witch doctor

The Witch Doctors of Malaysia

Before reading on, please be assured the image above came from Kenya, not Malaysia.

Technically still a “developing country”, Malaysian healthcare becomes a hot topic when discussing our impending move. Many people think only America provides highly educated quality medical services, regardless of the insane cost and ridiculous class based system that affords the best care for the lucky ones with employee sponsored group healthcare.

Actually, nothing could be further than the truth. In fact medical tourism is thriving as people discover the quality and cost benefits. Malaysia competes with neighboring Thailand, India, and countless others for the developed world’s business. As residents and not tourists, Diane and I considered availability and proximity to quality healthcare very high on our list of priorities. Rather than explain everything, below are some brief highlights, courtesy of The Malaysian Travel Council, an initiative by the Ministry of Health Malaysia:

Malaysia healthcare offers specialties in various medical disciplines and performs some of the most complicated treatments in the world. Today, the medical practices in Malaysia are at par with the some of the best in the world, incorporating both sophistication as well as international expertise.

Our team of renowned medical specialists have been trained in some of the most esteemed medical institutions in the world namely from the Australia, United Kingdom, and United States of America. Medical treatments are carried out in state-of-the-art facilities that have been furnished to meet international standards. Hence, the high quality in medical treatments is thus maintained at the technology as well as at the professional levels.

We offer quality service with compatible pricing. The typical current scenario of the international medicine, where the cost of medical treatment is skyrocketing in the United States and Europe, Malaysia’s healthcare service comes as a relief to patients from all over the globe. Malaysia certainly and confidently boasts of a medical care that supersedes in quality and affordability.

On a worldwide scale, Malaysia ranks 3rd best out of 24 counties according to International Living’s Global Retirement Index, scoring 95 out of 100 and beating out  Ireland, New Zealand and Spain. Regular doctor’s visits average $16 USD and a dental check-up costs $9

And as of September, 2014, rankings in all important categories were very high according to Numbeo, the world’s largest database of user contributed data about cities and countries worldwide.

Component of health care surveyed Satisfaction %
Skill and competency of medical staff 66.67 High
Speed in completing examination and reports 63.10 High
Equipment for modern diagnosis and treatment 92.50 Very High
Accuracy and completeness in filling out reports 66.86 High
Friendliness and courtesy of the staff 65.70 High
Responsiveness (waitings) in medical institutions 56.40 Moderate
Cost to you 67.26 High
Convenience of location for you 73.84 High

Naturally, staying healthy is probably the most important factor of all. While we trust the system’s integrity in Malaysia, we figured it’s best to milk our current employee sponsored Kaiser Permanente plan for all its worth while we still have it.


Notice the funny looking little nursing caps from yesteryear. And a smiling doctor. Obviously not the USA

Apparently my body decided the same thing. While coming home from a concert one night this past spring I noticed a bulge in the left groin area. Having already done hernia repair for my other side ten years earlier I knew exactly what it was. Since I can’t speak about Malaysia’s health care system any further from so far away,  I thought I’d share my experience of minor inpatient surgery for repairing an inguinal hernia and the associated anesthesia known as “conscious sedation”.

Not a good solution to a hernia

If you’re a man, there’s a 50% chance you will get a hernia sometime in your life. A hernia is a weak spot in the abdominal wall that can eventually give out. Usually this causes a noticeable bulge in the groin area, either painful or painless. I’ve now had two. Both were painless.

Ironically,  you enter the operating room to fix a painless condition and get wheeled out to a begin a  painful recovery. It almost makes you want to skip the procedure. Sadly, hernias don’t go away by themselves and can’t be repaired  without surgery.  If you enjoy an active lifestyle,  it’s best to fix them sooner rather than later.

Considered one of the simplest and most routine procedures, it’s performed by a general surgeon. Why anyone would spend all that time in medical school and then do unchallenging mundane tasks eight times a day is beyond me. Kind of like my 31 years as an operations specialist in the financial services industry. Quoting the great Rodney Dangerfield, “Hey I don’t get no respect”.

I suppose someone has to be a proctologist, urologist or male gynecologist (that one really baffles me).

surgeryThere are two ways to do hernia surgery; The first is laparoscopic surgery. Often performed for cases of repeated tears, this method involves a quicker recovery period but requires general anesthesia. Having fixed a hernia on both sides, I’ve never had this option. Associated with greater risks anyway, why wake up feeling extreme nausea when you can enjoy a relaxing procedure while half conscious and enter the recovery room happy as a clam?

The second method is known as “open” surgery. Utilizing this method, an incision is made, the abdominal wall back is pushed into place. and the surgeon inserts a superhuman titanium mesh patch to hold it together. Designed to last your entire life, it’s a pretty amazing little piece of medical innovation but it’s not the best part.

“Conscious Sedation”, also known as twilight sleep and moderate sedation takes the prize as the main reason you’d voluntarily sign up. It’s so awesome, you can even look forward to it. Not that I’m condoning injuries but maybe just something simple like a separated shoulder.

Happiness in a bottle

Happiness in a bottle

As the name implies, you remain technically awake while under the anesthesia. Apparently everyone’s experience is different. I’ve had it three times and each time found the state of total relaxation quite blissful. Describing it briefly, picture the best massage you’ve ever had in the nicest and most relaxing environment possible. Magnify that  by 100 and that’s conscious sedation. The choice of drug determines  the level of awareness. I remained entirely aware, heard every word of useless babble the staff spoke and enjoyed the sounds of a light rock station playing in the background. Perhaps due to the anesthesia team’s magical drug of choice, I believe I now understand what happened to Michael Jackson and why he elected to have a doctor inject himself into an early death.



While being prepped, I was surprised and a bit concerned that I was receiving a drug that killed The King of Pop for a minor surgical procedure. The anesthesiologist reassured me as he sarcastically said “We know how to use it.” Nice. $250K a year for snide comments to anxious patients. Whatever.

michael jackson

What the hell happened to this icon of the ’70s?

Placed in a nice comfortable prep room, the attending technician gave me a gown, took my blood pressure, attached some of those thingies to my fingers and told me to relax. Of course the surgeon was running late and I was already the last surgery of the day. Finally the surgeon walked in and waved as they wheeled me in and said “Here comes the good stuff”.

Within thirty seconds I entered a relaxed world somewhere close to Puff the Magic Dragon’s Trip to A Land called Hanalei. Gabbing the entire time, the staff of six poked and prodded. Unlike my last surgery, I felt and remembered all the bodily intrusions. Not caring, the propofol  ensures a smooth ride. Don’t worry. Be Happy. And happy I was. Almost at the peak of relaxation bliss you suddenly hear “All done now”. Crap.

Wheeled into the room where Diane was waiting, they gave me a strong narcotic for pain but it takes the entire evening for the wonder drug to wear off so you probably won’t feel anything but relaxed until the next morning. Had I been on the jury that convicted Michael Jackson’s doctor for injecting the lethal dose that killed him, I would’ve had to excuse myself. Yes, folks if you must have routine surgery, do yourself a favor and ask for propofol.

And you will be with Propofol

And you will be with Propofol

Five days later I was still very sore and unusually tired but that’s part of the fun. Six weeks of rehabilitation dragged on. Walking, hiking, swimming, cycling, elliptical machines and recumbent bikes are on the rehab menu. No core activities, yoga, weight training or lifting over 10 pounds due to risk of tear. Knowing that repeat procedures get stuck with general anesthesia instead of the lovely spa-like treatment provided by conscious sedation, I followed all the rules.

Here’s to hoping I never have to experience the operating room in a Malaysian hospital. But if I do, I’m happy that my doctor will probably not be a shaman.

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