as anywhere else.

While waiting, I had the opportunity to blush through an unearned embarrassment. I am a farung–a white-guy, and often, I’m the only farung in the waiting room of nearly 150 mostly occupied chairs. I was deep into John Steinbeck’s ‘Tortilla Flat,’ at that point where all of Danny’s friends are watching Danny’s house burn to the ground, when another farung, using his umbrella as a cane, walks to a nurse’s station near where the low-hanging fog glows from the embers that only hours earlier were occupied by Danny’s friends.

“But why do I need to wait in a queue when I have an appointment?” came the demand that shook me from the hills outside Monterey, California, to again deposit me in the waiting room of the out-patient clinic on the thirteenth floor of Sriphat Medical Center in Chiang Mai, Thailand.

“Please have a seat and wait, you are number eleven,” the woman instructed from behind the counter. (In Thailand, no matter what the business to be conducted, or the wait to be endured, sitting is a major component; I  believe that to stand is to exhibit poor manners–I made a mental note to ask Emily when she returned, but lost the note before I asked her.)

“But I have an appointment,” continued the whine in a volume that rose to demonstrate this man’s growing contempt, “and I just walked an hour in the rain to get here, and I can’t go home now to wait, and why did I even go to the trouble to make this appointment in the first place?”

By this time, if I was not developing a wince on my face, I could surely feel one developing in my being.

In spite of possessing a fairly well-traveled history, I have only acquired the ability to discern with any degree of certainty one nationality of the English-language peoples–American; this man’s dialect was American.

My embarrassment was not for this man, neither was it for Americans in general, but for me. You see, I have been that man in the past and know that I am capable of becoming that man again in the future.

The episode concluded and he took a seat and I was able to return to Monterey to witness the last of the smoke of Danny’s house usher in the dawn. I was brought back to the waiting room when I heard, “Mister Geg Aeyenn Gang-gah,” and then ushered into the office of Dr. Supranee Sau Annah (which, if I were to say it in Thai, would probably sound to her how Gregg Allen Granger sounds to me).

She looked at my cheek, then at yesterday’s notes from the pathologist, then at my cheek again, then at the CT Scan displayed on a large Samsung monitor on her wall, then again at me and said, “I believe you have a slow-growing, benign, parotid tumor, and the pathologist and I recommend we excise it.” She then gave me an appointment slip to see the surgeon on Thursday.

Before departing her office I asked about obtaining a copy of my CT Scan to which she instructed me to talk to the nurse. Then, I was ushered to the cashier to pay for today’s office visit, about US$10, before being instructed to go to radiology on the second floor to retrieve the envelope containing the images of my CT Scan as well as a compact disc with copies of the images and a viewer program that I described on my Facebook status as follows:

“…it’s really nifty, showing all the intricacies of my head. From now on, as I’m subjected to Lorrie’s interrogation following some stupid or sinful act on my behalf, when she asks, “What’s wrong with your brain?” I can simply hand her the cd and say, ‘You tell me.’”

Before returning to the Suan Doi House, I made a leisurely stroll along and then crossed the moat to enter the western gate of the Old City of Chiang Mai. The Old City is surrounded by a square moat, slightly longer than one kilometer on each side.

Inside the moat, the world turns in much the same way it does outside. Busy, with shops and nearly every kind of imaginable pipe and steel outfitters, welding shops, pharmacies, food stalls, guest houses, scooter sales, scooter rentals, scooter repairs, auto repairs, restaurants, coffee shops, silk shops, silver shops, and tire shops to name only a sampling.

I popped into a steel-roofed structure between two masonry buildings that housed an open-air eatery and ate Northeastern Thai (meaning spicy) style spicy (meaning more spicy) salad with fang mushroom—my best dish since arriving, however, I anticipate no small bit of havoc as it passes the recently extracted polyp from my colon.

Across the street from the restaurant where I sat stood three trees. The nearest of them was concrete supporting hundreds of wires for transmission of every conceivable thing that can be transmitted through, mostly insulated but sometimes not, wires. Leaning on this concrete tree trunk was a twenty foot bamboo ladder flexing like the bamboo fishing poles we used to use with grandpa. The man working from the ladder hung his upper body fully two body widths from the ladder and draped himself in the web of wires while he did whatever work it was he was engaged in there.

On completion, he pulled a roll of tape from his pocket to conceal or to seal in the life contained in the wire it was he was working on. It was times like these that made me question how I could have possibly left my camera at the Suan Doi House.

I certainly didn’t plan very well for this excursion. The only camera I brought to Thailand happened to be the camera on my American phone, the latter part of which I did not wish to use.

