an ER Doctor Guided by Mindfulness and Dhamma
– Dr. Rueangkit Ratanayanont –
Dr. Rueangkit Ratanayanont’s gentle and composed smile makes it hard to believe that he is a man who handles critical emergencies almost daily in the Emergency Department at BNH Hospital. Yet, that very smile has the power to transform chaos into calm, lessen severe situations, and alleviate anxiety in urgent circumstances. What lies behind the doctor’s smile? His story holds the answer.
A Life Where Birth Can’t Be Chosen, But the Path Can Be
“I was born into a very wealthy family in Ratchaburi province, but my family broke apart, so my mother moved out with her two children. Life wasn’t easy.”
When Rueangkit was seven years old, his mother moved him and his younger brother to Chachoengsao province in search of opportunities. His mother took on every job she could manage – cutting grass, washing clothes, cleaning houses. She never shied away from work to earn money for the family. Rueangkit was no different. On holidays, he never got to play like other children his age. He took jobs making sweets, wrapping snacks, selling newspapers, and selling fruit. During school breaks, he would go to work pushing carts of goods at his uncle’s house near Tha Tien to earn tuition fees.
“We didn’t dare to buy food at school because it was expensive. We had to cook food and bring it in a pot to eat ourselves, hiding to eat during lunch break. The most delicious food back then was fried chicken. On days we had a little money, we would buy 20 baht of fried chicken for dinner, for all three of us.”
His daily routine at school involved secretly eating the food he brought from home, then quietly reading alone. He never socialised with anyone until a teacher noticed and became curious. Upon learning about his family’s financial situation with a single mother as the sole provider, the teacher helped him secure a scholarship of 500 baht, which at that time was enough to cover nearly two months’ rent.
“Life was difficult back then, but I always thought I had to push myself forward. When I entered high school, I studied hard, sleeping at midnight and waking up at 5 AM every day because I also had to help my mother work.”
In fact, Rueangkit wanted to be a teacher, but the prevailing values of that era led him to choose medicine as his first preference, hoping to provide a comfortable life for his mother. He eventually embarked on this path at the Faculty of Medicine, Chulalongkorn University.
However, simply entering medical school did not improve his family’s financial situation. As a medical student, Rueangkit still lacked funds for his studies and had to balance intense academic work with working hard to support his family. In his second year, his grandmother began helping with expenses, providing 1,200 baht per month, and he also received a scholarship from the faculty’s alumni, another 1,200 baht per month. After completing his second and third years, he was awarded the Bhumibol Scholarship, worth 4,000 baht each time, for students with good conduct.
“This was the highest honour. So, I intended to do everything to the best of my ability, always remembering the immense gratitude owed to the land and to those who supported me.”
After graduation, Dr. Rueangkit completed his rural service at a district hospital in Chachoengsao province, located in a Muslim and Chinese community. This was where he witnessed the harmony in cultural differences that allowed people in a multicultural society to coexist peacefully. Engaging closely with Muslim patients, understanding their differences, led him to stop eating pork, even though he remained a devout Buddhist. Over time, he gradually reduced his consumption of other meats until his diet consisted only of vegetarian food and fish.
Dr. Rueangkit observed irregularities at his first hospital, leaving him as a new doctor with few options other than to transfer. However, when he served his rural obligation at another hospital, he still encountered similar problems. This time, however, he was the hospital director, making it his direct responsibility to manage the hospital’s corruption. He successfully resolved issues with stagnant and uncirculated medicines and medical supplies, and increased the hospital’s negative operating budget by approximately three million baht. However, this came at the cost of harassment, leading him to resign from public service for his own safety once the corruption case was closed.
Becoming aware of and entangled in hospital corruption problems twice in a row, even as a newly graduated doctor without much immunity to such issues, forced Dr. Rueangkit to fight for the hospital for quite some time. Meanwhile, after one year of rural service in the first district, he also opened his own clinic. Seeing many patients waiting to be seen outside regular hours, he thought the clinic business would succeed.
“But when I checked the accounts, the balance was just break-even. Reflecting on it, I realised I had charged patients very little. For three years, I didn’t even charge a doctor’s fee. I even had my mother help out because I didn’t want her to be idle. I was tired but happy to work. Patients would ask me to deliver their babies, and I wouldn’t charge, so they would try to give me gold. I wouldn’t take it. I felt I didn’t need a reward; if the patient survived, that was enough. My life has always been like this – kind. But eventually, I had to close the clinic because it was in a different district, and I wanted to dedicate my full time to the hospital where I was director.”
