Sunday, August 30, 2009

Urban cave death

It's funny that even though there's only one way for human life to begin, there is an almost infinite number of ways for it to end. Disease, homicide, car accident, bears, starvation, drowning, suicide, medical error. Death can be caused by animal, vegetable, mineral, radiation poisoning. It is everywhere, hiding in the margins.

Yet one cause of death rises above all, a cause so physically and psychologically agonizing that it is (I am just assuming here) universally regarded as the most horrific way to go: cave death.

Cave death is death by getting stuck in a cave. Of course, the cave isn't the actual killer - that would be starvation, dehydration or getting mauled by a cave animal, depending on the situation; "cave death" is just a catch-all term for all ways to die after getting trapped in a cave.

And who hasn't constructed elaborate fantasies - or nightmares - about cave death situations one may find oneself in someday? You're stuck between two cave walls in a narrow, sinuous corridor hundreds of meters below ground, and you can hear faint growls in the distance and coming closer; you've lingered too long in a tidal cave, your exit is flooded and you know you don't have the lung capacity to swim to the nearest oxygen; you inch forward on your belly through a tiny twisted crawlspace, no way even to turn around, and suddenly you find yourself inextricably trapped by a bulge in the ceiling. You can move nothing but one leg. You're getting thirsty and there's a tiny pool of water inches from your face, but it might as well be on the other side of the rock wall. You hear nothing and all you have to anticipate, in your last days of feeble life, are your own tormented thoughts bouncing around inside your head. Your flashlight goes out.

These are classic examples of cave death, but the rise of modern civilization has created the potential for a unique variation on the cave death theme. Instead of rocks it involves metal and plastic; oftentimes the torment comes not from solitude but from too much company. The actual danger of death is perhaps slim, but the desperation, the horror remains the same.

It is urban cave death.

Urban cave death is tiny elevators, cramped buses, mazelike hotel corridors. It is carbon-copied classrooms and sprawling malls without directories. Urban cave death is being stuck in a fifteen-person van with thirty Filipinos, rolling with agonizing slowness through the subterranean Gaisano City parking lot packed solid with gibbering thousands of midnight-sale shoppers and vehicular gridlock while sweat pours down your body from the heat and stale unmoving air.

It is a sacrifice to the gods of progress, all the horrors of modernity condensed into a most base terror. It is a primitive fear wrapped in cellophane and slathered with "50% Off" stickers.

Sunday, August 23, 2009

Ang damang si Boris

Went to my CR the other night and I see this:

Now he's climbing up my wall... 

I did a size comparison with my hand, but it doesn’t really do my buddy justice. He certainly seemed about three times bigger at the time.

After this I ate him.

Tuesday, August 18, 2009

They said, How long can you hang around? I said a year, maybe two.

Just until my skin turns brown and then I’m going home… (Joni Mitchell)

Last time I was in Manila, several volunteers from the batch before mine were preparing to complete their Close of Service (COS) and return home or move on to further Southeast Asian hijinks (including taking a long-delayed nibble of Mindanao, the forbidden fruit of the Peace Corps Philippines program). What struck me most was the total lack of fanfare, the abruptness of their departures. They packed their things into taxis and left.

Having just passed the one-year mark myself, I’m starting to feel like the lack of a big wrap-up, a summation of Life in the Peace Corps, is totally appropriate. I’m less than halfway finished with my own service and the experience already is too big to judge.

I did ask one departing volunteer to rate his service on a 1-10 scale. “Maybe a four,” he replied.

I don’t think I could rate my own as a number. I could use some words - “hot,” “weird,” “frustrating,” “rewarding,” “this fake cheese is disgusting” – but that’s sort of like saying “I went to the beach and there was this one pointy wave and another kind of flat wave” and regarding that as a sufficient description of the ocean.

The truth is that sometimes the best part of my day, provided that the insects aren’t swarming that particular night, is getting into bed after a cold bucket bath, knowing that I have a few precious hours to relax, time I don’t have to spend thinking about work.

But then – sometimes the worst part of my routine is leaving my center at night, saying goodbye to my kids when really I would love to stay and talk to them and try to figure them out.

I go to Iloilo City on the weekends to escape from my town and my center – yet it’s often the highlight of my day to run into someone from my community while I’m there.

Lots of things have changed. Some things have become less important – things like Time and Distance, which are both highly variable in Filipino culture. “Wait a while” is a common English phrase Filipinos use to signify a wait of any possible length, from a few seconds to days. Units of measurement, like kilometers, become elastic, subject to each person’s particular sense of truth.

Sometimes I’ll get one of those little reverse culture shocks, the vague sense that I’m perceiving something from the past but can’t quite recognize it. Recently I stayed at a pension that had showers with handles for both hot and cold water. I stared at them for at least a minute, trying to remember whether hot water was usually on the left or the right. I couldn’t do it – I had to try them out to be sure. Lots of things are familiar here, but there are plenty of differences - and sometimes the changes seep in slowly enough that I’m not even aware they’re happening until I get one of these little shocks.

