Friday, February 22, 2013

baptism by fire//trust fall

After our one-day safari to Tarangire, we mellowed out the following day at Pete and Charlotte's, and the day after that, boarded the bus to Nairobi.

Leaving Arusha, we were treated to a rare view of the summit of Mt. Meru (14,977 ft).

We traveled through Masai country toward the border, meaning in practical terms that we saw plenty of goats being tended by small boys, in some cases fatally close the highway. Fatal to at least one goat, at any rate, that darted out in front of our bus. There was no way to avoid it - thump-thump, thump-thump. So sad.

Ahead of us loomed a low mountain range with an unaccountable protrusion that only made sense once we'd skirted the flank of it and saw it from the other side - fantastic cliffs:

This was just shy of the Namanga border stop. When we got there, Kevin and I hopped out and formally exited Tanzania, then walked through 100 yards of no-man's-land to the Kenya immigration facility. By now I could recite my passport number, date and place of issue.

I snapped this photo of one of the many trucks going across the border, little realizing at the time the signifance of the message painted on its bumper:

"Don't Panic".

When we arrived in Nairobi some five hours later, we were coated with dust from the journey - it took two consecutive showers and a scrub with a washcloth to be presentable, which was a desired state of affairs because we were going out for a Real Dinner in a Nice Restaurant with a friend of Kevin's who's a professor at the University of Nairobi. We went for Indian food.

Kevin had the prawns.

Jama didn't have prawns - he's allergic - and I didn't have prawns, because they live in the sea, and are therefore inedible, as we all know. Therefore, when the next morning, Kevin felt queasy, we thought perhaps the prawns hadn't agreed with him. No real worries - it is not infrequent for food to disagree with Kevin. We spent the day running errands - trying to get our boarding passes for our return flight home printed out (and failing), doing a bit of shopping for gifts, and visiting another friend across town. Kevin grew progressively more tired, and when we got back to our hotel room in mid-afternoon, he faceplanted in the bed and napped.

Around 4 pm he started to feel a bit warm. This is where I made my first mistake. What I should have done is realized, he has a fever. He had mentioned burping up the taste of prawns, which meant they hadn't quite worked their way through his system - the fever confirmed food poisoning. What I should have done is, to quote one of the guys we'd hung out with on Lamu (we'd talked about exactly this circumstance) "lock that thing down": I should broken out my bottle of Cipro (a broad-spectrum antibiotic - do not go to a developing country without it) and given him one. But I didn't.

I did, to my credit, root through his luggage, find his passport, his wallet, his stash of Tanzanian cash, his Kenyan cash, and - what's this? oooh, a big stash of US cash - and the parking stub for our car at the JFK parking lot. I confiscated all of the above into my stuff, and got us both packed - we'd be leaving well before dawn the next morning, and clearly I was going to need to be the designated grown up.

I should just back up here and explain: I have traveled internationally since I was four years old. But with Kevin in Africa, I let him do all the talking: he's been here a gazillion times, it's a wayyyy different situation than the European travel I'm familiar with, and I don't always understand the Kenyan English accent. I did not have any Kenyan cash myself, and only about $28 in US. I didn't even know how to place a call on the cheap mobile phone we'd (Kevin) gotten when we first arrived in Nairobi. Which would have been fine, except now that Kevin was out of commission, it wasn't.

As I mentioned, we hadn't had any luck getting our boarding passes printed out, despite having gone to the KLM office a block from our hotel - their system was down. We'd thought at the time "oh, that will be OK - we can do it at the airport". But then I remembered that often, they don't let you into the terminal in Nairobi without showing a receipt of some kind proving that you're on a flight - and we didn't have that. We just had a scrap of paper with the ticket number written on it that the KLM agent had given us. We would not even be able to get inside the building.

I also didn't know whether I'd be able to find a cab at five in the morning.

Shit shit shit. Time to cowboy up. I went to the business center at the hotel and thank god and 400 shillings later, got the boarding passes printed out. I asked the guy at the front desk about getting to the airport, and he tried to sell me on the special limo option - $50 in US dollars, "safe and secure and comfortable, madam". Fifty bucks my ass. I marched outside to the curb where we'd found taxis during the day and flirted with the drivers (by which I mean, I spoke with them) - yes, they would be there at five in the morning, 2,000 shillings, $25. You're on.

That night, Kevin was hot to the touch, all over. His head was hot. His back was hot. His legs were hot. I fretted, but did nothing new, aside from mentally walking through the next day and giving myself a boatload of Reiki to calm down. We would be getting up at 4:15 am.

Oh, and my period arrived (early) - I had no supplies with me, and no way to get any.

The next morning, Kevin felt like crap. I told him don't worry, I've got this - I'll get you a wheelchair at the airport if you don't have the energy to get to the gate. I didn't think he'd need one. I was wrong. He needed one. It took a good half hour before a wheelchair could be found. I got our luggage checked and got us through departure, which is when you present your passport and formally exit the country, getting fingerprinted just as you do when you enter the country. They looked skeptically at Kevin and didn't bother to fingerprint him.