Running a private business but failing to manage income and expenses, for whatever reason, makes it difficult to survive long-term. Dr. Rueangkit thus learned that a path where he saved patients but didn’t save himself might not be suitable for him. He then returned to working in a hospital, starting as the first emergency physician in the emergency department of a private hospital 30 years ago. Eight years later, he moved to BNH Hospital, also becoming its first resident emergency physician.
“I would be the one to see all patients first, both serious and minor cases, then determine which specialist to refer them to. From the start, I pioneered the patient screening system, but everything was possible because of the excellent cooperation from the nursing team, which made everything smoother. We started a system for tracking specialists, and at BNH, specifically, there’s an International Standard that makes working easy and patients safe.”
From the first day Dr. Rueangkit joined BNH Hospital, he felt an impression of being back home, a sense of warmth, surrounded by colleagues who were true friends. To this day, Dr. Rueangkit is considered one of the senior physicians who has been with BNH Hospital for over 20 years, respected by doctors and nurses. This organisational bond facilitates easy consultation and referral of cases, especially in the emergency department, which requires cooperation from all departments to maximise patient survival and safety as quickly as possible.
“In emergency cases, we are not heroes. We have people around us, multi-disciplinary teams helping us work as a team. Everyone is willing. Sometimes, with critical patients, there need to be at least two to three doctors helping to see them. This makes me feel secure in my work today, knowing that I will not lack assistance at this hospital, and patients are safer too.”
More Than Just an Emergency Doctor
BNH Hospital’s location amidst hotels and condominiums means that when emergencies arise, people living in the vicinity, both Thai and foreign, come to this hospital. However, there were many times when patients couldn’t come. So, Dr. Rueangkit, along with nurses, initiated the ‘Hotel Call’ project to be a resource for patients. If there’s a problem in a hotel or condominium, or even in affiliated office buildings, the medical team would go to the patient’s location to provide initial treatment. Sometimes, it might not be necessary to rush to the hospital immediately, unlike calling an emergency ambulance, which is more costly and usually for severe cases. This project has been ongoing for over 20 years, demonstrating BNH Hospital’s involvement in caring for a large community with unique characteristics and special needs.
“When any problem affects us whilst treating a patient, we become mindful, fully awake. When a patient is affected by an illness, we must first become alert, and then teach them a new mindset: that their current illness is due to accumulated actions in the past. Poor work-life balance, unhealthy eating, lack of exercise, stress – these lead to illnesses or accidents becoming apparent. Some people have no symptoms and don’t want to come to the hospital. By the time they fall ill again, it’s dire. But if the doctor sees them early, they will be warned.”
This led Dr. Rueangkit, as an emergency physician, to adopt a concept of providing care that emphasises prevention rather than just treatment. Even though the emergency department doesn’t see the progression of diseases like other specialties, it is the front line dealing with patients experiencing symptoms in almost every part of the body. Some symptoms Dr. Rueangkit encounters are immediate results of a patient’s actions, whilst others are accumulated problems waiting to erupt. Dr. Rueangkit does not overlook this point. Even if many of the patient’s symptoms are far from being classified as an emergency, he will offer advice to help patients adjust their lifestyle initially or refer them to relevant specialists. This method of care aligns with BNH Hospital’s policy that focuses on holistic healthcare, or Complete Care, where patients come for specific issues, but doctors observe abnormalities in every part of the body to prevent potential diseases early.
During the COVID-19 pandemic, coming to the hospital carried the risk of acquiring undesirable viruses, yet people remained concerned about their health. Dr. Rueangkit recognised this patient need and initiated the ‘Anytime Check-up’ project.
“During COVID, people didn’t want to leave their homes. So, we became the front line, allowing patients to delve deeply into their holistic health in a short time. Patients just came to the hospital briefly to have blood drawn, urine collected, X-rays taken, ECGs done, and then went home. This differed from regular check-ups where you had to wait to see a doctor. After that, they would consult with me online, and we would have a ‘Self-Love Handbook’ that I designed myself, detailing chronic diseases, past surgeries, concerns, alcohol/smoking habits, and family medical history. This allowed us to delve into their background and provide integrated care, as we have many specialists who can take over, including comprehensive health check-up packages.”
