A Talkative Stroke Doctor
– Dr. Chonvipa Siriyutwattana –
Dr. Chonvipa Siriyutwattana, or “Dr. Fern” as she is known, is a stroke specialist at the Brain and Nervous System Centre at BNH Hospital. A self-proclaimed extrovert and a great conversationalist, she is perfectly suited to her work in neurology, which requires extensive communication and rapport with patients. Her personal interests also give her an additional advantage, making it easy for anyone to enjoy a conversation with her.
A Neurologist
“I’m a complete black sheep. My whole family is in law. My older sister was clearly an arts student, and my dad couldn’t force her into science, so she went into law like him. I don’t even see myself as a science student; my mind is more inclined towards the arts. I was just good enough at science to get by, and I got into medical school because of my high scores in English and Thai.”
Although her parents were lawyers, they wanted Fern to take a different path, to be in a professional field, preferably in the sciences. With her exam results, she was able to choose medicine.
Due to her reasons for choosing this path, the first three years of medical school—which are heavily theoretical—were not much fun for a student who was great with languages but only decent at science. However, everything changed in her fourth year when she started seeing real patients. Fern loved interacting and talking to people. Even with some sleepless nights, she handled it well. This hands-on work felt fun and challenging for her.
“Choosing to study medicine was the right decision. Medical school was one of the best periods of my life.”
Neurology is different from other medical fields in that doctors must perform a detailed, comprehensive physical examination before assessing where the abnormality in the nervous system might be. Each area has different details, and each disease is unique. This requires a lot of time taking a patient’s history and having a great deal of interaction with them, which perfectly suits Dr. Fern’s extroverted nature and love of meeting people.
“I once examined an elderly patient who told me she had never met a doctor who was this thorough before. It took a long time, as I examined her from head to toe. But as I worked more, I learned to focus on specific areas based on the patient’s history.”
A significant challenge she faced on her path to becoming a subspecialist in cerebrovascular neurology was having to take a physics exam, a subject she never liked or understood.
“I had to take the Certificate of The American Society of Neuroimaging, and it required physics. In high school, I struggled through it and never understood why I was learning it. Then, at over 30 years old, it came back to haunt me with an exam I couldn’t fail. I had to tell myself that you don’t need to love something 100%, but you must be able to answer why you’re enduring something you don’t like.”
In the end, she passed the exam with flying colours.
A Stroke Doctor
Globally, the leading cause of death is cancer, when counting all organs. Stroke, which is number two, affects only the brain’s blood vessels. Its progression varies greatly depending on the cause. Dr. Fern sees stroke as a common disease with uncommon aspects hidden within it, which is what led her to specialise in this field.
“There was one case where a patient came in with a loss of vision and muscle weakness. An MRI confirmed a stroke, but a blood test showed a white blood cell count of 500,000, indicating leukaemia. His white blood cells were so numerous and large that they escaped from the bone marrow into his bloodstream, causing an embolism. If we had given him a blood thinner or antiplatelet medication like a typical stroke patient, he would have bled to death. So, we had to give him chemotherapy to treat the cancer first.”
Another of her patients was diagnosed with a 70% carotid artery blockage, which is high enough to require surgery to remove the plaque. However, the patient adamantly refused surgery, leaving Dr. Fern with no choice but to have him take medication consistently to manage his symptoms. The doctor didn’t expect much from this treatment plan, as it went against her training. But after three months, an ultrasound showed the patient’s artery blockage had dropped to 50%, a significant reduction for medication alone. She learned a new perspective: if patients are disciplined with their medication, exercise, and diet, the results can be better than expected.
“Or even for stroke patients who are bedridden, many cases show a greater recovery than anticipated. Some can almost walk normally again. It depends so much on the patient’s willpower. They need to have a strong spirit, discipline, and patience. But the recovery is only significant in the first two to three months. If they get past this period, the recovery slows down or they may not return to a normal state.”
Neurological symptoms can also be very similar to psychiatric symptoms. For example, some migraine patients also suffer from depression. In many cases, after Dr. Fern talks to a patient, the conversation turns into a discussion about their mental health issues, with the patient often crying as they talk. But without addressing the underlying emotional problems, their migraines persist, and they remain at risk of a stroke.
Anyone who has been to Koh Phangan would know the type of foreigners who visit and live on this island, famous for its hippies and Full Moon parties.
Even though diagnosing neurological diseases is a detailed process that can take a long time, when it comes to stroke, Dr. Fern has to work quickly and race against time. For every minute after a blood vessel in the brain bursts, two million brain cells die. If a patient gets to the hospital within the first 4.5 hours, their chances of returning to their previous normal state are high. This need for quick diagnosis and rapid treatment planning is another key aspect of her work.
For stroke patients with risk factors—high-fat diet, smoking, drinking, lack of sleep, high stress, or no exercise—the fatty plaque that clogs the brain’s blood vessels can rupture without warning. Prevention, in addition to controlling these risk factors, includes regular health checks, measuring cholesterol levels, and monitoring blood pressure to understand one’s body and adjust habits. If a patient’s blood test results are unsatisfactory, Dr. Fern provides Complete Care, managing their health before the disease even manifests. The patient can undergo an ultrasound of the blood vessels to see the extent of the blockage and plan the necessary treatment.
“A stroke starts from a small point, just a little plaque build-up. But if a blood test shows high cholesterol, you can change your diet, control your fat intake, and exercise. Then you need to come back for another blood test in three to six months to see if it’s working. If the patient takes good care of themselves, they won’t reach the point where their blood vessels are completely blocked.”
