Another One to Everyone

Have you ever had a really bad hangover? Have you ever had a really bad hangover and then had to sit in oppressive heat and take blood pressures of smelly people all day? How about this one, have you ever had a really bad hangover, had to spend the day taking smelly blood pressures and then had the tent you are under collapse over you? Welcome to my Friday!

Thursday night was a celebration of sorts. Dr. J, our veddy British doctor, was leaving us on Friday morning and we were sending him off in Cambodian high-style. By which I mean, there were almost clean plates to eat off of and people who had had the foresight to bring their own booze from home broke it out. The misty, finger stained glasses at the restaurant were the perfect counterpoint to our fine Scotch whiskey, and in true Navy style we shot the two fingers of 22 year aged Glen Fiddich. Then the good Dr. broke out his private stash of Bacardi and we got down to a serious goodbye. It was in the midst of telling a story that I realized that my tongue was no longer under my control, and it was then that my friend Thompson and I decided to stumble back to out tents.

Have you ever slept on a spinning cot before? It is most unpleasant. The normal discomforts of camping are nothing until they are combined by a really good, beer, scotch, rum-drunk. I may have thrown up some rice, organ meats, random unidentified vegetables, the four massive Angkor beers I'd had before the scotch and then all the liquor I've ever seen. I may have thrown them up into a water bottle. It may have been an unfortunate water bottle to discover when I woke up in the morning. And when I say it may have been these things, I guess I mean it was so. Not that I am trying to duck responsibility for my actions or anything, I genuinely made the incredibly foolish choices that led to this miserable end, but there were extenuating circumstances… I really hadn't liked being sober the day before.

That morning started at about 0230. After having voided my entire body cavity at about 1030 I fell into a fitful and feverish doze. At 0230 one of the other fellows in my tent lost his iPod earbuds and blasted the rest of the tent with the supremely restful sounds of Minor Threat, or perhaps it was Social Distortion. At any rate, the group that played had a name that brings to mind the overthrow of governments by violent means. They are a loud, obnoxious, spirit-rending musical group and they were played at decibel levels that explain this fellow's general inability to hear orders when shouted at him. Finally we resolved the earbud issue and fell back into the snooze that had been formerly denied.

Within 40 minutes the local roosters started crowing, their internal alarm apparently set several time zones to the left of their actual location. When they ceased crowing the rise of the sun in Alabama there was a scant 20 minutes of rest before some spirited Cambodian mistook our tents for the home away from home of American Idol. He burst into frenzied song for 40 or more minutes, during which time I lay in a stupor of illness and fever. While I prayed that the singing would cease so that I could once more pretend that sleep was possible I envisioned a massacre. I saw myself wielding a bloodied machete, with the blood of a thousand roosters and all amateur vocalists, the world over, staining its blade. If I had had a machete, and had not been so given over to ensuring my continued breathing by intense concentration, what a legend I could have been.

When the local Cambodian William Hung finally ceased his endless rendition of "She Bangs Cambodia" I allowed my breathing to take over and slept the 10 minutes that the local populace allowed before their early morning horn and Caribbean steel drum chorus took over the musical duties. Might as well try to sleep at CBGBs. I wrestled myself from my mosquito netting and stumbled around in the remains of my dinner while using baby-wipes to clean the more egregious filth from the floor and my body. After a miserable shave and morning toilet I ate some MRE bread and jam for breakfast, drank some luke-warm bottled water and started taking morning vital signs.

The Cambodian people are not regular bathers. I have had experience with people who rarely bathe. The detainees in Guantanamo Bay are not, as a rule, the most hygienic of men. This did not particularly bother. They have a spicy smell, those detainees, they are a human curry. A rich mélange of spices and bodily oils. Afghanistani people are the spice of life, however evil and insane they may be. Cambodians, on the other hand, are like an armpit. Perhaps like an armpit that has not learned to adequately wipe its bottom, if your mind can conceive of such tortured anatomy. There is something in their odor that makes one wish for almost any other scent. Pure toilet filth has it over Cambodian peasant in the pure toilet filth is a distinct smell, not a mixture of foulnesses. Perhaps I overstate this, but there is truth in it.

Take this unpleasantness on top of already being filthily sick and repulsed by one's own smells and the day becomes an unpleasant admixture of nausea. It's also impressive how, in a country absolutely rife with skin diseases, parasites, amputated limbs, gross deformities and dengue fever there is daily someone who combines all of these features into so startling a visage that comment is forced from you. In so much as there are general unfortunates and general combinations, and the wearying morass of humanity parades before you without pulling one up short for comment, the ones that really stand out stand out in such a grotesque way. Your hand, reaching for their wrist to check the pulse, draws back in horror and then, nerve overcoming distaste, returning to the sore-encrusted member and squeezing for the heart-thumping pulse. All the while your mind screams for release and your hand shivers at the oozing pustules that are in its grasp. The milky, dessicated eyes that stare, unlevel, out of the too cheerful face, the toothless, rotten gum-landscape of their mouth. Unforgettable, and yet always topped within the day by some horror more grotesque. Dr Treves would have been beside himself here, so many discoveries for the Academy. The poor elephant man would have been only one in a crowd.

Miserable hang-over days are the longest ones, and it proved so on Friday. Though I was sitting next to my dear friend Thompson I still failed to appreciate the day as I have hitherto. Misery, heat, sweat, despair, the four horsemen of a Cambodian hang-over.

In the early afternoon a wind kicked up. When I say a wind kicked up I want you to imagine a scene from Pecos Bill, the tornado that Bill roped and rode was not less forceful than the wind that kicked the patient waiting-area tent off the ground and dropped it back onto the poor Cambodians awaiting treatment. In the second of time I had to react I started towards the people who were being endangered, which I will always feel was a heroic impulse, but our LT called us all to leave the tent area. In the moment of hesitation I was lost and by the time I had turned back to help, all help had already been rendered. I was only able to assist in the tent remediation, and even that I was not much use. My friend Thompson managed to give a local woman heart failure when he scooped her up from her peaceful seat and carried her bodily out of the imagined harm's way. She was never in any danger other than death by Thompson, but he wasn't to know.

After the eventual re-setting up of the tent there were many quiet hours of vital signs, punctuated by kids with large upper arms, friendly babies, pretty girls, and the occasional semi-human golem. We saw 987 patients on Friday and it was a long, long day. When the patients were finally gone we all had a medication sorting party until around 8, at which point I took my fence-line shower, read some Paul Johnson and collapsed into bed. The day over, I could finally reflect. Never again, I decided, never again. I don't care how many British doctors are leaving my life forever, I'm not mixing 151 and Glen Fiddich for anyone. And let that be a lesson to all of you. Much love as always and more to come.