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| I'm working through yet another backlog. We hit Tokyo and surprisingly lost all internet connectivity (Brill's Navy friend didn't have internet in his home, and, well, we weren't sober enough to log anyways). We're home at last, and I'm making my way slowly through the past two or three months. At least we have pictures again . . . From January 4, 2007
Quick riddle: How do you make four people who are awkward in each others’ company even more uncomfortable? Stuff them in a car for an overnight trip to Suzhou.
When our car hire arrived the morning of the 2nd, our Gang of Four was still burning off the residual fury and discomfiture from the day before. Our driver was, somewhat surprisingly, a twenty some year old girl in a 1990 Audi. We barreled through the rainy Shanghai morning and onto the highway, with Brill’s dad in the front seat, bantering easily with the super chatty driver girl. Brill was smushed into the back seat between me and his mother (hm . . . symbolic of the tug of war that he’ll go through for the rest of his life? Perhaps. . . .)
It was a full squashy fit in the back, the three of us with our winter coats. At one terrifying point, the car stalled right before a toll booth. After a few tries, it started up again, but the heater and defogger conked out, and much to our collective alarm, the front windshield started hazing over completely. Driver Girl fussed for a bit, then tried to wipe down the windshield with a towel, all the while neither down shifting nor loosening her leaden foot from the gas pedal as the aging audi flew through the gray mist of the highway.
We arrived in the city of Suzhou, historically one of the most important cultural centers of China. Today, it is the largest producer in the world of laptop computers and digital cameras. We passed beneath a banner welcoming us to the “Open City of Suzhou”. Swell. Before hitting any sights, we sniffed out, with some considerable difficulty, argument and complaining, some passable grub. At this point, you can assume for the purposes of this post and the next two days that anything regarding meals, accommodations, directions for Driver Girl, what path to take in a garden . . . really, anything, was accompanied by acid-sharp complaints and tension. Warmed by our lunch, we stepped back out into the cold.
My first impressions of Suzhou: gray and wet. It’s a small city of dual personalities, one catering to tourism, the other to industry. A former trading town, the city is built around a system of canals, which once inspired Marco Polo to nickname it “the Venice of the East.” Determined to make the best of this trip, I pulled on my gloves, turned on my ipod and set off to take as many pictures as I could. Before long, I realized that the overcast, rainy conditions matched the stark architecture of the city, and ended up taking a majority of the photos in black and white. Our first stop was the garden of the Humble Administrator. I dunno, I think a massive garden is anything but humble, but that's just my, erm, *humble* opinion. In any case, Chinese people like gardens. ALong with gold. Yeah, Chinese people like gold - exhibit A - the pre-furnished Brill inlaw's apartment. Hooboy!
 A pagoda, which bore the name of "House of the Mysterious Mum" or "Pagoda of the Pestering Petunia" or something equally typically perplexing in translation but erudite in the original Chinese (I'm sure). 
So, the point was to walk the cultivated garden paths and ponder proper governance and humility in the midst of all this tranquility. 
A circle door. Chinese people like circle doors too. Not so efficient for a rapid getaway, very pretty though.
After the garden, we walked down the street to the new Suzhou Museum, designed by Suzhou-native I.M. Pei. The museum hosts a modest but interesting collection of artifacts from the various dynasties: bronzes, ceramics, jades, as well as paintings. I was especially impressed by three exhibits from Chinese contemporary artists. One, by Cai Guo Qiang, an expanse of nine white panels with shimmers of black, bronze and gold describing ghostly outlines. It turns out the artist used gunpowder to create the effects, laying down figures on the panels then pouring different types of gunpowder overhead and igniting them, creating negative outlines on the panels. Another one of the installations consisted of a huge accurate re-creation of a classical Chinese watercolor painting of gardens, mountains and trees, all on a huge white screen lit from behind. The viewers are then directed to walk behind the screen to discover that the “brushstrokes” are in fact, literally, garbage – wisps of straw and hay and rope, paper, cardboard, like a recycling heap. I saw more than one visitor do a double take upon entering the back area, and most, including myself ducked back and forth repeatedly, comparing the front “painting” to the chaotic mess in the back.
The museum collection itself, however, is definitely secondary to the facility it is housed in. I.M. Pei’s design, both dramatic and modern, manages to at the same time blend seamlessly into the landscape of the traditional architecture of a richly historical city (a feat that some critics may say escaped Pei utterly at the Louvre).
The museum clearly mimics the stark black and white of the traditional Suzhou architecture.
The central feature of the museum is the courtyard, a reinterpretation of the classical Chinese garden.
