It must have been the seafood noodle yum.
That was our tentative conclusion in what was shaping up to be a game of Clue with a careless Thai food vendor as Colonel Mustard and a languishing octopus as the candlestick—the principals of the violent drama unfolding in the darkened corridor of my bowels.
The investigation had begun as I was writhing on the bed in my in-laws’ house in Buriram, a small town in northeastern Thailand near the Cambodian border, with an ice-filled sock pressed against my head and an empty shopping bag-cum-vomitorium dangling from my wrists.
Convinced that I was just suffering from a stomach bug, I resigned myself to spend the rest of the day and night moaning in perpetual motion between bed and toilet.
But my father-in-law Karl still had doubts about the case. “How many times have you gone today?”
Seven.
“When you go, does your sphincter feel tight? Like it wants to stay closed but it leaks out with a hissing sound?
Um, well, yeah, kind of.
“So,” he said, nodding his head slowly, synthesizing the data. “I think we should go to the hospital.”
With that word, a fresh sweat of desperation rippled through my bedsheets. I tried to recant my former admissions, saying my sphincter always felt tight, and maybe I had only gone six times. In fact, I was starting to feel much better. Anything not to have to go to the hospital.
But Karl was not easily persuaded. My symptoms sounded to him like something he called “para-typhoid,” an illness he had once had and whose peculiar sphincter-ratcheting qualities he could vouch for.
“You don’t want to mess around with that stuff here. It could be something serious. You know, they still have cholera outbreaks here.”
This news came as something of a shock. In the six years since I had met my wife, I had traveled with her to
But what really made me throw caution to the wind was the fact that
Suddenly life felt as real as fiction. Images of Gustave von Aschenbach eating strawberries on the
Okay, I said. Let’s go the hospital.
On the car ride over, I saw an elephant at a streetside café, carousing with a group of diners. Sweet Christ, I thought, I really do have typhoid fever!
“Sorry to interrupt, guys,” I said, “but did we just drive past an elephant carousing with a group of diners at a streetside café?”
Much to my relief, we had.
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Over the years my klutziness had made me no stranger to minor ER visits. A finger half-sheared in a meat-slicer. A wounded knee from falling off the ski lift. And, perhaps the all-time most degrading episode, dating back to my miserable high school marching band days— a throat swelled shut from an angry bee swallowed through the mouthpiece of my trombone. Based on these experiences, I fully expected to be keeled over for hours in a sweltering waiting room, the only unknown being the gallery of provincial ailments that would be sweating next to me.
When we walked through the doors, the waiting room was virtually empty. Only a kindly grandma propped up by her daughters and a mother bouncing two giggling toddlers on her knee. Where were the open abscesses? The mangled limbs? The consumptive hacks? The pus-filled scrotums? I barely had time to sink into the cool cushions of a couch before my wife had me checked in and we were called to the triage nurse. From there we were sent immediately to the doctor.
The doctor was an unprepossessing man resembling an Asian Doogie Hauser. He wore a striped polo shirt and leather slippers and could barely speak loud enough to push his voice beyond his surgical mask. My father-in-law Karl, an American expat who speaks perfect Thai, explained my symptoms in as clear terms as possible--
“runny shit”— violating the usual Thai tendency toward circumlocution in medical matters. The doctor seemed unconcerned. Sure, there had been a few cases of cholera in the area, but, without a fever, I was probably just suffering from good old-fashioned diarrhea. He was preparing to usher us out, when Karl reminded him that no one had taken my temperature. The inside of the surgical mask mumbled as an embarrassed nurse thrust a thermometer into my armpit. I had a fever of 102. In that case, the doctor said, it could be cholera.
Aside from the less-than-inspiring performance of the doctor, the whole admittance process was by far the swiftest visit to any doctor’s office, let alone the ER, I had ever experienced. I had been registered, triaged, seen by a doctor, and assigned a bed all within twenty minutes of walking through the front door. Not only that. My room and board, without insurance, would cost 1,070 baht per day—approximately 33 dollars.
In my wretched state I calculated what an indictment of American healthcare this bill was. For nearly all hospital visits, even a simple suture job, it would actually be cheaper for an American citizen to buy a thousand dollar plane ticket to
And I haven’t even told you about my room yet. My 33 dollars entitled me to a “VIP” room, the corner penthouse with private bathroom and wrap-around balcony, which was thoughtfully chicken-netted to guard against the self-destructive thoughts of the sick. The interior— replete with brown wainscoting and trim, green fake leather parlor chairs and matching sofa, pale green floral curtains, and a long wooden desk flanked by four high-backed chairs—looked like a 1950s conference room into which a hospital bed had intruded.
A retinue of nurses, smiling beneath their surgical masks, brought me some green XXXL pajamas to wear, a medley of cups for which to collect various bodily excretions, and an IV bag of medicine and electrolytes. Karl went back home and my wife Marissa, thankfully, stayed and slept on the green sofa.
