Death of a dynasty
The inside story of the sudden and shocking health emergency faced by Princess Bajrakitiyabha, and what it means for the succession crisis facing the Thai monarchy
Around twenty minutes past six on the evening of Wednesday, December 14, while exercising with her dogs at a Royal Thai Army event in Pak Chong district northeast of Bangkok, Princess Bajrakitiyabha suddenly lost consciousness and collapsed. Her heart stopped beating and she stopped breathing.
Bajrakitiyabha’s personal nurse, who accompanies her wherever she goes, was unable to revive her. A soldier performed CPR on her for more than an hour as she was rushed to Pak Chong Nana Hospital.
By the time she arrived at the hospital, her situation was already hopeless, despite the heroic efforts to keep her alive with CPR. When the brain is deprived of oxygen, permanent damage begins within five minutes, and brain death usually occurs within 10. Bajrakitiyabha had been starved of oxygen for far longer than this.
Nevertheless, doctors made frantic efforts to try to save her. The princess was connected to an ECMO machine, which is used to treat people with profound heart and lung failure, by circulating and oxygenating blood outside the body.
When he was informed of the seriousness of the situation, King Vajiralongkorn raced to Pak Chong in a military helicopter, arriving towards midnight. Meanwhile the best intensive care medical helicopter in Thailand, registration HS-BHQ, was sent to Pak Chong too.
I first heard about what was happening from palace sources as the helicopters were heading towards the hospital, and after I verified the information I broke the news on Facebook and Twitter, and have been publishing regular updates ever since.
When he arrived at the hospital, Vajiralongkorn was distraught when he realised how bad things were. He told doctors to continue to do whatever they could, even though it was clear his daughter was already beyond help. Eventually, with no improvement in her condition, a decision was made to bring Bajrakitiyabha back to Bangkok.
In the early hours of Thursday, December 15, medical helicopter HS-BHQ left Pak Chong with Bajrakitiyabha aboard. For the flight back to Bangkok it was flanked by two military helicopters, one of which was carrying Vajiralongkorn. To try to maintain secrecy, HS-BHQ did not file details of its departure and arrival locations, but its journey could still be monitored on flight tracking apps.
The helicopter landed at Bangkok Hospital around 2:15 am, and then Bajrakitiyabha was transferred to Chulalongkorn Hospital by road. The reason for the decision not to fly directly to Chulalongkorn is unknown. It may have been that they were trying to preserve secrecy, not yet knowing the story had already been reported and we were tracking the helicopter in real time.
By the time Bajrakitiyabha arrived at Chulalongkorn Hospital she’d had no brain function for at least nine hours. Her heart and lungs were still not working. Desperate intensive treatment continued but she was clearly beyond saving.
After her collapse at the dog training event, it had been assumed that she’d had a heart attack, because her heart had indeed stopped beating. But doctors at Chulalongkorn Hospital realised that in fact the princess had suffered a brain aneurysm causing a massive subarachnoid haemorrhage.
What this means is that a narrowed or weakened artery in Ong Bha's brain had caused a balloon of blood to accumulate at the weak point in the artery. This had probably been going on for several years but because it didn't cause any apparent symptoms nobody would have known about it. Meanwhile the balloon was silently but relentlessly growing and sooner or later it was bound to burst.
The princess unknowingly had a ticking time bomb in her brain, and on December 14 it exploded. Her skull was flooded with blood, which in turn caused cardiac and respiratory arrest.
Once this had happened, in provincial Thailand miles from a hospital, not even the best neurosurgeon in the world could have saved her
It was not until around midday on Thursday that doctors at Chulalongkorn dared to formally pronounce Ong Bha brain dead, but this fact has remained secret. On the orders of the king, Bajrakitiyabha continues to be kept technically alive by the ECMO machine. But she will never ever wake up.
As an ICU and trauma specialist consultant explained to me:
The ECMO basically makes the blood circulate in the body, the blood is oxygenated outside in a machine. The blood pressure from the ECMO can indeed maintain the body cells alive. But the brain does not come back from this damage, both from the subarachnoid haemorrhage and also from the lack of proper oxygenation to the brain for hours.
On Thursday afternoon, the palace finally issued a statement on the health of the princess. As usual with royal health bulletins, it was mostly fiction. It said that she had lost consciousness as a result of a heart condition, but that her condition had stabilised in hospital at Pak Chong and she’d subsequently been transferred by helicopter to Chulalongkorn Hospital where she was undergoing checks. It failed to mention that there was no hope of recovery.
