fat will

 

This post turned out to be kind of long. Sorry!

It’s now been three months since this happened, and many people who may read this have already heard the story. I didn’t write about at the time because, in addition to there being no blog, there were no pictures. Everyone who has listened to this story, before even asking me if I’m OK, has asked if there are pictures. To their and my disappointment, there weren’t, or at least until today when Petra Stumpf, the nearest volunteer to me, emailed them to me under the subject line ‘fat will’. So we’re good to go now.

            I worked for most of the March-June summer vacation planning my first real Peace Corps project, a two-day IT training to help teachers do their grades in Excel rather than by hand. Filipino teachers are burdened by, in addition to six classes of sixty students each, a heartbreaking amount of administrative work. For every grading period, teachers bunker down in their offices to fill out grade forms for each of their classes, and then for each of their students. And then they have to make copies by hand of most of those forms. It’s tedious, truly dull work. The worst part, though, is that this pulls them out of class for up to a week each quarter.

            So my teaching counterpart and I, along with our school’s handsome rat-tailed IT Coordinator, designed a training that taught the basics of Excel and how to recreate their grading forms on computers. The training was held a week before school started again, and it went as well as we could’ve expected. This past week was the end of the first grading period since the training and I was really happy to see that most of the teachers had started doing their grades in Excel.

            Anyways, I decided that the training allowed me to skip out on the second half of Brigada Eskwela, which is the pre-school year campus beautification week that sounds awesome and Peace Corps-y but is really just a lot of people standing about without anything to do and kids chasing each other with saws. Take it from the leader of the Weed-Pulling Patrol.

            Luckily, this coincided with a hiking trip Narra’s tourism office, a 1.5 man affair, was organizing to the mountain in our municipality. Narra is currently trying to remake itself as the Agro-Tourism Capital of Palawan (have you bought your ticket yet??) with the occasional tourism office-sponsored hiking trip. This was their maiden voyage; starting at waterfalls near the base of a nearby mountain called Estrella Falls and over four days and three nights climbing the sixty-five waterfalls above it.

            We were the tourism office guy and two of his friends, me, a couple tour guides from the provincial capital, a French girl and her Filipino boyfriend, an Australian who lives on the beach on Palawan’s largely uninhabited western coast and looked sort of what I always imagined Tom Bombadil from Lord of the Rings to look like, two guides we hired from the village near the waterfalls and all their friends. So about sixteen total.

the crew.

tom bombadil. is that off?

            After the set-up, I’m finding there’s not much by way of details. It was easily the hardest hiking I’ve ever done. There wasn’t a path, so we were either hiking in the river, climbing next to the waterfalls, or if that was impossible cutting our way through the forest. Though I didn’t do any clearing; no one would let me. What made it difficult though was that it rains all the goddamn time in the Philippines and this trip was no exception. Everything was slippery, from the rocks on the floor of the river to the rocks on each side of the river to the mud on the steep slopes of the forest. You had to make contact with the ground, trees, or rock ledges with at least three out of four limbs at any time to not fall on your face. Which I still did a lot.

Nevertheless, it was a lot of fun. The occasional leech and a tarp collapsing over my head and dumping its collected rainwater on my hammock the second night aside, the first three days were without incident and we reached the last and biggest waterfall, which had only been reached by guides for the first time recently, on the middle of the third day. 

            

65th waterfall.

            The problem was the descent on the fourth day, which had to cover the ground of the first two days combined. We ran really behind schedule and ended up doing things like jumping off the short waterfalls into the river’s deeper pools to avoid lengthier detours into the forest. This ended up not saving much time because many Filipinos don’t know how to swim and a couple understandably had mild panic attacks doing this and had to be saved. In addition, I was running out of food and all I had left was these cans of black beans that I foolishly bought believing they could be eaten on their own but really are for cooking and intended to be used so that you don’t have to add any additional salt to your meal. These cans contained all the salt you need, and Filipinos prefer their meals heavily salted. So these black beans were by some distance the worst thing I’ve ever eaten in my life. The other day I came across something that compared reading Dostoevsky to eating cement because you have to force yourself to consume it piece by piece, none of which are enjoyable. I substituted cement for those black beans and the writer’s comparison became much more visceral. Unfortunately, these beans constituted half of my rations for the trip.

            All of this, though, is the long and probably unnecessary precursor to my descent of a hill about an hour from the end of the trip. The slope was all mud with very few branches or ledges to cling to and I remember thinking, even though we tied a rope to descend with, that this probably wasn’t going to work. It didn’t work all of three tentative steps down when a slipped- not far since I was holding the rope- but far enough for the stump of a thin tree that had been cut down on the way in to spear me right above my right armpit. Luckily, there was a guy right behind me who responded to my yelling some foul language that definitely scared him a little. He used his bandana and tied it tightly around the wound and another guy was sweet enough to take my pack as I walked the remaining hour out of the woods. Apparently someone ran ahead to call an ambulance because I was only out of the woods for five minutes, most of which was spent being sprayed down with a hose, before an ambulance showed up and took me to the municipal hospital.