---
It was, as expected, a long night. Liquid evil surged from my gut every couple hours, accompanied by twisting pangs of nausea. I distinctly remember sitting on the toilet at 2 AM shitting myself into green oblivion, entangled in tubes and my sweat-soaked oversized pajamas, filling bed pan after bed pan with steaming upchucks of corn and bile. I had what at the time seemed like an epiphany: that the finely woven structure of my consciousness—the desires, perceptions, and designs that I called a self—could literally go down the toilet if the simple arithmetical balance of things called electrolytes were upset.
This ruthless logic struck me as at once preposterous and profound, though my realization of it was hardly profound, since there are countless similarly miniscule contingencies that underlie the conditions of our existence. But I had never really reflected, and with such foreboding, on how rooted our being is to water. This truism is laced with a particularly monstrous irony when the problem is not access to water but the ability to keep it from gushing out one’s ass too fast.
My wife experienced this same episode in the middle of the night as a revelation of a different sort. She was awoken by the sound of my hacking, momentarily disoriented by her strange sleeping quarters. While trying to get her bearings, she saw emerge from the dark a shaking pale hand clutching a mobile IV stand. Was this a vision of her future, of conjugal nights in the elderly years to come?
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With dawn came respite from my torment and the beginning of a steady stream of activity in the hospital room. Over the course of the day, a dozen different employees wearing a dozen different uniforms filed in each to carry out their own special task. Beyond my team of pill-bearing, blood pressure-pumping nurses, there were the yellow- clad sweepers, the orange moppers, the green bed changers, the red trash collectors, the blue food servers and water replenishers, the pitiable bathroom cleaner wisely wearing knee-high galoshes, and the newspaper deliverer donning a sequin fuchsia cocktail dress at 9 in the morning.
At ten the doctor—this time an older more convincing one—came in smiling to give the verdict. The lab had rooted through my feces and found no evidence of cholera. I was dejected. Earlier that morning Karl had brought me a printout of the Wikipedia entry on cholera, sure that I had hit the jackpot, joining a pedigree list of stricken personages, not counting the other anonymous millions. Nor did I have typhoid or any of its militant wings. They did, however, find a type of bacteria that wasn’t supposed to be there, the likely source of my infection. His diagnosis: I wasn’t used to Thai food. How this caused a bacterial infection was unclear. He spoke, while rubbing my stomach, in faster Thai than any of the native Thai speakers in the room could comprehend. By the time we asked what kind of bacteria it was and how long I would have to stay in the hospital, he was gone.
Americans coming to
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We spent the rest of the day in a thick haze, reading, sleeping, and wondering when and if the doctor would return. Knowing that I was no longer battling cholera or sweating out typhoid, my spirits flagged. Tethered to my bedside IV bag, I escaped into Bruce Chatwin’s travel account of the aborigines of the Australian outback and his meditations on the nomadic life. With the clock on the wall broken, my sick room had the suspended feel of Dreamtime, punctuated only by the cyclical rhythm of my bowels.
When moments of ennui struck, we flipped through Thai television for the channel showing the World Cup just in case we had missed it the last thirty times we checked. The closest we could get was two infuriating fat men in front of a massive deodorant advertisement yelling about the World Cup match currently being played. Thai television, even for a native speaker like my wife, has the advantage and disadvantage of being unwatchable for more than five minutes. In the hospital, we probably watched three hours. At all times of day and night you come upon what looks like public access soap opera, always with the same radio theater sound effects and same character types: prissy female lead, humorless male, envious female, and grotesque comic relief. The default shot is profile close-up, so as best to capture all the emotion being expressed in the character’s eyebrows and lips. One historical drama, meant to evoke traditional Thai village life in days of yore, looked like a women’s locker room epic, with all the women in modern make-up wearing purple towels around their chests.
I was in the danger of becoming wrapped up in the plot of the women’s shower saga when my mother-in-law Noi (whose name means "Tiny") showed up at the end of the day in hopes of springing me out of the hospital. She managed to track down the doctor, who said I needed to stay another night, without further explanation.
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The second night passed with the calm of a broken fever while a thunderstorm raged outside. The nurses freed me from my IV drip before bed and Marissa read aloud a few chapters from Don Quixote until I fell asleep. The next morning I woke up feeling human and ready for breakfast. I swilled ovaltine and ate rice porridge along with a salty Thai version of a beignet.
When the doctor popped in to inspect me, I tried to beam health.
“How are your bowels?” he asked. He stood contra posto with the back of his hand against his hip, like an aristocrat posing for his portrait.
“Better,” I assured him. “But very green. That’s not a problem, is it?”
“No, not at all,” he laughed. “We’ll give you some medicine to take home when we give you the bill.” And then he galloped away. Exactly what disease I had, I’ll never know.
The bill would not gallop in until three hours later, but when it finally did, we had little cause for complaint. The grand total for my two days and two nights in hospital, including meals, medicine, doctor consultation, and lab work was 6,000 baht—just under 190 bucks, no insurance.* And if I had really been looking to tighten my belt and willing to stare into some open abscesses, I could have stayed in a four-bed room for much less—though I can’t imagine the horrors of sharing a bathroom with a stranger suffering the same ailment as mine.
In the end, in the absence of cholera and typhoid, suspicion fell back onto the seafood noodle yum and the octopus handler of questionable hygiene. But I bore her no grudge. My confidence in