The comparison between Pei's modern garden and the traditional one was made all the more vivid from having just visited the Humble Administrator’s Garden. After exiting the Suzhou Museum, we bought some sampling of famous Suzhou embroidery. Then weary, we headed to our home for the night, a posh serviced apartment in the industrial zone of the city. We had a typical hotel-fare dinner, with a side order of negative comments and complaints. Brill and I then retreated to the bar for a beer and multiple smokes. Finally, utterly defeated and exhausted, I popped two Tylenol PM and fell into bed. The best part about Suzhou so far: the service apartment was fully heated and I slept for the first night in China, without a sweatshirt over my pajamas. 
Evening is starting to fall in Suzhou as we take an exploratory stroll down an alley. 
A twilight shot of the famous Suzhou canals.
I woke up the next morning, refreshed in body, if not spirit. I probably could have slept for another 10 hours, I had been so tired since arriving in China. We started out our day by hitting a Taiwanese-style breakfast joint that my MIL had spotted the day before. We each ordered some warm sweetened soy milk and long "oil doughnuts" (more accurately, cruellers). It was pretty tasty (although better in Taiwan, my MIL proclaimed - of course). Unfortunately, sometimes soy milk, particularly the chinese brands, gives me an allergic reaction, and pretty soon I was scratching furiously at my throat. A pretty glum start to the day. We hit Cold Mountain Temple first that day. 
This was the bridge and canal outside the entrace of the Temple. 
Right inside the main courtyard, visitors and worshippers alike lit incense and candle offerings to the gods. 
My father in law with some big offering candles. 
Further into the temple, there were some beautiful gardens. 
Past the first courtyard, you could catch a glimpse of the tall central pagoda in the rear. 
Yellow! Some color at last! 
A detail of the intersecting tiled rooftops. 
From the higher vantage point inside the pagoda, we could look out above the rooftops of Suzhou. Our second stop was Tiger Hill, perhaps the most iconic landmark in Suzhou. Built during the Northern Soong Dynasty (10th Century), Tiger Hill consists of a complex of gardens, cascading pools, the Tiger Hill Pagoda, also known as the Pagoda of YunYan Temple, and the tomb of a 4th century B.C. Chinese king. 
From the entrance, the 158 foot high pagoda is visible in the distance. 
A flat pavilion area of stone and water, shrouded in mist. The villas surrounding the pagoda are beautiful and ornate.  Circular entranceways (of course)
 Detailed roof tiles.
 Stone guardian lions.
A picturesque passageway, circular doorway passing through to underneath an arched bridge. 
The namesake pagoda itself, like Pisa, has leaned for the past 400 years (to the Northwest from what the local literature claims). 
The grounds of Tiger Hill are adorned by these charming "Engrish" signs. It makes sense in Chinese, really . . . 
Chinese tour groups at a chokepoint. How did I know they were all together? I dunno . . . something I couldn't quite put my finger on. 
During beautiful or inclement weather, Tiger Hill is a pretty popular place for a lesiurely stroll. 
Outside, a quick stop for a yam snack. Yes, yams. Afterwards, we started the trek back to Shanghai, stopping at the Tong Li District. A tourist-geared preservation of "canal town" life, it was largely empty in the drizzle. The reward was a tiny but really pretty garden (which was built by some bureaucrat or another back when) in the center. 
Although the water must was been frigid, the carp and goldfish still knew where they would be getting their meal. A young lady was selling little packets of fish food. 
Exiting the garden, the walked around the Tong Li District a little more, buying some chestnuts to snack on. 
I assume that these are tourist gondolas, parked for the winter.  This poor cat was shivering and mewing pathetically. He tried to crawl inside a store, sneakily, and was rudely ejected by the ear. It made me feel really terrible to see that, and I gave my kitties an extra long hug when I got home. A few last shots of the canals of Suzhou. The city was pretty and historically interesting, but honestly, I didn't have much to do except take pictures. The Gang of Four was not in the best of sightseeing moods.
 
As we left Suzhou, a wet dusk descended. We seemed to take a meandering route through the local roads on the way back to Shanghai, avoiding the major highways for all but the last twenty or so minutes. Nevertheless, Driver Girl kept up her breakneck speedracer pace. In contrast with the low rise white stucco of Suzhou and the towering metal and glass of Shanghai, the land in between the two cities remained open and flat, mostly agricultural. In the falling dark, the fields seemed to be shivering under the weight of the cold fog.