            I’ve been cautioned against going to Narra Hospital not only by the Peace Corps, but by most Narra residents. After her water broke, my teaching counterpart refused to go the hospital and instead insisted that the doctor come to her house to deliver her baby. You often hear in Palawan, “If you want live, you go to Adventist [Hospital in Puerto Princesa]. If you want to die, you go to a provincial hospital”. Not very pithy, but OK, understood. It was already too late in the afternoon to go to Puerto in a van, which no one would have appreciated me bleeding all over, but mostly no one asked me where I wanted to go.

            When I got to Narra Hospital I didn’t have to wait long, but long enough to read a memo posted on their bulletin board chiding the staff for being the only hospital in the province not to have its certification renewed by the Philippine Department of Health. Neat. Still, I was in and out in about ten minutes, with just three stitches, a bandage, a bag of antibiotics and an order to come back the next day for a tetanus shot, which I did. I got home and my host family surveyed the scratches all over my arms and face and announced that I looked like I had lost a cockfight.

           

The next few days I spent lying around eating and watching movies, which is why I wasn’t too concerned when I started to expand. It started with my feet and ankles, which I noticed were a bit plump around Monday night, three days after I got home. Every Peace Corps volunteer is issued a copy of a book called Where There Is No Doctor, which is sort of like heroin for hypochondriacs; a source of both great anxiety and comfort. But where it had in the past turned bed bug bites into smallpox, here it just attributed my swelling to “putting extended pressure or strain” on my ankles. Ok, check. But then over the next couple days my torso started to swell. I attributed this to eating lots of bread and not moving for days. It didn’t really seem like fat but rather something heavier, but it was happening in mostly the right spots. A day later, however, my legs were swollen to the point that I couldn’t stretch my quads and by Friday my face was pretty jowly as well.

On Saturday night, at the urging of every Filipino in my community and common sense, I checked into Palawan Adventist Hospital in Puerto Princesa. After taking my blood pressure and checking my pulse, I was put on a scale. I weighed 205 pounds, about 35-40 more than usual.

plus some pounds.

Over the next few days, different tests and scans were done, all of which came back relatively normal. But my swelling still wasn’t improving, and no one seemed to know what was causing it. All they knew was that despite the antibiotics, my wound was infected, that I had edema all over my body and that the two weren’t directly related. My primary doctor was one of the few bald Filipinos. He showed up to each of our daily meetings wearing superhero graphic T’s and mostly massaged his chin stubble ponderously while asking me the same questions over and over before ending our meeting by saying he didn’t know what was going on and that he’d keep me updated.

Still, I decided that I would be patient and let things take care of themselves. No one seemed to think my health was in any danger, and except on the third day when I had a reaction to the drugs that made me vomit and unable to keep any food down, I didn’t feel sick or uncomfortable. I watched movies on my laptop and on the TV when there was a signal. Plus, in addition to the crack team of eight nurses who arrived as a unit every two hours (including during the night) to check my blood pressure, I had a regular stream of visitors. Petra hung out for a few hours the first evening and brought me a copy of The General in His Labyrinth by Gabriel Garcia Marquez. It’s about a feverish and diminished Simon Bolivar who, now hated by the people who once loved him, is on his final trip to the ocean but doesn’t make it and arrives instead at his deathbed in the novel’s final pages. A lovely novel recommended for hospitalizations of all kinds. Lileth Pagobo and Benjie Lamitar, two of my friends from the English department, visited. Matt and Krystal Klebes, a married Peace Corps couple living in Puerto visited everyday and were kind enough to contact my parents before I finally got in touch with them myself on the fourth day.

I wasn’t able to reach them earlier because there was no signal in my hospital room. So I was forced to venture outside in search of a signal and a substitute for the weird Seventh-Day Adventist non-coffee served during breakfasts. Usually in the Philippines such errands are taken care of by a kasama, or companion; something every Filipino will have during a hospital stay. I didn’t have one, nor did I really need someone there twenty-fours hours a day just to make a two-minute run to the convenience store on the other side of the hospital’s campus. On the other hand, I think I’ve made more dignified public appearances than I did that week, dragging my rickety IV tree while trying to hold up my pants, which no longer made it all of the way around my burgeoning waistline, all while sporting an increasingly dirty T-shirt. 

            I finally did get in touch with my parents on one of these trips outside on the fourth day. I explained that my first primary doctor didn’t really know what was going on and that I was now being visited by a new doctor, who seemed more knowledgeable and more curious about my case, but who had a private practice outside the hospital and only stopped by for rounds twice a day, one of which was at 2 AM when he’d come into my room and ask me questions to which I must have drowsily replied but didn’t remember well the next morning. During his first visit he asked me if I smoked and I replied that I only smoked occasionally. From then on he took this to be his primary medical charge, and would in the following visits would brush aside my questions about my condition but urge me against the dangers of smoking and make me swear to stop. House M.D. I explained that no one really seemed to communicate with one another or to be even on the same team and that nurses were clueless about drugs the doctors told me I was supposed to take. That when my friends from Narra visited they told me it’s common in the Philippines to draw out care so as to rack up larger hospital bills.

