Ye Olde Massive Update, part one
9:30 Kolkata time, 9/05/2005
For a variety of reasons, I haven't been able to write out any full updates lately. In my text editor, I have the first line of a post called "Intestine Wars, Episode 5: The Intestines Strike Back" from about ten days ago. I wrote that title during a several-day-long period of being under the influence of all sorts of interesting infections and medications, and the whole time period is kind of hazy. I do remember, however, writing that title during a rare period of lucidity... and then, before I could write any sentences, being interrupted by the immediate and (at that point) all-too-familiar necessity of making a dash for the bathroom.
The ensuing half-hour completely wiped my mind of the focus and ability to do anything more complex than, say, crawling into bed and whimpering. Completing (beginning, actually) my post was as out of the question as walking to Nepal would have been. The week since then has been one of the most action-packed of my entire life, and I simply have not had time to write. I have, however, been maintaining an outline of what we did, and now that my co-workers have gone back to the US, I find myself with gobs of spare time in the evenings. So, now's the time to flesh out my outline and bring everybody up to date.
As I've said, my writing derailed when I got sick, so that's where we'll begin. Just a warning— I'll try not to get too... er... clinical. The details of being sick in India are often not very pleasant. That being said, there may be some parts of this section of the narrative that you'd probably be better of skipping. Just a heads-up.
So, for the first few days after arriving in India, I felt fine. I ate whatever was put in front of me, and, though I only drank bottled water, I accepted tea and coffee without reservation. I was trying very hard to be polite and adventurous, and as a result ate any number of interesting dishes. Not surprisingly, after a few days of this I began to notice some stomach troubles. I didn't think anything of it, though— after all, I'd been eating all sorts of crazy things, and not getting enough sleep besides. Also, Bengali food is incredibly heavily spiced1. It did not surprise me that I was having some digestive troubles. Surely, after a few days, my system would adjust.
After a few days, however, my system had not adjusted. In fact, things in the digestion department were worse than they had been initially. Also, I was beginning to feel rather weak and dizzy much of the time. By a couple of Thursdays ago (the 25th of August), I was feeling downright lousy. Friday rolled around with a new symptom— head-rushes. You know how when you stand up too fast, the blood rushes out of your head and you get kind of dizzy for a few seconds? This was happening to me every time I stood up, no matter how slowly. I'd stand up, grab hold of something, wait a second, and then go on my way. Also, my stomach was making sounds like a boiling pot. I didn't know it was possible for one's stomach to make some of the sounds mine was making. It was like some sort of gastro-intestinal symphony, complete with four-part harmony.
After I'd been at work for a few hours, I noticed that lots of people were telling me that I wasn't looking too good. I'd already been suspecting that whatever was going on with me wasn't just indigestion, and after five or six people asked if I needed to see a doctor, I decided that it was probably time to call it a day and go back to the hotel. I went over to find Kevin (my boss) to let him know that I was thinking of heading back to the hotel. He took one look at me, and before I'd even really opened my mouth, he was asking if I needed to go back to the hotel.
They called the car for me, which was good, because my brain was steadily descending into a kind of stupor in which I would have been unable to operate a telephone. Our driver had asked that morning if he could take the afternoon off and come find us in the evening, since India's cricket team was playing Australia's that day. Since we usually don't leave the office until at least eight or nine o'clock, we'd told him to go on ahead and watch the match at home. Since he was out of the picture that afternoon, one of the company's "logistics guys" drove me back.
These are a couple of guys that the company employs as general-purpose gofers. Need some random thing from a store down the street? Send one of the logistics guys. Is the toilet not working? One of the logistics guys will take care of it. Does the silly foreigner need to be medevaced back to his hotel? These guys will be happy to drive him. They're both very nice guys, and seem to be able to handle just about any random-ass assignment that the company can come up with.
In this case, we piled (well, the logistics guys "piled"— I sort of "stumbled") into one of the company's cars and headed back towards the hotel. Along the way, we stopped by a pharmacy and one of the logistics guys ran in to get me some rehydration powder ("Based on W.H.O. Formula!", boasts the package). This is sort of like Gatorade— lots of electrolytes— without the flavor. You mix it in with a liter of water, and it ends up tasting like very foul, slightly salty water. If, however, you have certain types of digestive troubles, dehydration is a major concern.