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| At 6 am, the city is still dark. I sleep restlessly because of the cold. I've learned that despite the fact that the thermometer rarely drops below freezing, it *feels* much colder because of the humidity and the awe-inspiring system of wind tunnels created by the vast network of skyscrapers. Near 7, I finally give up and get out of bed. Outside, the black gives way and all I can see are the grey ghosts of the skyscrapers and ubiquitous snazzy residential complexes in the murk beyond the window.
Yesterday I exacted a tiny bit of revenge and insisted on going to the Museum of the First National Congress of the Chinese Communist Party. The highlight of the museum is a wax diorama of the meeting/congress, with a spotlighted Mao center stage. Now Brill's grandfather was a general in the Nationalist army and his parents were raised in Taiwan, strictly KMT, (whereas my parents come from good proletariat peasant stock . . . hehe). I took a certain amount of churlish glee when they said they felt "a little funny" at being in the museum. But hey man, I'm just trying to help them fit in. Afterall, they are living in a communist country, paying all sorts of fees and taxes to the communist government and every time they pass a bank note in this cash-centered society, they pay homage to the visage of our beloved leader Chairman Mao which lies on the face of each bill. Between you and me, the irony is not lost on me that this museum is located around the corner from a Coffee Bean & Tea Leaf (that L.A. Paris Hilton/Nicole Richie bastion) and the other upscale designer stores of Xintiandi, a historical neighborhood turned fashion-centric development. (Xintiandi is touted as one of the few efforts at urban development which successfully (?) preserve the architecture of the old city).
We then hit a museum that had a mock up of an old Shanghai style Shikumen (stone gate) row house. It was pretty neat to wander around the furnished rooms and get a feel for what life in early 20th century Shanghai was like. The highlight was undoubtedly a wall display of photographs and panels showing the restoration and development of the Xintiandi area. Not because it was interesting in any way, really, but because for some reason, in those particular halls, they had the heat cranked up unbearably high - I’ve never been so warm in this country this trip yet. I basked in the blasts of heat, luxuriating inside my puffer coat, until Brill and his parents kvetched and I was forced to leave.
We stopped for tea and a snack afterwards and, oh yes, Brill’s mother got into a screaming fit when a waitress misdirected an order and kept us waiting for a red bean shaved ice (she likes to yell at people she considers inferior, i.e., everyone, her maid, the waitress, oh, say, the entire staff at a family resort in Turkey). She claims that she’s educating them because the “stupid” people here are dumb and need to be taught a lesson. Hum . . . for the sake of the few lingering scraps of good Chinese girl filial piety I may possess, I’m not going to say anything else about her and her yelling, save for the observation that, in my experience, people who get screamed at usually don’t learn anything constructive from the experience – they just walk away thinking that the yeller is a f**king pr**k.
Brill and his dad for some reason this day tried to talk to her about her yelling (a feeble and oft repeated exercise, as far as I have seen). She got a bit "het up" under the collar over THAT sulked like a 4 year old child for the rest of the day. I sat there awkwardly for the duration, murmuring quiet "Ho! Ho! Ho!'s" under my breath and studiously chomping away at the inflammatory red bean shaved ice, occasionally making loud dopey comments with a toothy grin: "Oh my, this shave ice is so good! Everyone should eat some!" (No going, my MIL would not touch the offending shave ice, claiming that she had "lost her appetite"). Despite the tension though, my mood was actually pretty good, for the following reasons. (1) It's pretty amusing to watch a grown ass woman sulk, she puts on a better show than my 2 year old niece. (2) I'm smoking like a fiend - *hack*. (3) I like to be a glass half full kinda gal so I think of it this way: "Oh, it's so wonderful that the Brill Family consider me part of their family and allow me to witness these heart warming family scenes and dramas". Oh and, lest I forget: (4) Liberal use of our credit card. Unlike Brill's mother, I don't sulk, I don't find it at all productive. Instead I retail revenge, because I know it really pains Brill when money flows outwards, much more than say . . . 4 hours of the silent treatment would (heck, if someone is constantly nagging, complaining and arguing, you think four hours of the silent treatment is punishment? HELL NO. it’s . . .well . . .it’s sheer bliss). Nasty, n'est-ce pas?
I'm engaging in retail and nicotine therapy with a vengence, drifting through aisles of designer wares in a dreamy head rush daze. After two years, I finally picked up a coveted B--------- bag, in China of all places, import taxes be damned. And I'm only getting started. If hell were freezing cold and had sweeta$$ shopping . . . .and oh, really really good food, I would know i'm there. In the words of Debbie Ho: “Peace out!”
