Belle Vue Clinic, Preventable Medical Disasters, and Stoic Lessons 277 Comments

[Warning: This post is one of my rare rants, perhaps my only rant, written last week when the reality-bending fury was fresh. Almost never seen, like a snow leopard, my angry self has come out to stretch his arms a bit, perhaps punch a few deserving people after warming up. The reasons -- primarily the safety of other people -- will become clear shortly.]

SEPTEMBER 25, 2011, CALCUTTA, INDIA
SAFE AT THE OBEROI HOTEL

Earlier today, a hospital superintendent snickered and offered me a feedback form if I had complaints. I declined, as I figured this blog would be a faster way of getting the message to the CEO in question, P. Tondon. Mr. Tondon, nice to meet you.

Forthwith, our promised programming…

The Power of the Checklist

Atul Gawande is an outstanding surgeon, Associate Professor of Surgery at Harvard Medical School, and author of “The Checklist Manifesto,” which details the power of checklists to prevent catastrophes or simply improve outcomes.

From the prevention of airplane crashes to decreases in hospital-based bacterial infections, having a clear, repeatable process is key. I read his book while flying to Amman, Jordan, and I ensured beforehand that I knew exactly where the best hospitals were close to our hotel, the fantastic Evason Ma’in Hot Springs. It’s as simple as calling the US embassy or consulate (if that’s your nationality) via Skype before you land. Here’s a list for your future use.

This week, I violated my own process: I didn’t check on hospitals before traveling.

“Ah… but where to?” you ask.

To Sweden? No, sir. To Japan? No, ma’am. I landed in Calcutta (Kolkata), India. Home of Mother Theresa and pathogens galore.

Ultimately, I ended up spending 3.5 days in two ERs and hospitals.

Before I explain the comedy of errors that led to this post, a few caveats to flavor the haterade for the anonymous ankle biters we affectionately call “trolls”:

- After 30+ countries visited, I don’t believe I’m a spoiled American. Puking on the floor of Chinese hospitals? Check. Getting probes and pokes (not that kind) in Argentina? Done. I’ve roughed it plenty of times and know the world isn’t covered with linoleum.

- I’ve been in dozens of hospitals and ERs around the world, had multiple surgeries, had food poisoning 4 or 5 times, and spent hundreds of hours with MDs for The 4-Hour Body.

- There were a few heroes in the following story, so this isn’t “us versus them” nonsense. Among the heroes: Pawan, our guide; Dr. Gunjanrai from Belle Vue, who saved our asses; and all of the friends I traveled with, especially Dr. Kareem Samhouri.

The Avoidable Pain of Poor Checklists

Preamble complete, here’s an abbreviated version of what happened:

- I ate a usually delicious local Bengali fish, Bekti, at the Tollygunge Club’s Belvedere restaurant, which my girlfriend Natasha later dubbed The “Tollygrunge” Club.

- Diarrhea and vomiting ensued through the following morning, as did fevers. I hit 101 and Natasha passed 102. I made the executive decision to go to the hospital for, at the very least, intravenous (IV) fluids.

- To stabilize my girl, who was incoherent, and avoid 1-2 hours of traffic, we first visited the closest hospital, the name of which I can’t recall. Now things get interesting.

- Enter war zone — Dr. Sumon and Dr. Chatterjee admit us to the ER. Natasha is wheelchaired in and put on a cot. No vitals are taken besides blood pressure. One of the doctors then alcohol swabs the arm, to prepare for IV insertion, following by slapping her forearm with the bare hand he’s just coughed on. I stopped him to correct course, as I had to do so with both doctors multiple times. Eventually, once her IV was delivering saline solution and lost electrolytes, I had to lay down, as I’d declined an IV and could barely stand. My only choice for rest was a cot with dried urine all over it, which Kareem covered with a towel. Who says chivalry is dead?

- The good news: when we leave, the grand total cost is 150 rupees for both of us, or about $3 USD.

Round Two at Belle Vue Clinic

- We leave for a reputedly much-better hospital, Belle Vue Clinic, where we’d be meeting an expat specialist named Dr. Ghosh. Sigh of relief. Natasha is still delirious and nonsensical, so I’ll be the only one coherent for our first day there. The pamphlet for Belle Vue Clinic is seductive:

Equipped with the finest resources of medical science, the clinic’s emphasis is on relief, reassurance, recovery and rehabilitation.

At Belle Vue Clinic, a patient is not a bed number. He or she is consider as a member of the Belle Vue family. A scrupulously clean and homely ambience is provided. There is always service with a smile.

- Without further ado, here are a few highlights from our slapstick treatment. Keep in mind, Belle Vue has good materials and drugs on hand. Their “Rules and Information” brochure reads “44 years of proven and trusted medical care of international quality.” In retrospect, I realize that “international quality” could mean “From St. Lucia to Somalia, we combine the most preventable mistakes possible.”

The following are process fuck-ups:

* Upon being properly admitted, a “sister” — or nurse attendant — takes my armpit temperature without paying attention. It’s half in contact with my shirt, resulting in a 98-degree output. “Fever, ne,” (“No fever”) she says and starts to walk away. I yell for her to wait, pull an electronic oral thermometer out of my pocket and repeat the drill: almost 102. “Fever, yes.” She later insists twice that I have no fever, until the doctor puts a hand on my forehead and settles the matter in my favor.

* Natasha had a terrible reaction to pain medication they administered, Drotin® (drotaverine), and collapsed on the floor that night after going to the bathroom. No one was watching her properly, so I had to leap out of bed with my IV and help her get up. They administered it the following day and Natasha’s temperature skyrocketed and she began to shiver uncontrollably. I called Dr. Ghosh, got no answer, and did what I could: tell all staff to absolutely NOT administer any more Drotin. When Dr. Ghosh arrived around 7pm that evening, I told him the same, which he said he’d note and convey to all staff.

That evening, as Natasha was falling asleep and I was going to bed, a nurse comes in with — guess what? — a syringe of Drotin to give Natasha. Fortunately, I wasn’t in the bathroom and intercepted it.

* Natasha ran out of toilet paper — as we did several times, which diarrhea will do — and rang the call button. The sister who came in asked her to use water instead to wash off. My girl, as I would hope, refused. The sister then took a dirty towel she’d used to wipe Natasha’s feet and offered that. Again, no dice. Eventually, we got the toilet paper with a chuckle of “fussy” in English. Bonus anti-hygiene points: The bathroom featured a used bar of soap from the prior occupants and nothing to dry your hands with.

* The second or third afternoon, Natasha’s feverish temperature was put in my chart, resulting in them attempting to switch our medicines. I had to make the correction.

* Critical requests for water (we’d been instructed to drink a certain number of liters per day), IV bag changes, IV blocks, etc. often took 10+ call button rings over 30 minutes. Calling Dr. Ghosh, as he encouraged us to do “anytime” did little or nothing, as he didn’t pick up 90%+ of the time. If he did, he said he’d speak with staff and then nothing changed. This meant we had no reliable English or supervising physician at the hospital until Dr. Gunjanrai rescued us by sheer good luck. Achtung: there appear to be quite a few people who speak English at Belle Vue. I’m not being an uppity entitled American; they had the capacity to triage this, even if it meant making the dietician, who was outstanding and spoke excellent English, our point person at additional out-of-pocket cost.

* Dr. Samrat Chatterjee (I ALWAYS write every doctor’s name down when being treated) enters our room to tend to us: a blood draw for me and a new IV for Natasha. He points to Dr. Kareem Samhouri, my friend who was visiting during proper hours, and says brusquely without looking at him, “You can leave,” while pointing at the door. I make it clear that Dr. K is my physician on the trip and listed as next of kin: he’s staying. Dr. Chatterjee then starts taking my blood sample and refuses to answer any of my questions, which focused on an odd yellow liquid in one of the collection tubes that mixed with my blood. Then to Natasha: Dr. Chatterjee rushes into the new IV insertion as Natasha screams in pain. He laughs and tells her she’s overreacting, repeating “fussy” with shake of the head. Later, when Natasha’s forearm skin swells up like lemon holding liquid, Dr. Gunjanrai will try and aspirate (draw out) blood from the IV — nothing. If you can’t get blood out of an IV, guess what? It ain’t in a vein. It’d been pushed into the tissue and several liters of fluid had been forced into Natasha’s worthless sham IV.

This is Natasha’s sham IV arm one week later.

Dr. Chatterjee, you’re a motherf*cker and should have your medical license revoked. Hopefully this post gets you part way there. You’re welcome.

* The next day, my IV clogged at least a dozen times. Somewhere between 6-12 times, I was therefore given “Hep-Lock,” named after it’s principle ingredient, heparin. Heparin can be quite dangerous, fatal if you overdose, and neither the nurses or Dr. Ghosh were remotely concerned. The blocks were blamed on me getting up to go to the bathroom or on me bending my arm. My left arm was so swollen and red from heparin that I had tingling in my fingers and couldn’t straighten my arm.

Dr. Gunjanrai, our repeated savior, replaced my IV when she removed Natasha’s sham IV. Problem fixed and perfect flow. No blocks. The only issues that cropped up were, again, process-related. On two occasions later, there was no drip; the nurses wanted to use more Hep-Lock (not a chance), so I used sign language to show they’d forgotten to put an additional needle in the IV bottle to create necessary vacuum and flow.

* On our last morning, we were to have fasting blood draws for follow-up testing. Natasha’s blood was drawn but mine was not. Since Dr. Ghosh had told us the night before we’d both be tested, I asked the sister, who replied with “Not you.” But yes! About 30 minutes after I’d finished breakfast, I was told that I’d have a sample drawn (we also had our temperatures taken right after we’d downed water). “Doesn’t it need to be fasting? Typically 8-12 hours?” No problem, I was assured.

Now, I’m no MD, but I’ve had compared hundreds of my own blood values. Blood readings taken 30 minutes after eating are not the same as from fasting. Not even close.

The End Result

We survived.

Even though I was more coherent than Natasha, I was a mess of delirium. My diarrhea was about three-times worse that hers (by frequency), I vomited more, and there were some episodes I won’t describe here, as they’ll make you nauseous. To maintain hawklike spider-sense while incapacitated, quality-controlling everything to avert disaster, is taxing beyond belief.

No one should have to do it when such simple measures can fix it. All of the above issues can be fixed with proper protocols and checklists. This is not the first time Belle Vue has had serious process screw-ups. Read this appalling news flash of a newborn baby declared dead, only to be later found alive.

But perhaps Belle Vue is too poor to make things work? Not likely, at least not based on my bill.

Cost: about $1,350 USD per person.

Dr. Ghosh’s fee? Almost 50% of each bill. Extortionary. He’s an outstanding ER physician, and he’s saved many people with horrifying injuries and infections. That said, if he’s almost never available to his patients (us in this case) and can’t manage staff to follow his life-saving directions outside of his 7-8pm visits, his expertise does next to nothing. I suspect he’s amazing when on the case 24/7. In our case, it was as if he weren’t there. 50% of the bill is an insult.

Dr. Gunjanrai’s fee? Less than $20. Give that woman a raise. She’s a superstar. I know she doesn’t have Dr. Ghosh’s credentials, but she fixed every problem she encountered, undid the messes created by others, and did it all with a Zen-like calm that made us calm. That’s a good doctor.

P. Tandon, fix your hospital. If you didn’t know already, now you do.

If you choose inaction at this point, you should be charged with premeditated homicide.

Here’s your feedback form:

The Bright Side

Experiencing pain allows you to appreciate pleasure.

Looking at the creature comforts of San Francisco, the world-class medicine I perhaps took for granted, my experience in Calcutta was a useful recalibration.

Getting the Belle Vue treatment is not necessary to increase your appreciation of what you have. This should be a principal goal in life, of course, as gratitude will determine your happiness more than achievement. In fact, Stoic philosopher and master statesman Lucius Seneca encouraged his students to practice poverty for precisely this purpose. From Martin Frost’s excellent introduction:

The second type of apathetic training proposed in the Moral Epistles is practical training, which is essentially a Stoic modification of a common Epicurean practice. In Epistle 18, Seneca informs Lucilius that Epicurus frequently set aside a number of days in which he satisfied his hunger with cheap food. The goal of this exercise apparently was to develop enough self-sufficiency that he would be able to remain happy, regardless of what his circumstances might be. Using this example, Seneca similarly advises Lucilius to practice extreme poverty for limited periods in order to test the ability of his mind to withstand the loss of his wealth in the future.

Although Seneca does not expect this type of practice to go on indefinitely or to be too severe, he makes it clear to Lucilius in Epistle 13 that it should be more than just a “mere hobby” that rich young men might play to “beguile the tedium of their lives.” Even though it is meant to last for only a few days at a time, the method should be harsh enough that it can prepare the subject for the most extreme reversal of fortune—the possibility of utter destitution.

Rehearse worst-case scenarios and they lose their power over you. Practice what you fear and ask all the while: “Is this the condition I so feared?”

You’re more resilient than you think.

Posted on October 2nd, 2011

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277 Comments

John Romaniello — October 2nd, 2011, 10:00 am

Much less scary reading it than seeing it in person. I do love a good rant, Mr. Ferriss. Well done, and so glad you’re feeling better.
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- Geoffrey Levens, L.Ac. — October 14th, 2011, 10:14 am
  
  Wow! I was in India over 20 years ago and was very lucky to only get bacterial dysentery and an American doc there gave me antibiotics and cleared it right up. Still, it took me at least a couple years to get my lower g.i. tract functioning normally again the illness was so violent (blessedly short though!). I had friends there on same trip (a guru chasing bit of foolishness) who were not nearly so lucky. They had experiences much more along the lines of yours (Tim). Some are still dealing w/ health issues resulting either from their treatment in hospitals there or from the nature of the parasitic bugs they acquired in India. Hopefully you dodged all bullets and have escaped only a bit “bloodied but unbowed…”
  Reply
Lauryn Doll — October 2nd, 2011, 10:14 am

Wow, this was a crazy account of serious malpractice.

I’m glad both you and your girlfriend were able to at least make it back to the US and survived this crazy ordeal. 50% for the $1350 hospital bill is ridiculous – I can’t imagine what this translates to in Rupees. It sounds like a deliberately structured fee schedule to induce indentured servitude in patients.

And I’m amused that you “cannot tip” the very doctor who deserves your money.
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Braden Talbot — October 2nd, 2011, 10:16 am

Well that was pretty hardcore.

Good idea for practical poverty over religious poverty.
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John Cortese — October 2nd, 2011, 10:16 am

Wow, scary stuff there… Glad to know you and your girlfriend are well after that experience!
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Laura — October 2nd, 2011, 10:16 am

Jeez, glad you are both OK.
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Brendan Gahan — October 2nd, 2011, 10:17 am

Gnarly. Glad you made it out of there alive Tim.
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Matt — October 2nd, 2011, 10:18 am

Im guessing that tourism India won’t make you an ambassador for travel there, but this needed to be said…It is not intelligence, money or even systems , it is shear laziness and a desire not to get better that is at fault here.
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John Taumoepeau — October 2nd, 2011, 10:21 am

Wow! Unbelievable
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- Maxim — October 2nd, 2011, 12:03 pm
  
  I had a food poisoning just 3 days ago but that one was resolved without hospital visits and in few hours but was very f**ng unpleasant. Could imagine what few days felt like… Good to hear you “survived”.
  
  Might be a good idea to write a post about check-lists for:
  - Dealing with medical doctors (what to check, what to ensure, etc) and
  - Dealing with food poisonings (how to do your best to prevent them, what medicines to have with you and take immediately when you start feeling less than perfect, etc)
  Reply
Dave — October 2nd, 2011, 10:23 am

This story is exactly why I’m hesitant to visit doctors, clinics and hospitals in foreign countries. If you hear of any action taken by the clinic to improve down the road as a result of this post, it’d be great to hear an update.
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mirekburn — October 2nd, 2011, 10:25 am

It’s good you’re alive I believe this is the worst problem with traveling. Sepcially with countires without good medical care. You’ll be suprised that even in EU contries like mine – Poland, stories described by you are also normal….
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Kevin — October 2nd, 2011, 10:27 am

Sorry to hear about your ordeal Tim, but glad to hear you made it out.
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Jared — October 2nd, 2011, 10:27 am

Holy shit! That’s all that comes to mind actually. Verifiably rant-worthy.
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Joan S — October 2nd, 2011, 10:31 am

This sounds like a bad dream. I’m very glad you all survived.
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Yukie — October 2nd, 2011, 10:31 am

I’m glad you and your girlfriend survived this agonizing event at the hospital. Just looking at that picture made me shiver.
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Andrew — October 2nd, 2011, 10:34 am

Are you still in India? I would consider recalling this post until you are out. You never know how politically powerful the head of the hospital is…just sayin. Good luck in any case and I hope you both recover fully.
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Shaun — October 2nd, 2011, 10:35 am

Tim, if you could redo the trip, what what would you do instead? Go to a different hospital to start with?

Glad things “worked out” — thank goodness you both survived. No telling what could have happened if she went through another round of the pain meds.
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- szook — October 3rd, 2011, 8:40 am
  
  My guess, if he had it to do over again….he would just order the rice and dal instead of the fish…….
  Reply
Yoni — October 2nd, 2011, 10:38 am

Glad to hear you are both recovered and well! I suddenly realize how immensely lucky I was when put under general anesthetic (this is after about 4 hours waiting) without my knowing of it (madness when i think of it now!) to relocate my shoulder in some dodgy clinic in Manali India. Sounds like you had a hell of a ride there – and Calcutta is deserving of this review, it seems passing though that place gives you a 50/50 of some dodgy sh*t.

Good thing its all but a memory now & Seneca was around for some good mental support. btw real grateful for having discovered Seneca through your site, massive wisdom!)