Once back at the hotel, I climbed into bed and slept. And slept. And slept. Next thing I knew, it was late in the evening and my co-workers were coming back from the office. When I woke up, I was still feeling lousy, but was somewhat better than I had been. As such, I elected not to see a doctor. It seemed like sleep had helped out a bit, and I felt like I could beat whatever was going on in my stomach all by myself. I didn't feel like eating anything that night, and the thought of food made my stomach do some very unpleasant things. As such, I held off on dinner, and just had part of a granola bar.
The next day, we were scheduled to do some sight-seeing around Kolkata. I had been looking forward to this all week— after all, the official primary purpose of my trip was for work... but my real purpose had very little to do with work, and everything to do with seeing interesting things and places. I woke up Saturday morning still feeling lousy, but also a little better than I had been. I took this to be a good sign, and decided that I'd be damned if a little sickness was going to keep me from seeing Kolkata. I resolved to fight through it, and to go out with Dan and Kevin that day.
This resolve lasted about fifteen minutes. We were maybe a quarter of a mile from the hotel when I had to ask the driver to pull over. I jumped out of the car, staggered around a little bit, crouched over, and started puking my guts out right there on the side of the road. I hadn't eaten much, so there wasn't much to vomit. As a result, all sorts of interestingly-colored (and flavored) digestive fluids came out as a result. Things came out of me that I hadn't even known that I had. That Saturday morning, myself and several thousand of my newest and closest friends got a rather vivid education as to the contents of my digestive tract. Did you know that you've got some crazy neon-green colored stuff somewhere in your abdomen? Neither did I, until the other day.
Eventually, after about three hundred years, I managed to get things back under control. Actually, that's a bit of an exaggeration. I did, however, manage to go more than about thirty seconds without semi-dry-heaving. We took advantage of this lull and got back to the hotel in record time. While I made my way upstairs to my room, somebody went to the front desk and asked them to send the hotel's doctor. After a few minutes, a very nice motherly doctor appeared. She shooed everybody else out of the room, poked and prodded at me, asked a few questions about my symptoms, and then pronounced that I had some sort of digestive tract infection. "Why", she wanted to know, "had I not come to her earlier?" Good question.
She prescribed some atomic-strength antibiotics, as well as a few other medications to help calm down my stomach. I was to take one of the Domperidone tablets, wait about a half-hour, and then try and eat some soup or something else very light and neutral. Then, I was to take one of the antibiotics. I should start feeling better, she said, within a few hours.
Dan and Kevin went off to find a pharmacy to fill the doctor's prescription, and I went back to sleep. They came back twenty minutes later with an interesting discovery: by American standards, drugs are dirt-cheap here. A full course of a Cipro-centric antibiotic cocktail, a set of Domperidone tablets, and a few other miscellaneous drugs ran us about five dollars. Kaiser's co-pay for a minimal emergency dose (four tablets, or two days worth) of Cipro was something like $30, and according to my receipt it would have run me around $75 without my prescription drug benefits. I can think of a few reasons why it might be cheaper here (no pesky FDA, far less liability to cover, etc.) but none of them hold enough water to account for that kindof cost differential. It just seems to me that US drug companies are gouging the living daylights out of us, relative to their Indian counterparts.
Once I was squared away with the drugs, Dan and Kevin went off to resume our aborted sightseeing trip. I ordered up some vegetable soup, took a Domperidone, and tried to stay awake until the soup showed up. When it arrived, I was only able to eat a little bit of it. I wasn't really hungry, even though I hadn't eaten much in the previous 36 hours, and the sight/smell of food wasn't being very pleasant. I got down as much as I could, took a Cipro, and went to bed.
I woke up a few hours later, and, amazingly, felt far better than I had when I had gone to sleep. The Cipro kicked in amazingly quickly. A measure of how much better I was feeling: I was able to read again. Those who know me know that, for me, reading is handled at roughly the same mental level as breathing. I fully expect that, were I to somehow have my head chopped off, my headless body would continue clutching whatever book I'd been reading at the time and occasionally manage to turn a page. So, the fact that I'd been unable to get my mind to focus enough to read even something brain-candyish should indicate just how sick I was. I'll say it again: I was actually unable to read. Being able to get my brain to concentrate on reading was a massive improvement.
