The surgical tourist

Hey Brucerdquo I exclaimed with surprise a big smile on my face as I bumped into him in the hospital corridor during my rounds At 6 feet 2 inches he was hard to miss He had a square frame upon which his broad shoulders rested His brown French beard made its presence felt over his fair complexion Even though he had a tough exterior he had the kind of face that if you saw the first thing in the morning your day went wellldquoItrsquos so lovely to see you buddyrdquo I said to all of his 72 years and all of his 72 hairs He had been born in Zimbabwe and after having lived on a few continents in his younger years he had decided to settle down in a quaint town in southern Africa ldquoWhat brings you back to usrdquo I enquired My orthopaedic colleague Dr Mudit Khanna had done a knee replacement on him a few years ago with such astounding success that from not being able to walk a few steps he was cycling 30 km every day I knew him well because when Mudit and I went to his country on a work visit he took us both for a fourhour cycle ride in the bush where lions roared not very far from usldquoIrsquove been diagnosed with prostate cancerrdquo he said matteroffactly ldquoand this is where I have faith so thatrsquos why Irsquom hererdquoTrust and conviction are so crucial in healing I thought to myself As one of the greatest physicians of the 20th century Sir William Osler said ldquoNothing in life is more wonderful than faithmdashthe one great moving force which we can neither weigh in the balance nor test in the cruciblerdquoldquoThe urologist will do a biopsy and then plan aheadrdquo Bruce added convinced he was going to be cured ldquoBut before I start any treatment I have a request Letrsquos go for a bicycle ride around the cityrdquo he said clearly reminiscing the wonderful time we had had together ldquoDealrdquo I confirmed as we shook handsSo at 6 am on the following Sunday Mudit and I picked up Bruce from the hospital It was the first weekend of the monsoon The three of us rode along wet Mumbai roads glistening from their first wash in the rain The crisp air and cool breeze made the climb up Pedder Road seem like a walk in the park and for Bruce the veteran it was more of a saunter We had decided to give him a cycle tour of the city and as we rode past Marine Drive we saw a bunch of overjoyed Gujrati adults indulging in garba circling a loudspeaker in the pouring rain at 7 in the morning Our day was madeWe rode past pigeons flying off near the Gateway of India and took pictures with the iconic Taj Mahal hotel as our backdrop The skyline of the city looked so beautiful as raindrops peltered the Arabian sea ldquoThis is such a great way to see the cityrdquo Bruce was thrilled ldquoYou get to see it from such a different vantage pointmdashnot too fast not too slowrdquo he pondered completely soaked in the rain After encircling 20 km of South Mumbai we stopped at Cafe Mondegar for breakfast and Mudit ordered a couple of beers for breakfast because thatrsquos what orthopaedics do We fed Bruce some kheema pav to tickle his tastebuds little did we realise that as an African he had tasted the meat of nearly every conceivable animal ldquoAre you allowed to drink and ride in this cityrdquo he asked ldquoAs long as you donrsquot hit a bump and spill the drink itrsquos finerdquo I jokedWe rode back via Kala Ghoda Flora Fountain and CSMT as the pelting rain stung us with pleasure It was an invigorating 40 km ride and an excellent start to the dayMedical tourism is the practice of travelling across international borders to seek healthcare services It was once a liberty of the rich who travelled to the hot springs of distant Mediterranean countries to soak themselves in mineral rich water that had healing properties or those who travelled from underdeveloped countries to developed ones for medical aid Today it is a common and an affordable affair for people in developed countries who are not that well off to travel to developing nations offering the same medical care at reasonable prices and comparable expertiseEvery individual wants optimal healthcare for themselves and their families Oftentimes however the care that one is seeking is not available within short distance Occasionally even when care is available one might not be able to avail of it within the desired timeframe The wait list for a knee replacement in countries like Canada and the United Kingdom which follow a socialist practice of medicine is over a year In India you could book a knee replacement as fast as you could get a burger from a drivethrough at McDonaldrsquos And unlike McDonaldrsquos at some places when you go in for a knee replacement you can get the other one at half priceSometimes the financial implications in the patientrsquos home country may be prohibitive An uninsured US citizen was once treated at our hospital by me for a complex multilevel spinal fusion surgery that was to cost her 100000 R82 lakh approx in her country She had the same operation done by us here for onetenth the cost and was so happy that she flew back business class There is also a certain special doctormdashpatient relationship that develops when patients travel long distances to see a physician or surgeon friendships are made bonds are established and families are extendedMetaphorically not literallyAccording to sources India ranks at number 7 among the 20 wellness tourism markets with over 56 million trips made to India for medical value tourism that generated USD 163 billion in revenue It also ranks at number 3 in wellnessfocused countries in the Asia Pacific with Thailand leading the race That may be because we offer only a bicycle ride as an additional service to our touristsOver the course of the next 10 days Bruce completed his treatment He looked well and rejuvenated He seemed happy to have made the choice to come back to us at Wockhardt ldquoMy doctors have given me permission to ride my bike as much as I canrdquo he said with glee clearly not letting the diagnosis of cancer interfere with his joy of living ldquoHakuna matatardquo I told him as we fistbumped each otherThe writer is practicing neurosurgeon at Wockhardt Hospitals and Honorary Assistant Professor of Neurosurgery at Grant Medical College and Sir JJ Group of Hospitals