Disgrace on the clinic and always good to read your rants or other more hygienic informative posts

Yoni
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Nathan Schmitt — October 2nd, 2011, 10:38 am

Tim,

Could you post your travel checklist? I’m going to be traveling around the world for 6 months and have little experience–I’m trying to plan to be as safe as possible. Thanks!
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Nate Green — October 2nd, 2011, 10:43 am

Dude, that sounds WAY worse than you conveyed in the emails. That’s some stoicism in action right there.

Glad you and your girl are doing better.
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Alastair — October 2nd, 2011, 10:45 am

Glad you guys are ok now.

What scares me is you’re pretty knowledgeable in the treatment you were receiving, but the average traveller probably wouldn’t spot half of these errors, and it might have gone horribly wrong. I’ve travelled a lot also and like to think even in places like Calcutta, surely you’re not going to be killed by a hospital.

Do you think you were particularly unlucky checking into this particular hospital? And what would you do differently next time — for example getting reviews for hospitals in every major city you visit seems a bit over the top, but perhaps it’s not?
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Dunn — October 2nd, 2011, 10:48 am

Most of us don’t have your medical knowledge and few have the wherewithal to challenge the actions of the staff. I wondered if a less informed person would have died.
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Woody — October 2nd, 2011, 10:50 am

Perfect example of ,under probable cause, questioning the tactics,procedures,and logic of the God complex that many physicians are susceptible to indulge in. Always respect, but always question.
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Anouar — October 2nd, 2011, 10:50 am

This is some serious sh*t
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Mark Turner — October 2nd, 2011, 10:54 am

Comedy of errors indeed. Roman summed it up quite succinctly, much less scary reading it now, extremely shocking at the time

Very glad everyone now much better
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- Tim Ferriss — October 2nd, 2011, 12:23 pm
  
  Thanks to you and Roman for being so awesomely supportive. It was certainly a shocker. Live and learn!
  
  Hope to share a pint in the UK soon,
  
  Tim
  Reply
  - Krupa.David — October 3rd, 2011, 1:39 am
    
    Dear Tim,
    
    Dam’n sorry to hear of your ordeal.I am from Calcutta and am a member of ‘Tollygrunge” club and I agree the food if often suspect.There are world class hospitals in Calcutta if you were staying at the Grand they should have advised you correctly.Bellevue used to be good at one time.If you want these m..f..rs fixed send me a full written report NOT by email but courier.I will see that some asses get kicked!
    Krupa David
    Goodricke Group Limited
    14,Gurusaday Rd, Kolkata 700019
    
    P.S I got this link from my son in law Jake Townsend ,CA
    Reply
- Camille — October 3rd, 2011, 7:52 am
  
  Certainly have to echo Mark & Roman – it was a hard time that reads a lot easier than it was to experience. Glad both of you are feeling significantly better and recovering.
  Reply
  - Chris — October 7th, 2011, 7:36 pm
    
    I guess I can’t really complain about the healthcare we receive. Glad to hear you and Natasha survived. That story pisses me off. Wish all those sisters would get fired. F*** them!
    Reply
Sakira — October 2nd, 2011, 10:55 am

Mazal F&^%ing Tov for having a Girl!!!! Kulululululululululululu

Thanks for doing this, you are saving life!

Good to hear you guys are safe n sound.
Reply
Graeme — October 2nd, 2011, 10:59 am

That’s terrible, glad you made it through alright.

I’m continually amazed at how many people will tolerate bad processes that actually make them WORSE off. I can’t imagine constant complaints are fun/cheap to deal with. It sounds as though the fixes aren’t expensive.
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Brian — October 2nd, 2011, 11:04 am

Geez, I would have gone ape sh-t on the water butt method alone. No amount of “fussy” is enough in that instance.
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Mark McGookin — October 2nd, 2011, 11:09 am

Sounds like a nightmare Tim. Glad you’re safe and well anyway!

Sounds like the pair of you need some much deserved time off to recoup. Did they serve slow carb meals in the hospital lol?

Take care.
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Todd Dosenberry — October 2nd, 2011, 11:12 am

Absolutely ridiculous. Glad you both survived! If that was me in that situation I am not sure if I would have survived. It pays to know a little bit in the medical world!
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Ariel — October 2nd, 2011, 11:28 am

Hi Tim, Have you read Shantaram? Maybe you should for perspective on India. It is very common for us frequent travelers to forget to take essentials like I did when not packing a first aid kit for a trip to Laos then stepping on broken glass that tore through my flip flop into my foot. Luckily the corner shop had all I needed to fix it (amazing what a little blood can do to get you what you need even if they don’t speak English). The next day at the hospital was a similar experience to the chaos you may have encountered in India, mainly lack of hygiene and privacy. I guess sometimes it’s part of the trip. Get well wishes to you both.
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Alex — October 2nd, 2011, 11:35 am

Glad you and Natasha are OK, must have been a terrifying few days. Like Dave, I’d be hesitant to visit a hospital in a foreign country, which raises a question: Based on your prior travel experience, had you contacted the U.S. embassy or consulate, do you think you could have found a hospital that met your criteria and expectations? Or is it more that you’d be choosing the best of a few bad options?
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Joao Eira — October 2nd, 2011, 11:47 am

What the f*ck, that’s scary.

While reading your account of what happened, I kept wondering whether anyone less knowledgeable, and without their own Dr. Gunjanrai, would came out of that place alive.

Glad every thing turn out alright, I don’t have any medical background but I would guess Natasha’s sham is mostly harmless and will eventually go away without permanent effects right?
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wesvista — October 2nd, 2011, 11:49 am

is this the infamous Dr. Chatterjee, http://www.isical.ac.in/~samrat_r/?
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- Andybee — November 26th, 2011, 7:19 am
  
  Unlikely (after having checked his CV in pdf format available on that page). The one you linked to is a doctor in Mathematics, not medicine.
  I guess the surname could be a popular one in the area of Calcutta, in which case it would be simply be incidental name sharing.
  Reply
Christy — October 2nd, 2011, 11:51 am

Thank you for sharing, and bringing us back to the “worst-case-scenario ” lesson. I just practiced this for a month (not intentionally) and know it will make you a kinder gentler person:Humble.
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Vic Dorfman — October 2nd, 2011, 11:52 am

“More water-butt cleaning, please.” LOL

Methinks you should vent more often Tim – it’s worth the quips, alone

On a more serious note, I’m glad ya’ll made it out alive and I’m sure a few days of leaning and loafing at your ease about your SF home felt amazing after that nightmare!

I’d like to share an interesting anecdote with you and the other commenters, as both my grandfather and grandmother were doctors in Kiev, Ukraine during the Soviet era. She – a head anesthesiologist, and he was a surgeon and oncology specialist.

A common practice at that time, which evolved out of the “normalization” of wages (e.g. doctors getting paid as much as steel workers), was clandestinely tipping particularly capable doctors for their services and endeavoring to engage them on behalf of friends and family with life-threatening conditions and sometimes not-so life-threatening conditions that could easily have evolved into something serious if left untreated.

Granny Dorfman, with a strange moral compass that HAD to have been built in the USSR, refused any such “bribes”, as she viewed them, and forbade my grandfather from accepting them, either.

After a lifetime of working for next to nothing and after splitting up with my grandma, grandpa Dorfman began accepting moneys for his services and ran what was, in effect, a profitable, if illegal, private practice.

I propose that Belle Vue and hospitals with similar “no tipping” policies are doing their doctors and their patients a tremendous misdeed by not allowing patients to help enrich the doctors who deserve it, help weed out the incompetents, and help motivate the apathetics with an exchange of value deserving of the killingly hard training and schooling that every doctor has to go through in order to save our fish-eating asses when things go sour.

Would love to hear ya’ll’s’ thoughts on the matter! :p

Best Wishes,
Vic Dorfman
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Jason Wagner — October 2nd, 2011, 12:00 pm

I’m glad to hear that you made it out alive. A friend of mine passed on September 19 while traveling in New Delhi.
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- PC — October 14th, 2011, 3:35 pm
  
  Sorry for the loss of your friend, Jason.
  Reply
Brad — October 2nd, 2011, 12:01 pm

That is some scary, scary stuff. It is one thing to go through something like that alone, but when you have to watch someone you care about go through the same thing (or worse), I’m sure it tears you up.

Is there anything you need people to do to enact change in this “hospital”? If so, just say it and I’m sure you could get some attention.

All the best!
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Neha — October 2nd, 2011, 12:03 pm

I’m so sorry you had to go through that.

I’m from India. I left the country five years ago and I hope I never have to go back and live there. Doctors don’t really give a shit about you and there’s not much you can do about it. I very much doubt they’ll ever respond to this post either. If they do, please let us know!

And it’s not just “foreigners”, they treat everyone like this.

The only exceptions are if you’re a relative, a friend or have a contact who knows them on a friendly basis, they’ll treat you like royalty. If you ever decide to go back, perhaps find someone who lives in the city you’re going to, become friends with them and keep them as your point of contact for situations like this.

Glad you’re both ok! Take care.
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- Aman — November 3rd, 2011, 4:24 am
  
  Neha, I’m from India and i still live here. I know that Tim had a really bad experience with this hospital, but that is not the rule for all hospitals. In all cities there are many shammy hospitals and clinics. Tim was unlucky in picking the wrong hospital. Calcutta is one of the less clean places in India (from what i’ve heard…i have relatives there), but i’m sure they have some world class hospitals. This particular one seems like the bottom of the pit.
  
  I live in Delhi and have all my life…and i can assure you all that there are wonderful doctors in India here who will go out of the way for a patient. Some even treat you like first family. India has become a destination for world class health care in the past few years and there are wonderful places to get treated here.
  
  Tim, I’m a big fan! Sorry about the ordeal you had to face. Promise me you’ll go to a better place next time. It was agonising for me to read about the way you were treated. TC Tim and Neha.
  Reply
ElleX — October 2nd, 2011, 12:03 pm

Your ordeal was scary. So thankful you and Natasha are back home.
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Dave — October 2nd, 2011, 12:10 pm

Great rant Tim and good to know you made it out alive.

Got to say I feel a little bad that I enjoyed reading this so much… All the health for you and your girlfriend.
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Chad H — October 2nd, 2011, 12:11 pm

Tim, great to hear you and Natasha survived.

It’s a mixed bag though. Upon initial visit to the Ampang Puteri in KL, my dad’s Doctor diagnosed his badly bleeding ulcer and later stomach cancer.

Something they missed in Canada for 2 years.

But more along the lines of what you experienced, myself and about 8 other foreigners were fighting in a “Draka” event in Siberia one time.

One of my comrades suffered a brutal knockout at the hands of his Russian opponent. At the after party, as the promoters were toasting our bravery to step in the ring with the Russian behemoths, my buddy was speaking gibberish, completely unaware of where he was and what he was doing.

So we figured we’d take him to the local Khabarovsk hospital.

The doctor, who reminded us greatly of Dr. Nick from the Simpsons, agrees we should scan his brain.

He finally shows us the X-Ray and says everything is good… lol, good to know his skull was still intact
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- Tim Ferriss — October 2nd, 2011, 12:26 pm
  
  Chad, good point. There are good and bad doctors everywhere. Since that’s the case, it’s all the more important to have good processes in place that prevent the less-capable MDs from screwing up.
  
  Head trauma is scary, and Draka is no joke.
  
  Tim
  Reply
  - Chad H — October 2nd, 2011, 1:11 pm
    
    It’s interesting, you see it here even. The nurses trained me on administering TPN to my dad, I had to be “extremely careful” to keep things sterile. However, observing the nurses doing the same procedure, they rushed through things far more than they should of.
    
    Maybe this is all just a matter of complacency. “Well, we haven’t killed THAT many people.”
    
    I agree with you on having processes in place, but heaven forbid wouldn’t that mean someone is accountable then?!
    Reply
  - steve ward — October 4th, 2011, 4:57 pm
    
    Tim you should hire Dr. Gunjanrai’s for something and get her out of that hell hole of a hospital
    Reply
  - John Fawkes — October 10th, 2011, 3:25 pm
    
    Tim doesn’t have to hire her for anything. The praise he gave her here is practically guaranteed to get her hired away by another hospital, for more money. Sometimes positivity is the best revenge. Best part of this whole story, IMO.
    Reply
Lau — October 2nd, 2011, 12:23 pm

I’m half Indian and have visited Kolkata many times as it’s where my family is from – every other time I do get something mild and I have had it as bad as you once or twice in the past (notably when I was a child.) Kolkata in general is a way behind other Indian cities in most ways mainly due to the repressive policies of the previous communist government (which have recently been voted out for the first time in more than 30 years so hopefully things should start improving soon.) It is ESSENTIAL in Cal to have a friendly doctor who can take care of you without having to rely on the health system if necessary – obviously not useful advice now but helps explain why it still remains one of the toughest places for travelers who can’t take advantage of a support network. I hope you still got something from your trip and hope one day you’ll have a better time in Cal
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Morten — October 2nd, 2011, 12:23 pm

Terrible story. This is the nightmare I always picture takes place in foreign hospitals.

I hope they didn’t inject any germs or viruses into your body which you eventually discover when your arm in a year or so suddenly falls off.

Lets hope for the best!
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Raj — October 2nd, 2011, 12:25 pm

When in India stay vegetarian and drink only bottled water (always check the seal). Seafood might me ok too but is not completely safe.

When I got sick I went to Apollo hospital which is generally considered one of the best in India. I had a similar experience to you and flew out to Singapore to get treated there.

I hope you get better soon.
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Jake — October 2nd, 2011, 12:33 pm

As an Indian raised in the US with experience in both health systems, it’s episodes like these that make me grateful for the quality of care we receive and provide here.

In India, if you don’t have relatives who are doctors, you’re f***ed. And we still blame Indian parents for wanting to make their kids doctors… look at it from their shoes.
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Dingo_Pug — October 2nd, 2011, 12:46 pm

I would like to hear more Ferriss rants in the future – this was interesting reading – although very unfortunate that it had to be said. I would add to the comments about your knowledge and assertiveness – the really scary situation is that the vast majority of people would not (or could not) second guess this dangerous treatment. There was a good episode of “ER” that went over the importance of checklists. It keeps ordinarily good people who have perhaps grown complacent or egotistic from doing really stupid things with real consequences.

BTW – loved your spots on the Carolla and Rogan podcasts – you should do those more often
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David — October 2nd, 2011, 12:49 pm

Wow, crazy stuff Tim. I wonder how this story would have ended for somebody who’s much less knowledgeable when it comes to medical treatment… :/

By the way: how are your plantar fasciitis and ultra running plans going? In Berlin you planned to get this done by end of this year

Regards from Greece,
David
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Gregg — October 2nd, 2011, 12:50 pm

Wish I could say I’m surprised but based on my travels there, I’d call India the nation of Tijuana. The knee jerk response to any inquiry or issue raised by a Westerner is “No problem,” bullshitting their way through the moment.
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David Hawkins — October 2nd, 2011, 1:04 pm

Glad you and Natasha are on the mend.

Aside from process issues the other one is perhaps an issue of attitude on their part, and that’s deeply seated in culture.

Stay hungry, stay foolish Tim!
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Amir — October 2nd, 2011, 1:08 pm

Hi Tim,

Looong time reader but first time commenter. It’s 4am here, and I just spent the last 2 hours or so catching up on your recent content. Then I found this:

“For the rest of the night, as my friends fed me shots, I thought back to 2007, when The 4-Hour Workweek was turned down by 26 out of 27 publishers.”

As an activist, digital entrepreneur and aspiring writer with a good NYC agent but who’s still struggling to find a good publisher and who sometimes gets frustrated after 3 years of trying, despairing and nearly giving up, and now finally being so close, I’d like to say, THANK YOU.

Thank you for the 4HWW which made me dramatically change my career path towards something MUCH better aka the New Rich. Thank you for all the tips you share on this blog and insights that have inspired me and kept me inspired for a long time. And thank you for just reminding me that with patience and perseverance great things can be achieved, even if the publishing industry is in a crappy state now.

Seriously, thank you dude.
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Amir — October 2nd, 2011, 1:12 pm

And damn, my bad, I just finished reading this post. Sucky that you had this bad experience. Good to know you’re fine.
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Arti — October 2nd, 2011, 1:28 pm

Tim,

Sounds like you guys had several close calls there – glad you are both safe.

Disclaimer before I say this next piece: I have never had a hospitalization in India, but I grew up in India up to adulthood, have several relatives there, and have had experience dealing with doctors who were caring for my grandparents.

I don’t know if your rant will have the consequence you are hoping for.

First problem, Indian doctors have major god-complexes. Indians deify them, consider it a blessing that a doctor even agreed to admit them to the hospital / see them / cure them etc, and consider it their duty to never question the doctor since the doctor knows best. If the someone dies in the hospital, this was because God works in mysterious ways, and the doctor couldn’t have done anything anyway.

Second problem, the legal system in India isn’t set up to prosecute medical malpractice with any level of efficiency. So what if this doctor almost killed you – who is there to hold him accountable for it?

Third problem, you went to a hospital without getting a referral, and you actually expected their marketing materials to be true. Enough said. We Indians know better than to do that. Granted you weren’t in any state to be conducting meticulous research and you admitted that you forgot to do prior research, but us Indians remedy that by having scores of relatives who all step in to do this research.

Fourth problem, Dr. Tandon is not going to care about your post because few people in India ever think to Google the hospital they are going to. Expats might, but they’re a small percentage, and Internet is difficult to access, as you well know. His marketing sounds just slick enough to get those who think that someone charging this high must actually be good (That’s a self-regulating-market type of thinking. Doesn’t always work in India).