We went to the gate area. In Nairobi, you go through security when you first enter the airport, and you go through again at the gate. They don't confiscate your liquids til the gate security check. We elected to delay the latter, so that we could avail ourselves of both water and the bathrooms, since once you go through the second security, there are no facilities - no food, no water, no bathrooms.

Kevin lay down on the floor with his head on travel neck pillows. I left him there and went to change all our Kenyan shillings for US dollars. Eventually I got him into the wheelchair and got us through security #2. He could barely get out of the wheelchair. Someone came over to me and asked if he'd need the wheelchair to get down the bridge. I said I wasn't sure. Kevin was barely responsive. She said, "He should not fly if he is unwell. I shall call the doctor. Wait over there."

This is when the trust fall began. A trust fall, if you don't know, is one of those exercises you do in team-building workshops. Everyone stands in a tight circle, with one person in the center. The person in the center allows themselves to simply fall, to lean in one direction, and keep going - and the circle comes together and gently catches them. Kevin, of course, had already fallen, and I was catching him, but this is when I started to fall, and the beautiful angels that are around us all the time in the form of other people caught us both.

A guy with a medical kit came over and asked us a couple of questions. How do you feel? How long has this been? Any vomiting (a tiny - dry heaving). Any diarrhea? (A tiny bit.) He did not take Kevin's temperature. He said, I think this is food poisoning. I said, I think so too. He said, don't get on the plane. It's a long flight (8 hours), there may not be a doctor on board, this can progress quickly and get very bad, you need to get tested and observed at a hospital.

I allowed myself to perceive this as an airline employee covering his ass. I allowed myself to perceive this as wise counsel. Which feels better? The safe option, as far as my personal comfort goes, is to get on the plane and not deal with Oh No! Ambulance! Oh No! Hospital! Scary Strangers Whose English I Don't Always Understand! He'll be fine! The safe option, as far as Kevin goes, is to go to the hospital. This isn't about me, this is about Kevin. Let the trust fall begin.

"OK, let's go to the hospital. How does that work?"

How it works is, this beautiful man and accompanying angels - the wheelchair attendant, the guys at immigration, the luggage guys, the ambulance driver, all pulled together. We re-entered the country. The doctor went over to talk to the luggage guys about getting our bags pulled from the plane while I went to buy more Kenyan shillings. An ambulance materialized and Kevin was transferred to it while I waited for our luggage. While I waited, I figured out how to text. Don't laugh at me - there is a default predictive type-ahead "feature" on the phone which is great...if you're typing Swahili, but it devolves into inanity pretty quickly in English. A luggage guy showed me how to disable that feature, and I texted Jama (our dinner companion) to let him know. I figured if we needed to stay a night in town, maybe he could put us up.

The luggage arrived and angels loaded it onto the ambulance. Kevin was lying on his side on a stretcher, very quiet, very hot.

Eventually the doctor rematerialized. He took Kevin's temperature. 39.5. What's that in Farhenheit? Oh right, I have this iPad with an international data plan. I googled it. 103.1. Holy shit. Kevin's normal base temperature is 96.8F (not 98.6) so 103.1 on him is like 104 something for anyone else. I think that was the moment when I knew yeah, medically, this was the right call. The doctor gave him a shot of something to bring the fever down. He tried to start an IV, but Kevin's veins typically laugh at such attempts and collapse, so that failed. No matter, said the doctor. Let's go.

Off we went.

For the first few minutes, we had no trouble, and then we hit Nairobi's traffic, which is just tremendously terrible. I felt us slow down and could see we were turning right. There is no right turn in this part of the journey to Nairobi. Why are we turning right? In Kenya, you drive on the left side of the road. We are turning right, meaning we are about to cross oncoming traffic. No, we're not going to cross oncoming traffic.

We are going to drive INTO oncoming traffic. On a highway. Oh. OK. Hakuna matata, motherfucker, I thought, as we barreled down the our-left, their-right, lane with the siren wailing. In the meantime time the doctor and I chat like this is no big deal. He trained at University of Nairobi. Oh really? Our friend Jama's daughter is going to med school there. Ever been to the U.S.? Yes, to San Diego. Oh cool, my brother lives near there. Yadda yadda yadda. I am falling, I am being caught, I am falling, I am being caught.

In the meantime, Kevin's temperature is already improving.

We get to the hospital.

The doctor tells me, "I didn't want to mention this before because it seems rude to do it in the moment, but there is a fee for the ambulance." I should hope so, I think! I give him $125 in cash and he explains how to handle the discharge - there is a special number to call once he's been discharged, they'll rebook us on the next available flight with no penalty, but they'll need the information from the discharge paperwork first. Exit airport doctor stage left.

In the meantime, Kevin was connected to the machines that go bing - we are familiar with these from the two shoulder, and one knee, surgeries he's been through. His oxygen is a little low - low 90's - no worries, that's how he rolls (his lungs are not his strong suit - comes of growing up with a chain smoker and having a touch of asthma), so they put him on oxygen. They scolded his naughty veins, started an IV, and dumped saline and more fever-reducing drugs into him.

