Chaos and Calm in Bangkok

This is our fourth visit to Bangkok. Bangkok is unique, fluid, and always changing. And we always look forward to further exploration of this vast and fascinating city, built over the swamp and floodplains of the Chao Phrayo River.

The Bangkok vision of a green city…from Benchakitti Forest Park

A lot has changed over 17 years since our first visit. There are new green spaces, MRT and SkyTrain extensions, and dozens (hundreds?!) of new malls and high rise buildings. But in many ways it hasn’t changed, including frenetic streetlife, food, and more traditional low rise and open living in most neighborhoods.

Bonus meet up with our friend Charlie, who used to live in Bangkok, and now leads and organizes amazing safaris in Africa and Asia with Remote Recreation

But the pace of change in urban mobility hasn’t happened as fast as you would expect, or in pace with other big Asian and global cities. And unhealthy air, noise, and traffic are still major drawbacks to daily life. Some of this is due to challenging and unstable governance, some due to a slowing of the economy and the pandemic, but at its core, Bangkok is fighting a legacy of car and scooter dependence that has been coddled, accommodated, and supported by street expansion and lots of (mostly free) parking at every destination.

A slightly more orderly but still congested Bangkok in 2023

Of course, the addition of more highways and toll roads has helped overall capacity, and apparently even the continuous congestion and traffic jams of 2023 pale in comparison to the true chaos of the 1980s and 90s before road expansion and rail transit began.

Yup, this is where you walk…also the scooter lane, and unlike the narrow lanes of Europe, cars, vans, and SUVs are big here.

But it’s a catch up game, as the first SkyTrain (metro) didn’t open until 1999. Luckily, major development has been concentrated along transit corridors. And there are now 3 BTS SkyTrain lines with 62 stations and 2 MRT lines with 46 Stations. The buses seem to be a missed opportunity as they have little or no dedicated space and suffer in the congestion. These old buses belch a scary amount of diesel along the roadways into air often in the 150-200 (very unhealthy) AQI levels.

Up on the skyway…choosing the right station exit can save you time and the stress of crossing mega intersections

There is also an elevated driverless train line to the somewhat distant Suvarnabhumi (BKK) Airport that opened in 2010. These have all helped to reduce car dependence and expanded the reach of transit. But overall, the system is not extremely user friendly as the BTS, MRT, and Airport Trains are operated by separate companies, so ticketing is still separate and connections a bit clunky and congested. But it all works and much of the service is good. We just carried two fare cards and swapped out for SkyTrain to MRT trips, and bought an electronic single-fare token for our trip from the Airport.

Adding fare to our MRT tap cards…once you get the hang of it, it sort of makes sense. Minimum add is 100baht, but machines only take one bill per top up transaction. Quirky.

We spent a week here in 2007 staying with two different expat friends. Outside of India, Bangkok was our first big Asian city experience. It was a globalization boom time. (And possibly peak?) We were mesmerized by the chaos and modernity of the city, then one of the fastest developing in the world outside of China.

The travelers loved the new SkyTrain in 2007…so young!
Varied street life on the side streets…explore and you never know what you will find

At that time, we explored the country for 6 weeks, so saw the northern mountain regions, northeast rural and Mekong, and the southern peninsulas and fabulous islands. Like most western travelers to Thailand, we loved it. We stopped over here for 3 days in 2014 and 2017 as part of travels onward in Asia. Both follow up visits were enjoyable as we stayed in two different neighborhoods, but always close to a MRT or Skytrain station.

Chatuchak Park next to the mega weekend market of the same name has a great 3 km loop to walk and is very well kept with park staff on bikes. Yeah Bangkok!
Lumphini Park is the old main park of Bangkok…still a nice respite with trees, but nearby mega construction and a bit too much “stuff” in the park reduces its luster somewhat
Asian Water Lizards are all over the parks and canals of Bangkok, they can grow up to 10 feet!

So fast forward to January 2023….two coups, military leadership, a new King, global slowdown, and three years of a pandemic devastating the tourist economy which accounted for over 20% of the GDP in 2019. It’s still the second largest economy in Southeast Asia, but the stagnation is obvious and frustrating for the hard working and constantly striving lower and middle classes.

Canal paths are arteries of a calm and old style life in many neighborhoods
Some canals could link up neighborhoods, but most are neglected or cut off…definitely a future walking network opportunity

Its growth and development is still chugging along, but it does feel like it the benefits of mega projects, skyscrapers, and industry are not reaching the masses. The unfortunate decision in the late 80s to embark on a massive roadway expansion in the city instead of transit set the patterns that feel intractable in today’s Bangkok.

The Bangkok Art and Cultural Center is a fun and free space to explore in central Bangkok

On the bright side, a new central train station has been opened in northern Bangkok, that the government hopes to use as a hub of a vastly expanded rail network, with a specific goal for tourist service. Good plans if they can find the will and money to execute the plan.