One of your other commenters mentioned that he had a bad experience in Apollo hospital. I know of the hospital, and I’m mildly surprised, but not really shocked. In my experience, the ONLY way of getting 100% awesome care in even the best Indian hospital, is to be a direct or indirect sort of stakeholder in the hospital (know the wife of the managing director/CEO personally, be recommended by an important businessman / politician / actor / VVIP).

What happened to you and your girlfriend is terrible, and I genuinely hope your post serves its purpose and pushes Dr. Tandon and his hospital to develop better procedures and checklists. Reality? I’m not so optimistic.
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Allen — October 2nd, 2011, 1:33 pm

I’ve had food poisoning twice on the road. Nothing is worse.

The only preventative measure I’ve come up with is to be unreasonably anal about sanitation. Don’t drink out of glassware or coffee machines in hotels especially.

Also go to the ER early. I’ve made the mistake of waiting till the morning. This only prolongs the torture.

I keep antidiareals in my first aid kit, along with a couple Gatorade packets. In a remote location this may get you back to civilization.
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Mike — October 2nd, 2011, 1:47 pm

This episode also serves as a reminder that in much of the world Doctors are still considered gods, and beyond reproach. This mindset encourages patients to surrender control of their care, and for the doctors, well, they simply want to maintain the status quo. For someone less knowledgeable and with less of a forceful personality, this episode could have ended in disaster.
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AMB — October 2nd, 2011, 2:03 pm

What a horrendous experience for you both, I am relieved that you are now back in good health.
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Lazynerd — October 2nd, 2011, 2:30 pm

Hope you are all feeling better now

I normally don’t eat seafood if I don’t think its fresh so I think it could be the culprit but what do you attribute the food poisoning/ilness to?

Also do you think it could have been easily prevented as I want to visit India some time in the future…

That’s all I just hope all the people that survived this experience are now recovered emotionally
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Alex Lickerman, M.D. — October 2nd, 2011, 2:47 pm

Tim,
So glad to hear you survived. And glad to see you promoting Atul Gawande’s idea about checklists (we talked about them and his work, I think, at “Hogwarts”). Though the care you and Natasha received was certainly egregious, mistakes that arise from lack of concern on the part of caregivers do indeed occur everywhere, even at bastions of care like American academic medical centers where I work.

Much has been written about the kinds of thought errors doctors commit that harm patients but for anyone interested, my two cents about why those thought errors occur and what patients can do to ensure their doctors don’t commit them can be found by clicking the following link (don’t know if you permit links in comments, but I mean this to be helpful):

http://www.happinessinthisworld.com/2009/04/26/when-doctors-dont-know-whats-wrong/
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Dip — October 2nd, 2011, 3:08 pm

It’s good to hear that you’re better. I would follow up on this as nowadays if someone is running any kind of medical facility they really should be striving for excellence, and responding to feedback. Anything less is a dis-service to everybody passing through their doors. And that’s not even considering the people that are less fortunate and can’t afford top notch health care.
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Dan — October 2nd, 2011, 3:10 pm

No on can say you dont suffer for your art Tim. Im living the dream in the Philippines, being very careful, still get a lot of bugs but never full on sickness like this.
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Keith — October 2nd, 2011, 3:12 pm

I give you a 6 on the rant, not enough F-bombs or profanity in general. You never questioned their sobriety or even cast aspersions on their parentage, try harder next time will ya?

Seriously, glad yer home safe and sound!
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Keith — October 2nd, 2011, 3:25 pm

OBTW, forgot to share a good story of crap medical care in Baja.
While in the midst of destroying a perfectly good motorcycle 100km north of Cabo, I found myself with a stick stuck in my stomach, (say it three times fast)
The darling new Grad from Tijuanas finest Medical shchool. (Hi Dr. Vicki!) managed to stitch me up with two 1″ pieces of wood still inside me. All done while her capable assistant attended with a boogery nosed baby on her hip.

Yay for third world medicine! Gotta love a good adventure!
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- Phil Smith — October 13th, 2011, 12:08 am
  
  Dude, write the story. Sounds like a cracker. I would be very interested as a rider.
  Regards,
  Phil.
  Reply
Tristan — October 2nd, 2011, 3:40 pm

Shocking story, Tim. Glad to hear you guys came out ok. Vent away.
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Janin — October 2nd, 2011, 4:08 pm

Sounds like you were lucky to make it out alive! My brother has some crazy stories about his time in a hospital in India many years ago. His are more funny than life threatening, however.

My experiences in even U.S. hospitals convinced me that one needs a personal advocate in any hospital.

Checklists work but if the people don’t care or won’t follow them, you have different problem.

I am impressed that you could focus enough to advocate for both of you.
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Chase — October 2nd, 2011, 4:24 pm

Natasha, huh? *Ghetto accent* I see ya boy!
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Steven L — October 2nd, 2011, 4:46 pm

Jeez Tim, that sounds like a nightmare. I’m glad your OK!

In happier news:

I subscribe to the Cal Berkeley Wellness letter. Did you know that you have been mentioned on the front page in no fewer than TWO letters in the past few months? In the most recent issue they even stole your headline “Forbidden Fruit.” They also refer to you as “Lifestyle Guru Tim Ferriss.” Try not to let it go to your head! haha
=)
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Lazynerd — October 2nd, 2011, 4:50 pm

my avatar isn’t showing my pitcure anybody know why?
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Lazynerd — October 2nd, 2011, 4:54 pm

Never mind guys and girls just ignore me hahaha

does anyone have any similar experiences to tim and his gang?

I always get food posisoning when I go to Egypt especially cairo but last time I went I didn’t eat dairy or wheat and fortunately I didn’t get sick
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Will Regla — October 2nd, 2011, 5:16 pm

Tim, reading about your experience, I feel compelled to share a link for Responsible Charity, a secular charity operating in Kolkatta. Our founder, Hemley, experienced conditions much like yours and worse while working with Mother Theresa’s Sisters of Charity. In response, his non-profit now works hands-on with some of India’s neediest families, providing food, medicine and educational opportunities. It’s really worth a look! http://www.facebook.com/responsiblecharity
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Graham — October 2nd, 2011, 5:19 pm

Belle Vue just made my checklist of places to avoid…
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Raghu — October 2nd, 2011, 5:20 pm

Tim, I’m glad you and your girlfriend have recovered well and are now fine. The situation you described is very serious and I’m sure that the actual experience must have felt even more nightmarish than what you have expressed.

The details in the post upset me. I grew up in India, studied pre-med before I changed my mind about becoming a doctor (one of my better decisions). Since the issue involves the quality of medical care in my country, I would like to offer my perspective here.

1. India has cutting-edge medical infrastructure that is comparable to western standards and generally, money (still cheap by western standards) can buy top-notch healthcare services. However, this does not guarantee that the doctors providing these services will also be equally dependable.

2. The most significant factor in an experience at an Indian hospital (as in a hospital anywhere else) is the doctor overseeing your care. There is remarkable medical talent in India. I have met and spoken to doctors whose medical knowledge would place them among the world’s best. Unfortunately, there are also a lot of doctors that do not deserve to enter a parking lot of a hospital. The good ones may not answer every one of your questions (see #3 below), may not have the finest language skills, may not be overflowing with courtesy (there are cultural aspects at play here), but they will always give a satisfactory medical explanation of what they are doing. If they offer anything less than that, walk away (unless it is an emergency). A doctor who cannot make you feel comfortable about the medical rationale of his actions should not get to treat you. This is my general advice when seeking medical care in India (and perhaps, at other places too). There are a lot of good doctors in India and you should not suffer a bad one just because you are in a foreign country. I understand that this particular institution in question proclaims to be a premier institution but such a title means nothing if you are assigned a crappy doctor who cannot give proper instructions to his support staff.
3. Being a doctor is the most venerable professions in India. A lot of people in India look up to their doctors as demi-gods possessing ‘superhuman’ ability to save lives. While this is changing with the new generation, the concept of two-way information exchange between patients and doctors is not welcome in India. Usually, the doctor prescribes and patient follows. A patient is not expected to question a doctor’s expertise. In fact, doing so would be equivalent to an insult to the doctor’s knowledge. As an example, for certain high-risk drugs in the US, the FDA insists that the physician should thoroughly discuss the benefit-risk of taking the drug with the patients and make a joint decision with the patient about prescribing. Such a concept is hard to find in a society like India where there is a perceived inequality in knowledge between a doctor and a patient. Therefore, I can see how a “western tourist’s” suggestions questioning an Indian doctor’s medical judgment (and their “unreasonable demands for luxuries like toilet paper”) would have been ignored/dismissed due to cultural biases. All I can say is, in such a situation, go with your instincts: if you feel something is clearly wrong and doctor cannot satisfactorily explain his actions, walk away.

Again, I am not trying to justify anything. This was clearly an emergency situation, so there was not a lot of time to window-shop for doctors and you did everything that seemed right at that time. However, while not intentional, it seems like the issue is being generalized to some version of the following; “medical care in developing countries is not as high quality as in some of the western countries.” I just want to emphasize that this one incident, while unforgivable, should not used for such a generalization. It is a case of a few rotten apples in a bunch, and not of a rotten bunch.
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K.o.T — October 2nd, 2011, 5:51 pm

Note: Skip India!

After a couple of years in Thailand, I cringe every time I hear, “Hello my friend, suit for you…”
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Delbert — October 2nd, 2011, 6:03 pm

It’s gonna be interesting to see how Belle Vue, and especially Chatterjee, responds to this.
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Brian A — October 2nd, 2011, 6:14 pm

Tim, Certainly an interesting post. Clearly one knowledgable about travel to foreign lands where GI bugs are prevalent should carry prophylactic antibiotics. A few doses of cipro could have possibly prevented your trip to the hospital in the first place. Don’t get me wrong antibiotics have their own problems like antibiotic associated diarrhea and C. diff infection but the benefits clearly negate the risk when heading to somewhere like India.

Also, interesting enough it is common place to administer large doses of IV heparin to patients with blood clots and the like. A tiny volume of heparin is used for a hep lock and even in the states we do not worry about having an overdose with a hep lock.

Axillary temperatures are BS. Core body temperature measurements- like oral temp and rectal temps- are really what docs order to document fever. Even temporal temperature scanners are unreliable when it matters.

Suggestion why not carry cipro and learn how to start your own IV just to be a bad ass? IV fluids are great for hang overs too by the way.

Hope this helps.
- your local (exhausted) ER doc
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Avi Solomon — October 2nd, 2011, 6:54 pm

Am glad you and Natasha are alive! The nightmare scenario you describe is all too familiar to me (having lived in India for 19 years) and your systemic alertness paid off in averting truly disastrous results.
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David — October 2nd, 2011, 7:07 pm

Hi, Tim.

For a guy who has written a health book, you get into a lot of medical misadventures. Let’s see. Injuries, surgeries, quite a few temporary illnesses, blood drawings, biopsies, and so on according the 4 hour body and this blog. (sounds almost medieval) of course, you did say in your book that medical science is kind of your thing.

One thing that is pretty scary about your post/rant/story is that a normal person doesn’t even stand a chance. Of course, you, tim ferriss, have the medical knowledge to spot mistakes and make corrections, Plus the confidence to stop a medical professional to voice your opinion. But how would a person without any medical knowledge fare in that situation? I don’t know the first thing about properly hooking up an Iv or If Heparin/Drotin is correct/incorrect as a treatment for food poisoning. It is a scary thought.

I think we are living in a world where one has to be his or her own advocate in all areas. (Medical, financial, nutritional, and so on) It is quite the burden to have to all the research on all of these areas by yourself.
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Shalini — October 2nd, 2011, 7:10 pm

I am from Calcutta and horrified at what you have gone through.. Belle vue is horrible…I wish you had been directed elsewhere. Woodlands hospital is where you should have been sent if you had better connections or information. I have treated there and your experience would have been different. Everybody gets delhi belly who visits India so you need to come prepared. In fact, if you plan to visit there again, email me and we can provide better information. We have had good experiences at the tollygunge club so it could have been a number of factors that led to you getting a bug. My father is now going to try the 4 hour diet.
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- Jitu — October 4th, 2011, 7:08 am
  
  Me too … I have dined at the Belvedere at Tolly and never had trouble!
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Chuck — October 2nd, 2011, 7:15 pm

Great illustration how primitive, 3rd-world medical practices facilitate the spread of such problems as NDM-1, a gene conferring high levels of resistance to almost all antibiotics to nearly any bacteria- and it is moving primarily from India to the West . There’s a reason this crap comes from India. I’m surprised they didn’t use leaches.
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Mike — October 2nd, 2011, 8:02 pm

Glad to hear you made it out alive. I had an almost opposite experience in Mexico when I went to the ER after a knife accident in our hotel. Hospital was in a sketchy area of Cabo San Lucas, but the doctor, staff, building, and medication was top notch.

Great suggestion on writing down doctors’ names. I will take heed to this advice and begin doing so if I need to see a doctor who is not my physician.

Keep up the outstanding work you do on this blog, your books, and videos.

Thanks.
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tim slechta — October 2nd, 2011, 8:11 pm

Damn Tim. Glad your ok! We need you to finish the new book for us.

Also, it surprises me that, despite the ridiculous experience you went through, your comment card was still fairly considerate. I would have expected something meaner. Be meaner next time.

Tim
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kris — October 2nd, 2011, 8:27 pm

Sorry you had to deal with so much crap. At least it did not hit the fan literarily. On the bright side, you and Natasha have something negative to bond over.

K
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Jeff Nabers — October 2nd, 2011, 9:05 pm

Wow.

My friend’s Dad went through a similar experience last month and almost died several times at a hospital in… LOS ANGELES.

His wife was a doctor and was able to jump in and stop some of the process mistakes from killing him, but governments’ licensure scheme doesn’t magically remove the need for one to research and find good service providers.

It’s funny that the last post mentioned credentials, gave the normal caveat disclaimer for licensure schemes like in medicine and law, and yet we see these real world examples that, in some cases, oligopolist licensure programs are no less valuable to society than other kinds of credentials.
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- Jarryd Nolen — October 4th, 2011, 7:59 pm
  
  Jeff,
  Brad Hallonquist’s cousin Jarryd here in Austin, Tx. Recognized the name figured I’d say hello. You a fan of the 4 Hour Work Week?
  Reply
Zita — October 2nd, 2011, 9:39 pm

Tim,
I am an Indian based in New Delhi.
First, I would, as an Indian citizen, like to apologize for the harrowing experience that you went through with respect to medical treatment in Kolkata. Hope that both of you are well-recovered now.
True, the medical practice here is more of a commercial venture than a noble calling. True, most highly-qualified doctors are more brusque than compassionate. True yet again, the level of hygiene in Indian hospitals is not comparable to that in the US.
And an absolute fact : your ‘rant’, as you call it, will NOT have even a passing effect on the perpetrators of the medical malpractice !

Yet :
- in a country of about one billion people, teeming with pathogens, food poisoning is a relatively minor ailment, and was probably considered such in your case ! the Indian physical constitution is probably inured to quite a few pathogens (comes with living in a tropical country !) and most people get well after self-medication with OTC meds !

- culturally, doctors are revered as Demi-gods, and whatever they utter is considered as the word of law. Many unscrupulous men take advantage of this fact to serve their own ends, rather than the patients. (you are lucky that you are medically-conversant. Most medical-speak is Greek and Latin to me ! I would probably blindly follow whatever the doctor asks me to do.)

- dedicated and competent medical professionals DO exist ! ( you met one of them – Dr. Gunjanrai ) But, a majority of doctors do their best to vilify the profession !

- there ARE good hospitals/clinics, where proper and comprehensive medical care is provided. Unfortunately, you landed up in one of the many that was not !
Always, always, always visit a corporate healthcare provider; rather than a shady back alley ‘clinic’, unless you have a referral.

I have been extremely lucky in avoiding doctors (and nurses) of the kind you happened to encounter. And I am still hale and hearty, inspite of (pretty) frequent visits to the doctor !
Hope this one incident doesn’t turn you off visiting India and enjoying Indian food and culture. Next time, just be prepared !!
Cheers !!
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kim — October 2nd, 2011, 10:11 pm

I’ve traveled to over 100 countries. My worst fear is to end up in a hospital overseas. I just got back from Shanghai and Vietnam. 16 days straight of diarrhea is nothing new and doesn’t bother me if there’s no pain involve. I don’t mind the colon cleanse. I’ve been blessed to have traveled so much and not end up with serious food poisoning requiring hospitalization. Reading your rant makes everyone appreciate how orderly and cautious doctors are here. Imagine the locals and what they have to put up daily. I’m saving India last because I’m too chicken to go now.
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Abhijit Bera — October 2nd, 2011, 11:11 pm

Really Tim, do your research next time. Belle Vue clinic? You should have called the American consulate in Kolkata for advice.
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Allain — October 3rd, 2011, 12:18 am

This kind of situation is not new to me. I heard a lot of bad stories about doctors who only want to earn. Especially doctors who are also shareholders or board member of the Hospital. They will give you a lot of crazy stuffs then charge you with a whooping amount. It’s a shame that these hospitals are the ones that are considered the best and advanced. Crazy.

Anyway, Im glad my idol is doing well. Cheers
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David Kurkov — October 3rd, 2011, 1:30 am

WOW! That is probably the WORST hospital experience I ever heard of! I’m really glad you and Natasha are doing better.

I really hope your post changes the hospital’s procedures there and in other places.

