One of my great fears became a reality: getting sick in a foreign country. I taught my first real class at the university on Wednesday afternoon, September 17, and only had time to eat a bag of potato chips washed down with a Coke for lunch. After walking “home” in the heat toting my laptop, I was tired and soaked with sweat. The computer seemed to gain a pound every hundred yards.
After cooling off and changing into shorts and flip-flops, I headed to the shopping area about a half-mile away to get supper. I was trying to decide whose shashlik (shish kebab) to try when the old intestines gave me a rude warning to get home in a hurry. A situation like that gives special meaning to the term “trots,” a description in use since the U.S. Civil War. Diarrhea set in and I had a miserable night
The next day in the early afternoon I was so weak that it was hard walking to the beach. I had cheap shashlik and fries in the outdoor section of the Flamingo Hotel. After sitting a few minutes, I realized that everything beyond the covered area, looking toward the Black Sea, was a pearly-white blur. It was like having yours eyes dilated and stepping into bright sunlight. At least I could see nearby things, like my hands and feet, fairly well. I sat for some time, waiting for my sight to improve, but it didn’t happen.
From the restaurant I headed toward home. I kept my eyes down and to the immediate front, walking slowly. Luckily, there were lots of benches, so I stopped often and rested. About 100 yards from one stop was a large building, about 10 storeys, under construction. It was white and the outside was nearly complete. I couldn’t make out any of the details at all, and couldn’t read car tags (one of my favorite compulsions) more than a few yards away. I almost asked for help, but figured it would come out as “I can’t see, so please take my wallet.”
I was, let’s say, concerned. A few months earlier I had read an article on poisoned vodka in Russia. The Putin administration had sharply raised taxes on the national beverage in a futile attempt to curb consumption. Some of the more industrious (or industrial) began making cheap moonshine with one of the ingredients being a high-strength cleaning solution that was mostly alcohol. They were also buying the cheapest commercial vodkas and spiking it with the same. Unfortunately, the cleaning solution had other chemicals that turned the skin yellow, damaged the liver and kidneys, led to temporary or permanent blindness, and occasionally killed the consumer. In fact, several hundred people had died. I was fairly confident that my skin had not turned yellow, and my sight was getting progressively better, so the crisis passed.
By nightfall the culprit had spread to my stomach. At about 10:00 I went to the main kitchen and made a cup of hot tea. Alexi’s wife and sister-in-law came in and I tried to explain my situation by saying “Ya bolen” (I’m sick.), pointing to my stomach, and pretending to throw up. (Alexi is a retired Russian Army colonel and is chief of security at the university. He is also my landlord.) It worked. They brought me some small pills, which they assured me were “ochen harashow,” (very good) and simulated throwing up. Somehow I knew the final part of the cure was yet to come: They gave me a big shot of vodka with salt stirred in.
Friday morning early I called Susanna, one of my student translators, and said I was too ill to make my 9:30 class. Susanna is Armenian and speaks very good English. She has more-or-less offered to take care of me, and she said she would call all the students and tell them. I had eaten almost nothing since Tuesday and was hungry and weak. I went into the main kitchen and pilfered some graham crackers and made a cup of tea. I think it saved my life. Then about 9:00 Alexi’s sister-in-law (whose name escapes me) knocked on my foyer door and delivered a large bowl of kashka (cream of wheat). I downed it faster than Phil Booth or Stephen Wedding at a chili-eating contest. That night I made it to the nearest beach-side cafeteria and had the omnipresent meat balls and mashed potatoes.
Saturday and Sunday mornings passed slowly, interrupted by bouts of throwing up. Sunday afternoon I felt much better and thought I was over the worst. For supper I went to a cafeteria and had borsch and, to add a little variety, boiled potatoes instead of mashed. (Culinary note: From what I can ascertain, borscht is Ukrainian rather Russian and is beet-based and purple in color. Borsch, without the t, is Russian, red in color and includes cabbage, potatoes, and a small amount of pork, but no beets.) I had a hard time making it the 300 yards home. Alexi was outside when I entered the courtyard and stopped me. I must not have looked very handsome, because he said he was going to take me to the doctor at 10:00 the next morning.