On top of once again being able to read, I was also actually hungry for the first time in a day or two. It was amazing— I was able to walk around without getting dizzy, I could read, and food seemed like a good idea. I still wasn't really feeling anything remotely approaching "good", but I was feeling light-years better than I had been. When Dan and Kevin returned from what had apparently been a harrowing day2, they couldn't stop saying how much better I was looking. I'd had no idea that antibiotics could kick in so quickly. Even correcting for any placebo effect that may have been going on, it was amazing.
It was a good three days before I was really feeling like my usual self, and a few days past that before I felt like eating much in the way of spicy foods. The drugs got me up and functional, though, and for that I'm eternally grateful. There are very few things less pleasant than being sick in a foreign country. It's happened to me twice now— once in Israel, and now once here in India. Both times have been very frightening experiences, and I'm quite happy to be done with illness for now.
A few days later, both Dan and Kevin started feeling somewhat unwell. As far as I know, Kevin's unrest didn't turn into anything, but Dan's turned into a full-blown intestinal infection. Apparently, it is sort of expected that first-time visitors will get sick. One of the people we've met here, a consultant specializing in auditing outsourced development projects, told us that he's gotten sick every single time he's come to India. I can certainly see why— the food here is vastly different than the food in the US, in practically every way imaginable. The water is not safe to drink, and it's very easy to accidentally ingest some. Public sanitation is sometimes not as top-notch as one might hope (it's not at all unusual to see people urinating into the gutters on the side of the street). On top of everything else, there are deadly mosquito-borne diseases everywhere you look (the city is currently in the midst of Dengue Fever epidemic). Basically, if you're not adjusted to it, there are more ways to get sick here than there are ways to get drunk in Boston on St. Patrick's Day. I'm glad that I've had my turn and am now starting to get adjusted properly.
1: In fact, tasting how spicy (and heavily spiced, and salty) the food is here has filled in a few puzzle pieces for me. About a year and a half ago, a new Indian restaurant opened up near my old house off of Walker. We tried it out, and more or less unanimously decided that it was too salty, and too heavily spiced, for our taste. Having been here, I can now say that the problem, so to speak, was not with the restaurant. It was quite faithfully serving up some very authentic food. Our palates were where the problem lay.
2: This was the last day that Clint drove for us. Apparently, he got quite lost at several points, and was driving crazily enough that the local co-worker who had elected to come and show us around Kolkata became nervous. At one point, according to Kevin, he took a wrong turn and got them stuck in a traffic jam on some sketchy bridge for almost an hour. This bridge, allegedly, had potholes so extensive that you could basically see the water in the below. According to Dan and Kevin, the Toyota SUV bottomed out a number of times dealing with the potholes. Note that the potholes and what-not cannot really be blamed on Clint; their concern was with his erratic driving and generally sketchy demeanor.
At the time, I was forced to defer to them on this matter. I'd picked up some strange vibes off of Clint, but nothing really bad enough to warrant a change of drivers. Likewise, his driving was always kind of erratic, but so was everybody else's in Kolkata. Also, when I had been sick on the side of the road, he'd been extremely kind to me— making sure I had water, giving me well-intentioned medical advice, etc.
The matter was ultimately not decided by us. The guy from Tathya who'd accompanied Dan and Kevin that day had been so unnerved by what he'd seen that he took the necessary steps to replace Clint. The next day, our driver was Sidni, Clint's brother. The difference between the two was night and day. Where Clint's driving was at times very aggressive, and his horn was always in action, Sidni seems to be in far more control of the car and its place in the road. He hardly ever honks, and when he does it's usually more of a "Hey, I'm in your blind spot" or "Hey, you just cut me off" than a "Hey, coming through here, out of the way".
Also, Sidni is much more knowledgable about Kolkata geography that Clint was. I feel kind of bad about this turn of events, as Sidni doesn't usually drive these days— he runs the driving company, and numerous other business ventures besides, but he does not typically drive. He was a very good sport, though, especially given the fact that the change in drivers meant that his entire schedule for the ensuing week had to radically change.
For our part, we tried to be flexible and made sure that he knew that he could take off during the day and attend to other business matters, as long as he was back at the office around eight or so to pick us up.