Do you have any recommendations (ie books, articles, or links) about health related traveling information? Like, do/get this, don’t do/get this?
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Dan — October 3rd, 2011, 1:38 am

I am surprised that you didn’t just walked out and took a cab to another place.
Seems like there was a greater chance they could do harm than good. Where you never considering this?
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Somraj — October 3rd, 2011, 2:17 am

Hi Tim,
I am an avid reader of your blog and also a fan
Glad you made it out of the predicament.
I am from Kolkata although living out of Mumbai for over a decade
I come from a family of doctors and closely associated with Belle Vue. I lost my father last year and I have smelled the shit first hand. The health care system in kolkata sucks! Its a mad and pathetically managed state.
You are correct in pointing out the state of health care affairs there in that state. The primary reason being a lacklustre state goverment punished under a pseudo communist regime. The communists have been kicked out this election after 33 years of corruption and exploitation.
I am really sorry for your and Nat’s experience over there and its an eye opener. But now with the communists gone things should look better. But this doesnt reflect the general state of affairs though. In Mumbai where I stay we have world class private hospitals. Next time you drop into mumbai please be my guest…I would glad to extend all possible assitance…..keep up the good work…..trust with your scathing attack Belle Vue pulls up some dirty socks.
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Tom — October 3rd, 2011, 2:25 am

I’ve backpacked around India for maybe a year total, and I’ve been sick there. The general idea is don’t go to a hospital if you can at all avoid it. 1000 stories I’ve heard beat it into me: there’s a potential huge downside of hospital visits in the developing world (and as previously stated here, the ‘developed’ world too btw), especially if you are incapacitated. I know I’m not as tough as Tim Ferriss so running a 102 temp I probably would have gone despite my resistance to the idea, esp if my partner was sick too and couldn’t care for me.

I live in Bali now; Indonesia might be a little better than India, though we have a good clinic here (BIMC). Singapore excellent, Malaysia very good, Bumrungrad in Bangkok better than any other hospital I’ve ever seen worldwide….

I’m glad you and your girlfriend made it through the ordeal Tim. Doctors doing their best without having much to work with is tragic but understandable, negligence as you describe is absolutely criminal. I’ve seen it and I’ve also screamed at people….
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Fabien — October 3rd, 2011, 3:30 am

Well I am absolutely not surprised by this post.

I went for 6 weeks in India last year as a mini retirement. And me and my partner went through exactly the same problems : in 6 weeks of trip, I spent in total 10 days at the hospital, in 3 different hospitals : Apollo in Goa, a small privately run clinic in Pondicherry and the American Hospital in Udaipur.

Each time I went, it was for different symptoms and bacterias, that could potentially kill me. I traveled to many countries before and was sometimes mildly sick, but never as bad as it was in India : there is defintely some hygiene problem in India.

Then about the hospital, I really understand your story, as I lived almost the same thing in Goa and in Udaipur : people who have no process, arrogant doctors who completely ignores you, nurses who don’t give a shit and who don’t know what to do or are being rude with you… and all of that for a very very high price (even if you have travel insurance). Strangely the hospital I went to in Pondicherry was the smallest one but the conditions were ok and the staff was more helpful.

I am anyways glad that you are now feeling better, you and your girlfriend.

Regards,
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Dan Morell — October 3rd, 2011, 3:37 am

Fucking hell Tim! Glad you are alive to tell the story.

My experience from a lifetime of hospital admissions is that in all hospital situations you need to keep your wits about you or have an advocate ensuring the ‘professionals’ are doing their job properly. Protocols are only as good as those following them. Hospital can be a VERY dangerous place. The lesson is taking responsibility for yourself at all times, in all situations…personal protocols and standards is what caused you to get through this episode alive and without exageration save your girlfriends’ life. If this had been your exit story I would have been really disappointed in you. I’d have hoped for something more worthy involving a space-walk, some dwarfs, 20 nude dancers and a trapeze…y’know, like your average Saturday night out.
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Sagar — October 3rd, 2011, 3:58 am

As an Indian I feel terrible and am sorry for what you had to go through. Hope you won’t stop visiting India and will come back again.
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Jimmy — October 3rd, 2011, 4:41 am

Oh my god, I can’t believe you’re writing was so coherent. I’d be livid beyond words. And anyone less knowledgeable than you would have died! What then?
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Dr. Kareem — October 3rd, 2011, 5:19 am

It was great traveling with you, Tim. I’m so glad you and Natasha are safe and sound, and I’m happy to have been able to offer you some level of assistance during such a brutal experience.

Your words were well spoken, but it’s hard to really imagine this place unless you’re there… the first hospital didn’t even have a sink on the entire ER floor.

Really scary stuff! (apparently Darwinism is still taking place to its fullest degree in India – I just hope their healthcare improves for the sake of all the people who are currently under their care.)

I’m not sure I had a chance to tell you, but one of our tour leaders has a wife in the hospital now with several broken bones and a clear head injury following getting hit by a motorcycle while walking – she’s having a lot of mood swings, etc., and they’ve decided to just ‘watch and wait’ to see if she requires any further testing.

Glad you’re safe, and, outside of this experience, grateful for the opportunity to have had another amazing trip. There’s a lot to love in India, but healthcare isn’t one of those things…

Wishing you the best,

-k
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Maria — October 3rd, 2011, 5:26 am

As a medical student, it always makes me sad to read about malpractice of any sort, especially if it’s that avoidable – but then again, perhaps it makes me more aware of how I will never want to act like.
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Olivier Roland — October 3rd, 2011, 5:49 am

I was in India in April and suffered food poisoning too. It’s almost a normal part of the journey here.

But it was far less terrible that what you and Natasha suffered. I’m glad you both survived and now have an horrible experience to compare with all your future medical problems !
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Anna — October 3rd, 2011, 6:43 am

Sounds like you did a great job of taking care of yourself and Natasha in extremely difficult circumstances. Wondering what – if any – medical supplies you took with you and what you will now take for future travels…
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Brian Kevin Johnston — October 3rd, 2011, 7:40 am

Glad you and yours are safe/healthy. I can only imagine how fearful you two were not “knowing”… Life throws curveballs at times, but how you cared for your Gal is to be admired…. Best to ALL…
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Jennifer Cornbleet — October 3rd, 2011, 7:41 am

Tim,
You bring back memories of going to India 20 years ago on a scholarship. I made the one-time mistake of having fish from the Ganges river and had the only case of food poisoning of my life. Guess the lesson is do not eat fish (at least from the Ganges) in India. Later issues–I went to a gynecologist there for some issues and saw rusty, unsterlized instruments on a dirty table about to be picked up and used on me! I’m not kidding. I left right away, and when my final health issue there happened–a kidney infection–I went back to the US to deal with it. When I returned to India, I didn’t get a single sickness for another year, as the immunity built up. I want to go back to India again, but am a little scared. If you discover good health care options there, let us know!
Jenny
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CoachDom — October 3rd, 2011, 7:54 am

Glad to hear you are safe!

But please admit you were just trying a new radical way to loose weight ! that’s it !
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Jimmy D — October 3rd, 2011, 7:59 am

Ummmm…you were in a hospital in India, and you were surprised the service was poor, and that it was dirty?
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Leonard Irwin — October 3rd, 2011, 7:59 am

Tim

Glad to see you and your friend are both back safely. We take for granted the lifestyle and quality of medical people in North America. That being said I like how you ended your post. Going through something like this especially on purpose will trigger the mind to become strong.

Stay healthy and get some rest.
Leonard
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Wes Roberts — October 3rd, 2011, 8:07 am

Tim…

…we need you to stay alive!!!

…and that from a man fast chasing 70 years olde!

…Next trip, you either take your personal physician, or me to be your man Friday to take care of you.

…extra thankful you’re still here

…very much appreciate your writing

…one problem with this post, though…where’s the rant

…read like you were just telling the truth

…taking the night train from Switzerland to Paris a few years ago, I’ve my own story

…glad we’ve both lived to tell about it.

…keep writing…I’ll keep reading…and take good care of that girlfriend…what a trooper
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John "Widgett" Robinson — October 3rd, 2011, 8:10 am

This may have been pointed out already, but I just wanted to single out the comments I have read saying “Wow, reading it is far less scary than the situation actually was”…? For me, reading this was *fricking terrifying*. So being there on the ground or hearing from it live as it was happening must have been stupidly intense. I’m glad everybody’s okay.

Can we put together a fund to bulldoze the facility you were in and turn *that* into a library? Just asking.
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Chris Wark — October 3rd, 2011, 8:11 am

Wowzers
Great post Tim!

Got a new vocabulary word for you:
iatrogenics: Disease or death (iatrogenicide) caused by medical examinations or treatment. i.e. doctors, drugs, hospitals.

Errors abound in hospitals because of the constant rotating shifts of doctors, nurses, med students, many of them working 18 hour days nights.
Care providers get tired, mixed-up, distracted, some of them don’t know what the flip they’re doing, and some just don’t care.

What might surprise a lot of people is that iatrogenics from drugs alone is the third leading cause of death in the U.S.

When I was in the hospital in 2003 for colon cancer at 26 years old, I remember telling one of the doctors, “Man you look worse than I do!” (That was the morphine talking) Seriously, he looked like the walking dead. Yellow skin, dark eyes… I remember thinking “How is this guy going to get me well?”

If malpractice, unsanitary hospitals, etc. are added to the tally of drug related deaths, one could make a strong case that iatrogenics is the leading cause of death!

Dr. Gary Null (Death By Medicine) is an authority on this subject.

Glad you and your lady didn’t end up completey iatrogenified!

(((c)))
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Kelly — October 3rd, 2011, 8:13 am

Natasha’s arm… if that happened to my girlfriend I would’ve tore some new holes in people. That’s F*ckin ridiculous.
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Raj Kotecha — October 3rd, 2011, 8:19 am

Sincerely glad you’re both ok Tim. I read 4HWW earlier this year and follow your exploits and advice closely. On that note, any advice on what to watch out for to prevent getting sick from food poisoning in India?

btw: The way you looked out for Natasha was inspiring. Something I’ll keep in mind when I think I’m “too sleepy” to do anymore.

Take care!

Raj
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Anna — October 3rd, 2011, 8:20 am

This is so unusual that it happened because of having cooked (I’m assuming) fish. During my multiple travels to Bali, Egypt and other countries where we are not used to the bacteria I always pay attention and never have raw vegetables and tap water. And in your case it was fish…
Scary.
I’m glad you’re both better. I hope you’re enjoying your vacations!
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michel frison — October 3rd, 2011, 8:27 am

Tim

I know of so many people who went to India and almost died. I have travelled troughout Asia and lived in a few places and to be honest Bagkok is as far east as I will go from now on ! I pushed my luck last winter in Cambodia and was feverish a few days and also a bit of vomitting and liquid coming out of everywhere.
Yes they all talk about Incredible India bla bla bla … But you know what there are other places in the world where I can see incredible things .If I want a spiritual journey i have no need to risk my life in a place like India.
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michel frison — October 3rd, 2011, 8:38 am

And one more thing about the far east… Always make sure the food is hot…or your noodles boiling. Stay away from eating fish, clams or oyster, stick to rice, chicken and beef well cooked.. Stay away from milk and milk products especially in China where they are known to add agents , forget salads and mellons full of waters. Eggs well cook are fine….but stay away from buffet scrambled eggs
And dont assume because the restaurant looks 4 stars and the floors are all marbles that the food is without risk ! The local corner shop with 5 tables full of locals can be a better choice if you see they have lots of business and reasonably clean tables and floor.
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- Phil Smith — October 13th, 2011, 12:28 am
  
  Words of well traveled wisdom. Thanks Mike. Phil.
  Reply
Gaurav — October 3rd, 2011, 8:59 am

Mr Ferriss,

I am a great fan of your work. Sorry to hear about your plight. I have had pretty nasty medical experiences in Calcutta. The last one being my maternal grandmother who had severe abdominal pain. The doctor gave her iv pain meds without even bothering to do imaging, or even basic work up, she died last month. I am an MD myself, and fully picture this happening, not only to you, but also to thousands of patients. I strongly encourage you to get your article published in the Indian media so that stringent action could be taken. As Dr.Jerome Groopman points out in How Doctor’s think patients should question their doctors always- what else it could be ? is there anything which does not fit ? But I guess these questions seem remote in your case, where even basic medical care is not delivered, bedside manners, care and empathy were oblivious of its absence, the hospital violates its own mission statement. It needs to come to the light of public attention.
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M.B. — October 3rd, 2011, 9:06 am

Sad you guys had to go through that, and though I would unequivocally feel the rage just like you, it is not surprising because I have an idea how health/medical systems are in other parts of the world. (And I would not be considered well-traveled).
Aslo that one can encounter unsanitary nurse/doctor (dentist in my case – shudder) everywhere (even in the US).
What I am completely taken by is one of checklist – hospital near the hotel? I can see why people would think it is a wise idea, but…this also means that you anticipate your rushing to the hospital or the ER (and not for research purposes)??? I have a couple of friends who travel the world extensively for pleasure, and do not recall hearing any “hospital” stories.
I’m sure the author of the blog understands what energy law I am referring. After all, is not one’s energy the same main factor in one’s financial success???
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Jacqueline Biggs — October 3rd, 2011, 9:08 am

That is one of the worst hospital nightmares I have ever heard and by all accounts in reality it was even worse! Shocking. Glad you and Natasha are both ok now. Though clearly mentally scarred forever! Not quite sure how you had the wherewithal to document everything, but then you are super-human!

Goes to show that even if you had all the money in the world (I know you don’t but you’re getting pretty close it can’t help you if you’re in the wrong place at the wrong time. We all like to think we’re invincible, but sadly we’re not. Guess the saying: ‘Fail to prepare and you prepare to fail’ is annoyingly apt right now.
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Martin Micevski — October 3rd, 2011, 9:38 am

Hi Tim,

Talking from travelers point of view-I was flight attendant for international carriers for 8 years,traveling from one continent to other in a week, if not in matter of days.
However,i totally vision your experience.Poor skilled doctor in a western named hospital…god knows how he ended up there.
My similar experience was in London-Uk, had a stomach virus.
Doctor was called in, checked me and he left after 5mins.His words, you got Stomack virus,take paracetamol and plenty of fluids.
Damn,take fluids??? reaching the toilet with crawling from my bed was like climbing to Mount Everest…:) it was that painful.
I asked him while he was leaving..thats all? He looks back,shaking his Head and say’s you will be fine..i got to go..:((
Luckily experience saves you sometimes and you deal with the problem.

Wish both you and your girlfriend to stay healthy..
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mike denny — October 3rd, 2011, 9:43 am

Tim,

Has this dampened your traveling spirit? Or only convinced you in the superiority of better checklists! Safe Travels
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Thomas Crown — October 3rd, 2011, 9:50 am

@ T Fizzle,

I would have to disagree with you – in that this is not a rant session – but a valid warning for anyone who might have gone to Belle Vue Clinic in search of medical tourism, or like you, because they had to.

Think of how many people you could be saving from your same experience – who knows if you have saved a life, saved someone from infectious disease, or just from a bad experience.

I endured light surgery on my left arm with no anesthesia at a hospital in David, Panama – and sat in the emergency waiting room in Panama City, Panama for hours as my face infection made me look like the “elephant man” and blocked me from breathing properly, only to be turned away because the nurses didnt believe it was an emergency and had more urgent matters to attend to, like texting and eating.

However, I would recommend Hospital Punta Pacifica in Panama City – which is affiliated with John Hopkins International Medicine.

By the way, any girl who can endure vomit, diarrhea, passing out, and being stuck with needles…is probably a keeper:)

“pretty pretty fren”,

Thomas Crown
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Wanda Freely — October 3rd, 2011, 9:59 am

Is Natasha still your girlfriend?!?
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matt — October 3rd, 2011, 10:12 am

Glad you’re not dead because I was really looking forward to The 4Hour Chef, and more random shows. That was serious, you seemed to have more patience than most people.
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SUDHEER — October 3rd, 2011, 10:40 am

Sometimes Visiting or Change of place may cause this problem. As i am having the experience in health care and hospitals, I didn’t see that much bill in my life for emergency food poisoning.The average biil might be not more than 500 dollars. That’s only because you non natives.

If you can give one message , any of ur followers in culcutta might be take care of this time

I hope you are ok.
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John Mac — October 3rd, 2011, 10:58 am

Tim what’s happened to you? You went from an adventurous, bootstrapping worldly travel to a high-maintenance, hypochondriac. Haven’t you ever heard a little Cipro, tons of water and a few days of suffering. Ridiculous post. Get over yourself.
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- Charlie Hoehn — October 4th, 2011, 12:35 am
  
  I bet you’re a delight in person.
  Reply
Jay Walsh — October 3rd, 2011, 11:18 am

So, basically, what you’re saying is:

Someone could make a mint creating an app that would tell you where the best hospital is – per ailment – based on your gps position in the world.

Glad to hear you and Natasha made it out of this alright.
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Eric — October 3rd, 2011, 11:46 am

Jay, I was just thinking the same. Someone get on it!

If I have time, I may…I love the idea of a project that might actually solve a problem. Seems like this could come in handy for a lot of travelers.
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ElamBend — October 3rd, 2011, 12:09 pm

Tim,
Great to hear you both made it through.

A very important, and unacknowledged, lesson of your experience is to make sure you are educated and not to let doctors bully you. You are your own best advocate. People, especially under distress, are too often willing to let others dictate to them, even if they realize that something wrong is being done.

It must of been doubly tough to stay aware under such condition.
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Sue — October 3rd, 2011, 12:11 pm

What a nightmare! I’m looking forward to more stories from Roman when I meet him in NYC in November. I sure hope you had a good reason to go to India and it was half worth the agony you all went through.
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Varun — October 3rd, 2011, 12:23 pm

A few quick points in order of importance:

1. I’m so very glad that you and your girlfriend are ok!! If y’all are still healing up, heal up quickly!

2. Thank you for your anti-troll preamble. Especially the “it’s not us v. them” part. As an Indian-American, you have NO idea how much I appreciate this. I know that both the US and India have their respective(if not at times, similar) problems, but framing it as a nationalist or racist incident does nothing to solve the problem(s). Thanks for being a better person than the morons who would’ve blown this out of perspective and the doctors who mistreated you and your gf.