In the end – or even now, twelve months in – nothing I write can be more than a store of notes, a collection of funny or sad stories, hopefully more of the former. There are no scales to measure my experience against what might have been otherwise, or what might be in the next year in another place.

It’s just what I’m doing, you know?

Friday, August 14, 2009

A kilo of cure

I start out of a weary sleep to see an indistinct white form standing next to my bed. My mind races: who is this person and why is she in my house?

”Good morning, sir. I will just take your vitals.”

It’s my second night at the hospital in Iloilo City. The nurse takes my blood pressure and temperature and leaves. I roll over, careful not to dislodge the IV sticking out of the back of my left hand, and check the time on my phone. Two-thirty in the morning. It’s my second vitals-check since midnight, and I’ll have another one before the sun comes up.

I started having pains on the right side of my chest on Tuesday, but for an hour or so they were only minor. I went ahead to work, but the pain got worse, dull and throbbing and spreading to my head, and breathing became increasingly difficult. Lying down didn’t help; sitting made me feel faint.

My center rushed me to the hospital, no doubt terrified by the thought of an American dying on their watch. Straightaway I was put in a bed in the ER, where my temperature and blood pressure were taken every few minutes by a different nurse, who always asked for the same information: name, age and symptoms. Coordination is not a strong point here. Nor is keeping the patient informed – I didn’t find out until the second day that I’d also had a fever when I first arrived. Sometimes as many as five or six nurses would crowd around my bed at once, pinching my toes and asking if I was Canadian.

Over the course of three days I met with at least four doctors, two of whom I never saw again, and none of whom gave me any solid information. They were at least polite and reassuring, with the exception of the first, who imitated a brick wall quite ably. Part of our conversation, after I mentioned my headache, went thusly:

DOC: Have you had a headache before in the same place?

ME: Yes.

DOC: So you have a chronic frontal headache.

ME: No, I mean I’ve had headaches there before. I have headaches sometimes in different places. It’s not chronic.

DOC: When was the last time you had a headache?

ME: Uh, maybe three weeks ago.

DOC: So you’ve had a chronic headache for three months.

ME: No, three weeks. And it was just one headache.

Straightaway she signed me up for sinus x-rays to discern the cause of my chronic headache.

The ER was quietly strange. My mind exaggerates the scenes of emergency rooms of true third-world countries: full of dim bare lightbulbs and the moans of the suffering, doctors running up and down the corridors without enough time to change their blood-splattered scrubs, small children whimpering in dirty corners, forgotten, as their parents or siblings are thrown onto operating tables.

My experience was nothing like this, of course; the most exciting thing that happened in my twenty-plus hours in the ER was someone smoking a cigarette in what was clearly a no-smoking area. Yet the ER had an odd kind of calm chaos about it, an institutional disorganization that left me totally clueless as to what was going on and why things were happening the way they did. My superfluous IV was stabbed in double-quick – well, after a short episode involving the not-so-reassuring phrase “Sir, I’m just going to insert it again” – yet I didn’t get any medication for the pain (which to be honest was the only thing I really wanted at that point) until I had been lying there for at least five hours. There were a thousand nurses in the place and every single one came by my curtain-lined cubicle to introduce themselves and get my vitals. I had numerous tests, all administered at apparently random times and without regard to previous tests – my blood was taken three times – and didn’t find out about the results until much later, if at all.

At one point a nurse loaded me into a wheelchair and started rolling me out of the ER for chest x-rays. He stopped, left me in the wheelchair in the middle of the ER corridor, and started pawing through a bag of snacks somebody had left at the nurses’ station. After several minutes of checking out the snacks and chatting with other nurses he finally got back to wheeling me to the x-ray room.

No rooms were available that night, so I stayed in the ER. I actually got more sleep on that night than the second because – oddly, I thought – the night nurses didn’t bother checking up on me until I was sequestered away in a private room.

It’s standard practice in the Philippines to have another person, a friend or family member, watch over you at the hospital. This person is called a kasama (companion) or bantay (watcher). The kasama picks up medication, arranges for billing and does other jobs a bedridden invalid can’t be expected to handle personally. A kasama is absolutely necessary because very little is explained to the patient, and it’s difficult to seek out answers when you’re restrained by an IV. Everything is done in such a strangely unfocused, inconsistent, seemingly thoughtless manner: nurses replaced my IV bag several times, but one time – only one time – my kasama had to go buy a new bag and bring it back. Because of prearrangements made by Peace Corps, I never received a bill for my tests – except for one blood test. Why only one? Why not none or all? My food was brought to me in plastic trays marked “Merfe” and often consisted of foods engineered specifically to be impossible to eat with only one hand. A group of nursing students – the hospital is attached to a college – came by my ER bed and requested an interview with me because “Your case is so very interesting, sir.” “And you’re the only foreigner in the joint” was unspoken but understood.

I escaped on Thursday, having recovered sufficiently for them to discharge me. No diagnosis, of course, just vague references to “some kind of viral infection.” “You just need rest,” my final doctor assured me. Hence those frequent early-morning vitals-checks, I guess.