I think this one tops most people's communication difficulties here in Bangkok.
Back on my first couple of weeks here, after I recovered from my cold well enough to start venturing out, I sought out the spas to try, and eventually pick for my weekly massages.
First one, next door, I dropped by to make an appointment. I should have known that something wasn't right when the receptionist didn't know the service menu in English.
Showed up the next day for my back massage. Couldn't understand why she wanted me on my back first. I figured maybe she was starting with a scalp and neck massage.
After eliciting a big "O" and squeal from me, the masseuse administered a full body massage on me.