For a variety of reasons, I haven't been able to write out any full updates lately. In my text editor, I have the first line of a post called "Intestine Wars, Episode 5: The Intestines Strike Back" from about ten days ago. I wrote that title during a several-day-long period of being under the influence of all sorts of interesting infections and medications, and the whole time period is kind of hazy. I do remember, however, writing that title during a rare period of lucidity... and then, before I could write any sentences, being interrupted by the immediate and (at that point) all-too-familiar necessity of making a dash for the bathroom.
The ensuing half-hour completely wiped my mind of the focus and ability to do anything more complex than, say, crawling into bed and whimpering. Completing (beginning, actually) my post was as out of the question as walking to Nepal would have been. The week since then has been one of the most action-packed of my entire life, and I simply have not had time to write. I have, however, been maintaining an outline of what we did, and now that my co-workers have gone back to the US, I find myself with gobs of spare time in the evenings. So, now's the time to flesh out my outline and bring everybody up to date.
As I've said, my writing derailed when I got sick, so that's where we'll begin. Just a warning— I'll try not to get too... er... clinical. The details of being sick in India are often not very pleasant. That being said, there may be some parts of this section of the narrative that you'd probably be better of skipping. Just a heads-up.
So, for the first few days after arriving in India, I felt fine. I ate whatever was put in front of me, and, though I only drank bottled water, I accepted tea and coffee without reservation. I was trying very hard to be polite and adventurous, and as a result ate any number of interesting dishes. Not surprisingly, after a few days of this I began to notice some stomach troubles. I didn't think anything of it, though— after all, I'd been eating all sorts of crazy things, and not getting enough sleep besides. Also, Bengali food is incredibly heavily spiced1. It did not surprise me that I was having some digestive troubles. Surely, after a few days, my system would adjust.
After a few days, however, my system had not adjusted. In fact, things in the digestion department were worse than they had been initially. Also, I was beginning to feel rather weak and dizzy much of the time. By a couple of Thursdays ago (the 25th of August), I was feeling downright lousy. Friday rolled around with a new symptom— head-rushes. You know how when you stand up too fast, the blood rushes out of your head and you get kind of dizzy for a few seconds? This was happening to me every time I stood up, no matter how slowly. I'd stand up, grab hold of something, wait a second, and then go on my way. Also, my stomach was making sounds like a boiling pot. I didn't know it was possible for one's stomach to make some of the sounds mine was making. It was like some sort of gastro-intestinal symphony, complete with four-part harmony.
After I'd been at work for a few hours, I noticed that lots of people were telling me that I wasn't looking too good. I'd already been suspecting that whatever was going on with me wasn't just indigestion, and after five or six people asked if I needed to see a doctor, I decided that it was probably time to call it a day and go back to the hotel. I went over to find Kevin (my boss) to let him know that I was thinking of heading back to the hotel. He took one look at me, and before I'd even really opened my mouth, he was asking if I needed to go back to the hotel.
They called the car for me, which was good, because my brain was steadily descending into a kind of stupor in which I would have been unable to operate a telephone. Our driver had asked that morning if he could take the afternoon off and come find us in the evening, since India's cricket team was playing Australia's that day. Since we usually don't leave the office until at least eight or nine o'clock, we'd told him to go on ahead and watch the match at home. Since he was out of the picture that afternoon, one of the company's "logistics guys" drove me back.
These are a couple of guys that the company employs as general-purpose gofers. Need some random thing from a store down the street? Send one of the logistics guys. Is the toilet not working? One of the logistics guys will take care of it. Does the silly foreigner need to be medevaced back to his hotel? These guys will be happy to drive him. They're both very nice guys, and seem to be able to handle just about any random-ass assignment that the company can come up with.
In this case, we piled (well, the logistics guys "piled"— I sort of "stumbled") into one of the company's cars and headed back towards the hotel. Along the way, we stopped by a pharmacy and one of the logistics guys ran in to get me some rehydration powder ("Based on W.H.O. Formula!", boasts the package). This is sort of like Gatorade— lots of electrolytes— without the flavor. You mix it in with a liter of water, and it ends up tasting like very foul, slightly salty water. If, however, you have certain types of digestive troubles, dehydration is a major concern.
