CR in CR- Death by Thai Food

My father-in-law is dying. I tell him he’s not, but he is. They’re killing him, not some vast faceless conspiratorial capital ‘T’ “They”, but the very faceful wife, daughter, and doctors surrounding him. I took him to Chiang Rai general hospital five days ago complaining of chest pains. They checked him over, declared him normal, invoked the diabetes clause (anything they don’t know the cause of they blame on Diabetes, a family of musicians in Mali I think), and then released him, in and out in less than two hours. How’s that for service? Would we have taken him in if he were normal? Yesterday he complained again of the same chest pains, only worse. We took him to a different private hospital, where they put him on a pacemaker after a pulse reading dipping below forty and a blood pressure reading up to a hundred-ninety-plus over a hundred. Did I mention that he’s been in the hospital at least once a month for the last six months with the same symptoms? So what does he do when he gets one of these attacks? Typically he’ll start walking down the street, clutching his chest all the while, ignoring my commands to lie down, as if he’d rather see the Homies one last time than actually try to ease the offending condition. If there’s anything worse than watching someone grow old, it’s watching someone refuse to, a warning to myself included. When someone goes into the hospital with the symptoms of old age at sixty and then gets the brilliant idea to start exercising, it’s probably better to save the brilliance for something else. It’s too late for anything but tai chi. Anything else and you could hurt yourself.

Stupidity and stubbornness are not usually listed as causes of death, but they probably should be, along with denial. That’s the longest river in the world, and seems to run through every country, drowning millions in its frothy waters. Thai food could even be considered a contributing cause of death in many cases I think. I told them all the first time that he’d have to give up salt, including fish sauce, totally- anybody knows that- and cut sugar and oil back sharply too. That means Thai food in general. For you people down south the local food up here’s a bit raunchier, hotter and nastier. Central Thai food can pass as health food in the US. Don’t try that with northern food. If you don’t believe me try some nam ngieow sometime. The doctors didn’t say anything about diet, either for his heart condition or diabetes. They never do, even though anybody who knows anything about diabetes knows that diet is the crucial factor. They gave him pills. They always do. He takes them religiously as his condition worsens. Guess what they feed him in the hospital? You guessed it, Thai food. That’ll keep ‘em coming back. Every kind of Thai food has sugar in it btw, in case you were wondering what that secret ingredient is. Variations on the combinations of sugar, salt, and red pepper pretty much define Thai food and are condiments ladled liberally on everything, even sugar in noodle soup, yes that’s right. Every one of those delicious curries has sugar in it, as does even fried rice. If it’s too hot, add sugar. If it’s too sweet, add chile or salt. It’s a vicious circle. Why not just add little or nothing and concentrate on creative combinations? After a trip to Penang, northern Malaysia, with food very similar to Thai, obviously a branch off the same culinary DNA, my wife’s only complaint was that it was too jeut, not sweet enough, salty enough, or hot enough. Guess what my complaint was? Thai food’s too much of all of those.

I told them I’d foot the bills for my father-in-law’s medical treatment if they’ll keep all the salt and sugar out of his diet, added salt and sugar, that is. It’d be almost impossible to totally remove it of course. I’ll probably keep my part of the bargain with a simple promise, but I doubt they’ll keep their end. Most Thais would probably rather die than eat ‘Farang’ food. I can understand the sentiment but it wouldn’t have to be so extreme if they could just cut back and the lower the ‘intensity’ of flavor in their food. In general they can’t. They live for that intensity, so even de-fanged Thai food won’t work. They pride themselves and compete with each other on threshold levels of intensity. They don’t eat for health; they eat for entertainment. Welcome to Italy. The idea that food has anything to do with health is totally foreign to their way of thinking. If you want to take something for health, you take pills, simple. Old men walk around villages selling out-of-date pills that they’re not even qualified to throw away, much less prescribe. Sales are brisk. Aside from that everybody’s got a favorite home remedy, ranging from the bizarre to the bazaar. In Hammurabi’s day in ancient Babylon patients had to run the gauntlet of people giving cheap advice, they say. Actually it was the other way around and the patient had to sit or lie there and endure these quasi-eulogistic epithets, whether as punishment or sincere advice would be hard to determine. I firmly believe in self diagnosis. Who knows your symptoms better than yourself, after all? But that doesn’t extend to the advice of any Barney or Betty who claims to be able to cure gout with apple cider vinegar. It’s not that easy. Self-diagnosis only goes so far also. At some point you have to surrender to the long loving arms of- not conspiracy, not science, but faith- and hope for the best.