3. Just wanted to say thanks for being such a great person. If anyone of Indian/Asian descent throws anything negative your way, let me know and I’ll handle that crap myself. (Not saying that you can’t handle it, just saying you’ve got some back-up if you need it).

You’ve earned my respect a long time ago. Let me know if there’s anything I can do for you.

Cheers,

– Varun
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patrick — October 3rd, 2011, 1:04 pm

Wow, that is pretty scary. I know how bad food poisoning is. I am actually getting over it as we speak. Lying hunched over for 3 days barely able to talk or use the bathroom isn’t much fun at all.

I can only imagine how much worse it is having to go to a hospital that sounds like it’s making your situation worse not better.

It is very true though that in times of pain you learn to appreciate what you have.

3 days of bed rest will make you think a lot about life and in my case how fortunate I am not to have to spend months or even years laying in a hospital bed or facility.

On a positive note, I’m glad you guys are feeling better.
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Juan — October 3rd, 2011, 1:04 pm

I’m glad everything worked out. Having traveled extensively as well, this is despicable and immoral. Unfortunately, it occurs with more frequency in some parts of the world than others. They say you can judge a society based on the value it places on a human life. By that benchmark, USA is still the greatest place in the world and many of us need to travel if only to understand that.
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Rob — October 3rd, 2011, 1:36 pm

Haha, being German, I had to check my language’s equivalent for little word “triage”: „Bestimmen der Handlungsreihenfolge während einer Notlage“
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- Elena — October 4th, 2011, 12:38 pm
  
  Das deutsche Äquivalent für Triage ist Triage – wird nur außerhalb vom medizinischen Kontext praktisch nie gebraucht
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Charlie — October 3rd, 2011, 3:19 pm

From reading this and the comments, it seems like a terrible hospital experience is possible anywhere in the world. (As is food poisoning. I got it once on a short trip to Tulsa, about 2 hours drive from home.) Though apparently some places are much worse than others.

Yet Tim has a chapter in 4HB about the wonders of medical tourism. This makes me ask: What would be a useful worldwide checklist for finding a good hospital *and* monitoring the quality of service? Obviously steps 1, 2, and 3 would be to call the embassy, ask trusted locals, and have an advocate present. But there must be more to the list beyond that.

Part of my confusion could be a difference between something planned and researched well in advance versus emergency care. Even so, what’s to stop a medical tourist from being suckered by a slick web site?

One other point: Don’t knock the water-butt method until you give it a fair try. I’ve kept a medical squirt bottle by the toilet for the past few years. Now I just don’t feel clean when I have to use dry paper. The traditional paper-only method also takes a lot longer and on bad days can cause irritation to the point of bleeding. Water is much better. (Toilet paper is good for drying off afterward and for blowing your nose though.)
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jay — October 3rd, 2011, 3:34 pm

Tim, So sorry that you had to go through such a nightmare in India. I’ve informed whoever [in India] I could about your experience. We’ll try to make things better for your next visit.
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Bendik L — October 3rd, 2011, 4:21 pm

Wow Tim! I am really glad both you and Natasha are well. You make me want to read up more on medical treatments just for my own health`s sake.

I encountered some hospital problems when I moved to Buenos Aires for a few months. I woke up one morning with acute asthma, using 70% of my energy to breathe, panicking because I felt I didnt get enough oxygen to stay awake, frightened to experience game over in my apartment while waiting for google to list nearby hospitals…

Luckily Google quickly listed a hospital 4 blocks away.
I ended up spending 9 hours in confusion at the hospital. I spoke little spanish at this point and was pushed around the hospital understanding nothing…
-Nurse losing syringe with cap on the floor before giving me I.V.
-Forgetting me in a corner with a smokey gas mask thing for 3 hours straight.
-Saying my X-rays looked NO PROBLEMO. BUT I had to show them at home to get to a specialist??

All in all, it turned out well…and they charged me nothing, not a dime.

Lesson learned: If you don`t speak the language, bring a phrasebook or a translator. It`s hard for people to help when they don`t understand shit.
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Jim McGlone — October 3rd, 2011, 4:30 pm

I had the same symptoms early this year. I went online before going to the doctor and they all suggested staying away. I sent the Westin Hotel staff to the pharmacy many times, lived on Imodium and Benedryl for days. Love the book and have lost 26lbs on the diet. Stay well, JRM
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Hooman Rabieh — October 3rd, 2011, 4:34 pm

Tim,

Sounds like you had a very unfortunate and frustrating ordeal.
If you find yourself traveling often to places such as India, or just in the SF Bayarea where ERs over prescribe antibiotics, you can look into an “open-source” remedy called MMS (http://www.miraclemineral.org/). It can be used to disinfect water as well as be taken internally to deal with infections, bacterial, viral, fungal, even detox heavy metals from your system.. something that costs pennies and can easily be included in everyone’s cabinet, at home or while traveling. Widely used and tested in Europe but of course banned by the FDA. May be worth checking out!

Best,
Hooman
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Tyler Carter — October 3rd, 2011, 4:50 pm

Fantastic post.
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elramirez — October 3rd, 2011, 5:39 pm

Tim. I am glad that you and your loved one are safe now.

I have to ask, did you stay through this nightmare for a test or you were caught in a situation that even your resources were limited?

I believe that there is more to this than procedures and checklists. Do you think that this hospital in question treats like these their governors and high positioned people?

You are taking a stand I am totally behind you because this needs to change and all be treated as equal and in the best interest of others well being, not cash in the pocket.

Thanks for this post.
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Robert — October 3rd, 2011, 6:16 pm

Tim,

Can’t you sue the hospital or staff? No offense (seriously) but I don’t think stoicism or an angry post will save anyone’s life, you need to hit them where it really hurts before they kill someone (if they haven’t already). The only reason they keep such worthless staff is because it’s cheaper than to hire or train good staff, so if you make it expensive, they’ll fix their policy.
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Benny — October 3rd, 2011, 6:56 pm

Damn I got frustrated by how they were treating you just reading it. It must have been a thousand times worse in person. Glad to hear you and your gf made it out okay. Easily could have been much worse, or even fatal.
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Ryan — October 3rd, 2011, 8:50 pm

Wow. Only one word comes to mind here: Nightmare. Like you said, we have to be grateful and appreciate what we have!
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- Ryan — October 3rd, 2011, 8:51 pm
  
  OH, and I’m glad you ane your girlfriend are ok!
  Reply
Rob — October 3rd, 2011, 8:58 pm

Wow, scary story, a man less involved in the medical market would have been in that hospital a lot longer with a lot more pain.

The UK has had a major outcry over the past couple of years about MRSA and after months of investigation they came to the conclusion they had at the start – it was caused by lack of washing hands/hygiene.

So even in developed countries with great healthcare these basic checklists can make a difference. One practitioner ignoring the basic health standards can cause an epidemic so it’s of the utmost importance.

I’d also like to add lastly your advice on checking local hospitals is something I’m going to start doing now, I’ve travelled for the past 2 years and never done that but it’s great advice. More so for a place like India which has a big reputation for making people ill.
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dave lawton — October 3rd, 2011, 9:33 pm

holy shit dude that was one intense article
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Robert Sullivan — October 3rd, 2011, 9:36 pm

I’ve also read the Checklist Manifesto, and was impressed that he drew knowledge from the construction industry, and airplane operation checklists, into the medical world.

It is no joke that you (Tim & Natasha) might have been better off by *not* going to that hospital. A friend of mine ran into a similar situation in Santiago, Chile. He ate ate some restaurant (I recall he was very sure of the source), and he got violently sick. His appendix burst, and he was taken to the hospital. Not the best hospital, or even a good one, because he was trying to save money. Long story short, due to sloppy hygienic practices, he got another infection at the hospital, and very nearly died. He ended up losing an incredible amount of weight, like a prisoner. Well, I can’t recall the details, but if his wife had not been there helping him (she studied biology and knew a bit about medicine), he probably would not be around today.

I think it is good to call out these morons, who seem to be utterly ripping off their clients due to their stupidity and incompetence, while meanwhile others are trying to do a decent job, such as the helpful doctor you mentioned. And certainly this is a problem not relegated only to third world countries, as we have seen in Atul’s book about U.S. hospitals, of course, perhaps not to the extent of the hospitals mentioned in the post. Drs are held in high regard in the U.S too, and they are not used to being questioned, but the old saying holds “patient, heal thyself”. You don’t have to be as knowledgeable as Tim (and consider he was in a delirious state), to *question* things. In software, there is the idea of the “Five Whys”, which is to keep asking “why” till you get to the bottom of the question, such as fasting blood draws.

Interesting message about Seneca. Given the current hoopla surrounding #OccupyWallStreet, and the news of future stock market disasters, perhaps we should all learn to live simply, and see if we can change ourselves. In a way, this is a bit altruistic, if the champagne swilling bankers knew what life was like, as they peer down from the balcony at the protesters, suffering from the ruin the banksters have manifested, perhaps the world would be a better place.
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Doc Kane — October 3rd, 2011, 11:48 pm

Good Lord, man, be careful out there. We kinda’ like having you around. Cheers, Doc
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Aaron — October 4th, 2011, 12:06 am

Tim, can you make a checklist that will help us avoid food poisoning / health problems while abroad
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Amar — October 4th, 2011, 12:07 am

Hey Tim,

Great rant and I wish this does lead to something being done and action be taking against that prick. Little bit of advice if you ever do end up in India again and in need of medical attention.

I’m a dialysis patient and travel to India quite often. I have experience in some of the best hospitals in India and ones where mice run around in the pharmacy. I thankfully, made it out unscathed every time. Calcutta is one of the WORST places to visit in India (as confirmed by most Indians) next time you are in India try to find one of the Apollo hospitals (I’ve been to the one in Delhi) and the staff, sanitation, and doctors were great. Aside from some of the snobby “sisters” but the doctor knew what he was doing. The best hospital in India I have ever been to is Kokilaben Dhirubhai Ambani Hospital (there’s a mouthful) in Mumbai (formerly Bombay). The NICEST staff I have met in any hospital in the world and I’m Canadian lol. Amazing doctors who care so much that mine went out of her way to check up on me every time and she only had her one time consultation fee when I arrived. Everyone speaks English, and made feel very comfortable, welcomed, and always checked up to see if I needed food or anything. Unparalled (in my opinion) to any other hospital in India.

There is a huge discrepancy in medical care in India and the only hospitals I would EVER visit are in Mumbai and Delhi. But, don’t every compromise for anything other than the most reputable ones, even if its life and death (in fact especially if it’s life and death).

Hope this was of some use to you.
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Amar — October 4th, 2011, 12:08 am

oh and p.s.

don’t eat, drink, or breathe anything in Calcutta
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Mule — October 4th, 2011, 12:55 am

Ferris!! What an account..!!..Hopefully your girl is right as rain for some lattes, fine dinning and sensational Melbourne shopping in a few weeks time!! Thats about the best remedy for any female…
Looking forward to you in action on stage while your down under…
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D — October 4th, 2011, 1:18 am

Dude, I surely expected some of your fans to keep you grounded on this one. Let me get this right, you went to a third world country, ate some dodgy fish, got the runs and a high temp, and instead of toughing it out you gambled with getting an IV at an indian hospital rather than staying home and vomiting in your own 5 star hotel??

C’mon Tim! Toughen up man and give yourself a few days to calm down before you write your next rant!!!!

You can get shitty health care where ever you live, there are crap doctors everywhere. No different to getting good service for anything else, you need to know someone or have plenty of money or both, or leave it to the gods.

I do like your blog and your books dude but jesus there are people with much bigger issues out there. Just chalk it up as another good story for your next million dollar book!

Now bring on the haters for my opinion!!
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Andrew — October 4th, 2011, 3:45 am

Tim,

We just finished spending two weeks teaching in a slum school in Delhi and living with two Indian doctors. I often wondered what the quality of care was like and your story provides a terrifying answer.

We’re nearly finished with a 7 month RTW trip and no country has been more fascinating to visit – or made us appreciate home more – than India. Glad to hear you and your girl are alright.
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Fredrik Eklund — October 4th, 2011, 5:16 am

Holy shit dude, sounds like you went through quite the ordeal.

Think that was Salmonella you guys picked up? My wife said that it couldn’t be caught from eating fish, and I don’t remember if it gave me fevers, but I do remember stuff shooting from both directions, so to speak, and I wasn’t exactly feeling fantastic…

Good to hear that you made it back (roughly in one piece)!
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Rob M — October 4th, 2011, 6:31 am

Great post Tim.

It struck me that with so many organisations focused on cutbacks (including my city, Toronto) and nations facing austerity measures in this economy, there’s huge need for this kind of analysis.

The typical uninformed response to sub-standard service levels in any organisation (especially government-run services) is that as a rule it is a result of poor funding. This example highlights the effect that a few simple managerial tweaks (at minimal additional cost) could have.

I’d actually love to see you take this kind of magnifying glass to more examples….perhaps a new book? How to hack systemic inefficiency. I would buy it.
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Joe — October 4th, 2011, 7:58 am

Great article…great story…sounds like a real adventure in the worst and best sense.
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Anna — October 4th, 2011, 10:02 am

Wait, did I miss the rant where you criticized your own pre-departure processes? The rant where you took responsibility for not adequately preparing yourself for travel in a foreign country with health care facilities of variable quality? The one where you realized you should have done some research and learned that in said country you would have a high likelihood of encountering pathogens with which your body was not familiar? The one where you kicked yourself somewhere appropriate for not taking easily procurable medical supplies – antibiotics for a start – with you? The one where you realize first and formost that YOU could have – fairly easily – prevented this medical disaster?
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Mike — October 4th, 2011, 11:33 am

Your post hit close to home. A few years ago I got an infected wound while staying in the countryside close to Kolkata and it got pretty bad.

I went to Woodlands Hospital in Kolkata (supposedly one of the best, if not the best hospital in town) and it was a mixed bag. I never stayed overnight, only went there a few times to do some X-rays and see a specialist, but overall the service was great. I could call the doctor anytime and the staff was generally nice.

However I’m still not convinced the involved doctor was all that competent. For weeks he refused to remove the infected scab over my wound, until another doctor finally agreed to do so, allowing the wound to finally heal. Besides the antibiotic treatment could have been performed a lot more efficiently.

So yeah. Travelers beware around Kolkata, there appears to be a pretty high infection risk and medical treatment quality is at best a mixed bag… But do go there, it is an amazing and interesting place in the world.
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Sathya — October 4th, 2011, 1:22 pm

Hi Tom,

I am from India but currently stay in the US. Your post doesn’t surprise me at all. I have personally had such experiences from top notch doctors who have diagnosed me wrongly for Tuberculosis when i just had fever which ran for 5 days. On other occasions i have had unwanted tests taken just to make more money. These include blood samples, scans, etc taken.

If there was ever a website that rated doctors or had reviews taken for doctor from patients i believe it will solve for a big problem out there in India.
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Josh — October 4th, 2011, 2:05 pm

had a similar experience but it was with a corrupt psychologist who i had to threaten with mal-practice for trying to give me very harmful drugs for psychosis, loosing touch with reality which i read up on only to find i had none of the symptoms, i have lived in india for 4 years as a general rule Tim stay the hell away from india their education system is corrupt anyone graduating from that country is a joke i am indian myself so i can say this without being racist, all the way to the cops who make daily runs to collect money from all the shops like the mafia in plain sight in bangalore and the beating of women who dont cloth themselves to the corrupt officials to let this happen because they are associated with them stay the hell away or atleast avoid ever having to depend on anything or any one in that country associated with the service industry from if you are in india, when you are out of india and their is a legal accountability that i would make an exception to i actually visited brickwork when i was in bangalore but all the names and titles there are a joke that is why i left my architecture course after a year and a half, this is not angry blabbing i have a scar on my wrist which should not be there for a doctor who operated on it and it still experiences pain i was also not given any pain killers during the healing process, with all the words i could possibly use stay the hell away from that sort of stuff in india, responsibility and legal action is almost impossible let alone possible with let lines and the corruption of the judges and police make it impossible to get anything done, i can say this because i have tried it out.

all the best to you tim cant wait for your new book
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Breakfast Josh — October 4th, 2011, 4:14 pm

Owe! I was sick in South America Once, but you story tops mine. Mine was more on the hilarious side, not the deadly side.
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Joshua Millage — October 4th, 2011, 6:14 pm

Tim,

I feel your pain brother. Last week I returned from Sanya, China (Hainan) because of some medical reasons. After reading your store I can relate. I came down with a rare case of food poisoning (according to the 4 docs that saw me) that caused a large amount of internal bleeding. I went to all three of the hospitals in Sanya. The first doc sounds like your bad doctor and the conditions of the hospital were insane, blood on the walls, rats, fecal material on the floor – really it was like a scene out of SAW. After passing out on the floor (from God knows what) my two translators and I agreed that I was more likely to be killed from something in the hospital rather than whatever was inside of me.

The second hospital pulled a “well you seem ok” and didn’t allow me to come in.

The third hospital made me prepay my visit and ended up having the same conditions at the first (blood, poo on the floor in the anal probing room). After seeing how and where I was going to be tested I started to feel better – really I think my adrenaline spiked and the extricating pain subsided for a hour.

At 5am after staying in a room with 10 other very sick Chinese men, waiting for a colonoscopy I decided it was best to go back to my apartment.

