Friday, March 30, 2012

One Hail of a Birthday

Mexico City
March 30, 2012

It would be hard to top last year’s “Social Security” birthday when I climbed a 12,000 foot volcano outside of Mexico.  So, not trying to outdo myself, I followed a lead from the New York Times Travel Section and made a reservation at a hacienda/hotel 90 minutes away from Mexico City in Tlaxcala, Mexico’s smallest state, a state blessedly free of the violence that have beset other places.

Early in the day, I followed the Times’ directions, and caught a bus to Santa Maria Tlaxcala.  I fully expected the find the hacienda a short taxi ride away, but that was not the case.  One taxi driver wanted to charge me 300 pesos.  Es muy largo, señor.”  It’s a long way away.  So I went back into the bus station, and caught a smaller bus to the town of Apizaco—20 minutes away.  Again, I fully expected to find the hacienda a short taxi ride away, but that was not the case.
When I exited the station, a steady rain was falling.  I pulled up the hood of my sweatshirt, walked out into the streets and went from corner to corner and bus to bus, but no one could direct me to where I wanted to go. 

And then…I began to hear another sound.  I looked up and saw that rain had turned to hail.  Now, that was a first.  It hailed for at least fifteen minutes and the ground was covered in a sea of white!  White!  I spend good money to get away from the white stuff.  I’ve had snow on my birthday, but never hail.
By now I was frustrated.  It was noon and I should have been at the hotel by now, enjoying the pool and its grounds.  So…I did what I always do when I can’t get from A to B: I hailed down a cab.  “I’m looking for the Hacienda Soltepec,” I told him. “Do you know where it is?”

Ah, si, señor…” 
Are you absolutely certain?

Si, señor.”  But to be on the safe side he called the dispatcher’s office to get confirmation.
And so off we went…leaving the city of Apizaco and the hail-covered streets behind us we headed into the deep, yet lovely, countryside of Tlaxcala—a landscape full of wide open fields, cattle grazing, and small volcanoes in the distance.  The day had cleared and a warm sun shone above us.  But I was suspicious.  We just didn’t seem to be going anywhere.  Again… “Are you certain?”  By now we were on a first name basis and he knew it was my birthday.

Finally, after passing little streams, and tiny villages, and after traversing down a dirt road for twenty minutes, we arrived.  But the hacienda hardly looked like a first class hotel. We drove down the long driveway, and an assortment of people met us. 
Si, señor, está es la hacienda Soltepec, pero no es un hotel.  Hay dos Haciendas Soltepec!

"Yes, sir, this is the hacienda Soltepec, but it’s the one you want.  There are two, and the other is more than an hour away from here. "
By now the charm of bumping along the back roads of Taxcala had worn off.  I got on my phone and had Miguel call the hotel—something I should have done at the onset of this adventure.

And so we drove the sixty minutes back to Apizaco, over the dirt road, past the villages, past the streams.
Finally, shortly before 3:00 pm, a full three hours after I hailed down this taxi, we arrived at the other Hacienda Soltepec.  I feared for the price.  He’d initially quoted me 200 pesos, then changed it to 400, but when I got ready to pay, the cost was 600!  $50.00.

OK.  I went back in time to some of my father’s best advice: "Be glad you have the money to pay for these things, Dan,”  he once told me. And so I did.  Handed over 600 pesos and absolutely refused to let this deter my day.
The hacienda didn’t disappoint.  It had been touted as being one the twenty best hacienda resorts in the country. 

Two hundred years ago this part of Mexico had well over 1,000 enormous ranches, and the largest ones had massive homes known as haciendas which housed the owner, his family, and the hundreds of workers needed to maintain the property.  Hacienda Soltepec was celebrating its bicentennial.  It had been converted from a rural school to a first class hotel more than fifty years ago and was often used as a film prop and had been featured in a number of Mexican television shows.
I spent what was left of the afternoon over a leisurely lunch, then a long work-out in the gym, and a long swim in the heated pool.  Dinner, of some way-too-spicy itty-bitty birds, capped the day.

It had been, well…a different kind of birthday. I’d expected full sun and a long day poolside, but it not only thundered and lightening, but hailed as well.  That was a first, and that was OK.
I’d expected to stay put in the same locale for twenty four hours, but had an unexpected three hour tour of the Tlaxcalan countryside.  And that was OK.

I’d expected to climb the nearby volcano, but once in the hacienda,  I never stepped foot outside until I checked out.  And that was OK.
Why bother? It’s not every day I stay in a 200 year old hacienda, and it’s not every day I turn 63.

It had been one hail of birthday.  And that was OK, too.

Medical Mis-Adventures--Part 3--Mexico City, 2012

Wednesday, January 11th

It’s my 6th day in Mexico City.  Early winter.  Soft, warm days; cold nights.  On the way to La Casa de los Amigos I realize I’ve eaten something that’s not settling well in my stomach.  I’m going to make it into the center, but the long metro ride isn’t doing much for my intestines.
When I get to La Casa, I just about race to the bathroom.  And then again 30 minutes later.

I reach into my pocket to get some money, but realize I’ve left home empty handed.  I ask the woman at the desk.  She lends me 200 pesos and I make my way to the pharmacy on the corner to buy some Imodium.  That gets me through the day.
I have little appetite, and what I do eat goes right through me.  Food poisoning, I think.  I’m no stranger to this!

Thursday, January 12th
For some reason, Steve is at home and not in school.  I text him and tell him I’m sick.  Really sick.  I can only get out of bed to go to the bathroom, which I’ve done all morning.  And even that’s an effort.

We agree to Skype.  I keep the computer in bed with me. 
“You’re scaring me,” Steve said.  I’m scaring myself, because I know I’m super sick but I’ve got absolutely no energy to get up, shower, organize myself.  I know I have to get to the doctor, so I text my friend Allison at La Casa and ask her if she’s be willing to go to the doctor with me.

I get out of bed.  Shower, I think to myself.  This is an effort.
Now you have to shave.  Put on socks.  Pants.  I’m having this running dialogue with myself.  I have no energy and am exhausted by the time I’m done.