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| *I have photos that go along with this, but of course it's proving impossible to upload them . . . it'll have to wait until the the internet gods are favoring me again.*
I have no idea what time it is. My laptop says that it’s 5:20 pm, all I know is that I’ve been up three times to pee and now can’t fall asleep in the cold. After two days of "let’s visit our friends" purgatory, we had a good day of sightseeing and walking around the city. We started out at Yu Yuan garden and the surrounding Disneyfied shopping market, with a quick bite to eat in a nearby food court. Then went walked through the streets to get to the new fabric market, three floors of vendors and stalls, each stacked to the ceiling with bolts of fabric – everything form cheap lycra, thai silks, ringspun denim to wool cashmere suiting. I found a pretty patterned silk and another black cotton eyelet fabric to have copies made of one of my favorite dress/rompers, at what will amount to a fourth of the original retail price. I also found a cute blue printed remnant of high quality silk and am having it made into a flouncy skirt. As we were at the tailor’s getting measured, I spotted a hulking bolt of faux chinchilla fur, incredibly soft to the touch and decided to have a pimp-worthy faux fur jacket made. I've always liked chinchilla, but can't bear the thought of slaughtering those cute dormouse looking things.
When we left the fabric emporium in the waning hours of 2006, there was not a cab to be seen. Brill’s mother started kvetching about this and that, our decision to hail from this street instead of that. Then we realized that we were right across the street from the local ferry that would take us right across the Huangpu river, a five minute drive from Brill’s parents’ place. Throwing a 10 yuan bill at the token booth operator (and getting 8 yuan back in change!), we sprinted through the closing gates (to the chorus of Brill’s mother wailing) and onto a dark unlit ferry. As the gates clanged shut and the ferry pulled away from the dock, my eyes gradually adjusted and I saw that we were on a deck crammed with locals and their motorbikes, bearing loads of lumber and produce. The ferry sailed smoothly and quickly across the Huangpu, both banks brilliantly aglow with the lights of dozens of skyscrapers. I was jumping up and down in my excitement, partly because of my mother in law’s discomfiture at being among the icky masses and partly because it was thrilling to be back on public transportation again (among the "icky masses"), and not crammed into the back of a stuffy cab.
As we cruised across, I finally had a chance to marvel at this city, literally burgeoning at the seams with its energy, hope and excitement. It’s a city full of stark contrasts: to be surrounded on both sides by neon-lit skyscrapers, yet sliding across the inky Huangpu river on a ferry with the local population, and their bikes and mopeds crammed into the hold of a ferry in near pitch blackness. Or walking down mostly pedestrian-narrow lanes, lined with 2 story shingled row houses with vendors displaying household good, cheap clothing or baskets of fruit, while skyscrapers loom every higher in the background. In every direction you look, there are at least another handful, some still being built at a breakneck pace. One in this direction is still a skeletal shell, another here is near completion, it’s outward skin of mirrored glass creeping from the ground up. China currently uses 40% of the world’s cement and 90% of its steel. Shanghai itself has more buildings classified as skyscrapers than the entire west coast of the United States. On the other hand, the breakneck development comes partly at the cost of heritage and culture, with whole neighborhoods and communities razed to make way for each new steel monolith. And for every nouveau riche Shanghainese shopping in the slick Cartier and Louis Vuitton emporiums, there are scores of Chinese (mostly elderly) begging and scrounging on the streets. Some sources suggest that the income gap in Shanghai society is disparate enough to rival that of the most inequitable, Brazil. Not to speak of the obvious environmental tolls of such rapid development - the iconic Oriental Pearl Tower of Pudong is literally sinking. And, granted, the weather has been uncooperative for a few days, a near perpetual haze blankets the city, such that one can see a few scant blocks from the windows of their posh luxury apartment.
Hopefully in the coming days I’ll get to explore more of this intriguing city of contrasts, of modernization and urgent industrialization arising from the foundation of Chinese culture and history.
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| *My current internet connection, while supposedly adsl, is in fact dial-up slow, intermittent and government filtered, so posting will be occasional. At least it's better than non-existent, as in Belize and Ecuador. Yes, I know, I still have to make up for that leg . . . oboy*
I know I’m woefully behind on my posting. Since my last post, Brill and I headed south of the equator, to the land of finches and giant tortoises – the Galapagos Islands. We had some pretty amazing, once in a lifetime diving. Then we headed up north to Belize, where I caught a nasty cold and almost saw a jaguar. But, I’m not going to get into either of those here. I’ll catch up eventually and post the pictures (many) that we have from those three weeks. Rather, I’m going to skip right to the present.