The massive new Krung Thep Aphiwat Central Terminal opened January 19th
Me and the Royal Family approving of the fantastic new station

Thailand still seems to need more tourist (and other?) taxes to pay for infrastructure. One of the highly touristed (and beautiful) islands Koh Tao has instituted an arrival tax for each tourist to help pay for much needed sanitation and environmental improvements, but it’s a modest fee (<$1), so progress will be slow. Thailand itself is also proposing an international arrivals tax of 300 Baht (about $10) starting in June, and monies are designated for accident services and development assistance. It still seems light based on the impact tourists have on the infrastructure. We all love Thailand, so we should help pay to make it more sustainable.

Platforms and multi level concourse are inside the grand hall, but no photos allowed…
Striking architecture
Recruitment for new taxi drivers….but the station is also connected to two metro lines
Beautiful, but a little vacant on opening as this was built for the future; including HSR

But the most obvious deficiency in Bangkok’s transport network is walking and cycling. It’s shockingly disconnected. The artery and capillary (Soi) network is disconnected by design and development legacy, as well as many routes being cut off by the remaining canals. But dead end streets are the nicest to live on and bring quiet from the chaos, so the challenge is to expand walking and cycling networks without inducing car and scooter traffic. It can work with some clever bollards, gates, or chicanes…and maybe some scooter traffic is acceptable as this would shorten trips for many from the arteries, as a grid is established.

This is the way!
Yup, Soi 14 does go through …just barely, but a fantastic calm link south of Sukamvit
There is literally no space for bikes on most roads in Bangkok…only for the brave and determined
Kitty finds some calm under a pick up truck

So for us, this is a livability failure. The lack of connectivity has been recognized by some studies (See UDDC Goodwalk pilot plan) and a few small steps have been taken recently to improve pedestrian mobility, such as new ladder crosswalks and a corresponding law increasing fine for motorists violating ped ROW in them.

The calm of some of the alleys and sub alleys is a delight and an opportunity for connectivity at a human scale

It is a bit encouraging, but pedestrians are still mostly a sub-species clinging to gutters, dodging scooters, and navigating a pretty hostile, polluted, and unpleasant streetscape on the main arteries. On hot and polluted days, which are many, it makes even the most ardent walker retreat to an alternate means. Tree planting and protection does seem to be coming with new development, which helps everything, heat, air, and sun protection for walkers.

Oh, but the food is amazing and tasty and still and integral part of daily life in Bangkok. The Northern Thai casual restaurant Hom Doam.
Cheryl enjoying Khao Soi at the amazing Hom Doam in Thonglor
A Northern Thai food sampler at Hom Doam
A main canal, just west of the Jim Thompson museum house, has fast ferry service and connects to the river.

But indeed this a just a drop of perspective from a non-resident Farang, and I don’t begin to pretend to understand the complexities of life and culture here. But the local officials and planners do. And many are working hard to make the long vision changes to lifestyle and infrastructure that will lead to a healthier environment and people.

Great meeting fellow travelers Heather and Volkan for a long chat at Chamlong’s vegetarian restaurant near Chatuchak
Buddhist Temples can be prominent or tucked away in hidden spots throughout Bangkok
Green alleys to quiet living oases…if you could only keep walking

Bangkok is a complex ecosystem of 11 million people, and finding the balance of economic growth and opportunity versus health, pollution, and mental health is tough. But as Asia often looks forward, I’m hopeful that next time we visit bangkok we’ll see more positive changes. Already they are considering a congestion charge, expanding the MRT, and modifying laws to improve pedestrian life. Just don’t move too many of the food carts out of the way….we can walk around!

The happy travelers in Benchakitti Forest Park

Happy travels and on to Southern India!

About my breast surgery…

Back in my 30’s I told my husband that I reserved the right to have a breast lift in my 50s. As a larger breasted woman I knew a time was coming when the complicated relationship I had with my chest would become simply annoying – like a party guest who overstays their welcome, and I imagined, in a non specific way, doing something about it.

Post surgery. We are both relieved to have the actual surgery complete.

And then for twenty years or so I pretty much forgot about the idea of surgery. I bought more expensive bras which did a good job of keeping me feeling confident and fairly comfortable. And my breasts were just something about me. Something I never really liked, but just part of who I was. But what woman hasn’t been annoyed or shamed or maddened by someone commenting on her breasts. Or her body in general. Not just men commenting, but mostly men.

One view from my hospital bed. The IV drip.

And then, in May 2022, the New York Times published this article by the talented writer Melissa Febos. The Feminist Case for Breast Reduction.

https://www.nytimes.com/2022/05/10/magazine/breast-reduction-feminism.html?smid=nytcore-ios-share&referringSource=articleShare

It was a lightbulb going on. An ah-ha moment. She had the words that I had never searched for about what it was like to live with unwanted attention for an accidental genetic attribute. I am sure that my sometimes quite prickly personality comes in part from people feeling free to comment on my breasts from a terribly early age. What 12 or 13 year old has the language or confidence to clap back at an adult man or peer boy who has absolutely overstepped today’s standards, but not the standards of the 1970s? Want to see a young girl shrink into herself? Comment on her body.