I call a taxi and meet him downstairs and forty minutes later I’m in the center of the city.  I meet Allison, and her Honduran boyfriend, and they go to the doctor with me.
I’m grateful to them as I just don’t have the inertia to try to communicate with the doctor who speaks no English.

She diagnoses Gastroenteritis, prescribes meds. I take another taxi home and sleep all afternoon and evening.
Friday, January 13th

Things are a bit better.  The meds are doing their work and I have more energy.  I manage to go into the city and do a bit of work, but am exhausted by mid-afternoon.
That evening, my friend Gerardo calls and asks if he can come by to prepare a meal.  I’m certainly not eating, so I say yes.  This is no small thing that he does.  It takes him an hour and a half to get to Coyoacán, where I live.  This city is a monster and getting from A to B can be an ordeal.

But I do eat, and I appreciate the company, and am grateful that someone here cares. He leaves for work, I go to bed.  It looks as if my body is turning around.
Saturday, Sunday, Monday, January 14th to January 16th

I feel better, but not what you’d call “well.”
Saturday I stay close to home, but venture to Los Viveros, the nursery near my apartment, to buy some plants.  What should take 10 minutes, takes close to 30, with a long break in the middle each way.

That evening I decide to go to the movies.  I’m almost back to “normal,” so indulge in popcorn and a huge vat of Diet Coke. 
Three hours later, home, my fragile stomach starts in with cramps.  Horrible cramps for more than two hours.  It’s the only time in my life I have a small inkling of what a woman goes through in labor.  My stomach is twisted and turned and I’m in a lot of pain.  I’m actually afraid, until they stop almost as quickly as they started.

The rest of the weekend passes well, and I’m slowing slow signs of recovery, but not as fast as I’d like.
Tuesday, January 17th

I leave my apartment, head into the city and start the 11:00-1:00 weekly meeting of La Casa volunteers..  I’m not feeling all that great, but what transpires in those two hours is simply astounding.  I slip into remission.  It’s the only time in my life that I have ever used that word to describe something like this.  I can feel myself sliding down, sinking into an abyss of sickness that is frightening me.  I can’t think.  I have no strength and it’s taking everything in me to stay present.
By the end of the meeting I can’t go home.  I ask for a bed and sleep for two hours.  I’m no better, but at least I have enough strength to go downstairs, call a taxi and get home where I sleep the rest of the afternoon.

That evening, my angel-friend texts me.  “Can I prepare you dinner?”  He comes with chicken, soup and rice, none of which I can eat.  I sit at the table, but my head is on the placemat.  I eat a bite of chicken and another of rice.  Just the smell alone nauseates me.  I can’t eat and I can’t even sit up straight at the table.
Reluctantly, he leaves at 9:00 pm.  He works nights, so I tell him I’ll text him every time I wake up. Which I do, a lot, because my intestines are in a full-fight battle and I’m in the bathroom every hour.  Surprisingly, though, I do sleep, and my reports through the night are encouraging.

Wednesday, January 18th
I’m up by 8:00, sicker than I’ve ever been in my life.  At least lying in bed I had the illusion that I felt alright, but the trips to the bathroom have increased.  There is radical diarrhea. For every liter of water I take in, two liters is coming out. I’m honestly frightened.

No one is in the house.  The landlady had left for LA early in the morning, and I’m alone in Coyoacán without a health plan.  I don’t even know where to find a hospital in then neighborhood.  I begin to experience a deep loss of hope.  There is absolutely no way I can get into the center of the city, and I have to acknowledge that I’m gravely ill.  What’s happening is beyond normal.
So I reach out.  I email an acquaintance from Plattsburgh who lives in Mexico City.  I know she’s constantly connected to the Internet via her Smart Phone. 

“Amy,” I tell her.  “I’m very sick.  Can you direct me to an English speaking doctor?”
What I didn’t know is that she picks up the email in Boston, immediately contacts her husband who’s a CEO for a multi-national in Mexico City, who then contacts his secretary who contacts the driver.  Within minutes Amy emails me back and says, “Marco’s on his way.  Be ready in an hour.  He’ll bring you to the hospital.”

I pick up the apartment, pull together things and put them in a day pack.  Somehow I have the foresight to pack my credit card and passport.  I email a few people at home to pray for me—my Aunt Gloria, my pastor at church, Ed and Rita Graf.  I’m afraid, but less afraid knowing that I’m on my way to medical help.
Then I wait.  I’m overwhelmed—not only with the kindness that’s directed at me, but that I’m going to be ok.  I start to cry—tears of relief and tears of gratitude. 

Maria, Scott’s secretary, is in constant communication.  “Marco’s 30 minutes away.”  “Marco’s ten minutes away.”
Then Marco calls, I go downstairs and he picks me up and we head up and out of the city to Interlomas and Hospital Angeles.  He gets me into the ER.  My Spanish is perfectly fine for checking in, but not good enough to describe the nuance of my illness.

Not to worry.  Two interns appear, both of whom speak very good English.  Scot had also called his internist, Dr. Taché, who shows up thirty minutes later.  These guys are good.  They can see that I’m dehydrated and they immediately order the first IV.  “We suspect something more,” said the good Dr. Taché.  Can you give us a stool sample? “
Dah, I think.  That’s all I’ve been able to do for the past 36 hours. 

I easily do what they ask.  I’m suspecting ghiardia.  It won’t be the first time.
Then I wait.  At least I’m waiting in a good place.

An hour later the interns and the doctor return with an initial diagnosis—ghiardia.  They prescribe a two more IV’s—hard core Flagyl, a super concentrated antibiotic that kills the bacteria causing this specific infection, and Pepto-Bismol to soften the effects of such a strong antibiotic on an already challenged intestinal system.
“We want you to spend the night,” said the doctor. 

I suspected that, and I’m glad for it.  I don’t want to be home alone in this condition.
Within minutes the “men in black” come by.  The accountants.  Whatever prompted me to bring passport and credit card? I have to prove my identity and whether I can pay for this service.