We spent about a week back in New York, heading up to Vermont for some skiing/avoiding rocks. I turned a ripe old age of thirty, celebrated really low key with a great bottle of Sokol Blosser Pinot Noir. Boarding also turned out to be a lot harder than it was a year ago for some reason (i.e., I’m waaaay out of shape), so I spent most of my nights smelling fetchingly of Bengay. Sexy.
Christmas was typically stressful with last minute shopping and frayed nerves. We all spent a good amount of the time saying “Ho ho ho!” in strained joviality. Two days afterwards, we hopped aboard the new China Eastern nonstop flight from JFK to Shanghai to visit Brill’s parents in their new adopted home city.
After a year of straight traveling, I am certain of one thing at least: I hate flying. China Eastern has a non-impressive safety record (including an instance where a flight crew leaving Heathrow elected to continue onto Shanghai after the airport reported that the aircraft had suffered a “significant” tail scrape upon takeoff). They also, from anecdotal accounts, don’t seem too perturbed from the tendency of some of their passengers to smoke cigarettes in flight. Ugh. Oh, and they don’t assign seats in advance. Instead, you have to show up at the airport early and hope that you don’t get shafted in the seat lottery at check in. Luckily, we arrived at JFK super early and managed to snag the bulkhead seats. (A flight attendant actually tried to move one of us to accommodate a woman with a baby. Brill, heartless man that he is, refused. Actually, there were about 5 other single bulkhead seats open at that point, so I have no idea why a flight attendant would try to separate a pair of passengers. Sheer laziness I suppose. In any case, we weren’t budging for anything less than an upgrade to business class.) The plane took off at 1 am. I popped two Tylenol pm’s, the traveler’s best friend, and slept for 11 hours. Yep, 11 hours of a 15 hour flight, my own personal record. I woke up, choked down a nasty airplane breakfast, and then we were in China. It was ungodly early, so we breezed through the bureaucratic nightmare of immigrations and customs in about 20 minutes.
Last time I was in Shanghai was 15 years ago, It was rainy and cold and grey and I thought it looked like industrial New Jersey. People told me that the city has changed tremendously and that it's modern and beautiful. Too bad I haven't been able to SEE any of the city. lol. No shit. I haven’t even seen the Bund yet. Tom Cruise and his MI:3 gang have probably scoped out more of the city than I have. Now, I know it's standard to complain about one's inlaws, and that everyone has inlaw issues, but you haven't met mine yet. For two days we did nothing but get dragged around the city visiting their friends and running errands. Good obedient child stuff, which I really haven't done since I told my own mother I had no interest in sitting for hours on end with her friends back when I was a teenager. Add to this the fact that, first, it is t---- f------ (really rude words) cold here. Colder than it was in New York when I left. Second, there is no heat anywhere. I kid you not kemosabe. Ok ok, my in laws' place has heat, but it's not central heat like this decadent capitalist piggie is used to. I'm walking around the place with wool socks, white flannel duckie jammies and a sweatshirt, typing with fingers like icicles. And then, whenever we go anywhere to visit people, no one has heat. They all sit around in puffy down jackets. My inlaws sniffed and said that winter was a bad time to visit and that we should have come in a better season, and it's no fun to travel during this time except to somewhere tropical. I really had to bite my tongue at this point to not say: "You mean, like PALAU?" (you see, we were supposed to all go to palau together, but they didn’t want to, and so we ended up planning a side trip . . . oh, nevermind, don't get me started... =))
So, still, I've got my winter layer of blubber on, I would be fine walking around and exploring the city. But since we've landed, as I mentioned, all we have done is get dragged around by his parents. We've gone to see their friend in her non-heated clothing design office. And then today, we sat in a cramped cab in traffic for over an hour, driving to meet another friend, to get into another car, to go to a bank, to go to the industrial outskirts of the city, to sit in an (unheated) factory drinking tiny cups of tea. From what I can tell so far, Shanghai is all highways, cabs and dingy gray unheated concrete offices.
Here's the bad disobediant Chinese girl part: where I bad mouth Brill’s parents. I have never seen a couple argue so much. About nothing and everything. (Regular readers may know Brill's mom, aka Mom-Ra from such greatest hits as "How I yelled at Altera's mom in Greece" and "Back in the Good Old Day When I Yelled at Everyone in Turkey"). I was stuck in a cab, in the back with Brill and his mother, wedged against a window, listening to his parents argue, yet again. The best thing I could do was turn on my ipod, concentrate on my breathing and zone out to Jack Johnson.
The good news is I think we're not going on any tours. The bad news is that I think we're going on a (car) day trip to nearby Suzhou. The good news is that my ipod has a long battery life and I've got lots of Jack Johnson.