If you go into (the) hospital in the US with kidney pains, the first thing they’ll ask is, “Do you have health insurance?” “No.” “Drink lots of water.” That’s it, cold and brutal. They don’t even ask, “Visa or Mastercard?” The credit limits don’t go that high. Thais have a more unnerving way of objectifying your health conditions- you don’t exist when you’re incapacitated. When I was laid up with a cracked coccyx, the little neighborhood girls who used to play with the hairs on my chest (shut your dirty mind) wouldn’t even look at me, kind of like ex-lovers forced to share the same old friends, even when I called to them in the same room. I finally had to make jokes about the diapers I was wearing- I prefer foreign-made Pampers over the local Momy Poko’s- just to break the ice with girls I’d known for months if not years (shut it, I said). The diapers were there ‘just in case’, since I couldn’t feel anything ‘down there’ any way. I’m better now. Ever wonder what it’d be like experiencing ‘the first time’ all over again? Ever see ‘Dante’s Peak?’ Actually being laid up half conscious in a hospital in Thailand for a Thai is probably a lot like being a Farang. They like to talk about you behind your back right to your face. It’s unnerving. Hospitals in Thailand are surrounded by coffin shops. Sales are good, even though they’ll only be burnt in the fires of cremation as the corporeal body (redundancy intended to simulate three dimensions) reverts to primordial hydrogen, carbon, and oxygen- one or six or eight electrons to an Adam- in preparation for the Big Recycle/Reincarnation/Rebirth.

The Big Moment for any Thai cremation is the moment when they open the coffin right before sliding it into the fire and anybody who can, the younger the better, rushes up for one last look at the body, imitating the facial gestures and bodily contortions of that ‘mere vessel.’ The coffin’s usually been on display for a week by now btw, if the family can afford the party. Carbohydrates or hydrocarbons? Alive or dead? Consumed or consuming? On the rocks or straight up? These are the choices for organic chemistry. You draw the lines and choose sides. As I watch the lines on my pa-in-law’s bedside EKG- I’ve never seen one before btw- I explain to the village people about the pulse and pressure readings. I might as well have been pointing to ancient hieroglyphics. They’re telling him to eat hotter spicier saltier food to ensure good health. Just for fun we each try the pulse-o’-meter on our own index fingers. I’m in fine shape in the high sixties and the wife’s okay for a woman in the low eighties. Her mother tops ninety, going going going… uh oh, it’s looking like another rehab, but I say no no no... Suicidal tendencies might help cut health costs, true, but it really shouldn’t have to come to that now really, should it?

Thailand Redux: Jet Rag, Medical Tourism, and Government by Goons

Home is where the heart is, they say. I figure they’re right, so my idea is to make as many places in the world feel like home as possible, something of a network of safe havens, you know, just in case… just in case all that apocalyptic symbolism becomes more than a metaphor; just in case things don’t work out like I have planned for my life; just in case I have a case of incurable wanderlove and feel like I’d be happier following the sun than following orders… ouch! Somebody pinched me a little too hard there! Where am I anyway? Searching searching searching… for a memory, a point of reference, anything… oh yeah, I remember now. If it’s Sunday, then this must be Thailand, and if this is Thailand, then that pinch in the butt must have come from (sound of blankets rustling) aha! The memories come flooding back now. That was a pleasant dream, though, the little bit that I can remember through my jet lag haze. Obviously all safe havens are not created equal. You wouldn’t want to try this at home anyway; concepts of home and nomadism are mutually contradictory. In reality it turns out to be not much more than a travel ethic, to feel like you’ve lived in a place you visited, as opposed to just seeing the tourist sites. I’m the lousiest of tourists actually. Friends come visit the Golden Triangle region of Thailand, where I’ve lived more than half of the last ten years, and see more in one day than I’ve seen in my whole time here. I’m jealous. My ethic may or may not be more ethical, but being a tourist is probably more fun.

