Monday, December 10, 2007

It's Science

Travel writers like to cover almost everything in a foreign land; tourist sights, hotels, restaurants, infrastructure in public transportation. They can be quite thorough, but seem to overlook, in my experience, one imperative element to a society.

That is why I decided to be rushed to the hospital in India.

'Decided' is a stretch. I wasn't really in a state to make decisions at this point.

On December 3rd my Indian friend Arjun and I went off to explore Bombay. I was originally going to fly out this evening, but pushed back my flight 24 hours to have a little more time in this overwhelming city. If India is a land of extremes, Bombay perfect case study. It is the most crowded city in the world - it's population desnity is approximately 15,000 people per square kilometer. In the city center, that number is 1 million people per square mile. The most crowded city in western Europe is Berlin, at 2,900 per sq. km. Bombay is also the financial capital of the country - the New York of India - and it accounts for 38% of all national taxes paid to the government. This all has absolutely nothing to do with my day.

Arjun and I wandered Colaba, the tourist neighborhood for a brief spell before catching a taxi to Bandra. Bandra is a wealthy suburb of sorts - though its feel is still distinctly overcrowded city, only with nicer apartments - and a lot of the Bollywood stars live in this neighborhood. Arjun's Uncle and his family live in an apartment here, where we are staying for the night. It's a simple, clean 2 bedroom apartment.

On the neighboring block of their apartment building, with a clear line of sight from their living rom window is the start of a massive, sprawling Muslim slum. During the 1993 riots, Arjun's family stood at this 6th floor window, watching the gangs congregate on the block downstairs with fire and weapons, shooting sporadically into the slums and trying to torch the homes. This went on for about 3 weeks. Shops would open for maybe a couple hours a day, but for the most part everyone stayed indoors, especially the Muslims who were being targeted and killed by the thousands.

Arjun's cousin Sunil lives in Long Island, but is back for a little under a year to take a couple classes and make a career change. He's a very kind, friendly man with a drawling American accent in his 30's. He takes us to some streets to do a little shopping, and shows us his favorite restaurants, including dinner at a Cricket Club in which his family is a member. If I thought any of you were going to come to India in the near future, I would repeat in detail my notes on the truly unbelievable meals we had. Instead, I'm just going to tell you generically how good the food was - it was unbelievable.

The next evening was my flight. It was around lunchtime when my stomach began to rumble and a very dispiriting way. For my first time in Asia, hoping that carbonation would help, I walked into a McDonalds and bought a soda. Now I'm not going to blame McDonalds for the illness that ensues, seeing as its virtually impossible given that I already felt terrible. But it's a nice thought.

We went home, and I got worse. I took a nap, and woke to sharp, gripping stomach pains. I called my Dad and asked for medical advice. We decided I should take a walk, pick up some Gatorade and snacks for the flight and see how I feel. I returned to the apartment and promptly threw up. A lot. I packed my bags, but couldn't carry them. Or speak above a whisper, stand up straight, or turn a doorknob. After much pursuasion, my friends brought me to a doctor. To be fair, they could've brought me to a transvestite bath house and I wouldn't have been able to object.

Like everywhere else in this city, waiting room was packed, and I found the only chair available. Children ran and jumped up and down in front of me, bumping my legs and successfully increasing my nausea. Sunil had called ahead and said I wouldn't have to wait. After about 10 minutes, I couldn't take sitting up anymore. I tried to make my way to the car to lie down, but the nurses offered me a back room with a bed. After about 45 seconds, mostly spent struggling to remove my shoes, they retrieved me and brought me back to my chair. Another 10 minutes passed, I was still sitting, squirming in pain, only a little more pissed. For their next trick, the nurses stapled my arms and legs spread eagle to two dead bodies, and threw babies directly at my stomach. Then they berated my side burns and spit in my mouth.

The doctor was a well spoken man, and wanted to admit me to a hospital. I put him on the phone with my Dad, the fever starting to take over basic thought functions. They chose the nicest hospital in town (this is why you buy travel insurance kids) and Arjun and Sunil drove me there.

The next hour was spent being directed down various corridors, walking at an infants pace, often retracing our steps to the ignorant directions given in the massive building. I then laid in the waiting room while Arjun signed me in with my credit card and password, and arduous process at best. I could draw out in unnecessary description just how long this took, and how much longer it felt, but instead I'll just write this sentence.

They put me in a wheelchair and brought me to the elevator. Security held the elevator, and had to search my backpack, stealing 2 of my gatorades and not allowing my video camera to travel. Arjun argued only slightly with them while I sat in the chair telling them to get the fuck out of the way. The elevator stopped at every floor on the way up to the 11th. The staff took their time choosing a room, and left me lying there for another hour or so before anyone came to see me.