More next time from the next feasible internet connection. Zai Jian!
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| So, first things first to ease everyone's minds. Title of this blog notwithstanding, I didn't actually get the bends. I did get inexplicably sick though, and Brill and I had probably the worst couple of days on the Rumspringa. It was six days of pain, anxiety, self-doubt, fear, arguments and realization that if one gets sick, there are far worse places to be sick than in Australia.
Diving the Great Barrier Reef was amazing. I would do it all again in a heartbeat, but the liveaboard was intense. Nothing to do but eat, sleep (if you can) and dive. Starting from 7am, it was into the frigid 72F drink, struggling in and out of clammy, ill-fitting wetsuits. I was cold, tired and probably not drinking enough fluids. After the very last dive (only 6 divers total chose to do that last dive, they didn't even send any dive masters in with us), while trying to breakdown my equipment and towel off, I also took a slight fall on the dive deck. It's a slippery place, Brill saw one of the divemasters totally bust ass while running to moor the boat. So, by the time we landed back in Cairns, I got off the boat feeling tired and a bit achey, but didn't think much more of it.
Brill and I headed up north to Cape Trib (you can check out his blog or else I'll catch up eventually too). I was still tired, and started to get an ache in my upper left arm. I thought it was probably because of the fall I took on the boat. While we were in Cape Trip, we did one of those jungle canopy surfing tours, which was lots of fun, and probably didn't help my arms any. Ack. Wednesday, we headed south back through Cairns, and my forearms started to ache as well, and I also occasionally felt a strange tingling in the ring and pinky fingers of my left hand. Fear set in and Brill and I took a detour to the Cairns Base Hospital ER. After an EKG, physical exam and some balance and cognitive tests, the doctor thought it was unlikely that I had decompression sickness (DCS/DCI/the bends), but I was given a precautionary treatment with high flow oxygen for four hours. When the pain in my left arm didn't improve (which it should have if I had DCS), I was sent on my way with a script for Bufren and a warning to come back if the pain spread or worsened.
The next three days were pretty terrible. We drove south down the coast towards Brisbane, stopping in Bowen, the very north of the Whitsundays. The pain in my left arm worsened, despite the Bufren, and I was experiencing soreness and numbness in both of my forearms and hands. Occasionally, I would also feel pangs in my back and shoulders. The anxiety and worry probably didn't help. Brill and I argued constantly, he was convinced that I did not have the bends, that I was making my symptoms worse by worrying and thinking about it. I agreed that it was unlikely that I had the bends, but could find no other explanation for the strange pains. Also, since we were to be flying in less than a week's time, I was doubly concerned that the symptoms would become severe (and life-threatening) with the increase in altitude. It would have been easy if my symptoms caused me to fall over crying, but they didn't. They came and went, varied in intensity and duration. After much uncertainty, Brill and I decided to scrub our plans for driving down to Brisbane and instead headed back north to Townsville, the location of the nearest recompression chamber, in case the symptoms got worse.
Which they did. The night before we went to the Townsville General Hospital, I think Brill finally accepted the possibility that I might have DCS. We made plans to go to the hospital the next day and thought about how many calls we would have to make, how many plans we would have to change, if I indeed had DCS. It would require treatment over several days, and I wouldn't be able to fly for a period afterwards (I've read that it can be as long as 3 weeks after treatment). I was really despondent, because it meant I wouldn't be able to meet up with my brother, sister-in-law, and niece in Hawaii.
We showed up at the Townsville General Hospital bright and early the next morning, Sunday. The hyperbarics medicine unit didn't appear to be open yet, so we went to the ER. We were promptly processed by a cheerful nurse who took my blood pressure and pulse, then escorted us to a private room. Very shortly, ER doc Rich showed up, all kindly smiles and gentle demeanor. We ran through my story and the whole barrage of tests again. We tested my visual reflexes, nerve sensations amd made me walk back and forth. The standard balance test: stand with one foot in front of the other, arms crossed with hands on shoulders, with eyes closed. In general, a healthy person should be able to keep their balance for at least a minute. People who are suffering from DCS can exhibit neurological impairment, which affects their balance, and sometimes will keel right over upon closing their eyes.