I’m wheeled upstairs.  This is no ordinary hospital, and certainly not the hospital that the average Mexican has access to.  My room is a suite with a fine view of Santa Fe.  These are highly desirable neighborhoods and real estate prices reflect it.  The day is lovely and it’s nice to check out the high end apartment towers nearby.
I’m a bit worried that this is going to cost more than the cap on my credit card, so I call home, call the Credit Union, call Visa. 

That evening I receive a text from Gerardo: “Estoy en la Catedral en el Zocalo. Estoy pidiendo a Dios por tu salud. Animo hora por media hora para tu salud.” I’m in the Cathedral in the center of the city praying to God for your health. “  How am I blessed with such a good local friend?
Doctor Taché checks in several times, as do the interns.  “We’re not totally satisfied,” he tells me.  “We suspect even more.  But cultures take time and we won’t know until tomorrow.”

I spend as pleasant an afternoon as possible.  And I’m feeling better.  What with the hydration fluids and antibiotics, by nighttime I already feel on the mend.
Thursday, January 19th

I’m quite content to spend the day in the hospital, and my instinct’s telling me I’m not going going home. I have my iPod and both phones—my Mexican phone and my New York phone.  There’s lots of communication and I feel connected to people at home and in Mexico City.
I watch movies, ask the nurses if I can take a walk.  They unhook the IV’s and I stroll around the hospital.  I sneak downstairs and buy a Diet Coke which I’m not allowed to have.  I take a look at the cars in the parking lot—BMW’s, Mercedes, a Porsche.  This hospital’s designed for those who have.

Those who don’t have do have access to medical via government insurance, but it’s nothing like this.  I thought back a year when I escorted a friend to his local hospital for out-patient surgery.  He came out twenty minutes later telling me that surgery had been canceled because the wall to the surgical unit had collapsed. 
Mid afternoon Dr. Taché and his interns visit.

He confirms the results of the cultures--E-coli and salmonella.
E-coli and salmonella?  These on top of ghiardia?  No wonder my stomach was so mightily assaulted.  They tell me that I’m going to spend another night, which is just fine with me. 

I do get a bit worried about how much all of this is going to cost.  I have good insurance, but this is a cash deal and I’m worried I won’t have enough to pay.
But it’s ok.  Whatever it costs to get better is a much smaller price than death, which was the only other option.

Friday, January 20th
I am feeling so much better.  I’m served lunch, then Dr. Taché and his interns come by.  They ask how I’m feeling, tell me I’ve progressed well and tell me I can go home.

It’s timeWhat I’ve come to realize is that the doctor has been keeping in daily contact with Scott and Amy, so I’m not surprised when Maria contacts me to tell me Marco can pick me up when I’m ready.
I ask for an English speaking accountant, as I want to go over each item in the 14 page document of expenses.  All seems to be fine.

And, to my utter surprise, the total bill is in the $5,000.00 range. 
$5,000.00.  In 1995 I wasn’t feeling well at school, ended up in the ER and the hospital for the night, and the bill 17 years earlier was $7,000.00.  My aunt later told me that she had a four hour stay in the ER last summer and her insurance paid out $4,000.00.  $1,000.00 an hour!

I get home mid afternoon, stay very close to home, as I do all weekend.  I’m better, and that’s the important thing, but it’s going to take a long time for appetite and energy to return.
Postscript:

For days after I was released from the hospital the only things I could eat were apples, ham slices and potato chips.  Obviously my body was crying out for something that it lacked.
I was only in the city six full days when i came down with the first symptoms.  Where did i get this tirad of infection?  I asked one of the interns, a young Mexican woman who'd grown up in Syracuse.  "It was just your bad luck," she said.  That seemed the best answer I'd ever get.
It would take a full three weeks beyond the hospital before my appetite and energy levels were returned to normal levels. 

In the end, I could see how people die.  I came close to it.  If someone is frail to begin with, an illness of this gravity would wear them out.  If someone lives far from emergency services, what would they do?
My body was assaulted.  On the morning that I went into the hospital, fluid was coming out of my organs.  It was only a matter of time before I would have gone into shock.

This happens every day among the poor.  My multiple privileges were never lost on me: escorted to the hospital in a bullet proof vehicle; top notch medical care that I was able to pay cash for; follow-up meds and appointments to make sure I stayed well.
I am grateful still for the angels in this drama: my local friend Gerardo who never abandoned me; Scot and Amy who made sure I got to their hospital and to their doctor; friends and family at home who stayed close and who prayed for me.

I write this more than three months after all this occurred.  I can honestly tell that not a day has gone by when I haven’t thought of this.  I wish I could say that my body fully recovered, but t here is something wrong with my stomach/intestinal system.  It’s just not been normal since January.
But I am grateful!   Grateful beyond mere words for all that was done for me and for the fact that I recovered and moved forward.

It is always best to think of the glass has half full.

Friday, February 3, 2012

Medical Mis-Adventures--Part 2 -- Nepal, 1998

Miracle and Jubilee: A Thanksgiving Story

If words were pictures, and I could show them to you now, you would see a full December moon hanging over the Taj Mahal. I would describe a perfect white Christmas on a tropical island, five degrees north of the Equator, white sand, white clouds, white surf and white hot days.  I would show you gorgeous days “Down Under” when, in May, leaves were at full peak autumn color and the first winter snows were dusting the Great Southern Alps of New Zealand.

