Why wake up in the morning bright eyed and bushy tailed when you could fall out of bed puking, coughing up bile and blood-stained mucus? You don’t even need cigarettes to achieve this sort of misery, it comes free from basic human interactions, made possible by microorganisms!
Everyone gets sick when traveling. The environment facilitates it. And when traveling internationally you’re usually exposed to bacteria and viruses your body has never seen before. A lot of people get the runs, sometimes on a regular basis. I’m the opposite in that regard. Sometimes when I’ve not known the toilet for a week straight and another person is making hourly visits it can feel like the grass is greener on the other side of the fence. But at least I can eat anything without getting sick. It might never come out, but perhaps that’s a worthwhile trade-off.
Sick and tired
I’m writing about this now because in these final three months of my trip, illness has routed many plans. It’s forced me to cancel bus and plane tickets, give up on hikes and dives, and just in general required me to take things slower than I may have otherwise. It really blows to be tossing and turning, sniffling and hacking in the top bunk of a dorm, knowing that everyone with whom you share the room is crossing their fingers, praying you don’t put them down for a couple weeks. Being a pariah in a foreign country, despised by those who most understand your experience is the exact reason I’m traveling, but I don’t want to feel bad about it!
I was raised to fear doctors. That’s what tends to happen to children of health care professionals: such parents often were so ready to bring their children to the ER for the slightest of symptoms, but so unwilling to treat even the most dire of their own, that their sons and daughters learn from their example and from the memory of invasive procedures that proved unnecessary to avoid medical treatment entirely.
This makes being ill or injured in a foreign country, where you do not know the local language and have no guarantee that the intelligentsia of the nation will know yours, a terrifying prospect. Shockingly, however, you can mostly rely on, at least as an American, a much cheaper fix should you overcome your fears.
Scuba diving considered harmful
On my third dive of my life, I rushed. I was anxious and really wanted to sink, to reach max depth. I was uncertain if I could and frantically descended! And because I rushed, I didn’t equalize the pressure in my ears, and it was quite uncomfortable.
And when I resurfaced I spat up gobs of blood and couldn’t hear out of one ear.
And I didn’t tell anyone.
For a week.
Then I went to a pharmacist and said I thought I might have an ear infection. She looked into my ear and said she didn’t think it was infected but gave me several medicines and medical devices to try to help. She made me quite comfortable as it seemed, despite living inland, outside of a national park, that she was quite used to treating diving-related trauma. She was, after all, a short two hour bus ride from the port most Thai visitors passed through on their way to learn how to Scuba dive.
To my great fortune, I healed completely, I assume, and resumed my journey, and went on to dive in two more countries on the way. I went to the Mediterranean in search of more great diving, with my eye on hopping over to the Sinai peninsula which is supposed to have the best (and cheapest) diving in the world, but finances and war will prevent my venturing so far in search of shiny coral.
What do they call Turkey in Turkey?
A: Hindi
The whole region is gorgeous and the lengthy history, the passing around between rulers, religions and languages — history trivia: how many empires have seen their demise at the Bosporous Strait — is tangible from every street corner to the top of every minaret and mountain. Early in this journey I had the opportunity to fall in love again with the southwest via the Taos/Santa Fe region. Türkiye and the Greek Islands might as well be the American Southwest with a salty sea breeze. The rocky, rolling hills and unique geological structures (consider the fairy chimneys in Cappadocia) that cover the country, the relaxing shorelines and the beautiful flowers that dot line trails and color canyons hint at a life even older than that suggested by monuments dating back thousands of years.
While I missed Cappadocia due to illness, and failed to make it Jalal al-Din Rumi’s resting place in Konya, or do any diving in Kaş, or any partying in Istanbul, I was able to partake of amazing food in Turkey and visit several museums and mosques throughout the largest cities. Ankara, the rarely visited busy capital of the country, where I spent an unexpected several days, was a surprising gem. The tourist infrastructure is minimal and amongst the major cities it is the least welcoming to an English speaker, but the food is incredible and inexpensive and the hills surrounding the city are gorgeous. I think it would have been a great place to party given the university scene too had I been more willing.
“You are willing to die you coward but not to live”
— Steppenwolf, Herman Hesse
n Korea illness never stopped me from drinking. But maybe in Korea my poor mental health was overriding any attempt to tend to my poor physical health.
Self Harm
I think a lot of people engage in self harm when they’re stressed or enduring some sort of mental “illness.” But I think self harm manifests in a lot of ways and we tend to only think of self harm in terms of things like cutting. Drug abuse is also often up there, and boy chain smoking and heavy drinking are my favorite means of self harm, but self harm can look very different too: I’ve known sad drinkers, but I’ve always been a happy drinker. I go nuts, tear it up on the dance floor, I get other people partying. It’s all a clever strategy aimed at not having to endure my own private thoughts.