At 10:00 Monday morning I was sitting on the front step waiting. In a few minutes Alexi’s wife said he had called and could not come, but was sending someone else. About 10:45 Elena, another student translator, rounded the corner—on foot. She said the hospital was between my place and the university, so we could walk. The university was two miles away. It was hot and I was weak, but the hospital couldn’t have been more than a mile. We went to the fourth floor (no elevators) and waited for Doctor #1. After a few minutes we entered her small office, which she shared with a secretary (?) who was filling out forms by hand at a frenetic pace. The doctor took two calls on her cell phone during our conference. With Elena translating, I explained that I suffered from diarrhea, vomiting, dizziness, and weakness. She seemed thoroughly puzzled and sent me to Doctor #2, apparently an abdominal illness specialist.
Doctor #2 had a small suite with a waiting room, office, and examination room. Her daughter, about eight or nine years old, sat by me in the waiting room and we drew pictures and looked at children’s books. In the examination room Doctor #2 took my blood pressure and said it was a little low at 80/60, which was pretty disconcerting because I take medication for borderline hypertension. She sent me to Doctor #3, who gave me an EKG (I think) in about two minutes and said there was nothing wrong with my heart. We went back to #2, who poked on my stomach a while, then gave me two shots in the booty. One was to raise my blood pressure, and I have no idea what the other was. She then announced that they were sending me to their “infection” hospital for a few days. I was mortified. We went to the front entrance and in a few minutes an ambulance arrived. It transported me, siren on, a short distance to what would be my home for the next three days.
It took about an hour to check in. There were two admissions people filling out lengthy forms by hand and making photocopies of documents that they glued to the forms. At some point, they took me to a restroom where I had to collect my own stool sample on a small metal wire brush and put it in a test tube. I also had a blood sample drawn and donated a little urine. After I signed some forms, they took me to my room. It was at the end of the hall on the first floor, and in getting to it I saw some of the most depressing things I have ever witnesses. (Granted, I have never been to a “real” third-world country.) Each room had a door that opened directly into the hall that locked from the hall side. Large windows took up most of the rest of the wall space between the door and next room, so that everything and everybody in the room was visible. There were four to six single beds per room, with no curtains or other partitions. Worst of all, most of the rooms on the floor were for children. Mothers cuddling sick or injured children, some of whom were crying piteously, filled most of the beds.
My quarters were in Room 8, last one on the left. It was smaller than the others, with only three beds, and it was empty, at least so far. I was getting the VIP treatment. The beds were single-sized metal frames with wire springs, much like camp beds for boy and girl scouts in the States. The “mattresses” were nothing more than plastic-covered pads, at one time (several years ago) about two inches thick, old, musty, and with hard-ridged wrinkles. An attendant came in with my linens—two sheets and a pillow case—and made my bed. The sheets were old and cheap and had blood and other unidentified stains that wouldn’t wash out. They would hardly reach from one end of the mattress to the other and were just wide enough to tuck in, so that the bottom sheet came untucked with every turn of the body.
By about 2:30 I was uncomfortably nestled in. The smells of antiseptic and urine battled for supremacy, with either holding the upper hand at any given moment. In a few minutes a nurse came in with a dreaded stand topped with two one-liter drip bottles and a one-liter bag. Each one took an hour. During that time I began to have serious thoughts as to whether I should try to pack it in for home. It really wasn’t an alternative because 1) It would be cowardly not to stick it out, 2) I was too sick to travel alone anyhow, and 3) I might be well in a day or two.
Sometime during the drip another nurse came in with a large clear glass jar. She rattled off instructions in Russian, about two words of which I understood. I said (in Russian) that I understood and spoke very little Russian, phrases that sometimes sink in and sometimes don’t. She continued to rattle on, repeating herself louder each time. This illustrated a theory of foreign languages I derived from many observations of people trying to communicate in various cultures, including America, and from Americans traveling abroad. The theory is that anyone can understand a foreign language (especially your own) if it is spoken loudly enough and slowly enough. It doesn’t work. After the nurse left, I looked at the jar and used my best logic. Its mouth was about five inches across and the bottom about twice that. It wasn’t big enough to hold a gallon, but looked about three-fourths that size. Well, it didn’t take a rocket surgeon to figure out that there wasn’t but one thing it could be for. Later I even discovered that it fit fairly neatly in the commode, whose water level was very low. After three drips and drinking two liters of water I was ready for the challenge. When the attendant checked my jar later that night, it was two-thirds full, causing her to flush in admiration.
