A Fourth Qatari Travelogue: Health Care and Fate

This is the fourth in a series of essays written after a business trip to Qatar. The first one is here, the second one is here, and the third one can be found here.

When I found out that I was fixing to go to Qatar for a fourth time, I found myself wondering “whatever will I write about this time?”

I was going out to Qatar with a co-worker (let’s call him “Jason”, because that’s his name) who is only a little less introverted than I am and had been there before so it’s not like I would have felt an obligation to take him to the souk or the Villaggio Mall or, for that matter, go out in general, so I thought it’d be a trip full of 12 hour days, fast food rather than sit-down food, and then collapsing into bed only to do it all over again tomorrow.

“What in the heck would there be to write about that?”, I thought to myself. “Complain about the drivers again?”

Golly, was *I* wrong!

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Day one of the trip started poorly. We made it to the Colorado Springs airport and the first flight of the first part of the trip had maintenance issues so we missed that flight and that failure was followed by a bunch of little cascading failures for the rest of the day that resulted in us missing our flight in Germany and making us spend the night in Frankfurt.

We got there with enough time before sunset to stroll over to a mall that was within walking distance to get a plate of food and stretch our legs. The victory of neoliberalism is that every single mall in the (first) world is like every other single mall in the (first) world. The food court is likely to have food that is local to the region and “exotic” food that is familiar to the region, but if you squinted and ignored the occasional umlaut as you walked past the stores to the food court, you’d have sworn that you were in Danbury or Reno or Austin.

There was even a Chipotle in the food court! I suppose that there is one difference between over there and over here: we noticed that they served more European portions. “It’s a flauta restaurant”, Jason quipped.

We found a Wurst counter and I put in my order and the lady asked me “Mild or Spicy?” and I brightened and said “Spicy!” and she served it up and I went to eat and… German “spicy” is not like American “spicy” at all. The “mild” packets you get at Taco Bell are spicier. This was about as spicy as Heinz 57.

Wandering back to the hotel, we took the elevator up and there was a poster in the elevator advertising the “American-style Sports Bar” with the phrase “I’ll have a double cheeseburger and a Diet Pepsi” and I found myself thinking “man, that does sound good” before thinking “HEY THEY’RE MAKING FUN OF ME”.

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We got to Doha and collapsed into our own individual hotel rooms the first night. The next morning, Jason told me that he was calling in sick and I should just go in without him. I went to work, went about my day, checked up on him when I got back and he was still feeling crappy but we managed to walk to get some self-care products from a little pharmacy in the mall attached to the hotel (note: it was exactly like every other single mall in the (first) world) and we got something to eat and then finished off the day.

It was the next day that he said “I’m feeling really, really short of breath. We need to go to a clinic.”

And then this is the story of getting health care in a foreign country.

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But before I tell you that story, I’ma have to tell you this one.

Driving to work one day, we saw a window sticker in the back of one of the trucks that passed us. It consisted of two lines. The top line was in Arabic and I don’t know what it said but I presume that it was translated in the second line which said “God Wills It”.

Which is one of those statements that sums up the driving over there. If God wants me to live, I will live. If God wants me to die, I will die. What is the use of my seat belt? Or turn signal? Or traffic laws in general?

The representative horrible driving story from this trip is the guy in the far right lane of a 4 lane road realizing at the last minute that he wanted to turn left and then turning so hard that he was driving *PERPENDICULAR* to the flow of traffic in order to get into the left-turn lane.

We hit the brakes and the wheels locked and the tires squealed and I was sure that I was going to t-bone him but, no, we stopped a few feet from him and then I was sure that I was going to get rear-ended and t-bone him anyway… but I wasn’t and I didn’t and he continued on his merry way, driving perpendicular to the road in order to get to where he felt like going.

Hey, if God wanted him to make the turn, he’d make the turn. And if God wanted him to die, following the same driving conventions as the other drivers would be no help.

He successfully made his left turn. God willed it.

Here’s a list of professions not eligible to apply for a driver’s license in Qatar.

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Early on in the trip, we visited the little currency exchange shoppe they had in the mall attached to our hotel. The Qatari Riyal has been holding, more or less, steady at .275 over the last five years with a little jump or dip here or there but, for the most part, you get just under 4 Riyal for a buck.

I walked in, took out a $100, and handed it to the gentleman behind the bulletproof glass. He asked me for my passport, I handed it to him, he checked to make sure that my passport was genuine, called his supervisor over, his supervisor checked to make sure that both my passport and my $100 were genuine, the supervisor gave the nod, the guy behind the window handed me my passport back along with 360 Riyal and a printed reciept.

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We first drove to a public clinic and walked through the door. It was what you might imagine a public clinic would look like in a 3rd World Country. After about 30 seconds, we turned around and walked out. We googled for private clinics in Doha and found one with all kinds of people complaining about how expensive the clinic was and we were grateful for our credit cards as we drove to it.

We parked in the parking garage under the clinic and then walked through construction to make our way to the counter . We passed a foreign laborer who was using his drill on some drywall and we noticed that his drill was modified somewhat. We saw that his drill had a cord that was originally only about 3-4 feet long and that was, apparently, too short to do work so, at some point, he cut the cord and rewired it manually to give it a 20-foot cord, with the two original halves of the cord still there at the ends. We stepped gingerly over the new wiring on our way to the front.