Once back at the hotel, I climbed into bed and slept. And slept. And slept. Next thing I knew, it was late in the evening and my co-workers were coming back from the office. When I woke up, I was still feeling lousy, but was somewhat better than I had been. As such, I elected not to see a doctor. It seemed like sleep had helped out a bit, and I felt like I could beat whatever was going on in my stomach all by myself. I didn't feel like eating anything that night, and the thought of food made my stomach do some very unpleasant things. As such, I held off on dinner, and just had part of a granola bar.
The next day, we were scheduled to do some sight-seeing around Kolkata. I had been looking forward to this all week— after all, the official primary purpose of my trip was for work... but my real purpose had very little to do with work, and everything to do with seeing interesting things and places. I woke up Saturday morning still feeling lousy, but also a little better than I had been. I took this to be a good sign, and decided that I'd be damned if a little sickness was going to keep me from seeing Kolkata. I resolved to fight through it, and to go out with Dan and Kevin that day.
This resolve lasted about fifteen minutes. We were maybe a quarter of a mile from the hotel when I had to ask the driver to pull over. I jumped out of the car, staggered around a little bit, crouched over, and started puking my guts out right there on the side of the road. I hadn't eaten much, so there wasn't much to vomit. As a result, all sorts of interestingly-colored (and flavored) digestive fluids came out as a result. Things came out of me that I hadn't even known that I had. That Saturday morning, myself and several thousand of my newest and closest friends got a rather vivid education as to the contents of my digestive tract. Did you know that you've got some crazy neon-green colored stuff somewhere in your abdomen? Neither did I, until the other day.
Eventually, after about three hundred years, I managed to get things back under control. Actually, that's a bit of an exaggeration. I did, however, manage to go more than about thirty seconds without semi-dry-heaving. We took advantage of this lull and got back to the hotel in record time. While I made my way upstairs to my room, somebody went to the front desk and asked them to send the hotel's doctor. After a few minutes, a very nice motherly doctor appeared. She shooed everybody else out of the room, poked and prodded at me, asked a few questions about my symptoms, and then pronounced that I had some sort of digestive tract infection. "Why", she wanted to know, "had I not come to her earlier?" Good question.
She prescribed some atomic-strength antibiotics, as well as a few other medications to help calm down my stomach. I was to take one of the Domperidone tablets, wait about a half-hour, and then try and eat some soup or something else very light and neutral. Then, I was to take one of the antibiotics. I should start feeling better, she said, within a few hours.
Dan and Kevin went off to find a pharmacy to fill the doctor's prescription, and I went back to sleep. They came back twenty minutes later with an interesting discovery: by American standards, drugs are dirt-cheap here. A full course of a Cipro-centric antibiotic cocktail, a set of Domperidone tablets, and a few other miscellaneous drugs ran us about five dollars. Kaiser's co-pay for a minimal emergency dose (four tablets, or two days worth) of Cipro was something like $30, and according to my receipt it would have run me around $75 without my prescription drug benefits. I can think of a few reasons why it might be cheaper here (no pesky FDA, far less liability to cover, etc.) but none of them hold enough water to account for that kindof cost differential. It just seems to me that US drug companies are gouging the living daylights out of us, relative to their Indian counterparts.
Once I was squared away with the drugs, Dan and Kevin went off to resume our aborted sightseeing trip. I ordered up some vegetable soup, took a Domperidone, and tried to stay awake until the soup showed up. When it arrived, I was only able to eat a little bit of it. I wasn't really hungry, even though I hadn't eaten much in the previous 36 hours, and the sight/smell of food wasn't being very pleasant. I got down as much as I could, took a Cipro, and went to bed.
I woke up a few hours later, and, amazingly, felt far better than I had when I had gone to sleep. The Cipro kicked in amazingly quickly. A measure of how much better I was feeling: I was able to read again. Those who know me know that, for me, reading is handled at roughly the same mental level as breathing. I fully expect that, were I to somehow have my head chopped off, my headless body would continue clutching whatever book I'd been reading at the time and occasionally manage to turn a page. So, the fact that I'd been unable to get my mind to focus enough to read even something brain-candyish should indicate just how sick I was. I'll say it again: I was actually unable to read. Being able to get my brain to concentrate on reading was a massive improvement.