Vajiralongkorn visited his daughter in hospital four times on Thursday, and again on Friday accompanied by Queen Suthida. Both were visibly exhausted and devastated as they left.
Vajiralongkorn and his daughter had huge affection for each other, and Bajrakitiyabha was also close to Suthida and probably her biggest ally and defender in the palace.
Later that day, the palace announced that the king and queen had caught the coronavirus and would suspend royal duties for the moment.
Meanwhile, Thais across the country have been urged to pray for Bajrakitiyabha’s recovery. Prime minister Prayut Chan-ocha and other senior ministers have visited Chulalongkorn Hospital to prostrate and present offerings at a large portrait of the princess. Military units have held mass ceremonies on their knees, exhorting help from the heavens. Civil servants and local administrations in all provinces have been ordered to organise religious ceremonies for the princess, as well as other initiatives such as donating alms to monks and releasing fish and animals that were due to be butchered. The supreme patriarch has told every temple in the kingdom to hold an extra ceremony each day. Christian and Muslim leaders have also mobilised their communities to offer prayers.
But this is all just a charade, because as the palace and regime are well aware, Bajrakitiyabha has been dead since December 14 according to any sensible definition of what it means to die.
A second palace health bulletin on December 19 indirectly acknowledged the princess’s condition. It said she had not regained consciousness and “medicine and equipment” were being used to support her heart, lungs and kidneys. This was an oblique way of saying that she is being kept alive by an ECMO machine.
It’s not clear how long this will continue. Several royal sources say the princess may be kept artificially alive for at least a couple of weeks until early January. The palace is worried that disruption to the New Year celebrations, after two years of economic agony because of the pandemic, would drag the popularity of the monarchy even lower. Delaying the announcement also allows them to exploit the plight of the princess to stir up royalist fervour across the country.
The news that the king and queen have covid — whether true or invented — also means announcement of Bajrakitiyabha’s death is likely to be days or weeks away.
Once her death is officially announced, the period of strict mourning is likely to be relatively brief, probably no longer than two weeks. Even during this period shops and restaurants will remain open but some entertainment venues will close, or at least operate more discreetly.
There will be further mourning for months afterwards but this will mainly just require officials to wear black clothing or armbands, plus plenty of additional royalist propaganda being pumped out. It won’t really affect the everyday lives of most Thais or tourists at all.
When King Bhumibol died in October 2016, there was a month of strict mourning in which Thais were told to avoid taking part in so-called joyful activities, and the full mourning period lasted a year. Mourning for Bajrakitiyabha will be significantly less stringently enforced, and the economic damage to the crucial tourism and hospitality industries will be relatively limited, although if New Year celebrations are cancelled it would be a significant blow to many businesses. The regime will be keen to limit the economic fallout — it’s simply not sustainable after the damage already wrought by covid-19.
As everybody knows I am opposed to the monarchy’s role in undermining democracy in Thailand, and I am no fan of Vajiralongkorn, but the death of Bajrakitiyabha is a personal tragedy for all of the royals and they deserve compassion and space to grieve. Nobody should celebrate her death.
But the people of Thailand also deserve to be told the truth, instead of being dragged into days or weeks of royalist theatrics to pray for the impossible resurrection of a woman who has already been brain dead for days and who has no chance of recovery.
So I am not writing about Bajrakitiyabha’s death to mock or taunt the royal family. I’m just doing my job as a journalist to try to provide reliable information to Thais because they can't get this from other sources, least of all the palace or the regime.
It’s also important to analyse what the death of the princess means for Thai royal succession and the future of the dynasty. It had been widely assumed that Bajrakitiyabha would be the next monarch after the death of Vajiralongkorn, or at the very least would act as regent on behalf of her younger half-brother Dipangkorn, whose severe autism means he can never really reign alone.
To help navigate the complex issue of royal succession, a friend has produced a superb chart showing the relevant dynastic history that brought us to this point, and our best guess of the likely line of succession. It’s so big and detailed that I can’t post it as an image, but it is an invaluable guide to the future of the monarchy, and you can download it as a PDF here:
The rest of this post, for Secret Siam subscribers, will discuss the implications of Bajrakitiyabha’s death for Thai politics, the game of thrones in the palace, and the future of the Chakri dynasty.
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1. Royal blood
The reason there is so much uncertainty over who will succeed Vajiralongkorn is that he’s had such a tumultuous private life that there are several possible candidates. To analyse Thai royal succession dynamics, we have to start with a history of the king’s marriages. The role of Bajrakitiyabha in the shifting royal succession dynamics over the decades is also crucial.