As Jason went up to talk to the receptionist, I checked out the 80″ television they had on the wall that was displaying the different departments and the various doctors associated with the various departments. Oncology, dentistry, Ob/Gyn, all kinds of stuff. A couple of scrolls on the bottom caught my eye and I noticed that they went left to right, rather than right to left… which meant that I had to start reading at the end of any given sentence and backfill as the scroll let me catch up to the beginning.

At the very bottom, Latin text was scrolling and I found myself recognizing it. I was kind of confused… I mean, I’m over-educated but I’m not *THAT* over-educated that I recognize long strings of Latin. Phrases, sure. But long strings? “Ut enim ad minim veniam”, how do I know that? Is it the Hippocratic Oath? But isn’t that in Greek rather than Latin? Then it scrolled to the first two words in the paragraph: Lorem Ipsum.

Jason came over to me and showed me the paperwork they printed out for him. Next to Ethnicity, they had “American Samoan”. Our best guess was that “American Samoan” was the first one with “American” and that’s what the receptionist put down for him.

I pointed out the Lorem Ipsum on the scroll and he said “you’ve got to be kidding me”.

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He got called to meet with the medical assistant to get his numbers taken and written down next to “American Samoan” and meet with the doctor. He came out with another printout and he explained to me that the doctor didn’t really speak English but got the gist from the labored breathing and coughing. Jason got diagnosed with Severe Bronchitis and the doctor prescribed 15 minutes on oxygen and two shots: Megion and Volataren.

Jason was also given a prescription for an oral antibiotic and we were told to use the pharmacy right around the corner.

We walked up to the pharmacist and handed him the prescription paper and he read it and then his face brightened and his eyes were dancing with laughter as he looked at Jason and asked “Your name is Jason? Like in the horror film?”

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Megion and Volataren are, when you google them, Ceftriaxone and Diclofenac.

If you’re not familiar with either, Ceftriaxone is an antibiotic that tends to get used when other antibiotics just won’t work. It’s one of the drugs they use with bacterial meningitis, for example.

Diclofenac is a nonsteroidal anti-inflammatory drug that was found to seriously increase “major vascular events”.

After we got back to the hotel, I dropped Jason off in his room to get some serious sleep so he could recover from his day at the clinic.

He later told me that he considered calling me and taking him to the clinic again because he could feel his pulse in his eyes, his temples, his neck, his thumbs… everywhere. The antibiotic also did a good job of killing dang near all of the flora and fauna he had been cultivating in his intestines.

The stuff did a number on his kidneys, too. “It was like I was peeing coffee”, he told me the next day.

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We discussed the cost of the trip to the private clinic at some point. My buddy explained to me that he pays about $200 bucks a week for his family’s health insurance here in the US.

“Do you have insurance?” the receptionist asked. “Well, I’ve got this,” and he gave her his insurance card and she apologized to him explaining that that they didn’t accept that and, unfortunately, he’d have to pay full price.

He told me he braced himself thinking “this is gonna cost around $6000” and he nodded and they told him that it was 200 Qatari Riyal to see the doctor.

After seeing the doctor, it was another 100 Riyal for the Oxygen, Ceftriaxone, and Diclofenac.

Then, at the pharmacy, he had to shell out another 100 Riyal for the stuff he got there.

That’s 400 Riyal. Start to finish.

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I didn’t know how to really evaluate the whole medical thing, given that I Am Not A Medical Professional, but then I thought “hey, I know a guy!” and so I fired off an email to our very own Dr. Saunders. I wrote him the following:

Hello!

It’s me. I need your professional medical opinion, if you can offer it.

While we were in Qatar, my buddy came down with some shortness of breath and we went to a private clinic to get him treated.

They diagnosed him with severe bronchitis and put him on oxygen for 15 minutes and gave him two shots: Megion and Volataren

In my googling, I found that the two official names for these drugs are Ceftriaxone and Diclofenac.

My questions are:

Is this right? Megion and Volataren are Ceftriaxone and Diclofenac? I don’t want to get that part wrong.

Also, is it right that my immediate response to finding out that this was how they treated bronchitis is something like “horror”? Should I instead be saying “well, that’s pretty much what he would have gotten if he visited a half-decent clinic in the US”?

Thanks!

He wrote me back:

I had to google Megion myself, since that’s a brand name I’ve never heard of, but it appears the ceftriaxone is the correct drug. I’ve heard of Voltaren, though have never prescribed it myself, and diclofenac is the correct generic name.

So, with a HUGE caveat that I do not take care of adults, and (as stated above) never prescribe diclofenac, my take is that your friend’s treatment was insane. Unless there are further details I am missing (entirely possible), I am wholly unaware of any role for diclofenac in the treatment of any respiratory illness at all. Perhaps a pulmonologist would give you a different answer, but I have no idea why that medication would have been chosen.

Similarly, I have no idea why they would give oxygen for 15 minutes, or why they would given an injection of a broad-spectrum antibiotic like ceftriaxone. I give that medication as a shot sometimes, but typically only when oral options have failed for some reason or another. I suppose if they were concerned about a severe respiratory infection that would be an appropriate option, but in that case he should have been admitted for further treatment and observation. I would not be giving people shots for severe infections leading to oxygen requirement, then saying “see ya later!”

Hope that helps!

I got his permission before posting the contents of his email to me.

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I showed everything above to Jason to let him give his opinion on what I wrote before I hand it to the editors to work their magic and he wrote back:

The voltaren was for chest pain. They prescribed a drug to treat my chest pain that causes heart attacks.

Also with that antibiotic they didn’t just give me a shot… I got a litre of the stuff.

So those are his edits and clarifications to the above.

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For what it’s worth, my buddy got better.

God willed it.