Doc. Bresson & the STD hotspot of the world

Thursday, 26 September 2013

A pic sent to me by Doc. Bresson - post reconstructive/ cosmetic surgery

I met Doc. Bresson when I was working in South East Asia. He's a tall, urbane Thai man who works in Pattaya as a GP.  He wears circular designer glasses, through which his gaze is calm, piercing and relentless. Sitting down and having a conversation with him is an experience akin to having a high-voltage power line shoved up your arse - an incredibly stimulating (and illuminating) experience, but one that, ultimately, leaves your hair standing on end and your bowels utterly void.
Of poo.

Now, the small, coastal city of Pattaya just happens to house the largest concentration of prostitutes in the entire world. As I've described before, it's a sex-tourism hotspot, which means that the majority of Doc. Bresson's work as an English-speaking practicioner involves the diagnosis and treatment of Sexually Transmitted Diseases (this isn't how we met).

The Doctor is a great giver of information - in one single conversation over sushi he offered me a number of illuminating insights which I struggled to swallow at such a rapid rate.
In a single sentence he'll drop mention of the mathematical theory of the 3:1 'golden ratio', use your body language and facial expressions to diagnose you with a number of mental illnesses, give you some brilliant photography tips, casually mention pearly penile papules, and then tell you that he has a best friend who saw your photo and wants to marry you.

Being a selfless man, I wanted to share the exhilarating and wrong-footing experience of having a conversation with Doc. Bresson, so I wrote him an email recently in which I caught up with him & asked a few questions about how he spends his days (namely wading through a sea of genital warts and membranous discharge) :

> You're still working in the STD clinic, right?

I have been working at this GP (General practice) clinic for 4 years (I graduated from med school with an MD in 2006... have been putting off getting specialization training for a few years by now... I will get a neurology training soon). It is great if you can spread the words about shitty Pattaya… it seems that it is a perpetual problems that cannot be solved… you know the prostitution, money boys, bar girls, shitty people, white trash, STDs
Lately, there's a blond guy in his 30's came in for an HIV test with a boyfriend … the preliminary test is positive and the PCR test (confirmatory test) is also positive… but the boyfriend's preliminary test is negative
It reminds me of me… I had a boyfriend in Jan2011… and I diagnosed him with HIV infection (in a window period)… I think no one has ever been in the situation I went thru…
There are 4 Caucasian gaymen who are my friends… and live in Bangkok and they are all HIV positive… 24, 27, 32, 34 are their ages… all 4 of them are my fb friends… and all 4 of them caught the bug in Bangkok.

Would you say that Pattaya was an 'international hot spot' for STDs?

> Yea as horrible as Sub-Saharan area... Pattaya always been a promiscuous / venereal city for the past 50 years (Pattaya city became a touristic city in 1960/1970 with the help of American soldiers around the time of the Vietnam war) have a look on youtube/google about Pattaya or Thailand... like BMW = Germany, Bjork = Iceland, Hookers & Sex = Thailand, gay bars with young Thai teen twinks, young uneducated female prostitutes at the soapy massage places, second-class, freelance hookers along the beach + walking street (these hookers don't have social security, no sex education!, they don't pay tax)
The number of foreign hooker increases every year (Laos, Cambodians, Ukrainians, Russians, Uzbeks, Kazakhs, Nigerians) + the number of Iranians/Indians/Europeans/Chinese/Australians tourists increases every year as well
Comparing to the rest of the world, I guess Pattaya has a relatively high "successful unsafe sexual intercourse (sexual intercourse with internal insemination through oral/anal/vaginal route)" rate... It's multi-dimentional problem... and it seems impossible to solve... every sector of the Thai society doesn't seem to recognize the size and the complexity of the problem

Why do you think there's such a big problem in Pattaya, aside from the obvious issue of prostitution and sex tourism? Haven't people learnt to wear condoms?

> Easy-going lifestyle...breast-feeding is uncommon in Thailand (so the kids grow up with insecure attachment issue + low-self esteem)... Thai don't have any idea about "Family planning", "Personal finance", "Social security", "Social responsibility" = family failure... capitalistic pressure (imbalance / non-optimized / non-sustainable economic development)... sex / food / fun / drugs are common and easy to get... swinging party, PNP, orgy are more common here than the rest of Thailand ...crystal meth is the major culprit... it is indirectly related to all the holistic shits in Pattaya... it has gained popularity for the past 10 years.

Is there one piece of sexual health advice that you wish you could put up on signs all around Pattaya? 

> "Live in Pattaya once but leave before it gives you HIV"  lol

Do you think Farang tourists are shocked when they end up with STDs? Don't they expect it to happen?

> Yea nervous breakdown / anxiety is common in Farang patients.

Do you have any funny (non-harrowing) stories from your work? 

> Caucasian guy in his 40's presented with hypochondriasis about his HIV status (we have many cases of the patients who want to get an elective test on HIV)... he was a classic hypochondriatical patient he had a long list of questions and concerns... it took me a few hours to talk with him... he was extremely anxious... I ran conclusive negative tests (PCR for HIV test + serial Anti-HIV tests at 0-1-3-6 months) and refer him to a psychiatrist... he developed Michael Jackson complex... you know, the extreme phobia of catching germs... like sharing the bed, utensils, helmet, barbershop, swimming pool etc... he developed the extreme anxiety about the HIV after the incident of condom break... his hypochondriasis needs psychiatric help cos it interfere with his life function [daily activity, work, relationship]

What's the strangest case you've seen?

> When you were here last year, I had one case of GOSH infection… it was a skinny Thai twink… 19 yo… presented with bloody mucopurulent/pus discharge coming out from the anus + fever
GOSH infection
GO = gonorrhea
S = syphilis
H = HIV / herpes proctitis (herpes at the ass)
There is one elderly Thai man... presented with shingles... he is 70 yo Thai... it's mandatory to find the underlying causes for shingles that affects a large area... and it turned out that HIV is the underlying cause for his shingles... sexually-active 70 yo

How are you, personally, affected by your work? 

> I have become more skeptical, negative and pessimistic. I have developed an unrealistic expectations of finding true love, sexual monogamy, ideal consummate love
I have lost my normal realistic views towards life and relationship and I have become less sexually-active... really.

What's the best thing about living in Pattaya?

> Russian gaymen seem easy and dumb in a good way lol... Russian lovers are great.


James Seyforth said...

all I have to say is wow! the world is crazy! people are crazy. I think I am going crazy. great article seriously, the reality of life outside the comfort of the places that we live in (not the west, just all places where people live without pain and live in happiness) are obviously being reported less and less as the mainstream media evaporates in its hyper reality of illusion and falsity. we need you people who are real and tell it real.