A nomad life: Indian, Thai or American?

Middle East Intern Maithili Bagaria was born in India, raised in Thailand and is currently a rising senior at Rice University in Houston, Texas. She writes:

As I feel another spasm of pain, I grab my phone on the bedside table and call my uncle, ranting to him about my terrible stomach cramps and begging him to think of a solution. He tells me to go to the emergency room if the pain is unbearable. I tell him I think it’ll pass within the hour. He then advises me to set up an appointment with a primary care provider and asks me to make sure my insurance will cover the visit.

I put the phone down in confusion. Insurance? How was that related to anything? I begin to recall the annual health insurance charged to my father as part of college tuition. I remember the Aetna plastic card that came in the mail during the first week of classes. I furiously rummage through my wallet and locate the plastic card, grateful that I had the common sense not to throw it away. My journey in American health care is off to a good start.

Logging in to Aetna’s website, I am stormed by various tabs that mean nothing to me. After locating the “Find a doctor” tab, I’m confused as to which insurance plan I possess. I go back through my records and find that I’ve been charged for student health insurance and try searching that instead. This time I’m taken to a website that allows me to locate doctors that are partnered with Aetna Student Health.

I call a university hospital and am quickly set up for an annual physical Aetna covers. At my appointment, my doctor tells me she’ll send a prescription to the nearest CVS. When I pick up my medicines, I find my insurance covers those too. All in all, I’ve been charged $0 for my visit.

In Thailand, the hospital process would have easily cost me $100. I would have had to pay for the doctor, the medicine and the administrative fees out of my pocket. The idea of health insurance for non-Thais living in Thailand is out of the question. Even many wealthy Thais opt out of health insurance and pay the hospital fee upfront when need be. Now, it is true that medical care costs less in Thailand than the US, but health care without insurance—which is common—can easily cost hundreds, if not thousands of dollars.

In my experience, doctors in Asia–certainly in Thailand and India–are less likely to prescribe medicines for “minor pain.” Doctors in Bangkok have often told me that if I can bear the pain, I should avoid taking medicines. In Washington DC, I was told there is no need to tolerate any pain. Daily medicines can easily fix the issue. I subscribed to the American model when the pain started interfering with my work schedule.

The question of which medical recommendation is better is more than a conflict between Western and Eastern medicine. It is a conflict between disparate cultures, ideologies and histories, which I face everyday as a modern-day nomad. By giving in to my American doctors’ recommendation, am I becoming a victim of American work culture and allowing my schedule to dictate crucial health decisions? Or am I simply being practical by embracing modern-day medicine?

The people around me had no trouble trying to put me in a box. On my first day at Rice University, a member of the cleaning staff started talking to me in rapid Spanish after she saw I was dark-skinned and understood what “hola” meant. American friends attributed my vegetarianism to my religion, even though I’m a practicing Hindu in name only. Indian family members assumed I had lost respect for Indian customs and traditions as an Indian who had grown up abroad.

It seemed I could never please anyone, except I could please everyone. The disparate philosophies embedded in me allow me to relate comfortably with others. I can understand the warmth one feels from living amongst 15 other people just as much as the independence one feels from living alone. I can transition from a direct and transparent communication style to one that demands more subtlety. And most importantly, I can listen without many preconceived notions, because I know the costs of trying to put people in a box. A modern day nomad’s life is full of internal cultural conflicts, but also one of rewarding connections with other people.