10 days ago I had an urgent appendectomy surgery that took me by surprise. I’m a foreigner alone in Pakistan, which plays no part in this except maybe the fact that I am female. 

My Story

The hospital I chose – Ali Medical – is in the area where I am staying, in Islamabad’s F8 zone. It has a good reputation and I contacted them in advance of my visit. Upon sharing my symptoms with the gent on the other side of the whatsapp line, he urged me to come in ASAP and gave me an exam time-slot at 11:00.

The surgeon – Dr. Tahir Hussain – recognised that I was suffering from appendicitis and requested to immediately admit me for an emergency appendectomy. He told me I needed to return by 15:30 to check-in, receive the required antibiotics before my surgery, etc.

The initial process from my arrival to the administrative staff and the nurses was stellar (even thanked them & Dr. Tahir the next day via a few Instagram Stories … FYI that was before I knew about the metal staples). Surgery began at 18:30, relatively on time, and was a success. Within 30 hours, I no longer needed pain medication and I bounced back to “feeling myself” within three days. I recovered very quickly.

In fact, I have ONLY ONE COMPLAINT about the actual surgery itself. Every respected private hospital and surgeon recommends to close the three small 1 to 1.5 centimetre incisions following a laparoscopic appendectomy with tiny dissolving (absorbable) stitches. Every one. My surgeon used metal staples on me, the type used for “open” appendectomy surgery, not laparoscopic. Worse yet, they didn’t inform me they did that, so imagine my shock to discover it in the mirror at home upon first removing my bandages. Using metal staples was NOT what was best for ME. Quite the opposite. They did it solely to save time for themselves. Period.

My Complaint (beyond unnecessary metal staples!)

IMPORTANT NOTE: Laparoscopic appendectomies are out-patient surgery in most countries and mine would have been if I had it in the morning or afternoon instead of at night.

By 9pm I was back to my executive suite private room. The surgeon came by to advise me that all went well. He said that my appendix was more swollen than most but did not indicate that there were any health concerns because of it. I understood that I had a standard appendectomy and there were no complications. That was great!

I grabbed my laptop, sat up cross-legged in bed, and started catching up on some work.

However, I quickly realised that I would not be able to sleep in that room unless I was heavily sedated. The windows didn’t shut properly. Every motorbike on the road could be heard in the room. The next-door mosque had a speaker right outside the window. Whenever a patient on our floor rang their bell, a sound played above my bed from an overhead speaker (chiming up to a minute or more non-stop). And I could hear animated conversation at the nurse’s station.

I would be better off back home. 

So at 11pm, I asked to be discharged. I felt great and met all the requirements for going home after surgery. Most importantly, I knew I would not be able to sleep in that room – it was going to be like trying to sleep on an overnight bus ride, if that makes sense. Because the surgeon was at home and not there to sign me out, I needed to sign a waiver stating that I was leaving against their recommendation and that I took full responsibility. That’s fine, I understand that CYA (cover your ass) measure 100%.

Penalised or Punished?

Then, things took a turn. The surgeon (via a nurse) asked that I return the next day for an IV drip but couldn’t explain the “why” in a way that 1) made sense or 2) made it seem like a requirement for my health (it was presented as a “nice to have”). I asked them to please write a prescription for whatever they wanted me to take in the IV drip so I could take it orally the next day instead. But the surgeon refused to let the hospital write me an Rx.

Worse yet, he forbade them from sharing even the most simple care instructions with me. He forced them into silence and sent me home as a penalty (or punishment?) without knowing how to clean my wounds, how to sleep (on my back or my side?), how much physical activity to take on the first days after the surgery, etc. 

Was It Ethical?

Did this happen because I am a woman? If a man paid over Rs300k cash for his surgery and signed a formal waiver saying he checked himself out, would a female nurse really have TOLD A MAN NO when he asked how to change his bandages?  

The surgeon didn’t allow them to inform me I had 11 metal staples that would need to be removed nor when, which came as a HUGE shock when I removed my bandages and saw my wounds! Those types of instructions are easily shared by the nurses but he told them not to.

The entire next day I tried to learn and receive a copy of my post-operative care instructions via WhatsApp. I did my best. But all the Patient Coordination Dept would say is “our consulting surgeon will not allow”.

One thing is very true … I am grateful for Google and all of the respected hospitals and surgeon blogs worldwide who’ve written the details of appendectomy post-op care on their websites. I had to learn EVERY SMALL DETAIL of ‘what to expect’ and how to care for myself on Google … instead of from the hospital that I trusted to take care of me.

Final Thoughts

Today it has been 10 days exactly since my surgery and I feel LOADS better since using a home nurse service yesterday to remove the metal staples! I’ll be in Pakistan another few months and really liked Ali Medical but I’ll never go back, which is a pity. The staff were wonderful and so was their service.

From my point of view, I was the hospital’s patient because of all the dozens of tests and departments and staff I engaged with 10 days ago. I simply had Dr. Tahir as my attending surgeon because he was on rotation that day. I wish the hospital had stepped in more.

Two Notes:

1. I shared this article a week ago with the hospital, they did not comment.
2. Twice I asked for items on my bill that I know were not consumed by me to be removed and they have yet to issue a refund.