Operation Vacation

Shaw is more a medical traveler than a medical tourist. On this trip, he's focused purely on surviving heart surgery that he can afford.

Choosing Bangkok

Shaw and his wife arrive at Bangkok's new international airport in the wee hours of a June morning. They don't hassle with logistics: The hospital sends a greeter to speed them through customs, and a driver takes them to a spartan apartment building next to the hospital.

Some patients stay in the upscale hotels in the downtown area; Shaw has opted for a $50-a-night room with a kitchen in a hospital-owned building. We meet the next morning, when he first sees the hospital and doctor to whom he is entrusting his care.

Shaw, 59, looks relatively fit and healthy, except for a bluish tint to his lips. At 5 feet 10 inches tall and 190 pounds, he's stocky, with a full head of dark hair. Outgoing and talkative, Shaw seems particularly energetic, a true Type A personality.

After suffering several times last spring from what seemed to be extreme indigestion, Shaw saw a Dallas cardiologist. Tests revealed that one of the arteries of his heart was 90 percent blocked; 70 percent of the other two coronary arteries were blocked. The cardiologist recommended the highly esteemed Baylor University Medical Center in Dallas for his angioplasty, a critical but not emergency surgery.

Sticker shock hit. Shaw, who owns patents on retaining walls that he travels the world to market, immediately thought of Asia. He settled on Bumrungrad after talking with Dallas friends who were working as missionaries in Thai prisons. One, a nurse, raved about Bumrungrad.

We arrive outside the hospital, near the Queen Sirikit National Convention Center, to find hospital valets parking cars and hailing taxis. Inside, beneath a soaring ceiling ringed by a second-story balcony, plush upholstered chairs are grouped around carpets on the marble floors. A Starbucks sits in one corner, computers for public use in another.

On the balcony, an upscale Japanese restaurant sits next to Au Bon Pain and McDonald's. On the next floor is the International Patient Registration Center, which includes a travel agency, a visa center and registration desks with translators fluent in 13 languages.

One indicator of the types of patients Bumrungrad targets: a sign advertising the services of "Dr. Golf," an orthopedic doctor who specializes in golf injuries. (Dr. Golf offers free written advice, in English or Japanese, at http://www.thaigolfer.com.)

The facilities add to a sense of confidence but don't surprise the well-traveled Shaw. They would shock a lot of friends and neighbors, he says.

"When I told people I was having surgery in Southeast Asia, some looked at me like I was crazy. They were clearly imagining me in a straw hut with someone holding fishing line and tweezers."

Although Shaw's operation is fairly routine, risks include kidney failure, heart attack and stroke. A stent -- a thin tube that props open closed arteries -- can puncture the heart, damage an artery or dislodge a blood clot or fatty tissue. Not something to entrust to just any surgeon. Malpractice suits in Thailand do not allow for punitive damages. (American patients must agree beforehand to settle any disputes within Thai jurisdiction.)