Next the day I went to hospital 2 again and found a good doctor who admitted me and took a series of tests. Nothing is conclusive, but he suspects that it was a extreme type of food poisoning – I’m not convinced. Im back in the States now to make sure everything clears.

The interesting thing is that the doc who tested me yesterday said that if I would have been infected with a specific type of e coli – the meds that the doc gave me could have caused kidney failure – I guess the e coli releases toxins when it is killed by antibiotics. I guess I got lucky there…

Sorry for the long comment, but I want to know that I can completely relate with this post and I agree. We are very blessed to have the medical treatment we have here in the states. Its not perfect, but it is way better than what most people have.

Pressing on…
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Christian Baker — October 4th, 2011, 6:46 pm

Good reminder to stick to your own rules and always find good hospitals!
Glad to hear you are both ok, goes to show not even a dodgy indian hospital can take down the amazing T Ferriss
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Rajiv Hudek — October 5th, 2011, 12:38 am

Tim,

I feel your pain. I am Half-Indian and Half-American, but since I grew up in the States I’m more inclined to Western Culture. On every visit to India I have always had to sit down and complain about something or the other concerning the systems that are set in place. I mean if you just look around you can see that there is obviously no civil sense prevalent. When I was in Medical School here I got into a few drunken mishaps and went for stitches afterwards and I had to do a little micromanaging myself when it came to proper disinfection practices before sticking a needle in my arm!

It’s really just the state of India’s mentality at the moment. People are not properly educated and the people in charge of the country are more worried about embezzling all the tax money for themselves rather than setting up good systems. I don’t know if it will ever change when you have a billion plus people to contend with on the social ladder. Every one is just worried about themselves including, as you can see, the doctors.

Just the other night I was confronted by some cops about my friends and I sharing a cigarette and beer at a hill near my mom’s house here in India. They jumped off their motorcycle with a bamboo stick and I just let loose on them. I started yelling so loud and grabbed the bamboo stick from him and said, “Are you going to beat me like I’m a dog?” He got so scared he and his partner ran away!!! They brought back up and I yelled at all of them as well and their egos were crushed. They did end up calling the chief of police and I so we bribed him and them with 4000 Rupees (about $87) and they treated us like kings and told us to call them if they ever needed someone “taken care of” or any other help. I’m not justifying what I did as right, but just giving you a glimpse into how things really work here.

As for the water-butt thing, that is how Indians wash their butts. Water and their hands are the standard method, so that is why the lady mentioned it. I don’t think she was being lazy or nonchalant about the situation. She probably just got back from the crapper after having washed her butt with water. Every Indian I’ve ever questioned (high class and middle class) think that using toilet paper is the single most gross thing Westerners do concerning personal hygiene. It’s just a very different cultural element, I guess. But there is no excuse for a used soap bar in your bathroom. If it was such a good hospital they really should have had soap dispensers… but alas, it seemed like a pretty janky establishment.

Any ways, I’m sorry for your terrible experience. I hope you and your girlfriend came out alright.

Raj H.
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Michael — October 5th, 2011, 3:16 am

When we need to see a hospital in a third world country (and we try to prevent it absolutely!!), we call our doctor at home (got his mobile number) and then tell the foreign staff/doctors what exactly to do.
A good thing about third world hospitals: You pay AND you are the boss (unlike at home, where you pay but the doctor is the boss).

By the way, we would NEVER go to a hospital to get some intravenous fluid.
Vomiting and diarrhea often happens in such countries. We then pump salted water rectally (a big injection without needle will do, or a clyster of course).
You can put in as much as you want – the body absorbs as much as it needs, the rest will come out again.
Works very great with babies or kids as well – no need for a hospital (which is always a big risk, as you know!!), no need for needles.
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Cem — October 5th, 2011, 6:08 am

I never would have created that checklist when travelling. Now thanks to you, I will.

Another moral here: Do NOT piss of professional bloggers or seo experts. They can do a lot of damage.

I’m glad you are both ok.
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Josh — October 5th, 2011, 7:05 am

Tim, glad you’re feeling better. Big fan of your books, but this post is a bit depressing – mainly because it has brought out a bunch of really narrow-minded comments.

To all of you who expect the same medical care that you’d get at home, there’s only one way to ensure that: stay at home. Travel carries its risks, and getting sick and not having the same medical care that you’d get at home is one of them. Deal with it.

Josh
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Cary — October 5th, 2011, 9:08 am

I was in the Air Force medical service for 22 years and experienced Japanese/English medicine firsthand. For those of you who think socialized medicine is the “fairest” way to take care of sick people…I have news for you. You’re right in concept but most countries get it terribly wrong in application.

Japan and England are 1st world nations…yes? I have seen Japanese ambulance drivers (few if any emt’s there) literally pick motor vehicle accident victims up and toss them into so-called ambulances (few supplies). Emergency rooms had re-usable urinary catheters!!! On the other hand…they had state-of-the-art CT scanners, MRI and other diagnostic equipment. Shocking difference from circa 1800 medical care in one room to the next isn’t it? This was a few years ago so hopefully things have improved somewhat.

In England…we would routinely “undo” any English medical care to include suturing of wounds because local docs didn’t think that washing gravel, grass and an assortment of other items out of gaping holes would be helpful. I also witnessed the Brits as they tried to start IV’s in the field and (upon missing the vein) drop the catheter in the dirt, pick it back up and attempt again. Well, at least they try! Give me our “unfair” American medical system ANY DAY!
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thomas — October 5th, 2011, 10:27 am

Wow – thank god you both made it!
How frightening, and at the same time it makes it even more apparent that we all need clear plans and paths in case of emergency in traveling to these countries. It is also a question as to whether or not to seek treatment vs. keeping some supplies on hand and doing it yourself under all but the most extreme examples.

best of luck and hopefully you will never have to endure this again.
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Charlie — October 5th, 2011, 11:55 am

I think all sides of the popular debate about who should pay for medical care can learn something important from this incident: Much of the quality of care, good or bad, has no real effect on the hospital’s budget. It costs very little extra to wash hands, cover coughs, disinfect wounds, use sterile needles, insert a needle correctly, or look at the name on the chart. But those practices prevent expensive complications.

Not that I’m any kind of expert. But every hospital or clinic I’ve seen in recent memory has had this stuff on signs on every wall.
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Beau — October 5th, 2011, 1:18 pm

Is there an update as to what this place is doing in response to your post?
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Shawn — October 5th, 2011, 2:06 pm

Okay Tim…so I know you are all for self experimentation.

Try this next time you eat something bad like that. Now I don’t recommend this as a daily supplement (like you see touted on the Internet), but it does work extremely well for food poisoning which is basically an out of control intestinal (bad) bacteria bloom.

Take at least 12 oz bottle of (reputable) colloidal silver on trips to places like that. The best way to catch it early is to take two shots (aka drinking shot glass shots – 1.5 oz each) directly after a risky meal.

However, if the deathly fun has already begun take two shots every three hours up to three times a day. Stop after two days, because it will mess with your good bacteria so it’s best to do some probiotics after taking the colloidal silver shots. The silver ions interrupt the bacteria’s ability to “breathe” therefore stopping the bloom.

I will warn you, it tastes like you are drinking liquid pennies, but will work it’s magic in about 1-2 hours. My brother got food poisoning in Mexico on a cruise, saved his ass that I just happened to have some with me.

You will still have a fever if the anal/vomiting fun has already begun, so just alleviate that symptom with Tylenol or Ibuprofen.

BTW, It will also kill h pylori bacteria that causes ulcers (1shot in morning and 1 at night for 3-4 days). Do not consume for more than a few days. It can give your skin a bluish tint if you take too much taking you one step closer to becoming a real live Smurf. Do a search on the Internet, some dumbass did that back in 2000…Granted you would have to take it for months, but why risk that.
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Josh — October 5th, 2011, 2:49 pm

Such a crazy story Tim but I’m glad you and your girlfriend made it out okay. I currently don’t have any health insurance and was curious if you have any recommendations on provider and plans?
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Val — October 5th, 2011, 6:38 pm

Oh dear that’s just another addition to all the horror stories my friends told me bout India – that country is a bloody shithole I’ll never go there – hope you are better! Thanks for sharing
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Matt — October 5th, 2011, 8:56 pm

Crazy story indeed, glad you’re both back ok. I got food poisoning traveling in London, put me out for 3 days. I’m a little surprised Tim, with as many languages as you’ve mastered, that you don’t speak a little Hindi?
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John Konrad — October 5th, 2011, 9:34 pm

Tim, Check out GlobalRescue, they are basically a medical travel insurance company on steroids. Their director of ops is former SEAL team commander and they come very highly recommend by a few special ops guys I know. Plus they are affiliated with John Hopkins and can get you first rate care ANYWHERE in the world. -John
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Chris M. — October 6th, 2011, 5:32 am

Here’s to you and your girl being completely recovered and never having to go through any of this again.

Now, to one of my biggest pet peeves: please fix “named after it’s principle ingredient” to the correct version, “named after ITS PRINCIPAL ingredient”.

It’s should be its
Principle should be principle

Thanks!
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Jesse — October 6th, 2011, 1:14 pm

Wow! thats crazy Tim, glad to hear everything is ok.
I also have contracted food poisoning from dodgey chicken before and been hospitialised from vomitting blood… things were bad… real bad…., however since becoming vegetarian this is not something i have to really worry about any more and have much better health

next time reach for some fruit instead of that fish, your body will love you for it!

Take care!
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Daniel Lim — October 6th, 2011, 1:26 pm

This is simply insane. We’re all just glad that you made it out of there with Natasha, alive.

Are you going to take any action, or just going to let this rant post gain traction and hopefully reach the ears of those whom are able to impact change?

Take good care Tim!

//Daniel
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Milica — October 7th, 2011, 3:39 am

This ordeal you wrote about on Oct 2nd which is my birthday, sounds pretty seriously detrimental to your health. It almost makes me not want to ever go to India. The real reason for the comment here is to suggest a good book on a subject of doctors, and it’s a romance and a novel, so not a source for information on how to, but an entertainment. Written by Abraham Verghese “Cutting for stone”. It is set in India, I think. I got it in audible and haven’t really read it all the way throug.
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EKG — October 7th, 2011, 6:06 am

Welcome back to the USA, TIm and Natasha. Glad you are safe. I hope that your “bully pulpit” can force some changes.
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Nahyan — October 7th, 2011, 2:41 pm

thankyou for that insight, great msg at the end
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JC McGuire — October 7th, 2011, 8:08 pm

I don’t have any thing of value to add….I just wanted to make sure you knew that 4 Hour Work Week was mentioned in the latest episode of The Office
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Abhi — October 7th, 2011, 10:10 pm

Hi Tim, this is a rant. Please feel free not to approve this comment if it’s too graphic or negative for your readers. But I had to let this out.

Just like you, I’m speaking from personal experience here. When in India, always avoid Government hospitals and small private hospitals like plague. The small private hospitals are usually run by an experienced doctor, whose intent is to make money rather than offer quality healthcare.

There might be only a handful small private hospitals in India, but those are rare. Also, most doctors who run their own small hospitals don’t know how to run them or have enough time to spare to see if the nurses are doing their duties properly.

The doctors also have ego problems like Dr. Chaterjee. This is especially true if you are an Indian. In which case you aren’t treated well. In comparison, foreigners are given VIP treatment everywhere in India! But still not good enough in some cases, as I can make out from your post!

Finally, there’s a problem of incompetency. Doctors often misdiagnose, either due to lack of knowledge or from not spending enough time to listen to the patients symptoms or take them seriously.

I am a guy, and was admitted for a UTI infection a couple of years back at the age of 25. When a few rounds of antibiotics did not resolve it, and the urine culture was negative for any pathogens, the doctor asked me to get admitted for a invasive diagnostic procedure known as cystoscopy (endoscopy).

He then diagnosed the problem as a urethral stricture and told me I would have to get urethral dilatation done every six months. Then he put me on a 6 month long course of Flouroquinolones. He was a very convincing doctor and runs a well known urology hospital.

So after six months on the antibiotics, I started developing tendons problems, body wide pain, depression and insomnia. I kept telling him I felt something was wrong. He said nothing was wrong and I was overreacting. He never took my concerns seriously. Anyway, after six months, he stopped the antibiotics when they clearly weren’t working, and said I would have to tolerate the mild urethral pain since that’s how strictures are.

I would go to his hospital to get urethral dilatation every six months which was painful. As years passed, the pain only got worse, until I couldn’t do anything but only survive. When I had enough, I went to another small private hospital. That doctor did a x-ray called retrograde urethrogram and found out that I did not have a urethral stricture, but the pain was from the previous dilatations. He said it would go away with time if I did nothing going forward.

But the pain kept getting worse. So I went to a professionally managed big private hospital in my city. There are only a few of those in every major city in India. And within a week, the doctor there who was an American Indian, diagnosed the problem with a series of non invasive tests. He found out that I was suffering from chronic bacterial prostatitis. The bacteria was resistant to flouroquinolones, hence they never worked. The urethral stricture was a misdiagnosis. It was actually a sphincter spasm from the infection.

He then gave me very non toxic antibiotics and it cleared up most of the infection. So I learned my lesson. When in India, you have to get admitted in only reputable hospitals no matter what the financial costs are. These are usually very old and well known or are run by professional corporations from the private sector.

But I think it’s too late for me. At the age of 29, I’ve developed a host of health problems and immobility from side effects of the flouroquinolones, including frequently tearning tendons, unbearable body wide pain, low fertility and testosterone.

Recently, I consulted with 3 doctors, all of whom have treated me for the side effects of the flouroquinolones, without knowing that they caused the health problems I’m facing. They told me I can’t sue the doctor who misdiagnosed me, since I paid in cash and don’t have a bill (invoice) from him. The doctor had told me if I paid in cash, I’d get a 12% discount. Turns out he was cheating the government too by not paying the service tax, hence he accepted cash payments without giving invoices.

RANT OVER! Sorry!
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Mason McClellan, LAc — October 8th, 2011, 2:47 am

Surprised you don’t travel with anti-food poisoning meds or herbals??

Glad you survived, not fun especially watching your significant other go thru that too, makes it all the worse.
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barbi wildish — October 8th, 2011, 4:12 am

Hi Tim
Sorry you were sick. Fish is the worst to eat anywhere in Asia. I do not under any circumstances consume it. In Australia I eat 2 lamb chops a week then fruit and vegies.
When I go overseas – I don’t even eat my beloved lamb chops or any meat/fish. Did in Hong Kong twice and really sick. Won’t be caught again.
Keep well my dear friend…barbi
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Rafe — October 8th, 2011, 12:32 pm

4 hour work week just got name dropped on The Office!
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carol — October 8th, 2011, 4:39 pm

RULE #1: Do not eat fish or seafood in India, Nepal, Tibet, etc., these foods often have to be brought in from other areas and refrigeration for perishables via truck or train is not reliable. The water is filthy, eating fish from filthy water is never a good idea. Best to stick with local, hot foods, never use ice cubes, carry a proven, reliable water filter and use it so that you can control the quality of the water you drink, avoid even a drop of water that could be left in “clean” glasses, plates, silverware….it can contain who knows what, which can make one sick. Having volunteered in Nepal for 2 years in a community clinic and in a district hospital… I totally understand what Tim F. experienced r/t the lack of understanding about cleanliness and sterile technique, which is widespread. Tim and Natasha have a bigger concern related to possible diseases that could be contracted via the needles used to infuse the IV fluids and to draw blood – hope they have had labs to check for HIV, Hepatitis. etc. and get repeat labs over the next few years…. ya just never know. My personal and economic survival philosophy: Prepare for the worst, while praying for the best.
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Vivek — October 8th, 2011, 7:48 pm

I have to disagree with Raghu above regarding his statement about this simply being “a rotten apple, but not a rotten bunch”. I am also Indian, and find that the experience you’re describing here is the norm in India, not the exception. Even outside of hospital settings, men like Chatterjee, who have callous disregard for others, are exceedingly common in Indian culture. Women like Dr. Gunjanrai are often much more amicable than their male counterparts, but women being publicly shit on (literally) is again a norm in India, with the country ranking as one of the top five most unsafe countries in the world for women. This is somewhat changing with the globalization process as Indians attempt to suck up to & appear similar to Westerners, but even this is primarily motivated by the pursuit of wealth rather than being a genuine infusion of caring or compassion into society. My advice to Western tourists is to, quite simply, avoid India altogether. This type of thing happening is just too common, and sometimes the end result is much worse than it was for you.
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Michele — October 8th, 2011, 10:00 pm

What a NIGHTMARE!! Glad you are recovering.

As a traveler, I’ve had many scary hospital visits as well, a few in the U.S. (Florida). What I find particularly outrageous is that most of the errors could have been avoided had they been using checklists.

‘Switch’ written by Chip & Dan Heath has several interesting case studies on changing procedures to make hospital procedures safer that might be of interest to those working in the medical profession.

Keep well!
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Ryan Garcia — October 9th, 2011, 12:55 am

You still need to consider yourself lucky. In my native Philippines people die in the hospital lobby, too ironic for country famed to be the world largest exporter of health professionals.
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- A reader — October 12th, 2011, 4:18 am
  
  Excellent. and Well Said.
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A reader — October 9th, 2011, 11:09 am

Hi Tim,

I read your blogs regularly. I was always pleased with your ideas, topics and suggested. Implement a couple of them as well.

My feedback on this post. Yes, it is hard that you underwent such a pain when you were in India. But before you even got admitted into the hospital, you must have done a analysis. Indians are known for their kind heart and good service oriented people, be it any sector. There are tons and tons of very well educated medical professionals from India as well.