The Doctor from the Island
Before specialising in neurology, Dr. Fern worked as a rural doctor on the island of Koh Phangan.
“Oh, it was wild! One of the reasons I’m so happy treating patients here is thanks to Koh Phangan. It’s a very international place, albeit in a different way. I got to practise my language skills, so when I came to BNH, I wasn’t afraid to talk to foreign patients.”
Anyone who has been to Koh Phangan would know the type of foreigners who visit and live on this island, famous for its hippies and Full Moon parties.
“Most were indie foreigners. Motorcycle accidents were a frequent occurrence. They used magic mushrooms, and it was a normal sight to see people high on shrooms, running naked around the hospital. The hospital had 10 beds, and they were often all occupied by foreigners. One day, a whole ward of patients had dengue fever. I once had a foreign mother bring her four-year-old daughter to test for dengue fever, but she refused to let me give her any medication because she considered it a chemical. She was a ‘green’ person and wouldn’t have it. Instead, she had her daughter drink boiled papaya leaf juice.”
After her rural service, Dr. Fern went on to specialise and work at a Bangkok Metropolitan Administration hospital before pursuing her subspecialty in cerebrovascular disease. She returned to work at the Bangkok hospital for another three years, then moved to a private hospital before a fellow doctor recommended BNH.
“I came for an interview and felt an immediate connection with their mindset. There’s no pressure to rush examinations or focus on numbers, which allows me to work to my full potential. You can’t rush a neurological examination; rushing leads to mistakes. All the doctors here give their all for the patients. There’s a policy that doctors can consult with each other directly, without going through nurses, and the work culture fosters close relationships among staff.”
Psychology, History, and Understanding People
Dr. Fern feels that neurologists share a similar trait: a keen interest in understanding people and a love for conversation.
“Many people tell me I’m a good talker and never stop, but I’m also a good listener. My juniors call me ‘Big Sis,’ and my friends say I have a ‘mum’ quality. They say I give good advice, so they often come to me for work or life problems. But when it comes to my own problems, sometimes I can’t figure them out and need others to advise me.”
Dr. Fern loves to read. She buys so many books that she could open her own rental shop. In an era of new media like podcasts, she still prefers reading. She feels she understands concepts better through text than by listening. One of her favourite genres is psychology, which helps her understand her patients at work and solve problems for those around her in her personal life.
“I love psychological and personality tests, like MBTI and Enneagrams. I want to understand people. I want to know why each person thinks differently. It helps me understand others, and in turn, it helps me understand myself, my own strengths, and my weaknesses.”
Dr. Fern took the tests to evaluate herself. She falls into the ENTP (Debater) group, which describes a person who is independent, loves challenges, seeks novelty, and enjoys debating, seeing conflict as a positive way to move things forward.
In the Enneagram, she is an Enneagram 8 (The Boss), which describes a person who is straightforward and brave when they feel something is unjust.
“Before, I was hot-tempered. If I saw something wrong, I couldn’t help but confront it. Everyone would tell me to calm down and ask if I was just ‘hangry.’ Combined with my ENTP trait of loving conflict and not being afraid of confrontation, I became the ‘Big Sis’ of my juniors because I was always ready to speak up. But as I’ve gotten older, I’ve realised that I can’t just dash into every argument. I need to be more mindful. I feel I’ve calmed down a lot.
“Many patients also tell me I’m very direct, which they appreciate.”
History is another subject that deeply interests the doctor. These stories give her topics to discuss with patients, helping them to open up and share their health-related stories. Many patients at BNH Hospital are foreigners, and her knowledge of their countries’ history, including their culture and general traits, helps Dr. Fern understand them better.
“For example, for a French person, food is a big deal. A two-hour lunch break is normal. I would chat with them about food and then ask them to control their diet because it helps lower blood pressure and improves their headaches. Their main diet of cheese and wine can lead to cholesterol problems and sleep apnea. So, I have to find a way to talk about it with them. I feel that having a basic understanding of their country is helpful for their treatment.”
“To cure sometimes, to relieve often, to comfort always.”
“This is my motto for treating patients. Curing a patient completely is a reality only in some cases. Making a patient’s symptoms better is what I see often, but the duty I must always perform is to make the patient feel more comfortable, both physically and mentally.”
Dr. Fern loves meeting and talking to patients. She enjoys the challenge of her fast-paced work, which requires her to race against time. She uses her language skills, psychology, and history to care for her patients. Being a doctor makes her happy where she is, and she wants to continue in this role as long as she can be of service to others.
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CHONVIPA SIRIYUTWATTANA, M.D.
พญ. ชลวิภา ศิริยุทธ์วัฒนา
Speciality
Neurology
Stroke and Neurosonology
Clinical Interest
Stroke
Stroke and Neurosonology
Board and Sub board Certification
The Medical Council of Thailand, Neurology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University
Language
English
Thai
Gender
Female
Schedule
Neuro Centre
| Day | Time |
|---|---|
| Monday | 12:00 - 20:00 |
| Tuesday | 08:00 - 16:00 |
| Wednesday | 08:00 - 16:00 |
| Thursday | 09:00 - 19:00 |
| Friday | - |
| Saturday | - |
| Sunday | 09:00 - 19:00 |
This is the doctor's regular weekly schedule. Actual availability may vary — please confirm the available date and time when you make an appointment.