The other view from my hospital room.

I started researching breast reduction and started really resenting the limitations large breasts cause, and resenting even more the objectification society puts on women. I shared my feelings with my wonderful husband and he was, as expected, amazing and accepting and supportive.

We discussed where. The US was not really on our radar since the cost would be higher there and we both have a high level of comfort with healthcare around the world. We considered Türkiye, we’d been there last April and felt that Istanbul or Izmir would be good places to stay for a few weeks. But Thailand rose to the top of the list because I read good things about experiences there, and we know and enjoy Bangkok. And we hadn’t been to Thailand for five years, and could work it into broader Asia travels. Thailand is well known for medical tourism, so you can find a lot of information on line.

Hospital breakfast. Once Rich let the nursing staff know I’d prefer the Thai menu to the western menu the food got really good.

I contacted a company called Medical Departures and was sent two quotes for two different hospitals and doctors. I choose Yanhee International Hospital because they specialize in cosmetic and plastic surgery, and because it is right next to an MRT line, the Blue Line. Yup, our desire to have good access to public transit does influence all our decisions. I was able to research the Doctor on line and got a sense of his level of experience and how many of these types of surgeries he had preformed. I arranged two appointments, a consultation and an actual surgery date. These were confirmed December 1, 2022, for January 19th for consultation and mammogram, and 20th for surgery.

We could also order food from the hospital cafe to be delivered to the room. For myself and for Rich. So when the only thing that sounded good was pad see ew, we got that.

We both agreed that if anything felt off, or if either of us wasn’t comfortable with the hospital or Doctor we’d hit the brakes. I didn’t share our plan with anyone- sorry good friends and family, I needed to be in my bubble about this and didn’t think I could handle any kind of reaction from my nearest and dearest. I have pledged to never do that again. Rich took the brunt of that decision since he had no one to support him. So, for anyone else considering this, consider your partner’s need for support versus your desire for privacy. We had each other for support, which was enough for us, for this decision.

Asian water lizard in a canal near the hospital. Nothing to do with this post but how cool!

The incredibly well staffed hospital was clearly signed with a specific check-in desk for international customers, and we were accompanied up to a waiting room and given a number. For our consultation appointment we did spend the usual amount of time waiting before meeting the doctor, and then a lot of time waiting to complete the blood draw, EKG, mammogram, ultrasound mammogram, and chest x-ray. We broke the cardinal rule of hospital visits – we failed to bring a phone charger. And snacks. We both felt a little shaken when at first the Doctor seemed to have no idea that we had booked a surgery date already, but then the international coordinator, a young man with a clipboard, showed up and all was well.

The hospital.

Six hours of tests, signing consent forms, paying with a credit card, waiting, and one lunch in the hospital cafe later, we were sent off with an appointment slip for the next day and instructions for me to neither eat nor drink anything after midnight.

After the first follow up appointment.

I’m not sure international elective surgery is for everyone, you need a certain level of acceptance that you’re going to feel at a loss at times. When two nurses are chatting in Thai while trying and failing to get an IV in the back of your hand – that requires a strong belief that all will be well. Turns out I have small and deep veins in my hands so after 3 tries (yikes!), the very calm anesthesiologist whom I’d met the day before told me he would put the IV in my hand once I was under. Phew!

Out for a walk a few days after surgery.

Not since I was a child with a fractured jaw have I been put under general anesthesia so I have no experience to compare this to. Was it what we in the US would consider usual? No idea. I breathed in through my mouth as instructed and woke up to a nurse gently patting my cheeks and saying Madam, Madam. It was three or four hours later and when they rolled me back to my room there was my husband. What a welcome sight. I’m sure he has more to say about what it’s like to be the one waiting for surgery to be over, but I will be forever grateful for his support and planning skills and calm manner.

A comfy room with a view in which to recover. The air quality has been pretty bad at times, and fine at other times, depending on the wind.

Apparently in the US this surgery is sometimes accompanied by an overnight stay in the hospital, sometimes a same day discharge, but at this hospital they planned for a three night stay. I asked for a two night stay after the first night, since all seemed to be going well, and the Doctor agreed.

We’ve just returned from the first follow up appointment where some of the stitches were removed and the dressings changed. We will have one more follow appointment in five days where the final stitches will be removed and off we’ll go to our next adventure.

The happy and relieved travelers post international surgery experience.

One final thought, I’ve been grateful to be strong and healthy for so long. Able to do everything I want to do – bicycle tour, hike long distances, travel with Rich, enjoy family and friends – now I look forward to doing everything I do with a bit more comfort. As I was signing consent forms the day before surgery the lovely Thai nurse, dressed as all female staff were in fitted lavender skirts and jackets, with matching nurse hats, said “Madam, this is consent form for breast reduction.“ she broke from form for a moment and sighed, and gestured to her own chest, “And god has not given me enough.” So many of us have complicated relationships with our bodies. I’m glad to have been able to make mine a bit less complicated.