Dr. Rich then said that he would call in a consultation to a dive doctor, which (and here is the amazing part) he did immediately. In fact, he went to the phone right outside the room and called the hyperbarics unit. When he came back, he said that the dive doctor would be down in 15-20 minutes to do his own assessment. Here's another amazing part, the dive doctor showed up in 15 minutes. Perhaps I'm doing my American medical professionals a disservice, and I'm sure my doctor friends will write me a scathing email about the difficult conditions under which they work. But, so far, my experiences in the Cairns and Townsville ERs were eye-opening - in almost every ER that I've been to stateside, both urban and suburban, crowded and non, I've always waited in excess of 3 plus hours before talking to a physician. Yes, I understand the concept of triage and have never presented at a hospital with a gunshot wound, but it was nonetheless an interesting contrast. The differences don't end there either. When we went to the pharmacy to fill my script for Bufren, a chirpy young lady took my name, then told me my order would be filled momentarily. I took a brief walk down an aisle, looked at some sunscreen products, then heard: "Altera? Your prescription is ready!" Barely a minute and a half had elapsed. I was floored. My usual experience at the Rite Aid around the corner is this: phone in order to "1 hour" pharmacy, opt for low-stress next day pick-up, wait on line for 25 minutes to pick up, find out that they haven't filled script yet and wait another 40 minutes.
The dive doctor was equally kind and concerned. We ran through all the tests one more time, me balancing like a monkey. He also had me do some rudimentary mathematics, subtracting 7 from 101 continuously. Let me tell ya, my "maths" are not so good. And I haven't really used my brain for too much in the past 4 months. It was slightly embarassing, it didn't take me long, but I did have to resort to using my finger to chalk up numbers on an imaginary blackboard. The dive doc confirmed with Brill that that was indeed my typical mathematical computation speed. Ugh. His conclusion: He didn't know. I exhibited a number of the typical DCS symptoms, pains in muscles and joints, fatigue, numbness and tingling. These are also symptoms of hundreds of other diseases as well, from Dengue Fever right down to the common flu. Also, DCS, especially mild "pain only" cases, is notoriously hard to diagnose. Many times, milld cases will resolve themselves, and I'm sure tons of divers have had such cases and not even realized it or received treatment. The problem, though, was our scheduled flight later that week, which could exacerbate an untreated case of DCS. To be safe, he recommended that I take a precautionary "dive" in the recompression chamber. If I improved, then we would know that I had the bends. Ifnot, we could rule the bends out and I could board my flight home without the fear that my head would explode mid-flight.
And that's how I found myself in the Townsville hyperbaric chamber breathing O2 at a "depth" of 18 meters for 5 hours. Possibly the nicest place to undergo such treatment if you ever have the need. Many of the chambers in the states are the "coffin" type tubes. I don't know about you, but if I didn't feel like crap before, five hours spent lying in a coffin would certainly f**k me up. The Townsville chamber was large, with room for 8 patients, in reclining armchairs, and one full time nurse. It was basically a big metal room with round porthole windows (complete with a cute stuffed clownfish). There were two airlocks for two separate chambers, one of which held a curtained toilet.
The beginning of the dive, I started out with 5 elderly gentlemen who were receiving oxygen therapy. They were a funny and chatty bunch, quizzing me about my diving "What's yer deal? Too deep or too long?" The commented that they couldn't tell from my accent that I was American, much less a New Yorker, then proceeded to make merciless fun of the New Zealand accent. "Fesh and Cheps! Fesh and Cheps! Who can understand that?!" We all sat around in our recliners, watching TV through one of the portholes, in cotton scrubs. Ah yes, One of the small risks of recompression is that O2, especially at depth, is especially flammable. I was essentially sitting in a huge bomb. With diligence and careful attention to safety precautions, Australia has never had a chamber fire. But one person, accidentally bringing in a lighter in their pocket could cause a chamber fire, taking out everyone inside and a good chunk of the hospital as well.
The initial "dive" to 18 meters (60 feet) was trippy. As a diver, I'm used to equalizing and clearing my ears during a descent. But the increase in pressure in the chamber took about 30 minutes, and I cleared my ears, easily, about every two seconds during that period. Once "at depth", we were instructed to begin breathing from hoods (them) and masks (me), for intervals of up to an hour, with 15 minute air breaks. From time to time, the nurse would check on me, making sure the mask fit was secure and monitoring my conditions. I was really numb and tingly from breathing the O2. I was also pretty loopy and struggled to concentrate. It felt like I was trying to talk with a cork in my throat, and when I did manage to speak, my voice and her responses sounded like we were truly speaking underwater.