I in fact looked into therapy at some point on my travels. A telehealth kind of thing. Unfortunately in the US there’s a very well-intended restriction on providing psychological services in that one must be licensed in the state in which they practice, and the state of practice is apparently actually the state of the patient, not the practitioner. While I never actually tried to engage with a therapist, stopping at the research stage, never reaching the action stage of health care, I had heard from another traveler who had been having regular calls with a therapist that when they accidentally let it be known they were outside of the country, the therapist terminated their professional relationship until such time as the traveler had returned to the specific state in which the therapist practices. Like yanking away the life preserver when the sea is choppiest. A traveler is highly vulnerable to mental health problems due to their being uprooted from their traditional support structures and routines. Taking away mental health support services is only adding another bullet to the chamber.
Medical tourism
It’s funny to me how traumatic medical experiences can be in foreign countries, even if the anxiety is primarily of our own invention, when this idea is juxtaposed with the fact that there are so many people traveling for the sake of medical procedures. Getting your butt or tits done? Go to Medellin. Need some chin work? You can’t walk down a Seoul street without tripping over a plastic surgeon. Going bald? Istanbul’s hair plug scene is world famous. Dental care? Get some Thai teeth tending.
When I got my teeth cleaned in Hanoi, can I just say before this that they did an amazing job and only charged me the equivalent of 10USD, I felt some trepidation. I had some strange horror story scenes playing through my mind of a dingy dental office and draconian practices, a screaming patient, some vaguely communist symbology adorning the walls…! By golly America has trained me well to fear non capitalist health care industries. But it was a brightly lit office and more comfortable than the vast majority of experiences I had with teeth cleaning stateside, partly because they didn’t try to upsell me with terror stories about how my teeth were falling apart, literally splitting at the seams. In Hanoi, I got only what I came for.
Still medical tourism is a huge deal. I met a man getting several teeth replaced in Bangkok. I met one woman who had flown to Korea to feed two birds with one crumb: grammable vacay and cheap Botox. I don’t know which man I met had gotten hair plugs but more than one mentioned to me that it was a big deal in Istanbul. Maybe they all had naturally lush hair despite their age. Perhaps the most interesting was the woman I met who was getting a full exam: chest X-rays, bloodwork, colonoscopies, etc in Seoul, so that she could take all these details back home (Poland, iirc) and add them to the medical record with her GP back home. Knock out any important health concerns where she lived, but get the diagnostics done where it was cheap. Apparently three days of tests were only going to cost her about 2KUSD. I could imagine a colonoscopy alone costing twice that in the states. What does that say about our world healthcare systems if capable people travel to different countries for specialist care than they do for preventative care? Different countries for procedures than for checkups?
Vaccinations
I think I spent 4KUSD on vaccinations before leaving the country. Some of them were standards that I was a little out of date for (eg, tetanus). Some of them seemed like a stretch (rabies) that I was later, experiencing life in some of these countries (the absurd number of confused bats and aggressive stray dogs) grateful I’d opted to take. Others, well, I’m sure glad I never contracted Japanese encephalitis, but was that because of the vaccine or the season or just good fortune?
Health care is a huge money sink. And these travel clinics know how to get you. The anti-malarials and bug spray, I think, is where they make the most money. I was suckered into four bottles of bug spray. I rarely use bug spray so I didn’t know how fast it went. I don’t think I cleared half a bottle, even sharing it most of the time. They also don’t tell you that in a lot of these countries diseases like Malaria are more seasonal, or that diseases like Dengue are more dangerous, more likely, and you can’t do anything about them before hand or during, you can only hope to avoid the bite. Perhaps worst of all, when I was looking at parts of Central Asia, I looked at the recommended vaccines and because I couldn’t figure out how I’d get them, I just decided not to go. I reduced the richness of my life out of fear of losing it. Trading freedom for security.
I will clarify I don’t regret it. I’m happy to be alive, though I doubt I was at much risk in the first place, and the less time in Central Asia, the more time elsewhere. In East Asia, or Europe, for example. Life is series of compromises, not in the unhelpful, ugly, modern sense of “compromising ones values” to mean selling out or being a rubber-spined turd, but in the sense of a free and consensual exchange of one thing for another. Time here for time there. A little money for a little freedom. A little longevity for a little living.
When I return…
No doubt plenty of my health issues are attributable to…
- Lack of exercise
- Too much alcohol
- Too much tobacco
- Poor sleep
- Poor nutrition
- Loneliness
And this is true even when I’m not traveling, but less so. Really just the loneliness and tobacco. I look forward to running again. To being able to cook my own dinner. To sleeping in a normal bed instead of sharing a bunk. I think I might go vegan for a while just to get a break from the meat-heavy diet I’ve endured the past year.
And I’m definitely, totally going to go to the doctor to get those things checked out that I’ve been just quietly enduring for years. Absolutely.