The hospital doctor explained he needed to be tested for bacterial infection, malaria, and typhoid. She handed me the paperwork for this and told me to go outside, to the right, up the ramp, to the lab, pay for it, bring back the receipt. "Wha'....?" I'm thinking. That's weird. Just do the frickin' tests, look, I have a boatload of U.S. dollars, I'm not going to NOT pay you guys. I don't say any of this, I just think it. Whatever. This is how it works. Let's do this.

I go pay for the lab work. They take credit cards, thank god.

Nothing to do but wait at this point. I am hungry. I am thirsty. I'd missed dinner the previous evening (and if you know me, you know I do NOT skip meals), I hadn't had any breakfast, and of course since security #2 at the airport, I'd abandoned all my remaining water. There are vending machines in the waiting area but they spit out my paper money, even though my 100 shilling note is brand new. I have no coins. The cashier in the waiting room has coins, but they're "the new coins" and the vending machine only takes "the old coins". I proceed to hit up people in the waiting room for change. No one has any change until one guy takes pity on me and gives me the money for a bottle of water. Just one of many angels.

I rejoin Kevin. He's sleeping, his fever's going down, down, down. Hours pass. The results come back - it's not typhoid, it's not malaria, he seems to have a bacterial infection. You don't say. The doctor and I discuss meds. I have Cipro, I say - can we just use that? Sure, she says, but I want to start him on antibiotics through his IV to get him started. Here's a prescription for that, and for a special formulation of acetominophen for his fever, and potassium citrate (his potassium's low), take this to the pharmacy (which is in the waiting room), pay for it, bring us a receipt.

Grumble grumble. What kind of crazy system has the family member picking up the meds that the nursing staff is about to use? That is just effed up. Whatever. I do what I need to do. This requires cooling my heels in the waiting area, which is packed with people. The pediatric clinic is right there, and while we're all waiting for our respective issues to be resolved, an infant at the clinic is evidently being tortured, and letting us all know in no uncertain terms that s/he doesn't approve.

Finally, my name is called, I get the meds, I take them back to his room. They add the antibiotic to his IV drip. The guy in the next bed has some sort of crisis and when it's over, someone comes in with a mop to clean up a bunch of blood on the floor. Good lord. I'm thinking, this is, from a logistical perspective, my worst nightmare, but ultimately, not too serious - this is treatable, he'll be OK, my boy is going to be OK, Jesus, this is a baptism by fire, isn't it. This is not how I would have picked to learn to be comfortable navigating by myself instead of relying on Kevin.

By now I'm through with my bottle of water and terribly thirsty for more. My confidence is high from this whole experience. I waltz out into the waiting room and flirt shameless with a group of people, offering to give them a 100 shilling note in exchange for 50 shillings in vending machine-compatible "old coins". "Better than a bank!" I smile, and they all smile, and someone finds 100 shillings in coin for me. I get more water.

I see Jama's texted me back. "So sorry! That happened to me recently too!" Jama is out of town. Damn. That's going to mean another $200 and change for a hotel room. So be it. I text our travel agent buddy Amit to get that started, although I don't yet know when our flight out will be.

The doctor and I start talking discharge. His oxygen is low - we want to do a chest x-ray, they say. By now, Kevin is alert enough for both us to say no no no, no x-ray, no need, low to mid 90's is normal for him. I show them the scars on his shoulders from surgery. I know all about the machines that go bing. OK, they say. Whew, close call.

But it takes them a while to agree to release him. They want to hold him overnight, because they want to be sure he is strong enough. But he hasn't eaten anything for even longer than I hadn't eaten anything, so for him to get "stronger" is going to require some calories. I had some McVitie's Digestives (a sort of bland, slightly sweet graham flour biscuit) with me, which I'd been noshing on, but Kevin can't eat those (he's gluten-free).

So I brave the big scary world and go out on the street and get a bunch of bananas and even more water from one of several loud and enthusiastic banana and water angels (read: vendors). They initially wanted to sell me a bunch of bananas the size of my torso - I'd never seen so many on a single stem - like 15 bananas.

Back indoors, Kevin was improving. He was tired and a little groggy, but the fever had broken. They kept coming in and asking us, now where are you staying tonight? I don't know, I explained. If there is a flight out tonight, we'll go tonight. Otherwise, tomorrow. He needs to be discharged first, I explain, before I can tell you where he'll BE. Finally, the doctors decide it's OK to release him, and start to initiate the discharge procedures.

Oh but wait! You need actual paperwork, explaining what happened, for the airline? That's a medical report, that costs extra. You got it - back in line in the front office. Pay for it, bring us the receipt, we'll give you the letter. I get to the front of the line. Where is his patient ID card? He doesn't have one. Another line. Another form. He's issued a patient ID number. Back to the first line. She's never heard of a medical status report and can't find out how to code it, but she does know it's going to cost me 1,290 shillings. Hello, MasterCard, old friend!

I get the letter. We get Kevin into his clothes. The new nurse on duty calls us a taxi and we head into town. The taxi driver drops me off at the KLM office and continues the rest of the block to our hotel, where he drops Kevin and the luggage.

Next up: you can't there from here, or, why getting to Amsterdam is going to require going 500 km SOUTH into Tanzania first.

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