The nurses stabbed me with a bunch of needles, and inserted an IV needle into my left arm. They began pumping me with rehydrating fluids, as I hadn't been able to eat or drink most of the day. One or two nurses had reasonable English, the rest just smiled and nodded. "Am I dying?" I asked. At least she said yes with a smile.

But I wasn't dying. And eventually, after a truly Indian admittance, I was settled, in a delirious state of pain and fever. For some reason, they chose to wait until everything else was done to administer any time of pain killers.

Arjun slept on the guest bed/couch in the room with me. We had a plasma screen tv, dvd player, air con, and our own immaculate bathroom. At least he wasn't slumming it.

To my Dad and any doctor he consulted, it was an easy diagnosis. I simply had a bad virus from something I ate. For the doctors, they were curing cancer. I'd see my original Doctor, Dr. Shimpi, twice a day for mostly small talk and resassuring jabs on the shoulder. The nurses couldn't communicate any real information to me. And then there was the resident. She called herself a "doctor under Shimpi," but from what I could gather she hasn't yet graduated high school, or at the very least didn't earn the diploma.

On the 2nd day I was feeling a bit better, though still sleeping on and off all day. She came in and told me I had Pancreatitis. It's a pancreatic virus, very easily diagnosible. She gave me no such evidence, but told me that was her prediction. I hadn't heard anything from Dr. Shimpi, and I was being treated with the most generic antibiotics possible. My Dad was as confused as I was, and told me the proper questions to ask, which were never answered. Apparently the whole thing was dropped.

Day 3 I was walking around, feel much better, feeling a bit weak but healthy. The resident woman came in again that afternoon to tell me I have malaria. What? "Well you're at a very high risk, and you have a lot of bug bites." I tell her I'm taking anti-malaria medication. "Well you're at a very high risk, so I'm going to start treating you for malaria."

In case she's unaware, inform her my father is a Doctore. I also kindly let her know there is no fucking way she's treating for malaria without consulting with him first. "Oh, we don't need to get him involved." Yes, we do. "Well, let me consult with Dr. Shimpi and I'll get back to you." And with that, she left.

In expensive hospitals, with insured patients, they often practice a type of defensive medicine: keep them there just in case, until we know what is going on. This is less defensive, and more of a script. They're playing their parts in a play to milk the white dude, by providing no answers and no information. The Dr. wakes me early in the AM to remind me he's keeping me a alive, high stepping out the door before I can connect my sentence fragments. By day 4, I'm bench pressing most of the nurses, and throwing punches when they try to stab me with any more needles. We've been waiting for the results of something called a blood culture, a 48 hour period of watching my blood. If nothing grows in it, i'm fine. it's been almost 60 hours and they have no results. I'm this close to ripping the IV out of my wrist myself.

I'm pissed. I can't book my flight to Australia until I know when I'm being discharged, and I'm getting generic responses at best from the Dr. I've had to book and cancel at this point the only cheap one way. I've missed my time in Thailand - I spent it watching HBO and DVDs with Arjun, and I'm fine with that. I feel better, healthy for the most part, and ready to move on. But I'm also waiting for the resident woman to come tell me that I've had a heart attack due to my onset diabetes.

By the end of the 4th day, I'm refusing all antibiotics. I'm fine, I've been diagnosed with nothing, and I can barely move my left arm due to the throbbing pain in my veins from all the fluids pumping through. The nurses are confused, some downright scared. They don't know how to respond to this. Arjun has left to return to Pune today, where he's from, because I'm fine and we know it. I'm by myself, watching war movies and very frankly telling them I will attack them with a blood filled squirt gun if they don't discharge me.

At 8pm a nurse tells me its my last dose, that I'm being let out tomorrow. I allow it, and wake the following morning to another nurse trying to pump more shit into me. I can't find my squirt gun, so I just tell her to get out. And I continue this 16 hour tirade; every nurse that enters, I inform them I'm checking out. Finally, the Dr. comes in, says "congratulations!" and discharges me. Now that I've paid, they're adament about me leaving. I spent about 45 minutes showering, at least an hour packing. I am taking my sweet ass time and they know it.

I managed to book a flight 36 hours after discharge, and I enjoyed my last day in Bombay a great deal. It was an interesting experience to say the least. The room itself in the hospital cost me $200 a night, probably 1/5 of the cost in the US to an uninsured sucker like myself. There were many other costs involved, but even in this luxury hospital it was all reasonable, when you really think about it. Why am I so calm about the costs you ask, while backpacking on a budget through Asia? One reason my friends - a lesson to share with all of you: Always. Have travel insurance.