But this is not a travelogue.  This is, instead, a story of jubilee and thanksgiving.
A year ago this week I found myself in Nepal.  Trekking the Himalayas had been a long-held dream, but our Northern Hemispheric summer is not the time to visit that part of Asia.  Monsoons obliterate views of the mountains and the rivers are dangerously high.
Nepal’s season is November when days are clear, blue and warm.  Poinsettia trees are coming into bloom and the rains, recently ended, have cleaned the air and all around is a lush, semi-tropical green.  Views of the mountains are at their most magnificent.  It’s the perfect time to visit the Himalayas.
On the morning of November 17, 1998, my guide, Gorkha, and I flew into Jomson, a small village shadowed in the valley of the 25,000 foot Annapurnas.  From Jomson, our plan was to hike up to Muktanath.  At 4,000 meters, this was the highest Tibetan village in Nepal.  From there, it was, more or less, a seven day downhill walk to Pokhara, our ultimate destination.
These days were filled with magic and wonder.  Hiking would begin early and we’d punctuate our trek with long breaks.  By 2:00 p.m. most of the trekkers were settled into a tea house where we’d chat, play cards, read, journal write, dine with new friends then retire early.
This was how I spent those first, exhilarating days in the Annapurnas.  By the fifth day, however, I was ready for a break, and the village of Tatopani was the perfect place.  It was the largest town on the Annapurna Circuit for good reason; it was almost home to multiple hot springs that kept trekkers in the village for days.  It was the ideal location to rest tired muscles, and gear up for the two remaining days of hiking. 
And that is what I planned to do, until…life took one of those…unexpected twists.
Now…be warned…the story that develops is mighty low on the scale of human misfortune.  It is, simply, a cautionary tale, a thanksgiving metaphor, a lesson in miracle, and an encounter with the divine.
On the morning of November 20th, I decided to start the day with long soak in one of the hot springs.  Now, these springs lay on the banks of the Kalikandaki River, and for those adventurous, or foolish enough, the sport was to heat up in the springs then dash into the river a plunge in.  This was no balmy act; the water was icy cold, glacial runoff, but there were plenty of crazy people on the Circuit, and we’d soak up the heat until we couldn’t take it anymore, then jump into the river.  No problem there, until…the final plunge…when I landed on an incredibly sharp object.  I knew I cut myself, but had no idea the extent of the injury until I hobbled out of the water. Blood was gushing from my foot, and when I lifted it I could see tissue and fat hanging out of a deep, two inch laceration.  The bleeding would not stop and the only way to control it was through tourniquet.
I tried to be as unobvious as possible, and managed to wrap my foot in a sock, gather my things and begin the slow walk off the beach and up the stairs to the tea house.  Immediately, I strapped on First World assumptions.  This is just a gash, I reasoned.  I’ll go the emergency room.  It needs stitches and all will be well.
Gorkha saw me first.  I showed him the foot and said, “I need a doctor; take me to the clinic.”
Well, it didn’t take long for initial assumptions to be shattered.  I was in Nepal, not Plattsburgh.  How presumptuous of me to assume there was an emergency room in this town.  There wasn’t even a clinic in Tatopani, nor was there a doctor, or a nurse or any medications to ease the pain and stave off infection.  The nearest town with anything close to a medical facility was easily a ten hour walk away.
But then a series of miracles began to unfold.  Oh, not the miracles of Biblical proportion, but the subtle little events that you just know are the acts of an omniscient God.
One never really hikes alone in Nepal.  You’re constantly bumping into people you’d passed earlier on the trail or met the night before in another town.  From the beginning of this hike, I’d unofficially teamed up with Michelle Jones, of London.  We’d been on the same flight, our guides knew each other and Michelle and I seemed to have the same destinations in mind.  She’s start our earlier than I, but my mid-day we’d connect for lunch and seemed always to stay in the same lodges.   We had a lot in common and she fast became a good hiking companion.
I was sitting in a chair in the garden of the tea house, foot elevated, trying not to think about my foot.  No one was quite sure what to do.  I wasn’t surprised, then, when Michelle emerged into the garden and asked what happened.
Like me, she knew the full extent of the problem.  We discussed options.  There was no way I could walk.  Gorkha suggested I be evacuated by helicopter—for $2,000.00.  But two thousand dollars was two month’s budget, and it certainly wasn’t an option, at least for the moment.  But, in the tropics, where all sorts of microscopic creatures lurk, expediency was a priority. 
Michelle did what, I suppose, many of us would do.  When help isn’t immediately available, the best thing to do is go out and find it.  And so she went, angel that she was, onto the trail, stopping people as they approached.  And then the first miracle began to reveal itself.
In the end she found sutures, a half bottle of antiseptic and a used needle.  Others at the tea house contributed items a surgeon might need: gloves, an irrigations device, Betadine, bandages.  Fine supplies, if you’re a doctor with the skill and know-how to use them.
A young British couple entered the garden and questioned the gathering crowd.  Did I need help? they inquired. 

And this was the second miracle.  Both of them were physicians.

Sarah and Peter took control.  They assessed their limited equipment, issued orders: boil the needle, bring scalding water, layed out supplies in order of need.
And so, in the garden of a Nepalese, tea house, on a stunningly beautiful mid-autumn morning, these two doctors, using a limited reserve of medical tools. Stopped the bleeding, cleaned the wound, stitched it up and said, simply, You must leave now and return to Pokhara as quickly as possible before infection sets in.

And so I bid farewell to my new-found friends I’d met along the way, thanked Sarah and Peter.   Michelle gave me her bamboo hiking stick, we hugged, and I was off.
But some things are never simple.  Gorkha had ordered a horse, but in order to get to the horse I had to climb a considerable distance up, and over, a huge landslide.  And so, with new stitches, we set off for the long, difficult hike to the horse.  Good Gorkha, who’d never experienced this sort of thing before, carried everything.  Never did he stay more than a few feet away from me.  Step by step, walking on the heel of my right foot, I made my way over the slide.  Four hours later we arrived to where the horse was waiting.

That night, wrapped in a sleeping bag, I sat on the stoop of the simple guest house Gorkha had found.  I was the only Westerner there that evening and I felt really alone.  Finally, the fears flooded in.  Would the stitches hold?  Would I get back to Pokhara without infection? Would I have to end the trip? Would I lose my foot?
Looking deep into the clear, inky, star-studded skies of Nepal, I remembered what my friend Margie had written to me earlier when I’d asked her to keep me in the light because I was doing this trip alone.  Of course you’re not doing this trip alone.  God is with you all the time, she wrote back.  And I remembered my mother, who daily circled me in God’s care.  And I thought of every God imagery I’d learned and I knew, just knew, that at that moment I rested in the palms of a loving, protective God.  It was then that I was able to turn it all over and say, It’s in your hands, God.  This is too much for me.
And a great peace came over me that night, and a confidence borne of Christian faith, and I was absolutely convinced that I’d been cared for that day, and that I would continue to be cared for that night, the next day and every remaining day I’d be away.  In the midst of fear and aloneness, I felt the presence of God and experienced what the writer of Hebrews had written: I will never leave you or forsake you.
Well…Gorkha and I, the faithful horse and its owner finally made it to the trailhead.  Two hours later we caught a bus that brought us on a nightmarish ride out of the mountains to another town where Gorkha hired a cab.  Ultimately, I did get to an emergency room—33 hours after the accident.  Two doctors examined the foot.  It was clean and uninfected…and…the stitches had held.  They simply rebandaged it, gave me a Tetanus booster, a ten day supply of antibiotics, complimented the good doctors from the UK, and said, “You’re a lucky man.  The Buddha was with you.”
Later that week I moved on to Kathmandu, reconnected with friends I met earlier, and together we shared a Thanksgiving dinner.