Emily and her classmates returned to Chiang Mai late in the day on Wednesday, and I met-up with her. She agreed to stay after her classes finished for the semester to help me though the surgeries.

On Thursday, I had an appointment with the Ear, Nose, and Throat Surgeon. Dr. Pichit asked the question once in his office during my initial visit, and again on the first day following my surgery: “Why do you have this work in Thailand?”

My answer the first time was a lame, “I like Thai medicine; it is very good here and costs less than in America.”

He appeared puzzled at this response, but went ahead with the business at hand, which was to explain the risks and necessity of the surgery. (The risks had to do with potential damage to a number of nerves controlling the right side of my face, the necessity–I already knew that–but he had to tell me nonetheless.)

We scheduled surgery to extract this tumor from my cheek one week from this coming Sunday. May 22.

On Sunday, May 15, Emily accompanied me to Dr. Puttan,the plastic surgeon,  who looked into my files, all electronic and all accessible to every medical professional that I spoke to. Then she looked at me.

I told her of Doctor Supranee’s and my Michigan doctor’s concern about the old basal-cell carcinoma in my nose, and about my eyelids. I  inherited a fatty droop that has been repaired in my maternal grandfather, my mother, and her brother.

She began speaking about the surgery for my nose, and continued on about my eyelids. She then grabbed her cell-phone to show Emily and me photos of a recent surgery she had performed. She continued to tell me how we should go about scheduling this surgery. I spoke up and said, “I am already scheduled for surgery next Sunday. Dr. Pichit will be extracting this thing,” pointing to my jaw, “here.”

“What time is that surgery scheduled?”

“One o’clock, and he says it will take about three hours.”

She then said, “That works great. I will conclude my time in the clinic here and come to perform these surgeries when I finish. I will follow Dr. Pichit, and as soon as he completes his surgery, I will begin.”

As Emily and I were shuffling around and believing this appointment was nearing completion, Dr. Puttan looked at Emily and then to me and said, “Your daughter?”

“Yes.”

“I wish I had a beautiful nose like your daughter.”

Saturday found me again on the thirteenth floor handing my appointment slip to one of the pretty women at the receiving desk. She indicated I was to report to the nurses’ station outside of door number 11. There, a pretty Thai nurse poked an IV port into the big vein on the back of my right hand. She first looked in the crook of my elbows, but since they each were recovering from Friday’s lab work, she had to settle for the hand. I don’t wish ever to become an expert at being a patient, but I prefer the hand over the crook of the elbow. I don’t know where this idea comes from; maybe the hand is situated farther from the main of my being, or maybe I am better able to talk myself into believing it doesn’t hurt as much there, I don’t know, but I prefer the hand.

I was then instructed to report to the cashier’s station where I was shown a number to pay for the morning’s event, a CT scan. I paid it—8,626TBt, or about $290.00, depending on whether a dollar would buy more than, or less than thirty Thai Baht on a given day.

A young man in a white coat, pushing an empty wheelchair, arrived as I concluded the transaction and wheeled me to the staff-only elevators to again deposit me at Radiology on the second floor. I was made to wait all of three minutes before being wheeled in, next to what appeared to be a brand, spanking-new, Seimans CT scan machine. The attendant there motioned me to move from the wheelchair to the moving table that would zip me into and out of the imaging ring. Then I was told to hold still while the first round of imaging occurred. All the while, I could see this thing under a less-than-transparent part of the imaging ring spin orbits about my head. After several commands of “breathe” and “don’t breathe” and having this piece of equipment operate in several different levels of whirring with an occasional clicking, the sounds stopped and the table on which I lay pulled me out of the ring thing. “Am I all done?”

“No.”

A chemical was then injected into the IV port on the back of my right hand. The young man administering this procedure told me it would be ‘hot’. He was right, and I guess I’ve never had one of these tests before as I would remember that sensation–kind of like the feeling I remember being delivered by those pills we received in exchange for an extra ticket to a weekend rock concert outside of Toronto some thirty-five years ago, without the corresponding weirdness.

The table was then repositioned in the ring thing for another round of imaging with “breathe” and “don’t breathe” and whirring and clicking, this time with dye running through my veins.

And then, this part of my testing was over. I returned to the steamy Chiang Mai morning just before noon and hired a song tao—a covered small pickup truck, with benches in the back, serving as mass transportation—to drop me at the Suan Doi House for the afternoon. Day two in Thailand, and surrounded by the best cuisine in the world, and I couldn’t partake because—oh, to heck with it—fasting for Sunday’s test could start a bit later.