The night was miserable. At some point an attendant delivered supper, consisting of a bowl of soup and some bread. She also left a large soup spoon. Later she picked up the soup bowl and bread saucer, but not the spoon. I wondered if a spoon washing specialist would get it later before it dawned on me that that was my spoon for the duration, and I should keep it clean myself. The hall light shone directly on me until midnight, but it was the noise that was most disturbing. For reasons unknown to me, the staff would not let me keep the hall door shut. When I tried, they would open it and leave it ajar. During the course of the night I heard the most awful sounds I ever heard made by human beings. Mostly, they were the sounds of children in such pain and fear that they screamed uncontrollably until they became exhausted. This happened several times. Not for the squeamish, but imagine if you took a child between the ages of three and five and broke its arm across your leg. The strangest thing is that I don’t know why this was happening. No hypodermic could ever make even the most pain-sensitive child scream that loud and in such horror for that duration.
Tuesday morning at 6:00 a nurse flicked on the room lights to draw blood. I hadn’t slept anyhow. At about 9:00 I thought my salvation had arrived. Alexi had come and was raising hell with the hall guard. I honestly felt terrible, but was ready to say, do, or sign anything to get out. Alexi, Elena, and I went upstairs to a doctor’s office to discuss the situation. I said I felt fine and wanted to go home. The doctor, who seemed to be a competent and concerned person, explained that I had an intestinal infection and was not ready to leave the hospital. The results of the tests I had on Monday would not be back until Thursday or Friday, and until then they didn’t know what to treat me for. I was disappointed, but in the back of my mind I knew he was right—I was in no condition to leave. In the meantime I had to drink two liters of purified water a day with an awful tasting powder mixed in.
At about 11:00 I started another three-bag drip that confirmed one of my theories about nurses. Experience has led me to believe that the more attractive a nurse is, the more she or he is going to hurt you. An unattractive nurse can give a shot or start a drip like magic, but the pretty ones are going to make you suffer. I’m sure there are a lot of exceptions, but I haven’t personally met any. This nurse was slender with short brown hair and cute. I knew I was in trouble. I nicknamed her Jim Bowie. She stabbed me in the left arm, taped down the needle, started the drip, and departed. Susanna showed up a few minutes later with two other translators—Tonya, and Tonya—bringing bottled sparkling water. The drip took about an hour, during which Jim Bowie never checked back. Thirty minutes after drip #1 was finished, she came back and started drip #2. Somehow that one didn’t work, so she took out the needle and started over. Once she got the needle reinserted and the drip working, she left and didn’t come back for another hour. In the meantime, someone had brought my lunch, which was by then stone cold. Jim took out the needle so I could eat. Lunch consisted of some soup, cracked buckwheat, and a slab of something I couldn’t identify that had the consistency of potted meat but smelled like fish. Hungry as I was, I couldn’t eat it. Jim returned and stuck me in the left arm for the third time but couldn’t get it right. We had to use the right arm, which was still sore from the day before.
The night wasn’t nearly as miserable as the one before, mainly because I moved to another bed that was out of the hall light and there was a wall between it and the door to muffle the noise. Still, I could hear children screaming on and off, and what had to be a woman having a baby without anesthesia. I am not making any of this up.
By Wednesday I had become reacquainted with the smell of my own body. When I checked into the hospital on Monday, I had no toiletries at all and no extra clothes. I was wearing blue jeans, a button-up short-sleeve shirt (Wal-Mart), briefs, and an undershirt. I could take the shirt off, but nothing else. People close to me will vouch that I am a profuse sweater, and this week was no exception. My undershirt humiliated the smells of antiseptic and urine. At about 9:00 Alexi and Susanna arrived. I made sure they kept their distance. We finally figured out how to call the States on Alexi’s phone, and I got Beverly. She had not heard from me in nearly a week because I had not been able to get Internet access. It was about 12:30 in the morning, Mississippi time. I told her not to worry, that I was going to be fine, and hoped I was telling the truth.