How coincidental, I though, that this occurred during Thanksgiving week.  The metaphor wasn’t lost on me.  I wasn’t observing the holiday in the traditional sense, but it had been a week of powerful thanksgiving.
I thought of Michelle and her selfless act of tracking down surgical supplies. 

I thought of strangers who provided needle and suture.
I thought of Peter and Sarah, good Samaritans, who’d performed the surgery under difficult conditions and with true Hippocratic spirit.

I thought of Gorkha, who stayed with me right to the end and lever left me out of his sight.
I thought of all those praying for me at home, and I knew, again, that this had been no coincidence, but a well orchestrated miracle.

I think of this story often, and on many levels.  Over the past year it’s gone beyond a simple story of care and ultimate thanksgiving.  It was, after all, a minor injury, corrected under extraordinary circumstances.  But after months of traveling through Southeast Asia, living and mingling with some of the world’s poorest people, I began to see how privileged I really was.
I’d taken for granted many of the peripheral events in this drama.  It was sort of fun to come out of the Himalayas on a horse.  “How romantic,” one trekking friend commented.  “Riding off into the Nepalese sunset.”

I never considered our two hour taxi ride back to Pokhara as anything more than a two hour taxi ride getting an injured patient to hospital.
I never stopped to think about the immediate attention I received.  Two doctors consulted with me and a third intern was left to administer the Tetanus shot and rebandaged the foot.  Nor had I taken into account the lack of triage that evening.  I simply went to the head of the line.

It was only later that I put it all together.  As a Westerner in Nepal, I was given preferential treatment.  Doors opened for me that might not have opened to a poor Nepalese.  With dollars in my pocket, all things were possible.
In Nepal, where the typical income is about $2.00 a day, what would the average resident of Tatopani do had it been him who’d injured his foot?  Would he have been able to hire a horse, pay for the bus and taxi and double medical consultation?  Would he have been able to afford the Tetanus booster and antibiotics?  What would have happened to him in that village that day without even basic medical services available to him?  I think we all know.

Countries are poor, or rich, for a variety of reasons.  Nepal is poor because of forbidding terrain and tough climatic conditions; it’s poor because of its diverse social structure; it’s poor because, in a way, it’s still emerging from its feudal past.
To offset this, loans are offered countries like Nepal.  Few governments turn down the offer.  Ultimately, however, there is a huge price to pay—the piper must be paid.  Today, Nepal’s foreign debt is about six million dollars.  A  huge chunk of their national budget is used to pay back that loan.  Think of what those payments could do for hospitals and schools.  Think of clinics that could open, even in small towns like Tatopani.
There is a Biblical prescription for this, and that’s the year of Jubilee.  Levitical code dictated that ever fifty years debtors be freed of their debts, thus allowing those most heavily in debt a way out of their misery, a way to restore financial balance in their lives. 
In a few weeks it will be the year 2000.  Radical Christians worldwide are suggesting that poor nations,  like Nepal, be freed of their debt and creatively use debt payment for programs that will improve living conditions.  Indeed, this would be jubilee in a small country like Nepal.
Our bottom line probably recoils at this but it’s not a bad idea.  We, in this country, certainly have more than we need.

Well..Thanksgiving is over, but what was it for you?  Was it simply a day off from work, a day to spend with family and friends?  Did we even catch a glimpse of the excess we have in this country?
I have finally reached this conclusion.  As full, fat residents of the Developed World, I don’t think we have a clue.  It’s not our fault, really.  The only way most of us are exposed to the poor is through television, and we all know how numbed we are by that medium.

However, when we see human need first hand, it’s a bit more dramatic.
Two weeks after the accident, a little boy in New Delhi caught my eye.  He wasn’t speaking to me directly, but his words still haunt.  He was holding a tiny baby and his word still haunt.  “Milk please,” he said.  “Milk please.”  Like many of us, I adjusted my blinder, passed him by.  I’ve often felt guilty about that; and I’ve never forgotten him.
Last week I was coming out of the Farmers market in Montreal, when an elderly man approached me, asking for food.  Ahh…chance for redemption.  I’d promised myself I’d take off the blinders the next chance I had, and this was it.  “I’ll be back in five minutes,” I told him.  A sausage stand was selling hot dogs, so I bought him one. 
As I was leaving the parking area, I saw him smoking a cigarette.  Hmm, I thought.
On the way home, I figured I’d been taken, but I also knew that I’d done what Jesus would have done.  Later, I was thinking about the number of times Jesus had been burned, taken advantage of.  Certainly, some of those present at the multiplication of the loaves and fishes had been opportunities.  I knew I’d done the right thing.
You’d think I’d have all the answers after this year away, but you know something…I don’t.  But I do know this: we have to give,, and go out of our way.  We have to bend over backwards, take chances with people and run the risk of being swindled.  It’s was those strangers in Nepal did for me.
It’s what Jesus would have done.
It’s what he did.

(This was originally given as a sermon at first Presbyterian Church in Plattsburgh on November 27, 1999. When I decided to include it as one of my medical mid-adventures, I initially thought of adapting it for my blog but decided against it.  Twelve years and three months later, the original story still has impact. While the style and tone is different from my usual writings, the message remains the same.)