An hour and a half in, they moved all the other patients, bidding me good luck with waves, into the side lock. They were finished, and I had 3 1/2 hours left to go. I watched "A Life Less Ordinary" with Cameron Diaz and Ewan McGregor. Not the worst movie I've seen these past months. I read an Aussie fashion magazine, or tried to. I did some sudoku puzzles, or tried to. Midway through, they brought me some lunch, which I scarfed down during a 10 minute air break with a renewed appetite. My nurse and diving companion urged me to eat quickly during the break, "No need for manners!!!" while helping me unwrap a bread roll. I also needed to use the bathroom once, so they brought the other lock down to the right pressure depth for me. The nurse escorted me in, pulling the curtain around the toilet while motioning at the ceiling: "Make sure the curtain is completely closed or else the boys out there will perv on ya!" The same "boys" also basically informed Brill, waiting patiently in the waiting area, that they had observed him picking his nose on the cameras.
The five hours didn't pass quickly, but they didn't seem that long either. I'm sure it felt a lot longer for Brill who had to endure the whole experience, sans the in-dive movie entertainment. When I came out, my dive doc greeted me, checking on my condition. I felt f**ked up. I was light-headed and woozy. My throat was dry, and my limbs felt leadened and numb. Recompression will do that to you, and he anticipated this result. He sent me and Brill home for the night, warning against excessive exercise (as if), alcohol (as if) and caffeine (ok). We were to return early the next morning for a follow up. I said some goodbyes and thank yous to my nurse who gave up a goodly chunk of her Sunday and the department operator. As we drove back to our hotel from the hospital, I felt a dull pain in one forearm, then the other, and I've never been happier to feel pain.
After a night of take-away (that's Aussie speak for take-out) pizza, Batman Begins and intermittant aches and pains, we returned to the hospital the next morning for the all clear from the dive doc. I said some final farewells to the chamber operator, and even the Monday nurse who had welcomed me in anticipation of a second dive. Some of the familiar patients waved goodbye as well, and wished me luck. The longest we ever had to wait during the whole experience was while the accounting department was figuring out our bill. Also, for those of you seething at the cost of health insurance and medical care, Australia is for you. We had to pay out of pocket for everything, I'm charged with trying to recoup from our travel insurance. Each ER visit cost AUD$170, about USD$140. The five-hour recompression treatment ran about AUD$800, about USD$640. For comparison purposes, a full hyberbaric treatment for the bends would have run about AUD$3000-4000, depending on the severity (about USD$2,400 - 3,200). From what I understand, out of pocket cost for DCS treatment in the states costs upwards of USD$10,000. Oh yeah, and I paid full price for that Bufren script - AUD$12/USD$10 - less than the USD$15 insurance co-pay I pay for prescriptions at my charming neighborhood Rite Aid. From what I gather in my discussions with the hospital staff, Australians still complain mightily about their health care and hospitals. In fact, we're in Australia right before the local Queensland elections, and health care is their major issue. This patient has no complaints.
So the good news is that I'm not bent. I can fly tonight without the fear of needing to be offloaded in Guam for recompression treatment. (A friend of mine recently described Guam as hell, and alas, in my limited 14-hour layover experience of it, I would agree with this description). The bad news is that I have no idea why I hurt. Brill thinks it's because I'm old and about to crest that 30 hill. It could be dengue fever, thanks to some blood-sucking mozzies in Cape Trib. At least with dengue fever, there is no treatment, you either get better or you die. My forearms and hands actually feel like they have carpel tunnel syndrome. In fact, I actually used the term to describe the sensations to Dr. Rich, asking him, like a typical doofus, "Do you have carpel tunnel here?" He assured me that the afflication was well known Down Under. On the other hand, I cannot fathom why I would be getting carpel tunnel, especially now that I am no longer sitting in front of a computer for 14 to 20 hours a day.
What I did learn is that Australians, at least Queenslanders, are some of the nicest people I've come across on my jaunt across the world. From the gracious owners of the B&B in Cairns where we're staying, to that random woman giving us aisle directions in a supermarket, to everyone who was involved in my treatment, I've been blown away by their genuine kindness and sincerity. Even though I turned out not to have the bends, I never felt patronized. Not one doctor ever suggested that the symptoms might be mere paranoia or overblown symptoms of a hypochondriac (that task was left to Brill. Snap! Oh yes I did!) I was really impressed by everyone's attitude and demeanor at the hospital, from the too-pleasant-are-you-for-real Dr. Rich all the way to the cashier at billing. I'll be glad to leave Australia, with its memories of my DCS scare and their heart-attack attitude towards cuisine (the local fave is lard laden pies filled with meat and gravy). After five months on the road, I'm getting really tired of living out of my backpack and dressing in synthetic performance fabrics. Getting sick also brought on a sharp pang of homesickness. But, it's definitely going to be bittersweet to leave this place and return to where they don't smile at strangers on the street. Or offer an unexpected: "How ya goin'?" or "Good on ya!" greeting out of the blue. | | |
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