Alexi and Susanna left, but Susanna said she would be back. At 11:30 Susanna, Tonya, and Tonya—Benski’s Angels—showed up with packages in tow. Alexi had given them money, and they had bought sparkling water, paper towels, liquid soap, handi-wipes, a magazine in Russian that I couldn’t read but had a lot of good pictures, and a short novel in English called Theater by Somerset Maughn. That at the fact that I didn’t have any more drips made it a comparatively good day. They also told me that the doctor said my test results were back early and indicated that I didn’t have anything deadly. I could go home the next morning at 8:30 if I didn’t have fever. I almost asked the girls to go to my apartment and bring four Tylenol from my stash, two that I would take at midnight and the other two at 5:00 in the morning. No fever for me. They asked me if I needed anything else and I said that I would really like to take a shower, but didn’t have a towel. They asked the nurses for one, but it seems that towels were not part of the deal. Susanna left and came back in five minutes with a nice one. The girls left and I took a hand-held shower, halfway afraid that a nurse would catch me and take my new towel away. I put my pants and shirt back on, but left the offending undershirt hanging on the foot of the bed to dry out. It helped a little. That evening I read the entire Maughn book and thoroughly enjoyed it, despite the occasional screams.
In a conversation with the girls, they told me some interesting things about the Russian medical system. Medical care is “free” for Russian citizens, who have medical pamphlets about the size of a passport with their pictures and other information. The girls seemed to have a hard time grasping that in the U.S., most people actually pay for medical care. I tried to explain that most people who work have insurance provided by their employer and that people without insurance have various options for medical care, even though it isn’t as convenient. I told them that people all over the world go to the U.S. for medical care when they really need it, because American medicine is the best there is, hands down, although it is very expensive. The most interesting part of the conversation dealt with doctor’s incomes. I knew that they were not highly paid in Russia in comparison to Americans, but the girls said that doctors and teachers are among the most poorly paid professionals in the country. I don’t know what that means for doctors, but my Russian salary as an assistant professor is less than $500 a month. I told them that the one sure career for making a lot of money in America was medicine. I continued that it takes a smart, dedicated, and talented person to become a physician in the States. Earning a college degree, getting through medical school, internship and residency meant that doctors entered the workforce relatively late and often deeply in debt. Doctors (and nurses) had to be amply rewarded to draw the most capable people into the medical field because peoples’ lives are in their hands. This also seemed strange to them. To me, it is a partial explanation for why the life expectancy of the average Russian has actually gone down since the collapse of the Soviet Union in 1991. I believe that the life expectancy of Russian males is only 67 years and dropping, and the birth rate is so low that the population level cannot be maintained. These were rather sobering thoughts to have while lying in a Russian hospital.
Susanna arrived promptly at 8:30 Thursday and asked if the doctor had been by on time. Out of the question. Russians have the patience of Job out of necessity. The doctor came in at 9:45 looking harried, said I could check out, and to have my bill calculated. The bill concerned me a great deal. I had no idea what to expect and figured that I would have to pay cash. (Hardly any businesses but the most upscale take credit cards and they would have laughed at my Regions Bank checks.) What if I didn’t have enough? I had about $250 worth of rubles on hand. My ATM card worked, but I could only withdraw $400 a day. Would they hold me hostage until I could cover the bill? Susanna and I went to the business office, where an elderly woman asked a few questions and worked on her calculator for a few seconds. Billings for non-citizens were normally 500 rubles per day, but since I had not stayed three whole days, mine would be less than 1,500 rubles. The total came out to 1,086 rubles—$42.50 US. Russia may be the only place in the world where a hospital stay for foreigners is cheaper than staying at home. I would still prefer home. The paperwork was finished in yet another hour and I was a free man.
One thing bothers me for now. There is no further treatment, meaning no antibiotics or other medication. In the States, I am relatively sure that I would have been given a strong anti-diarrheal medication and probably a heavy run of antibiotics. Here I had six drips and a bunch of foul tasting powders over three days. If I had an intestinal infection, what has cured the infection? Do I still harbor bacteria or other critters that will flare up later? One thing for certain: If it happens, I’m on the first available plane home.
Tags: Hear That? // Add Comment »
Deer season is upon us in Mississippi, and like any other year, I’m starting to lose my wits …
When I can get over there with AnnSR and Villiard, it’s a good 45-minute workout with little to no wait for machines or equipment. And the stuff over there is nice … really nice!