Medical Mis-Adventures--Part 1 -- Singapore, 1990

Singapore.  Early August. 1990.  Latitudinally, I’m one degree north.  I have a raging fever, although I don’t know it.

It’s a Sunday, and I’m poolside at the hotel where I’m staying.  I’m shivering uncontrollably and have no energy to do anything but lay by the pool, trying to keep warm, under a white-hot and blazing equatorial sun.

I’m exhausted and there’s no reason for this.  Only after returning to my heavily air conditioned room, when the sweats begin, do I know something is terribly wrong with my body.  My body alternates from being so cold I turn off the air con and wrap myself in every blanket there is in the room, to being so hot that I have to turn the air back on to avoid sweating rivers.

I rest a bit, have the idea that I’m sort of ok, and leave the hotel and wander around my neighborhood and decide to eat fish (I never eat fish) at Long John Silver. Only after eating, when nausea takes over and the sweats being again, do I acknowledge the need for help.

“I need a hospital,” I tell the young man behind the counter.

“Mount Elizabeth Hospital is around the corner,” he directs me.

Off I go.  I’m rapidly becoming the stuff of Emergency Rooms.  Luckily I have my credit card and suitable identification.

I check in. Someone takes my temperature, looks at my tongue, and pushes me into a cubicle.  My fever is dangerously high, but it’s in Celsius and it means nothing to me.

They ask questions and are not pleased when I tell them I’d spent all afternoon lying in the sun.

“But I was freezing,” I tell them.

Yes,” they said, “but it spiked your temperature.”

They can tell I’m dehydrated by the coating on my tongue, and that I need antibiotics to lower the fever.  I’m prepped for an IV then spend the night and a good part of the morning in the hospital.  By noon, though, I tell that I have to leave, that I have a flight to catch that evening.

“But you can’t discharge you,” they tell me.  “You still have a fever.”

“Yes, I know,” I tell them, “But the next available seat on this flight is in September and it just isn’t an option.  I’ve got to return to my hotel, pack, check out and get to the airport.

So I check myself out, against their good judgment.  I’m literally half way around the world and I just want to go home.

By early evening I’m at the airport waiting for the daily Royal Jordanian Airline flight from Singapore to Amman. It’s an absolute struggle just to sit upright.  I’m still sick with full-blown influenza, but I have no choice.

It’s a full flight...and long.  Twelve hours maybe.  I sleep, but not the good sleep the sick need to recuperate.

I arrive in Amman early the next day. There’s a huge time difference and my body is on Asian time.

I catch a taxi to my hotel, shower and crash, waking up seven or eight hours later.  It’s late afternoon in Jordan, but could be the middle of the night in Singapore.  My entire body clock is off kilter.

But I feel remarkably better.  And hungry.  My natural curiosity tells me to hit the streets, take a look around, have some dinner.  So I decide to take a walk.

Downtown Amman.  Late afternoon rush hour.  I’m just wandering around, getting a feel for the place, when I meet a small group of young men.

One of them asks me: “Are you a Christmas man?”

I know what he’s really asking.  Am I a Christian?  The irony isn’t lost on me.  I love Christmas so, yes, I think to myself, I am a Christmas man.

But I don’t want to embarrass him, so I respond.  “Yes, I’m a Christian.”

Passions in the Middle East are high at this moment.  Kuwait had fallen five days earlier to Iraq and support for Saddam Hussein was running high.

I do not have my wits about me.  I still have a fever, albeit lessened, and my body is pumped up with antibiotics.

“Are you American?” one of them asks me.

Hmm, I think.  Not good.  I tell them I’m Canadian, that I live in Montréal.  It’s not the first time I’ve played the Quebec trump card.

"Bad,” another one says.  “Friend of America,” he hisses.  He catches me off guard and pushes me off the curbing, into the street.  Fortunately, there was no oncoming traffic.

OK, I tell myself.  Get yourself out of here…now.  Just walk away as quietly as possible.

Which is what I do.

I get back to my hotel, but the seven hour daytime sleep, coupled with the who-knows-how-many-hours time difference there is between Singapore and Amman, prohibits my body from sleep. 

Nine o’clock.

Ten o’clock.

Two a.m. 

I dose, only to be awakened by a Muslim call to prayer.  My hotel is right night door to a Mosque.

I simply cannot sleep and have heaps and heaps of time to think. 

I develop a plan.

By 8:00 a.m I’m out the door.  I grab a taxi to the nearest Royal Jordanian Airline office.  My ticket, an around-the-world deal, is extraordinarily flexible.  When the office opens at 9:00 I’m the first one in.

“Can you get me to Amsterdam today?” I ask the clerk. 

She searches the flight’s database.  “You’re lucky,” she tells me.  “There’s one seat left in your class of ticket.  But the flight leaves in four hours.”

“I’ll take it,” I tell her. She rebooks me and I grab another taxi.  This time I tell him to wait at the hotel while I repack and check out.  Within fifteen minutes we’re on our way to the airport.  I play the Montréal trump card against his twenty questions, but this time there’s no need. He wants to get out of Jordan, emigrate to the USA, does not like living in the tension of the Arab/Palestinian/Jewish/Christian issue. 

Eight hours later I land in Amsterdam.  My dear friends Lomme and Ina do not expect me for another two weeks.  I find a pay phone, and a phone book.  They’re home.

They pick me up and for the next week I use their home as a health sanitorium.  They bring me to their doctor and I’m put on additional meds.  I sleep fifteen hours a day.  It’s there that I recover, but it’s not for another six weeks that I feel fully back to my old self.

I have never forgotten their kindness, and whenever I see them, I remind them once again of the gift they gave me.

I was sick and I was exhausted.  They opened their home and gave me the time and space to recover. And for that I am forever grateful.

Monday, January 2, 2012

People Remembered: Howard Ladue: My Dad's Centennial--Born 100 Years Ago Today

Had my father lived beyond his 82 years, he’d have turned 100 today.  A century!