The uniqueness of ‘Anytime Check-up’ goes beyond just doctors collecting health data. Whilst consulting with Dr. Rueangkit online, he provides appropriate advice to patients to adjust their behaviour in three areas: diet, exercise, and emotions. If patients fail to change their lifestyle, they are advised or referred to specialists. All this is aimed at long-term healthcare for each patient.
During the COVID period alone, over 2,000 patients used the ‘Anytime Check-up’ service, and the project continues to be available today.
“Instead of waiting to fall ill, we prevent illness first and then promote healthier lifestyles for them.”
Around 2007, Dr. Rueangkit observed that many emergency conditions patients presented with could have been less severe if proper first aid had been given early. He thus initiated the ‘First aid and CPR’ project, which the emergency department and marketing department jointly implemented. They sent teams of doctors and nurses to provide emergency first aid training to staff and building managers in nearby communities. The understanding gained by personnel in these organisations has saved many emergency patients.
Under Critical Situations
If you recall the incident where a mentally disturbed patient intruded into St. Joseph Convent School and attacked students with a knife, Dr. Rueangkit was the doctor managing the situation that day.
“As soon as I saw it, I knew it wasn’t a normal situation. I immediately announced a ‘mass casualty incident’ code for all doctors to gather and help. At that time, six students were victims, one severely. We had to perform CPR in the operating theatre, but everyone survived in the end. Looking back, I feel happy.”
Being a doctor in the emergency department requires constant mindfulness to face unexpected situations. Under that pressure, Dr. Rueangkit never forgets to understand and empathise with human beings. Many cases he has handled have taught him lessons about human psychological flaws. Many emergencies resulted from physical abuse, domestic violence, suicide attempts, or consequences of mental health problems, which are distressing.
The doctor’s care, therefore, tries to address these underlying problems that patients exhibit during treatment. Even in emergency cases, it may not be Dr. Rueangkit’s role to take a patient’s history to diagnose an illness, but if he observes abnormalities, he will not overlook them. For instance, one case presented to the emergency department with severe headaches.
“There was a patient with a severe headache who came to the emergency department. I went to see her and thought something was odd, something pricked my heart. So I asked, ‘You can’t sleep, can you? Why do you look so sad?’ She then cried hysterically. It turned out she had emotional issues related to family relationships. I talked to her, didn’t give her any medication, and her headache went away on its own. I’ve encountered many cases where people come to the ER not just with physical ailments, but mental ones too.”
Kindness is what patients and relatives often see in Dr. Rueangkit. Under emergency situations, the doctor remains mindful and composed, which helps reduce tension in the immediate situation, but without neglecting the patient’s suffering. His life experiences have already taught him how to handle such distress.
“We must speak kindly, humbly. When a patient comes, we must introduce ourselves. Practise having a ‘smiling heart’ first. I have a habit of having an easy ‘smiling heart.’ Then, open up so they feel we are friends and can reveal their concerns.” This is a practice of cultivating empathy towards patients and relatives through the doctor’s and colleagues’ eyes, demeanor, words, and emotions.
Emergencies sometimes catch patients’ relatives unprepared. The doctor must therefore also be ready to assist the patient’s close ones who are in a vulnerable emotional state.
“We do our best. We must use the word ’empathy.’ Sudden loss is normal. In cases where the doctor can no longer help, we have a procedure for providing information. We have a team that cares for relatives. We must maintain neutrality. We must help them accept it. For instance, a patient who is unconscious from cardiac arrest will no longer feel pain, but the image the relatives see – we must not make it linger. Sometimes relatives can’t bear to see a patient intubated or with tubes, or coming in from an accident. We must clean up the blood and everything before letting them in to see. This is very important.”
Balance on the Middle Path
Dr. Rueangkit defines himself as a kind and giving person, viewing his compassion as both a weakness and a strength.
Under emergencies, compassion alone, without regard for reality, does not improve the situation. Since childhood, when the doctor practised Dhamma to increase his concentration for studying, Dhamma still guides him back to the middle path in patient care. It helps him balance listening to problems, providing treatment, and willingly helping patients without letting compassion become an obstacle, which ultimately benefits patients and their relatives more.