A proper inquiry about hospital agencies to match international standards is at all places these days. Its not the cost that matters, I have seen people in pain, I have seen people in happiness as well. Is it that you did not find a right hospital you have posted this message? So what is your take to improvise the health system here? I see you raise funds for many people across world. Why cannot you take any initiative on how hospitals be managed?Cannot this be your business in healthcare adventure? You have not met real Indian and real Indian valued people.

What is the difference you created by posting about this hospital? Can you see how the feedback and be implement in your guidance?

Regards,
A reader
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- Heather — October 9th, 2011, 2:39 pm
  
  Tim’s critique of his experience is a service to the hospital so that they can evaluate their poor service and improve upon it. It isn’t Tim’s responsibility to remake hospital’s. This hospital clearly had access to modern equipment and training. They were responsible for choosing to misuse it.
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Vanessa — October 9th, 2011, 11:37 am

Gracious. That sounds harrowing. Should you find yourself in this sad circumstance again, there are lots of things you can do. I work in international healthcare (Patients Beyond Borders) and we run into people in similarly dire circumstances with some regularity. Your idea of checking the website of the closest US embassy is a great one. They often list recommend healthcare providers. And they have numbers to call in case of emergency. Here are few other dependable options:

- If you are fortunate enough to have an internet connection, check the Joint Commission International’s website. They have a list of accredited organizations around the world. The Joint Commission accredits US hospitals and their international division has now accredited over 400 international hospitals. Hospitals that go through the accreditation process spend tremendous resources to achieve and maintain accreditation. In an unfamiliar location, a JCI-accredited hospital is always safest (not to say there aren’t perfectly fine non-JCI hospitals but why guess unless absolutely necessary?). In Kolkata, Apollo Gleneagles is your best (they do have toilet paper).

- If you are somewhere even more obscure, check for brands in the JCI listing for the country you are visiting. Often hospitals that can manage JCI-accreditation are a part of larger brand with many hospitals. Although a particular branch might not be accredited, there is usually some level of consistency within the brand.

- Another option is to find the most expensive, Westernized hotel in town and ask for their concierge … they will be able to tell you where they send all their fancy guests.

Of course, if you are stuck in the loo or are floating in and out of consciousness, this level of research is impractical. In this case, it is best to use your remaining strength to call some competent friend or family member and get them to sort it all for you. Or, you can toss an app on your phone that has all the info at the ready.

Anyway, Belle Vue sounds like a horror show. Glad it (eventually) ended well despite their rather shocking efforts. Vanessa
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Johnsmith — October 9th, 2011, 6:18 pm

1,350 is nothing for a multiple day hospital stay! Do you have any idea how much would be charged to you insurance in the united states. Sure the care would better but in retrospect would you rather have paid 1350 versus a likely 20000-40,000$ U.S. bill? Please answer truthfully
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Glynnis — October 9th, 2011, 6:19 pm

Been there, done that. You know what INDIA stands for, right? I’ll Never Do It Again.
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- A reader — October 12th, 2011, 4:07 am
  
  Is it so? Where is all the outsourcing getting done? it is one of ideas in 4hwk.
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Roman Northcut — October 9th, 2011, 8:50 pm

Wow! That is horrid service and I am very happy to hear you and Natosha made it through that experience. Im currently reading “Letters from a Stoic” by your suggestion. In addition to it being an amazing book, I recently read the part about practicing poverty. I tried it for only one day and it was a great experience. i discovered that being jobless isn’t such a horrible thing…and quite survivable and even enjoyable! haha Next time, I rough it even more. Great blog and thanks for the continued inspiration!
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Kirk L. — October 10th, 2011, 8:44 am

Sounds like a horrible place to be sick. The fact that patients could die from treatment makes matters worse.
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postscripter — October 10th, 2011, 10:16 am

Can’t wait to see Belle Vue replying!
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Andrea Fairbairn — October 10th, 2011, 6:29 pm

HI Tim, I am a fan and have been reading your findings in the 4 hour body. What I was wondering is…I am 43 and am going through breast cancer for the second time. Would you please apply your inquisitive mind and interllect to the cure for cancer. There is so much ‘stuff’ written but really, what is the truth? It would help so many people. I think we need your ‘changing things from the outside’ mentality. Would you consider doing research on the 4 hour cancer cure????
Andrea
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marc manieri — October 10th, 2011, 7:11 pm

great story, seriously enjoyable reading (obviously glad you and your girl made it out okay)

curious: did this piss you off enough to follow up and see what happens and bring more publicity to this tragedy of a hospital to hopefully bring some accountability down on Mr. Tondon? Or does it end at your blog post? just curious.
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Mark — October 10th, 2011, 8:30 pm

Wow, what a story! I hope you had some extra time to put towards enjoyment!
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m. — October 11th, 2011, 1:05 am

one myth standing in 4 hour body: more muscle is a positive thing. on medical occasions sometimes yes. in general, mostly no though. 1 kilo (of muscle) makes you stronger absolutely, weaker relatively to the time you want to sustain an effort. it causes more wear and tear, on all aspects of the system.

a simple one: 1 kilo less does more for you then one kilo stronger. if you train for strength: make muscle stronger without growing it bigger. loosing weight is also loosing muscle weight, after all when the over-all mass deminishes, the core can be reduced, the energy producing inners at that.

the ’4 hour body’ old as santa monica bodybuilding myth is what makes bodybuilders the ultimate losers in all lines of competitive sports and activities (measured against opponents, time, distance or any other yardstick or combination).

above statement (if acknowledged by you) could be the core of a rewrite of the ‘body’ to be published in two-three years?, surfing on the success of ’4 hour body’. you could present it as science does: organic writing, a la mc. gee (science and cooking). i would be glad to collaborate with you (as does the whole world). the book merits it’s energy in paper, if updated to include this aspect it is close to the ultimate guide for comprehending the functioning and toning of the performant body. it will stand the dent of time.

just a suggestion: genetics (the absolute and severe limitation to all and every, including the of and on of genomes within the pool) hasn’t been stressed enough. it will deceive potential readers in their projections and ultimately discourage them, the dieter will drop the book.

if these lines do not get lost as they are supposed to, success generates push (back) and discourages pull (why look for bones if steak is all), my sincere compliments to you as a fenomenon, i will not say freak since it has a negative ring. you truly have an out of the 99% personality, an out of the system attitude (how can four years of robotic feeds in university and no empirical experimenting beat your approach), and not at least an instinct for usurping the same traps of capitalistic society. i wish you a long life, so you can develop and maximize the strand of originality in method into original and lasting content.
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Rory — October 11th, 2011, 1:44 am

Wow, that’s a hefty bill for Calcutta! Did you consider suing them for malpractice or at least reporting it to the local medical board?

It’s ridiculous that you could have died from things that could so easily have been avoided, especially at a place that claims to offer such great care.
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mattshiloh@gmail.com — October 11th, 2011, 10:43 am

While I am sure Tim won’t personally respond to this, it’s my hopes that maybe one or two readers who are truely in the know and can help might.

I’ve been heavy my entire adult life. I’ve tried diet after diet with no success until about two years ago when I actually dropped from 445 lbs to about 290 lbs over the course of about 7 months. However once I started back to my normal career, meeting deadlines, etc. I started eating on the go and over the course of two years put all of the weight back on again. I have not been able to shake the weight again despite numerous diets.

About a month ago I had a heart-attack. It was an eye-opener that something and something serious has to be done now, not several weeks from now. A friend recommended the 4-Hour Body to me, but I am not entirely sure whether this will work for me needing to lose over 245 lbs or not. At the moment I can barely walk down the stairs or up the stairs in my home without being out of breath, and I can barely function. I won’t even go into the nights I cry going to sleep because I have let myself go this far, or the embaressing things that most people cannot imagine like going to the bathroom at home let alone in public.

I need some direction. What exercises do any physical fitness minded people on here recommend for me. I need to shed this weight and soon or I won’t be alive this time next year. I’ve already been following Tim’s guidelines for food but haven’t noticed a difference. Please help.
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- Mike — October 17th, 2011, 10:09 pm
  
  Hi Matt,
  
  I am over 6′ tall and was at 232 pounds… and growing : ) . I dropped 34 pounds over 7-8 months, my cholesterol ratio is now in the normal range as is my glucose, I have no more heartburn every night, more energy, and I’m feeling much better.. I dropped weight with absolutely NO exercise.
  
  My suggestion to you would be to
  1) read pages 1-99 of the Four Hour Body
  2) Activate and follow the program (religiously) after consulting a doctor
  
  The important keys for me were to stick to the program:
  
  - 30g of protein within 30 minutes of waking (for me this was 1 whole egg + 1/2 cup egg whites scrambled, 1/2 cup frozen spinach, almost 1/2 can of black beans all done in the microwave) on days that I didn’t have time or the stomach for that meal I would mix 1 – 1/2 scoops of GNC Pro Performance® 100% Whey Protein – Unflavored http://www.gnc.com/product/index.jsp?productId=3244942 and drink that instead (GNC gives a 20% discount when you buy during the first week of the month if you join their club for like $15 a year – totally worth it.. I stock up with 3 of these containers every few months… they are great when I’m traveling and can’t get my morning meal).
  
  - Maintain the “circle” of foods for each meal (vegetables, legumes, protein). I eat breakfast, lunch and dinner and will sometimes have a similar meal between breakfast and lunch if I get really hungry.
  
  - Drink a lot of water during the day (I drink about 40 oz at breakfast and try to drink multiple 16 oz bottles using an empty Snapple glass bottle throughout the day and then another 40 oz with dinner).
  
  - Legumes are critical… try to eat them with every meal (I usually use black beans or lentils). They give me the carbs I need to keep my energy up and they don’t burn off quickly like white carbs.
  
  - I eat as much as I want to eat during each meal as long as I keep to the “circle” of vegetables, legumes and protein. The guys at Una Mas laugh at me every time I come in because I order the same thing and lots of it.
  
  - I found it especially important not to eat fruit, not to drink my calories (I switched all my drinks to just water), and to put no sugar or milk in my coffee. It was also key to stay away from cow’s milk and cow’s cheese. No beer, no mixed drinks, no white wine… except on cheat day!
  
  - The biggest thing that kept me going was the promise of “cheat” day. I tell people that I lost 34 pounds by eating 5 donuts a week (of course, they were all on Saturday which was my cheat day). I always new that just around the corner would come that one day that I could eat whatever I desired. I kept a mental list (donuts, pancakes, whopper malt balls, M&Ms, pizza, french fries, bread…)
  
  - Nibble on baby carrots throughout the day.
  
  - I measured my total inches in the beginning and also took pics of myself in underwear front and side. I never remeasured my inches since I could tell the pounds were dropping by the belt notches, pants and shirts.
  
  - I weighed myself everyday and logged the weight. Tim has a spreadsheet on one of his sites which was put together by someone to track their glide weight. I found that I would often be losing more than the “glide” decline, but there would be days and weeks were my weight would drift back up.
  
  - I came to realize that the weight reading on the scale varied substantially from day to day (by +/- 4 – 5 pounds). I started to only care about my lowest reading of the week which often came as I got closer to cheat day. In fact, I stopped weighing myself the first two days after cheat day as it was just a downer. Now I tell people to weigh yourself everyday if you want, but only “count” your lowest reading of the week and ignore the rest.
  
  - I saw 4-5 pounds drop in the first 2 weeks, but I also had weeks when nothing was happening or I might have gained… don’t ever be discouraged and continue to religiously stick to the program. Not following the program can create setbacks in weight loss.
  
  I wish you luck and I know that you can do this. I have a few friends and family I wish would ask the same question you just did here.
  
  Peace
  Mike
  Reply
- toby — October 27th, 2011, 6:52 pm
  
  Matt:
  
  Your cardiologist should be your firstline contact for approval of any new course of action, diet or exercise, since you have so recently had a heart attack. I assume that you have had a thorough workup by a physician who specializes in extreme overweight problems. if not, get a referral from your cardiologist and get an appointment. If your health plan or HMO offers clinical help for weight loss, go there and avail yourself of professional services. Same advice for seeking help to reduce stress in your life and improve your emotional well being. In fact, this is critical for health, especially since you are experiencing symptoms of depression such as crying yourself to sleep.
  
  Here is what works for me on diet.
  
  Read Eat to Live by Dr. Joel Furhman
  
  Read 4 Hour Body by Tim Ferriss (the weight loss recommendations for now, exercise later.)
  
  Establish a firm guidline for the number of calories I will consume in a day by constructing a detailed menu. I use a spreadsheet.
  
  If I deviate from the menu, I list what I have eaten and the extra caloric load. If I am not consistently below 2000 daily calories, I will not lose weight, no matter what I eat. Obviously, you should not go that low, check with your doctor, but 2500 calories seems about right, until you get in the neighborhood of about 250 lbs. Ok, I am a numbers guy and you may not be, but I think that you will really benefit from a food diary.
  
  Follow Tim’s advice on repeating the same simple meals. If it is complicated, the tendency to drop the program is overwhelming.
  
  I am a 5′ 10″ male, reasonably well muscled, I should weigh about 170 and I currently weigh about 180. My maximum weight was about 230, 10 years ago. At that time I lost 40 pounds. The mental picture that I carried with me was the difficulty I had in carrying a 5 gallon bottle of water upstairs to my office. After my weight loss, I was lightened by that amount for every trip up those stairs.
  
  I wish you the very best.
  
  Toby
  Reply
Brian — October 11th, 2011, 12:42 pm

I’ve had a similar experience at a hospital in Vietnam Ho Chi Minh City. After a bar scuffle turned into a mini-brawl, my friend ended up with a glass broken on his head. Entering the hospital with blood pouring, they bandage it and take 3 hours “To DECIDE” okay he needs stitches… The images at the hospital were sad. You just knew that people were dying literally because of their slow or obsolete processes.

Thanks for making the world aware, and I hope the world changers (which I hope to be one, one day) will find a way to change all of this madness.

To Change!
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Bryan — October 11th, 2011, 3:51 pm

talk about holidays from hell!
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Neal — October 11th, 2011, 6:15 pm

Hi Tim,

Glad that you and Natasha are recovered now but what a horrible experience for you to go through. It is amazing to read that despite your delirium and debilitating symptoms you were able to advocate for Natasha and yourself when Dr. Gunjanrai was not present. From my own work as a nurse I am sad to say that I have seen examples of patient mismanagement and neglect in hospitals I have worked at in North America. A book I thoroughly recommend if you have not read it is Norman Cousins’ Anatomy of an Illness which essentially describes how the author who has a devastating illness advocates for himself in guiding his treatment and works in partnership with his doctor.
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LGZ — October 11th, 2011, 9:43 pm

Are you back in SF yet? Let’s grab a beer and talk about the Top 10 Places to get Food Poisoning in the Tenderloin, and then I’ll tell you what I think of your book if I’ve finished it. No Jamiroquai allowed, ya space hippie. Jesus.
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Murph — October 12th, 2011, 6:24 am

[COMMENT MODERATED]

I’m sure the post made some people uncomfortable, but it needed to be said, and in my view, this harrowing experience was presented in quite a balanced way. As you say, it wasn’t “Indian medical standards” that caused this problem. It was the laziness and incompetence of a few select members of staff (while other performed admirably).

As such, all indignant comments to the tune of “you have not seen real Indian service”, “this is an unfair representation”, etc, should be duly ignored. As should any that try to extrapolate this into a general argument against socialized medicine.

I have lived on three continents, and experienced extremely high-quality, AND lazy and negligent service in British, Japanese AND American hospitals (where apparently you have “the best healthcare in the world”). On balance, the average quality of service I have experienced on all three continents is the same. The only difference is that I paid approximately 200% more for treatment in Japan, and 2000% more in America.

If I’m going to have incompetent doctors, they should – at the very least – be cheap.
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Haitham Razagui — October 12th, 2011, 4:23 pm

Got similarly sick in India myself but didn’t visit a hospital, which on hindsight was a dumb move until I read this post. However the illness lost me weight faster than the slow-carb diet, for which I’m grateful.

Most people would not have the medical knowledge you applied to save yourselves from extreme danger. We had a similar experience of so-called professionals doing things blatantly wrong.

I travelled India by motorcycle, which kept breaking down. A mechanic decided to replace the fuel pipe with a new one, which was unfortunately too narrow, so whad did he do? Tried to melt it with a cigarette lighter so it would stretch.

Yes I said fuel pipe, which was at this point connected to the fuel tank of the motorcycle. The whole thing went up in flames, but fortunately it was quickly extinguished and nobody was hurt. I was even able to ride the machine away from the scene but when I tried to leave without paying in protest at the mechanic’s stupidity, a mob surrounded me until the wallet was opened.
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Lisa DeLay — October 13th, 2011, 11:43 am

Calcutta. Your story confirms what I thought one could experience over there. What a horror story. I’m glad you are back and well.
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Tony Bourke — October 13th, 2011, 2:06 pm

Having had a somewhat similar experience in China, that and Tim’s shows that it pays to know a little bit about medicine and hygiene, even in the US. Self advocacy can make a huge difference in medical outcome.
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PJD — October 13th, 2011, 3:24 pm

Thanks for this piece, Tim. My boss suggested I might like to do some systems development in India with our in-country consultants in November. I think not.! Sometimes I have my reservations about this geoarbitrage business.
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Josh — October 14th, 2011, 4:39 am

This is an awesome article for people in my business (executive security). If my principles ever wonder why I am humping a med kit full of clean needles, IV starts and meds to every corner of the earth, I’ll refer them to this tragic set of events.

Glad to see you and the GF made it, Tim.

Checklists save lives…couldn’t agree more.

-Josh
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Rochelle — October 14th, 2011, 10:14 am

I’d love to read the first draft of this post. I bet it is a lot more R rated and full of vitriol.