            I really wasn’t bothered by any of this until then. A sharper person than I would have probably added these things up on his own but it took me saying them aloud on the phone to my parents to realize that this probably wasn’t going to work. After I got off the phone with my parents I called the Peace Corps doctor and they agreed. The next morning I checked out of the hospital and flew to Manila.

            The Peace Corps doctor picked me up from the airport and drove my straight to Makati Medical Center, perhaps the best hospital in the country. Volunteers are regularly reminded that no matter how much they integrate into their communities, no matter how poor our housing or how small our living allowance, we are still one phone call away from things most Filipinos will never have access to. If my private hospital room at Palawan Adventist was a luxury, the room I was given at Makati Medical was embarrassingly opulent. The class of rooms that Peace Corps volunteers normally get were all booked, so I was bumped up to the next level. The room was large with a couch, arm chair, and desk. There was an internet connection and sixty channels. Easily the nicest bathroom I’ve seen in this country. The most extravagant part was the meals, which showed up on a rolling cart adorned by the cast of Beauty and the Beast, including one of those semi-spherical tins that covers your plate. So as much a hotel as a hospital.

            But if my ability to enjoy this was tainted by guilt and embarrassment, then the real reason I was there, the medical care, was a genuine relief. As soon as I got there I was seen by Dr. Paul Tan, who I’d met once before and who thankfully did not put me back on IV and immediately ordered a half-dozen tests and seemed as interested as I was to figure out what caused my edema, which had not improved. He didn’t know what had caused it, but he knew immediately how to get rid of it and prescribed me a drug that I was told would make me pee every 15 minutes or so. They put a scale and a plastic jug in my room and I was ordered to weigh myself daily and to measure my urine, a task I took to with diligence and enthusiasm.

            Otherwise my week at Makati Medical was spent reading, napping, and talking to people on Skype. It was a thoroughly pleasant week. My trips to the coffee shops were no longer hindered by an IV tree and my though my pants were getting always dirtier, they fit better every day as I steadily peed out the extra 40 pounds I’d been hauling around. Manila is a medical hub for some of the Peace Corps programs on small South Pacific islands with few medical resources, and I met a volunteer from Micronesia on the floor below me who had accidentally put her hand through the glass window of her bedroom trying to ward off a snooper. We snuck out one day and went on a long walk and got ice cream. Talking to friends and family on Skype made me homesick. This was tempered by finally getting around to Jonathan Franzen’s Freedom, which made America seem exhausting and insufferable. And remember all of this came about because I wanted a vacation, so I wasn’t exactly longing to be back in Narra either. I was kind of exactly where I wanted to be.

            As my body returned to normal, they continued to do diagnostic tests, all of which came back normal and none of which discovered a cause of the edema. After repeatedly narrating the events leading up to the hospitalization to a series of specialists, my primary care doctor came to the conclusion that the tetanus shot I had received the day after my accident at Narra Hospital had temporarily shut down my kidneys, causing my body to well up the water I was ingesting. This next bit is a bit unclear, because for some reason it was conducted in Tagalog, but the reaction was because the tetanus shot was either manufactured for or from horses. Possibly even by horses. There must be some obscure superhero who got his powers this way.

            I was scheduled to go back to Palawan within a couple of days but was held up by a last blood test, which indicated that I was fairly anemic and would have to stay in Manila for another week for monitoring. I can’t really remember how that turned out but I think I’m OK. I spent the week walking around malls, exploring the old Spanish part of Manila, going to the movies (the three Filipinos in the theater were not feeling The Tree of Life). Real-life deux ex machina saved this narrative from petering out with no real ending when a rainstorm flooded all of Metro Manila on my last afternoon and stranded me at the hospital where I was checking in for the last time. All it did was rain all afternoon and Manila was knee-deep in floodwater. All I’ve heard about floods in Manila is that they kill people because the waters get contaminated because Manila itself is essentially one big infection and people who have open cuts on their legs get infected and then die. So I decided not to trudge through the waters to the nearby light rail and instead hailed a cab to go the five kilometers to the pension I was staying at. It took five hours. We’d get really close only to come to a section of the road that was impassable. Then we’d have to turn around and find another way with similar results and repeated this for five hours. It went from being frustrating to funny to infuriating to funny to delirious. The driver was incredibly kind not to leave me on the side of the road and we spent the time talking, smoking, being bummed, and taking turns talking to his wife on the phone to give her updates on our situation. I got back to the pension just after midnight

            I took a plane the next day to Palawan and the day after started going to school, of which I had missed the first three weeks.