My Dad’s name was Howard William Ladue and he was born “on the farm,” on the Durand Road in Beekmantown, New York on January 2, 1912.  The “Howard “ in his name comes from some obscure, lost to history, surname on the Ladue side of the family; “William” was his father’s brother’s name.  There had been two brothers—William and Charles--both born in the 1880’s--who’d also been raised in Beekmantown. One brother, William, went off to medical school; Charles, Howard’s father, stayed on the farm.

Charles married a young woman in the farm neighborhood—Maude Boutillier, a.k.a. Butler.  Even today, the Butler Road, which runs perpendicular to the Durand Road, is a 21st Century reminder of my grandmother’s family who’d settled that road in the mid 1800’s. 

In May of 1910, my grandparents, then in their 20’s and single-handedly working the farm, brought up from New York City a young Willie McGuth.  Willie was a product of the Great Catholic Protectory and had been trained in agrarian skills at the Westchester campus.  Not all boys had stellar experiences on the farms of New York State, but this young man did.  When my dad was born, Willie had been there two years and was, in all aspects, my grandparents’ son.  My father, and then his sister Katherine, born two years later, only knew Willie as their older brother. (Many, many years later, in the young years of the 21st century, and in the twilight of my aunt’s life, when her mind would slip in and out of dementia, the memory of this fellow was so strong and so positive, that she said to me one day…”I always loved Willie.”  He was, and would always be, their older brother, and the love would flourish for more than ninety years.)
His sister, Catherine, was born in June of 1914 and his second sister, Margaret, was born in March of 1919.  All the children started school at the one room school house in Beekmantown.  They, along with their father and Willie, assisted in farm chores.  But my grandfather, seeing the future, moved them off the farm and into Plattsburgh so all three could have a sturdy Catholic education at St. John’s.

In 1992, just before my Dad’s 80th birthday, I made a video for him.  “This is your life, Howard Ladue.”  One December’s day, I put Kay in front of the Beekmantown home, still standing and looking good 80 years later, where she narrated their life in that house.  The property extended past Route 11 and beyond the Tastee Freeze.  Route 11 wasn’t there then and the Durand Road was the only north-south passage in that corner of Clinton County that led to Plattsburgh.  They had fields of corn and, according to Kay, who still spoke, for some reason, in that peculiar French-Canadian-English patois, “We malked the cyous,” she happily told me.  Bill Ladue, her first cousin, and oldest son of Dr. William, Kay and Dad’s uncle, was with us, also.  “Tell him how we used to come spend the summers with you.”  Life on the farm stayed with my dad and my aunts, and all their cousins, until the end of their lives.  It was a happy place and an important part of their lives.

My father was fond of children, dogs, cats, michigans and hard candies.  He loved chimpanzees and clowns and shooting pool at the Elk’s Club.  He was what we call a “Regular Joe” and he fit in almost everywhere he went and with whomever he was with. He was easy going and easy to please. He liked just about everyone and everyone liked him. I never heard him say a bad word about anyone.  Never.  Once, I was complaining about someone we both knew.  “Dan,” he said.  “She’s a sick woman.”  And she was.  She had a debilitating muscular disease and was unwell all the time.  I try to remember that about him, and apply it to my life now, these many years later.
He was a great practical joker.  I will never forget Thanksgiving 1979.  The living room was full of company, mostly my friends.  The day before, a woman bearing Steve’s surname, very uncommon in the North Country, then or now, had been implicated in a robbery. 

“Steve, I see where your sister robbed the Grand Union.,” he said. 
Steve, knowing my Dad to be a practical joker, waited.

“She’s my wife,” responded Steve.  There was momentary silence.  My father’s turned to me, staring at me imploringly to get him out of this predicament.   Then all of us who really knew the story, started to laugh, uncontrollably.
My father never played another practical joke on Steve again.

When we were younger, he’d often ski with us. He still wore old, lace up boots that were strapped to dangerously old skis and more-dangerously-still bindings.  (Once, during that time, I was given a similar pair of skis for Christmas.  The following April, I broke my leg at Whiteface.  Two years later, a few days after Christmas, my brother, wearing the same skis, broke his leg.  Shortly before New Year’s Eve that year, he ceremoniously broke up the skis and fed them, sacrificially perhaps, into the fireplace.  From then on we had much safer skis and bindings.
When I was in middle school, and before I imagine, he smoked cigars, (in those days I gave him a box of Swisher Sweets every Christmas, marching myself into a pharmacy and buying them was I was as young as 12 years old) but my allergies to cigar smoke and the cloud it engendered in every room, and the Surgeon General’s exhortation to stop smoking, stopped that habit.

He loved to cane and the chairs he caned (almost all with a story of him and me traveling the summer back roads of Clinton and Essex counties, buying up beat up old wooden chairs, their cane come undone) are still in my home.  He’d buy them for $5.00, take them home, wait until autumn settled in, and happily refinished the chairs then caned them.  I can still see him in the living room, fireplace blazing.  Those chairs filled my parent’s home on Grace Avenue, then at the condo and finally, after my mother moved, at Lake Forest.  If my mother gave one away, it was to someone she loved deeply.  Each of my cousins has one now, and I have the rest.
My Dad loved warm weather.  During World War he chose to enlist in the Army.  He was trained as a radio specialist and was assigned to Honolulu, Hawaii, until 1945.  It forever changed his life.  Now that he’d known another reality, far different from the cold, lifeless winter reality he’d grown up with, he wanted to live in that warmth for the rest of his life.

The War ended, he came home, and married my mother, Rita Boyer, raised in the icy Adirondack town of Saranac Lake, New York. They were married at 8:00 a.m. on September 15, 1945.
My mother had come to Plattsburgh to study business then got a job as the bookkeeper at the new two-story Montgomery Ward on Margaret Street.  My Dad had a light trucking business that he’d purchased from one of his uncles and he would transport goods to the store on a frequent basis.  They became engaged, and then the War broke out.  When he enlisted, she broke off the engagement—not an unwise thing to do.  But sometime in 1945, probably through letters, they were re-engaged and set the date for their wedding.  My Dad looks handsome in his Army uniform and my mother is quite beautiful in a dress she bought in Albany.  He was 33 and she was 29.  After the wedding, they moved to Fort Dix, New Jersey where my Dad finished out his enlistment.

