Saturday, October 12, 2013

Medical Care Made Easy in Chile

Possible Squamous Cell Carcinoma? Basal Cell Carcinoma? We sent this photo to a dermatologist in the U.S. and he said it could be squamous cell carcinoma and it needed to be excised (removed). Within a couple of weeks it had grown rapidly and was very inflamed. It wasn't prudent to wait until we finish our mission.

Of course I am thinking about Luke 22 -
49 When they which were about him saw what would follow, they said unto him, Lord, shall we smite with the sword?
50 And one of them smote the servant of the high priest, and cut off his right ear.

So we need to find a dermatologist not named Peter.
We went to the best clinic in Chillán. We had previously helped to set up a contract with this clinic so they could treat our missionaries. I felt reasonably comfortable receiving medical care there. The facility was fairly modern and up to date.

We went to the clinic to make an appointment to have my ear checked. At the check-in desk they told us that we had to make the appointment by phone. That was disappointing. Chileans are not easy to understand and it is especially difficult to understand them on a cell phone. Nevertheless, I stepped away from the check-in desk, called the number and made an appointment for the following week. The appointment was with Dr. Miguel Torres, dermatologist.
The following Thursday we arrived at the appointed time. We went to a waiting area by the check-in desk. Soon Dr. Torres came to look for me. I don't suppose I was difficult to find - a bald gringo. When I saw his haircut I immediately felt at ease. He escorted us to his office and looked at my ear with a magnifying glass. As I struggled to understand him,(my Spanish vocabulary outside of gospel principles isn't very good), he confirmed that the lesion needed to be removed. He told us that he had a private clinic where he does these procedures or he could do it at the Clinical Chillan.  We would be able to do it the next Thursday at his private clinic. I opted for the private clinic as the lesion was growing and becoming more uncomfortable. He told me it would cost $90,000 CLP (that is about $180 USD) and that he would send it to a pathologist to get a diagnosis which would be a separate charge. I could call or go to his clinic to make the appointment. The clinic was only a block from our apartment building so we went there immediately to make the appointment. We found the address.
Calle 18 de Septiembre 325. We walked through the gate to the building at the end of the walkway.
When we got to the reception desk I asked for Dr. Torres and was told that his office was down the hallway. We went down the hallway and found another reception desk. It was in a common waiting area for many doctor's offices. Each doctor had his name on the door. I told the lady that I wanted to make an appointment with Dr. Torres.  She picked up a little notebook where she had handwritten the days, went to the following Thursday, and wrote 6:00 pm and my name.
The following Thursday we arrived shortly before 6:00 pm to the same area in the building. I checked-in with the receptionist and paid the $90,000 CLP. Within 10 minutes Dr. Torres came out of his office to get us.
His office consisted of his desk with 2 chairs in front of it and another small separate area with a fixed gurney and a place to store his supplies.  We sat down in front of his desk and he went over my medical history, or at least that was what I thought he was going to do. He asked me how to spell my name, my Chilean RUT (ID number used by everyone in Chile) and how old I was. Then he invited me to lay down on his gurney. He cleaned me ear with some betadine and gave me some local injections with lidocaine. They stung a little bit but not too bad. He used a radio frequency surgical unit to remove the lesion which hurt a little. He then bandaged up the surgical site.

I got up from the gurney and sat down with Sally in the chairs in front of his desk while he wrote a prescription for some topical medications. He told us that the lady at the desk would give us the information we needed to send to our insurance company. Here the insurance form, I guess.
And here is his note to go with it.
He had placed the biopsy in an unlabeled jar of formalin which he put on his desk in front of us. I thought, "Good, he is going to send this for evaluation to a pathologist." He then put the jar inside a glove, tied the top of it, gave us the address of the pathology lab, which was on the other side of the plaza and wrote a note to go with the biopsy. He said they were open until 8 pm, and we could take it right then. So that is what we did. Here is the biopsy being delivered to the pathology lab along with his note.
We had no trouble finding the lab. 
Many homes and businesses do not have addresses but this one did. We could also tell it was the right building because it had a picture of a microscope as our clue.
We gave the lady at the desk the biopsy along with the note written by Dr. Torres. She told us that it would cost $45,000 CLP (about $90 USD). Here is the receipt she gave us that we can send to our insurance company.
Why did I pay so many people to process insurance claims all those years in my dental practice? Anyway she told us the results would be ready by next Thursday.  I hope someone labels the jar or maybe the glove serves as the label.

So there you have it, medical care made easy in Chile.


  1. Yikes! I didn't know it was growing quickly. Did he excise the entire lesion or was this just a biopsy? John

  2. Where else has that glove been? Now, that is a scary story, just in time for Halloween! Let me know if Deseret Mutual ever gets back to you. It will be the first outside USA ever! Hope you're feeling chipper!

  3. Oh My! So sorry you had to have this done Dr Pulsipher! But you sure entertained me this evening reading this and getting to see your smiling face!
    Think of you and Sally often and the Good ole day's building Riverstone Dental Care!