I admire your writing, Tim, and your ability to take this totally f*&ked-up situation and so clearly lay out your grievances based on fact and not emotional distress. I’m glad you and Natasha are feeling better.

This post can also serve as a reminder of what can go wrong when traveling. Spontaneity is fun after you’ve made preparations for it.
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Blake K — October 14th, 2011, 1:00 pm

THAT was intense. Glad you’re calling them out on it though.
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KARANJI — October 14th, 2011, 1:55 pm

First rule: don’t eat meat at India, specially fish. I was there years ago, so I can tell you. Option: Be veggie temporarily.
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PC — October 14th, 2011, 2:44 pm

Hey Tim,
Many things come up for me as I read your post. First, I am grateful you both lived to tell the tale. Having taken care of more than one ill relative spending a fair amount of time in (wonderful) US hospitals, I am struck by the conditioning that keeps most people from speaking up on their own behalf. Even under the best of circumstances, advocating for one’s own care, being committed to paying attention to what’s going in is essential. Many don’t, can’t or simply won’t speak up for themselves, or trust their instincts if they feel something is wrong. Too many are used to handing responsibility and power over to medical, (or any) authority figures.
Just a couple of weeks ago, a woman died in an Oakland, CA hospital because she was given liquid food designed for her belly feeding tube via IV, by mistake. Sadly, she was being cared for by a nurse brought in temporarily, during a strike.
Speaking of striking, I appreciate your willingness to display the vulnerability and fear beneath your anger. It means a lot that you would share such an intimate story with this audience. The outpouring of concern for the two of you here was remarkable to see. I wonder how it feels for you to witness that?
Remarkably striking, too, is the stunning lack of an outpouring of concern for the people who live in that city, everyday, humans who cannot escape those conditions, who probably have a much lower life expectancy, bury their children, and loved ones much too soon.
Its almost as if, as westerners (mostly, here-my assumption), we are only able to feel the pain of those we identify with. Others seem to disappear into the scenery. They become the background in a cool photo of our journeys, tweeted back for the admiration of our friends and followers.
I am grateful for the brilliance and ingenuity I see displayed on this site on a regular basis. I find myself inspired by something every time I visit.
So, in the true spirit of this blog about creativity, passion and action-taking, I invite ideas as to how we could help improve conditions both for adventurous travelers like you and those whose daily life is an adventure by accident of birth.
Here’s some juice to get us going. I love this story about how game designers have been enlisted to help find a cure for HIV. I hope its ok to place the link here. Remove it, if its not ok. I have nothing to do with these folks, at all:

http://www.topnews.in/health/computer-game-may-help-find-cure-hiv-22438

Following up on some comments in the thread above, how about a checklist app for travelers with the proceeds going toward local health care in some of the exotic locales that magnetize adventurers? I’ll bet there are tons of wonderful solutions waiting to be born. Perhaps some greater good come from the awful experience you had. Maybe your willingness to tell the story could help others in a tangible, long-lasting way. Any ideas?
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Nicolaï — October 14th, 2011, 4:35 pm

Honest concern here. What are the chances the doctors and nurses were (knowingly or not) using used needles? Wait 3 months and get tested. HIV in India is no joke.
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Jill Chamberlin — October 16th, 2011, 6:25 am

I’ve been traveling far and wide since I was 17 and haven’t had any serious medical challenges. Once we starting going to foreign countries with a toddler, however, we realized it might be best to update our “checklist.” The toddler is now grown (but so are my husband and I) and we have two recommendations we follow: l. We subscribe to a global rescue service when we are out of the U.S. There are several services, depending on your requirements. They’ll come and get you with a medical jet if both parties agree; they also provide telephone access to a team of screened doctors at reputable hospitals 24/7. Traveling several years ago in Morocco’s High Atlas Mountains, that service and a sat. phone provided a lot of assurance–especially since the number 1 health problem Americans face in foreign travel is auto accidents. (think: blood transfusions.) And second, a good overall primer is “Shitting Pretty”, (Travelers Tales, 2000 San Francisco.) Amazon should have it. It’s by Dr. Jane Wilson-Howarth, fellow of the Royal Society of Tropical Medicine and Hygiene…and she has good tips on how to stay healthy and what to do if you get sick.
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Valerie — October 16th, 2011, 9:39 am

I have a very close friend from India. The primary reason he has chosen to live in the USA, rather than there — even though he and his wife both come from rather wealthy families and would not have to work, is because of the medical care. When he first came to the states as a student, he suffered a collapsed lung. Here it was dealt with and he survived with no long-term problems. He’s quite sure, even though one of his uncles is a doctor, that he would never have received treatment in time and would have died. Even if you have money to spend, the medical care is bad. He doesn’t want to risk it.

So, his trade off, rather than living a life of luxury in India as the sole heir to his family’s fortune, he works a 9-5 job in the states. All because he wants access to quality health care.
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Anish — October 17th, 2011, 5:34 am

HI Tim, glad you are ok now.
Quite frankly, you were in the wrong city if you were looking for decent hospitals. Chennai/Madras is the city you need to go to for this, if in India. Unless you landed in Calcutta/Kolkata as a tourist and then fell sick, in which case you should have gone to the Apollo hospital.
Nevertheless, glad you and Natasha are better now.
PS: welcome to the Indian medical system.
Cheers Anish
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jbizou — October 18th, 2011, 2:40 am

I’m glad you are both feeling better. Food poisoning is no joke. I have had it from eating fish at a reputable restaurant in Clarendon VA. I am heading to India next week and have heard so many scary stories about getting sick out there from either food or drinking the water. Prevention: I had my brother prescribe me some antibiotics to take with me and reading this just reminded me why i will not be eating much. I will hate to get sick.
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sameerr — October 19th, 2011, 2:33 am

hi tim,

am from pune, city very close to Mumbai.
Being an Indian i apologize for the treatment yu recieved in calcutta…
But that is the harsh reality in iur country..
Though most of the world feel india is progressing..this is the harsh reality…

Any ways get in touch when yu come next time and i will make sure yu get to experience a better india.

cheers,
sameer
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Steven Wright — October 19th, 2011, 4:43 am

Hey Tim glad you and the lady friend are okay! Sounds like an awful experience, my guess is it happens around the world far to often. Have you ever thought about taking your practical, best-practice, DIY knowledge and creating a Medical Care Urban Survival book? Something of a guide book for the in-the-know patient or traveler..

As I was reading through your story, a thread that came to mind several times, was “Dang good thing he knew about the IV drip” or something like that. I think many of us in that situation would end up in much more pain or worse. Thanks for all you do!
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ramanuj — October 20th, 2011, 4:52 am

Dear Tim,

I am from city of Calcutta where you had this terrible experience. I am very sad to hear the terrible experience you had to go through.

Medical negligence is a reality that haunts India. even the rich do not have access to safe medical care. the laws are so underdeveloped and anti patient that doctors and hospitals get away very easily almost with any malpractice.

My dad had two surgeries last year, the first one at belle vue. He paid a lot more than what he would at other cheaper hospitals hoping for a safe surgery. He developed an infection on the surgery wound that is yet to be completely cured. He had another surgery on his heart 6 months later in another ‘reputed’ and costly hospital, following which he developed hepatitis B, and he believes it happened due to blood transfusion during the 2nd surgery. he spent most of his savings in the last 10 years on these surgeries.

We need to break the situation where doctors and hospitals know they can get away with negligence and careless attitude towards well-being of patients. I am living in Mumbai now, and I find the situation to be the same here. With help of a few friends, I have started a blog called medicallaw.in, and we are trying to organize a group of lawyers and doctors who will try to address these issues at a policy level.

Since you have suffered this traumatic experience Tim, you may now understand what my countrymen face every time they go to hospitals. I have made it my mission to change this, and find myself facing a very uphill battle. I have not even identified a very effective way to make a difference yet. Would you like to help?
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- Tom — October 22nd, 2011, 10:22 am
  
  Would you like to help?
  
  He just did.
  Reply
Greg — October 20th, 2011, 5:35 am

Hi Tim,

Great to read that you are not only an amazing self-promoter, but also great at taking care of others, in this case your girlfriend.
Natasha was lucky to have someone like you at her side throughout this ordeal, a “mere mortal” would not have had your knowledge and things might have ended up much worse.

Cheers,
Greg
PS: your copyright notice still says “-2010″, might not be worth to change this anymore for 2011 though
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Joe — October 20th, 2011, 5:55 pm

Hi Tim,

I just read your post regarding the Belle Vue Clinic. Nasty experience! I’m glad to hear you both survived and made it back to where you can get proper medical care.

I’ve really enjoyed your “4-Hour Work Week” on audio. I’ve started my own company, while working full-time to start the process of redesigning how and where I work.

Thank you for the inspiration!

Joe
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Daniel — October 22nd, 2011, 2:09 am

It’s a good idea to carry antibiotics with you when travelling in India. These can be bought *without* a prescription at a local chemist’s.
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Jason Stevens — October 22nd, 2011, 11:04 am

I learned two things from this post.

1. Vacation in first world countries

2. Always eat at Micky D’s when on vacation.
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Jose Lira — October 25th, 2011, 4:20 pm

I lived in India for a year and can totally relate to your story. Accepting cultural differences is one thing, but being negligent and irresponsible is something entirely different; these people deserve this rant. I applaud your commitment to quality and your appreciation for the people who actually helped you. Thanks for sharing Tim, it´s appreciated.
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Jane — October 27th, 2011, 1:58 am

You got out alive! Anyway, next time you visit India, you might want to try Kerala or Chennai for a change.. Compared to the rest of the country, I guess the South Indian states are better wrt medical tourism.
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Sysy — October 27th, 2011, 6:26 am

All I have to say is, somebody’s in love!
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A K Singh — October 27th, 2011, 2:32 pm

Guess who’s listed on the US Kolkata consulate hospital list? Yup- good ‘ol Bellevue.

http://photos.state.gov/libraries/kolcata/231771/PDFs/List%20of%20Doctors%20and%20Hospitals%20in%20Kolkata%20CONS%20District-27-JUN-2011.pdf

Perhaps, send them your blog link:
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Jason — October 28th, 2011, 9:57 am

Tim,

Welcome to the club of “man up.”

This sounds like one of my ordeals in Iraq a few years back when living on the local economy. It’s amazing how excellent any sort of health care seems after ordeals of this nature.

Good on you for watching out for your girl!

Best,

Jason
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Joseph — October 31st, 2011, 2:56 pm

Holy cow! I am glad you survived that and could share.
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Andrea — November 1st, 2011, 11:30 am

My husband and I were just talking about the issue of foreign hospitals (in developing countries) this evening. We’re serial expats and could possibly end up in the Middle East next year. Stories like this really make me nervous about the possibility of needing care…it’s good that you were able to be diligent and monitor your own care – you probably saved your own lives!
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Michelle Courtney Berry — November 1st, 2011, 10:47 pm

Dear Tim, I’m a big fan of yours…and was quite concerned, naturally, to read this post of shocking negligence, indifference, hygienically-challenged (to be polite here) medical facilities and so much more. I’ve had several brushes with incompetence, fatigue and general malaise working with many in the profession here in the States, who feel over-scheduled, blamed, misunderstood and the like..and we’ve seen numerous cases- in my wellness work and training experiences- (and personal ones) of the danger of oversight, burn-out, etc. BUT- I think you story has topped all others. If your humor returns, do read or-read, Troost’s “The Secret Lives of Cannibals- Adrift in the Equatorial Pacific,” it sounds like you could use some cheer. Be well, Michelle
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Maansi — November 2nd, 2011, 4:36 am

When I first read your post, I was like YIKES! I’m an expat living in Mumbai and I got ill around the same time that your post came out. Lucky for me, I had a very pleasant experience being treated for the illness. It appears that yours and mine were two extremes, and of course, India being India, there’s everything in between as well.

I will say this: If I had had a similar experience to yours, I would leave this country and never come back. That’s scary.

Luckily, there are options. Unlucky for you that yours was such a bad one!
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Jason — November 5th, 2011, 12:07 am

Holy cow! I am glad you survived that and could share…
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Taylor — November 5th, 2011, 1:51 pm

More rants, please!
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Bethany — November 11th, 2011, 10:08 pm

Oh My God! You have inspired me to think my family and I really can get this 4HWW thing together and travel, but I think I’ll skip traveling with my toddler to 3rd world countries for quite a few years.

Maybe I’ll also insist we eat vegan…
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4HMuse — November 13th, 2011, 12:32 pm

Tim,

If you were staying at the Oberoi, it would have been simpler to ring up reception and ask for the in-house doctor to come up and do a check-up. You would have saved yourself all the trouble.
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Madhu — November 16th, 2011, 8:15 pm

I am from India. I have seen episodes like these and even much uglier ones. I am really lucky that whenever sick i got the best doc/hospital around. Like you said there are really really good ones and the bitch ugly ones.
I am glad now you guys are ok.

The bathrooms anywhere in India(except our home and maybe star hotels) give me the creeps. The scum scaled tiles, moldy damp smell, ugh.

One a curious note – Did the hospital bathroom have a ‘health faucet’(the thing with which you spray water at your butt) or a large mug?
I understand Americans don’t really like the idea of water butt method, but i think if you got used to it, there’s no going back. Just my opinion. Esp if I have a diarrhea, water feels much better than paper.
For Indians, in general the thought of cleaning butt without water is unthinkable.
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Madhu — November 16th, 2011, 8:19 pm

on the lighter side http://www.oddee.com/item_96471.aspx
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Avinash Dhoot — November 16th, 2011, 10:28 pm

Dear Tim,

Sorry to hear about your experience at the “City Of Joy” and relieved you survived to continue sharing such insightful knowledge that has helped so many people.

Wish I knew you were in town and could have helped. Do get in touch whenever you visit this place again, and I promise to make your next trip a most memorable one.

Cheers to life!
Avinash
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Hugo — November 21st, 2011, 3:35 am

Somalia! The doctors there are decent. not a joke. The doctors are well trained, mostly in Italy and I found them to be be practicing good gygiene… I got an emergency surgery ” removed an appendix” and it all went well…the doctor’s name was Dr. Nur. He spoke fluent Italian and English, He did the operation under a tree with Mosquite net and plastic bag to make sure no flies or pathogens get there….. he must operated 20 others on that day. Thinking about it, he was experienced and he was nice and seemed really concerned about my situation. I did not call him, he actually called three of four times to check on me when he was not there. That was my experience and there were so many people with bullet wounds, misile and sharpnells showing up at his hospital called Martini. At the end, I did not pay anything, it was free. Hugo, Spain.
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Frank Zed — November 23rd, 2011, 5:34 am

Fantastic!
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Samantha Peterson — November 28th, 2011, 1:31 pm

Hey Tim,

You mentioned your girlfriend a few times in this post. I wonder if she would be interested in giving a fellow lady-traveler/entrepreneur some advice.

1. Tim has posted packing tips for his adventures in the past. After reading them, I’m always left thinking how men are lucky because one outfit is socially acceptable for 90% of situations, while it’s not for women. Also, most of them don’t have long hair to contend with. What’s your go-to pack list look like? How do you bring outfits that fit into everything you plan to do?

2. Have you traveled solo before? If so, any tips on staying safe and/or dealing with the cat-calling that goes on in lots of countries? Any tips on things to avoid while traveling solo? Or, tips on meeting a semi-normal, trustworthy travel companion?

Thanks!
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Levi — December 5th, 2011, 6:59 am

Sadly, good and bad doctor or hospital experiences are not limited by geography. One of the things in Tim’s story that is really important not to miss is being informed and being your own advocate. Whether you’re going in for a routine physical or are needing emergency treatment, being prepared, asking questions, insisting on answers and refusing to defer simply because someone is an MD are all critical components of receiving the care you need. No one knows your body better than you no matter how smart or experienced they are.
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Brian — December 9th, 2011, 9:18 am

I don’t know if this is the same hospital, or even associated in any way, but I saw this tragedy and thought of your experience Tim.
http://www.bbc.co.uk/news/world-asia-india-16104610
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Alice — December 29th, 2011, 2:31 am

My arm looked like that after leaving a hospital here in the US of A. I have entered ERs here with terrible food poisoning only to be ejected without any fluid treatment at all. I have left after being treated for a broken back with a kidney infection because all the nurses gave me to drink was Sprite, not water, even though I asked for water. It’s as hard to advocate for yourself here when you are sick, perhaps moreso: the nurses feel their “top-notch” education equates to know-it-all status.

Good for you, however, for advocating for your gf. My husband is a total wimp . I wouldn’t travel with him anywhere.
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Wendy — June 7th, 2012, 3:55 am

Oh my god. As an Emergency Room employee, this story made me cringe ten ways to Sunday. What does that phrase even mean? IDK but it sure feels right in thins instance. Gads. So glad you two made it out OK! I wonder if the good doctor ever made it to a better facility?
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Donna — August 24th, 2012, 12:40 pm

If anyone is still following this thread, please give me some advice! I will be traveling to India (likely New Delhi and vicinity) for 10 days in December as part of my business graduate program and Tim’s post (and so many others here) are beginning to weird me out. I’ve traveled to Europe several times and have a healthy body and an adventurous spirit, but man, things aren’t sounding too good over there. What drugs should I be packing in my suitcase?
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Robin — January 30th, 2013, 3:05 pm

Thanks Tim, I caught a strange bug in India but luckily it lay dormant then surprised me two weeks back to London. One night in hospital and several more nights at home doubled up in agony. What a hellish week. Just about to set of for a trip to an Indonesian island without so much as a chemist on it. Anyway what I really wanted to say is Four Hour Travel Book must be on your list. It know it would be a blockbuster. Everything from advanced travel hacking, air miles, upgrades, hotel all the way through to how to survive those inevitable medical situations.
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