Life moved on after the War.  He finished his gig in the military and he and my mother moved back to Plattsburgh.  They lived on the north side of duplex his parents owned at 144 Oak Street.  He got a job on the Delaware and Hudson Railroad and some of my fondest memories of my dad on the days when I’d go to work with him. Sometime during the day, when the train passed through on its way to Plattsburgh, he’d put in the hands of someone on the train.  I’d ride in cabooses or engines or in coach.  My mother was always waiting for me when the train arrived.  To this day, I will always take a train over any other form of public transportation.

His dad, the grandfather I never knew, died in June of 1947, at 66.  I remember my dad’s 66th birthday—1978.  I know he was reminiscing when he told me, a bit alarmingly, that he was now the same age his father was when he died.
I was born in March of 1949, when my Dad was 37 and my brother joined us three years later, in June of 1952.  Pictures from that time tell me my father, and mother, loved us.  Whenever he held either of us, it’s always with a smiling face.

But his years in Hawaii instilled within him a yearning for change, and shortly after my brother was born we all moved to Florida.  This was epic—then and in the annals of Ladue family lore and history.  This story has been told elsewhere; suffice to say that we moved back to Plattsburgh in the Fall of 1955.  As far as my mother was concerned, it was a shut book.  But not so for my father.
He returned to his old job—with the Delaware and Hudson Railroad, but he’d lost all his seniority when he left for Florida.  By the late 1950’s, train travel was fading fast.  He and my mother said a Novena to the Sacred Heart.  “It never failed us,” she’d often tell me.  They prayed for direction, and that direction came in the form of the purchase of the only answering service in Plattsburgh.  Plattsburgh Answering Service.  561-0800. The first switchboard, in the summer of 1961, was set up in the kitchen, and as the business grew, my parents built an addition onto their home, and, until they retired, my parents, worked 24 hours a day, 7 days a week, 365 days a year.

And then life settled into the routine I knew as a child and then a young man.  We skied in the winter and went to the beach and played golf in the summer.  Things my dad liked to do.  He’d bring my brother or I to New York City and we’d spend a weekend at my Aunt Sheila’s in Rego Park.  It was always a thrill to board the train at midnight then sleep in a Pullman Car.  When we arrived at Grand Central Station, we’d cross the street and eat breakfast at Horn and Hardet’s Automat.  Slip in a dime, open the small door, and take out a piece of pie or a sandwich. 
Dad would often get tickets for shows that were still broadcasting out of New York.  I have a very early memory of going to a live radio broadcast and then to a live television broadcast of The Howdy Doody Show.

My brother and I went through the grades at St. Peter’s School, then on to Mount Assumption Institute.  I graduated in 1967 and my brother three years later.
By 1976, when my mom was 60 and my dad was 64, they sold the answering service.  They were free at last to pursue other things.  The following winter they spent several months in Venice, Florida and then, in 1980, they bought a mobile home in Sarasota where they wintered until 1990.

By then the cancer that had taken his kidney in 1984 had metastasized on his lung.  It was time to return to Plattsburgh full time.  I know it must have broken his heart to sell the mobile home at the Buckingham Club and it must have broken his heart even more to return to the chill wind of long winter days.  But I never heard him complain.
On his 80th birthday, January 2, 1992, video camera rolling, I casually chatted with my Dad about his life.  By then he’d had a stroke, a quadruple by-pass and was battling lung cancer.  “I’ve had a good life,” he told me.

I have thought often of that simple statement these past twenty years.  “I’ve had a good life.”  So simply said, yet so powerful.  Words to live by as I rapidly approach the twilight years I remember my parents living such a short time ago.
My dad died two years, almost to the date, later.  The cancer, which had slowly ebbed the life out of him, finally took its toll.  In December, 1994, I could see him failing.  My mother had asked me to come over one Sunday afternoon to sit with him while so she could go to a Christmas party.  He and I sat at the kitchen table.  As hard as it was, it was time to have a talk.

“It’s ok to go, Dad,” I told him. 
“Do you want me dead?” he asked.
“No, Dad.  Of course not.  But you’re tired and it’s ok to let go.  We’ll all be ok.  I will miss you terribly, but it’s ok to go.”
When my mother got home, I told her what I’d told him, and said that she, too, had to have that conversation, as hard as it might be,

Sometimes I think some people need permission to die.  I have no idea what they talked about.  But two weeks later, on the morning of Christmas Eve, my mother called and asked me if I would come over.  There was a change.  We called hospice.  Later, as twilight settled over Christmas Eve, his nurse calmly, and as empathetically as she could, said…”Your Dad’s going to die.  Not now, not this minute, but changes are occurring that tell us it will be within a few days.”
He lasted through Christmas and left us at 6:35 on the morning of December 26, 1994.   It was a brilliantly blue and sharp and bitterly cold early winter’s day.  I helped the Hospice nurse prepare his body while Mom and Steve stayed downstairs.  “I could never have done that,” said both Steve and my mother.  But to me it was a holy experience, and the last loving act I could do for my father.  It was a privilege.  (Sixteen years later I would pass this privilege on to Vicki, my sister-cousin, when it came time for my mother’s body to be prepared.  Vicki never talked about it, but I know, for her, it was an equally holy experience.)


It’s been seventeen years since my Dad’s been with me, and I miss him still.  I was fortunate, though, to have him for 45 years.  My cousin, in a Christmas letter to me, commented how lucky I was to have had my mother for as long as I did.  “Mine died when I was too young,” she wrote, “and I filled the void with my two aunts.”
And I was lucky.  I knew that then, and I know it now. 

I still miss my Dad, and probably always will, but that is the price all of us pay for loving someone.  His values live on and I often find myself quoting something I learned from him over the years.  (Once, in my twenties, I was complaining about some unexpected bill that had come my way.  I had a secure job, though, and his response is a response I still utter: “Just be grateful you have the money to pay for it.”
The dead do live on in us.  It’s a cliché, but it’s true.  My life is richer for having known Howard William Ladue, and I am grateful to have been his son.

Happy Birthday, Dad!                                                                                                                       Happy 100!