Lorrie told me of a great restaurant, the Lemon Tree, near my guesthouse, and I went in for some kway teou and a bowl of tom yum. Kway teou is an innocent noodle dish that carries only the aggressiveness you spoon from the spices provided. Tom yum, on the other hand, raised my concern about welding the semi-molten remains of tomorrow’s test equipment to the walls of my large intestine.

The instructions from the gastroenterologist seemed easy enough to follow. Beginning at noon, now 2:00, I was to fast and to consume massive quantities of clear liquids.

By 4:00 PM, I was back at the guest house and in good form to begin fasting and a clear liquid diet. At 8:00 PM, I began the laxative cocktail.

Sleep is different following air time and airport time and time in the care of Sriphat Medical Center on the other side of the world. I slept peacefully from one in the morning until rising before the sun at 5:30 in the morning, which at home, where I my body’s clock was located, it was 6:30 at night and the dishes were being carefully placed in the dishwasher following dinner. I began the day with a rapid trip to the loo. And another…and another

10:00 AM was my appointed time to finish part two of the laxative cocktail, and following a number of additional visits to my dear porcelain friend, I made my way to the hospital for the big event.

I arrived, changed into a scrubs-green shirt and sarong, the latter of which occupied one of my hands for every standing moment so as not to surprise anybody with the lily-whiteness of my normally-clothed parts. I was next escorted to a room to be fitted with an IV port connected to a bladder of clear liquid by means of a long tube and hung from a stainless steel tree on wheels. Once again, a wheelchair waited to escort me down the elevator to a waiting gurney.

In the operating room there were four pretty Thai nurses giggling about. “You speak Thai?” one cooed. All of the nurses are pretty in Thailand.

“Sawasdee Krub, no,” (hello, no) I responded, to which all graduated to a more serious giggle.

They then milled about and readied their equipment and pretended otherwise to busy themselves.

When the time approached for my procedure, one of them came to me and asked in a sweet and beautiful singsong voice, “you want relax now?”

My answer here, according to Lorrie in a subsequent phone call, is where I made a mistake. I said “no”.

The doctor arrived, the procedure began, and I quickly became aware of the fact that I did not like this procedure. It hurt. Bad. Very bad. And all the while they kept telling me almost finished, for a long time, a long, long time, it was almost finished, and then it was finished.

Being not required to stay put while the anesthesia wore off, I was free to leave. I had a small pain in my gut but that soon wore off. What with the laxative and fasting and all, a highly motivated and unforgiving hunger grew in me.

I ate at an open-air stall amid a dozen or so open-air stalls across the street from the hospital.

My first dish was Thai noodles with pork that I requested be spiced up a bit. This dish didn’t fill me and while I was eating it, I witnessed a number of other great looking presentations pass by me on their way to various guests; one—fried rice with a foo yung omelet looking thing on top should round out my order and my belly. I believe that often the most gratifying way to order Thai food in Thailand is to look at what rests on other people’s plates or swims in other people’s bowls, and to point to the most appealing dishes.

This day marked my third day in the care of Sriphat, where appointments were made on my behalf for the next several physicians, or procedures or treatments to be seen or to undergo. An appointment would be made on the hour. All of the physicians were on the faculty of Chiang Mai University Medical School, and depending on their commitments to either the school or to other clinics, would work on the thirteenth floor for at least one hour but often for several hours each week.

I witnessed as many as twenty-two appointments being made for the same hour for the same doctor. How it then worked was that on arrival to the nurse’s station serving that doctor’s office, a slip of paper with a queue number was handed to the patient, and the patient was asked to have a seat. Two methods exist to minimize one’s wait: show up early to get an early position in the queue, or show up late in the hour of one’s appointment—the doctor will see you, and the doctor has commitments elsewhere, so he or she will see you soon.

Under this kind of workload, there is one responsibility that the doctors in Thailand do not appear to perform. From my experience, doctors in Thailand do not coddle, or hold your hand, or cozy up to the patient under an aura of warm fuzzies. They are doctors, medical professionals, and pretend nothing more and nothing less. Don’t get me wrong, all of the medical professionals I met with were warmly professional.

In the waiting room of the thirteenth floor of Sriphat Medical Center, Faculty of Medicine, Chiang Mai University, healthy young people were fixtures on the arms of any persons my age or older. This is a cultural norm, an expectation, that one will be available to assist senior family members when medical services become necessary. The medical profession in Thailand firmly encourages the assistance of family members for the purpose of softening the impact of the cold, calculating, ministrations the profession provides–the bedside manners we so demand in the United States–as well as for the purpose of meeting any other non-medical requirements the patient may develop.

It was for this purpose that I asked Emily to stay with me beyond the completion of her studies in Thailand