People travel for all sorts of reasons now. I almost feel like everyone’s following me around, or maybe I’m following them. First there was simple backpacking, back when you’d actually carry a sleeping bag with you, and maybe even a tent. Then there was adventure travel, seeking out remote areas simply because they’re there. Then there were the world craft searches, seeking out interesting ethnic arts for sale to the Homies back stateside. Then there were the blue gene tours, looking for potential recombinant DNA possibilities. These days medical tourism is catching on quickly, not surprising given the disparity between Eastern and Western medical costs and the fact that we’re all getting older. If the US Democrats get elected and institute a health care system, Thailand may be out of a job. Don’t worry; I’m sure we can find some other work for them to do. When the cost of a simple tooth extraction can mean the difference between a few dollars or a few hundred, the logic is as simple as the arithmetic. The opportunities are endless- root canal tours, hair transplant holidays, sex change vacations, etc. The only problem is that many procedures require multiple visits, that and the fact that a day-long trip to Thailand is usually counter-indicated for emergency care. If you may need multiple visits, of course you could just hang around a while, and voila! Another new industry is born, retirement care. Bring on the private nurses! The average nurse in Thailand with ten years experience makes about three hundred dollars a month, is between thirty-five and forty years old, single, speaks enough English to get past first base, and has a little smile cute enough to melt hardened hearts. Interested? Keep checking for a Google Ad to appear somewhere on this page, and then click on it. The robots and web spiders don’t seem too smart, though. I told you I’d help you cheat the Eurail Pass, and then their ad shows up a day later, so go figure. No matter what I talk about, the ads for Thai girls keep coming up, so that seems like a growth industry. I only wish I’d clicked on ‘Timbuktu- Know Before You Go,’ before I went.

Tourists can’t get the same rates for medical care as the locals here, part of Thaksin’s legacy, but you probably wouldn’t believe it if you did. Appendectomy for six dollars? I’d be scared maybe they left a lug wrench inside or something. Even so, my wife’s scar wasn’t pretty, but it was cheap. To some extent, you do get what you paid for. Going to an American dentist after my Thai dentist was like riding in a Cadillac after a VW beetle, but guess which one I can afford the easiest? I wouldn’t advise buying into the whole Thai system of health care, though. Conceptually it can be a bit disturbing, particularly in the overemphasis on antibiotics. The EU called them on it when they started using them as food preservatives in export food products, though. The dairy industry anywhere in the world is no better of course. Livestock feed routinely includes antibiotics. Still, Thai conceptions of health are quirky. For some reason, Thais get a form of diabetes that seems to come and go. It’s typically a contributory cause of death also, usually one of four for some reason. Maybe they’re right and there is no single cause of death. I advise just taking the mechanical treatments and leave the high concepts to others, maybe yourself. I passed a remote hospital in the Isan outback once advertising brain surgery. I’d pass on that, but some Bangkok hospitals are getting a world-wide reputation, and Chiang Mai’s certainly acceptable for most procedures. I went in to a hospital in Chiang Rai a few days ago to get my kidneys checked and it was okay, if a bit factory-like. X-rays and medical advice for less than ten bucks is hard to beat.

The health care is better than the government; that’s for sure. At least Thaksin’s regime had some bright faces and some bright ideas, even if the main man was, and is, a megalomaniac who brooks no competition, nor criticism. His second-team cronies are like a re-visit to the dark side, Darth and the boys. The premier seems to think nothing really happened back in the student massacre of 1976. He must be studying conspiracy theory like others study The Art of War. But you’re supposed to wait longer than thirty years before re-writing history. Even Germans alive during WWII do it, though, using logic to make the Nazis seem more human, even though Nazism wasn’t especially logical. They like to rationalize that they wouldn’t have treated their workers ‘like that’, as though Jews had applied for work at the day labor office for temporary assignment to Auschwitz. The new Thai Interior minister is father to the son who executed a police officer point-blank in a crowded bar a few years ago for the crime of stepping on his foot. After a long runaround giving his father time to grease palms he was cleared because no one really saw anything. Now it’s payback time for daddy I guess. Mix me a Molotov.

Anything sounds better than jet lag right now. For the uninitiated, that’s something between a hangover, an attack of sleeping sickness, and Coriolis effects. I’m writing this in the dark by the light of the TV in my room, in some new take on the Lincolnian ethic. The best movies on cable TV come on in the wee hours of the morning btw. When’s the last time you saw ‘Nashville’ or anything by Robert Altman for that matter? I miss him. I love it, a kind of signature American film, even where it falls short. It’s long and sprawling, funny without really trying too hard, meaningful while trying even less, just like the America he manages to capture perfectly in the rear-view mirror. Did you know that everyone wrote the songs they sang in that movie, even Henry Gibson? And the metaphor is perfect, too. I love America most through the rear-view mirror.