“No one can encourage themselves better than themselves. We practise Dhamma to encourage ourselves. We must heal our minds with mindfulness. So, we practise mindfulness. Be aware when we are losing time. When we become aware, we stop. Mindfulness is the brake, to remind us to deal with the problem dictating our minds, and to do what is right.”
To maintain mental balance, Dr. Rueangkit frequently practises mental care daily and listens to Dhamma at least three days a week. He also exercises six days a week to maintain physical balance. He often runs on a treadmill or lifts weights while listening to Dhamma to cultivate mindfulness. During this time, he refrains from thinking about other matters to practise concentration. Even when commuting to work, Dr. Rueangkit chooses to walk while practising mental awareness from his accommodation, which is not far from the hospital. During the day, he uses the stairs instead of the lift. All this is to exercise his body and train his mind concurrently in daily life.
As Dr. Rueangkit advises patients about the consequences of their actions when living mindlessly, he also sets an example for them. In his diet, he lives mindfully.
“We eat well, not lavishly. When we see food, desire can pull us in. But when we are mindful and aware, ‘This might be high in fat, high in sugar,’ we see tomorrow as the result of today. Then we are mindful of the present. We see and know if eating something is beneficial, so we eat it. Eat in moderation. If you eat beyond moderation, even beneficial things can be harmful. Everything must come with moderation. The Sufficiency Economy philosophy of His Majesty King Rama IX also starts from this practice.”
From his life experience, having been close to Muslim communities until he stopped eating pork, then gradually moving to stop eating all warm-blooded animals, he also stopped eating sweets that he deemed unhealthy for his body. Now, Dr. Rueangkit has found a balanced point in his consumption, adhering to a vegetarian diet with fish.
Living mindfully and being guided by Dhamma means Dr. Rueangkit has many regular patients who initially came for physical emergencies, but then their conversations about Dhamma with him helped them relieve mental distress. Patients would then come to see him again, unannounced, to alleviate their suffering, receiving simple principles of practice to understand and access the reality of the mind (following the Buddha’s path): being aware, knowing the body, knowing the mind, as it truly is, with a stable and neutral mind, at every moment – standing, walking, sitting, lying down, eating, drinking, doing, speaking, thinking.
“It’s strange. Sometimes, when I meet patients, as soon as we see each other, we can start talking about Dhamma. We just click. Positive meets positive, and I’ve seen this many times. Some whose families are ill call me for advice on who to see. Sometimes cancer patients come to talk about Dhamma to help them live with cancer. Some come and say they want me to talk about Dhamma. This is what’s impressive. I feel they visit me and they are happy. They come to the hospital and feel that the hospital is a home, with a doctor they can rely on for advice.”
“If patients feel comfortable with us, that means it’s okay. If anyone interacts with us and we can be a cool soothing water for them, that’s enough. We only want this. It doesn’t need to be immense. We don’t need to expect anything, but we must work with a clear goal: to wish well and treat patients and their relatives correctly.”
Having endured many hardships in life and received kindness from others numerous times before reaching this point, Dr. Rueangkit’s life experiences have shaped him into a person who understands and empathises with people, whilst living on a middle path that benefits others. It’s no wonder he continues to care for patients with mindfulness and serenity, and can transmit positive energy to them even under the pressure of emergency situations.
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แผนกเวชศาสตร์ฉุกเฉิน
สาขาเฉพาะทาง
เวชศาสตร์ฉุกเฉิน
ภาษา
ไทย, อังกฤษ
– Cardiac Life Support
– 1997-2005 Emergency department at Saint Louis Hospital
– 2005-present Emergency department at BNH Hospital
2005-present MOI committee
2024 BDMS Good Doctor Award
– Diplomate Thai Board of General Practice, Chulalongkorn
– Certification in Advance Cardiac Life Support, Ramathibodi Hospital, Thailand
– Certification in Emergency Medicine (short course), Thai Association for Emergency Medicine
– Certified in Occupational Medicine, Thai Occupational Medicine, Thailand
– 1988 Doctor of Medicine, Chulalongkorn University
– 2007 Occupational Medicine training course
– 2024 Advanced Cardiovascular Life Support (ACLS)
– 2025 Pediatric Advanced Life Support (PALS)
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