On top of once again being able to read, I was also actually hungry for the first time in a day or two. It was amazing— I was able to walk around without getting dizzy, I could read, and food seemed like a good idea. I still wasn't really feeling anything remotely approaching "good", but I was feeling light-years better than I had been. When Dan and Kevin returned from what had apparently been a harrowing day2, they couldn't stop saying how much better I was looking. I'd had no idea that antibiotics could kick in so quickly. Even correcting for any placebo effect that may have been going on, it was amazing.
It was a good three days before I was really feeling like my usual self, and a few days past that before I felt like eating much in the way of spicy foods. The drugs got me up and functional, though, and for that I'm eternally grateful. There are very few things less pleasant than being sick in a foreign country. It's happened to me twice now— once in Israel, and now once here in India. Both times have been very frightening experiences, and I'm quite happy to be done with illness for now.
A few days later, both Dan and Kevin started feeling somewhat unwell. As far as I know, Kevin's unrest didn't turn into anything, but Dan's turned into a full-blown intestinal infection. Apparently, it is sort of expected that first-time visitors will get sick. One of the people we've met here, a consultant specializing in auditing outsourced development projects, told us that he's gotten sick every single time he's come to India. I can certainly see why— the food here is vastly different than the food in the US, in practically every way imaginable. The water is not safe to drink, and it's very easy to accidentally ingest some. Public sanitation is sometimes not as top-notch as one might hope (it's not at all unusual to see people urinating into the gutters on the side of the street). On top of everything else, there are deadly mosquito-borne diseases everywhere you look (the city is currently in the midst of Dengue Fever epidemic). Basically, if you're not adjusted to it, there are more ways to get sick here than there are ways to get drunk in Boston on St. Patrick's Day. I'm glad that I've had my turn and am now starting to get adjusted properly.
1: In fact, tasting how spicy (and heavily spiced, and salty) the food is here has filled in a few puzzle pieces for me. About a year and a half ago, a new Indian restaurant opened up near my old house off of Walker. We tried it out, and more or less unanimously decided that it was too salty, and too heavily spiced, for our taste. Having been here, I can now say that the problem, so to speak, was not with the restaurant. It was quite faithfully serving up some very authentic food. Our palates were where the problem lay.
2: This was the last day that Clint drove for us. Apparently, he got quite lost at several points, and was driving crazily enough that the local co-worker who had elected to come and show us around Kolkata became nervous. At one point, according to Kevin, he took a wrong turn and got them stuck in a traffic jam on some sketchy bridge for almost an hour. This bridge, allegedly, had potholes so extensive that you could basically see the water in the below. According to Dan and Kevin, the Toyota SUV bottomed out a number of times dealing with the potholes. Note that the potholes and what-not cannot really be blamed on Clint; their concern was with his erratic driving and generally sketchy demeanor.
At the time, I was forced to defer to them on this matter. I'd picked up some strange vibes off of Clint, but nothing really bad enough to warrant a change of drivers. Likewise, his driving was always kind of erratic, but so was everybody else's in Kolkata. Also, when I had been sick on the side of the road, he'd been extremely kind to me— making sure I had water, giving me well-intentioned medical advice, etc.
The matter was ultimately not decided by us. The guy from Tathya who'd accompanied Dan and Kevin that day had been so unnerved by what he'd seen that he took the necessary steps to replace Clint. The next day, our driver was Sidni, Clint's brother. The difference between the two was night and day. Where Clint's driving was at times very aggressive, and his horn was always in action, Sidni seems to be in far more control of the car and its place in the road. He hardly ever honks, and when he does it's usually more of a "Hey, I'm in your blind spot" or "Hey, you just cut me off" than a "Hey, coming through here, out of the way".
Also, Sidni is much more knowledgable about Kolkata geography that Clint was. I feel kind of bad about this turn of events, as Sidni doesn't usually drive these days— he runs the driving company, and numerous other business ventures besides, but he does not typically drive. He was a very good sport, though, especially given the fact that the change in drivers meant that his entire schedule for the ensuing week had to radically change.
For our part, we tried to be flexible and made sure that he knew that he could take off during the day and attend to other business matters, as long as he was back at the office around eight or so to pick us up.
posted by steve | 10:16 PM
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