Sunday, April 24, 2011

MEDICAL TOURISM


It is Sofia’s spring break from school and we are off again, exploring Asia.  This time our destination is Lombok, the next island to the right of Bali on the map.  We load our bikes onto our car and our car onto a ferry, sailing four hours aboard a not particularly clean, quite crowded vessel; a good time for a bubble blowing contest.  

Aside from our friends traveling with us and a handful of backpackers, we are the only non-native Indonesian passengers.  Once we dock in the port town, we let our intuition be our guide and happen upon a wonderful place to eat and hang out beside a picturesque stretch of beach.  A few Indonesian surfers are catching waves beyond a rocky outcropping as we eat Italian Indonesian food and sip limoncello.  Wandering further along the coastline, we discover a dramatically lit hotel with 30 foot Goddess statues beside tiki torches and decide to spend a few days floating in their gigantic pool beside the ocean, then in the ocean beside the pool.  Sofia has her first ever bicycle riding (no training wheels) experience on the expansive oceanside lawn.
While enjoying my family and the location tremendously, my heart symptoms persist almost daily.  I find myself not wanting to go off on my own, on my bike, strolling down the beach, for fear that something happen to me and my family not know where I am.  Certainly this is not me, living in an increasingly narrow box.  In the midst of my physical symptoms and the terror they trigger in me, I feel myself committing more than ever to living fully, adventurously, joyously.  And so, in Lombok, I make a decision.  I promise myself that I will get whatever help I need... medical tests, medical procedures, exorcism, blood letting, anything.  I tell my heart to hang in there until we get back to Bali, and then I will go wherever the next place is to go for assistance.  I breathe in and breathe out, telling myself all is well.  I visualize every vessel in my heart open, clear, flowing smoothly.  I meditate through each wave of uncomfortable sensation, yet one night in Lombok I still need to take a valium in order to get any sleep.  So much for vacation on a tropical island. 

Back home in Bali (it’s still fun to write that!) I phone Singapore to set up a cardiology appointment, schedule an angiogram and arrange for blood tests to check my hormone levels... until I learn the prices and stop in my tracks.  I have no health insurance and the cost is as high as in the United States.  If I need a procedure to keep me alive I won’t have funds to continue on with my saved life.  In one day I research and call Singapore and Bangkok, ruling them both out, then focus in on Jakarta, the capital of Indonesia as well as the capital of Java, next island to the west of Bali, making all the necessary arrangements to visit there (including finding out the best restaurants, of course!).  This kind of organizing has always come easily to me, but of late I could not manage a fraction of the energy output it requires; most of my energy has been turned inwards.  I notice that I am able to handle the stress of language difficulties, differing cultural norms, multiple phone calls.  Without any medical intervention I have reached a turning point.  
My friend Michelle who, conveniently for me, was a cardiac nurse in Bend, Oregon, accompanies me to Jakarta.  Michelle is an avid athlete, including an enthusiasm for the athletics of international travel.  We label our traveling to a Jakarta hospital “Medical Tourism” in order to reap as much pleasure from the journey as possible.  
It begins with a portentous synchronicity.  While visiting a clinic in Ubud for possible blood work, a gentle mannered Balinese attendant had recommended a cardiologist in Jakarta, even calling the hospital and gathering all the pricing for me.  His bald head is an unusual shape and his persona is serene, giving the appearance of an alien from an enlightened planet.  As Michelle and I board the crowded flight to Jakarta, while squeezing through the narrow isle to Louis Armstrong singing “What A Wonderful World”, I am pleasantly surprised to see my helpful friend seated on the plane.  After landing he offers us transport with his driver who is already waiting and helps us find a reasonably priced hotel near the hospital.  It turns out this humble angel is a doctor and the owner of the clinic where I met him.  The next day I learn he has phoned ahead to my new cardiologist, further paving my way.
I have one word to say about Jakarta: traffic.  In Bali people complain about the growing number of cars on the footpaths-turned-roads.  It’s all a matter of perspective.  Bali is a breeze when compared with Jakarta.  It’s a wonder that pedestrians survive the exhaust choked, nearly gridlocked byways without a sidewalk in sight.  
Stashing our bags in our hotel room, Michelle and I venture into the Jakarta night.  Excited to be in a big city with big city entertainment, we find a nearby mall housing a cineplex but discover every film is some variation of slasher movie or horror flick.  Instead we buy inexpensive Indonesian made girlie trinkets for our daughters in a cute shop with a pink and white picket fence and eat street food from a cart.  The queue of people waiting for padang food find humor in seeing two western women on a nondescript side street eating with them and laugh at my communications in Indonesian.  Returning to our hotel, we hire a becak motor, a converted motorbike with a back seat for two and a colorfully painted metal housing that keeps out the sun and rain but allows in all the exhaust fumes.
Early in the morning at the hospital, while waiting to see the doctor I show Michelle photographs of my previous incarnation in Oregon.  So far in Jakarta I have been feeling great and sleeping great.  The photos of our friends, our Applegate house, our cat Malia, the construction of our garden, trigger a feeling of loss and I feel it right in my heart.  My cardiologist is competent and speaks English well.  He detects a slight irregularity in the stress test I took in Bali that no one has pointed out before, but seems unconcerned about it.  He also is not worried about the protein level in my blood from my first heart event 2 months earlier.  He is not convinced that I had a heart attack at all.  He schedules me for an MSCT, a multi-slice scan that utilizes the most high tech equipment available and is less invasive than an angiogram.  First they draw blood for my battery of information gathering tests and to check for kidney function before injecting me with dye for the scan.  While awaiting the results I skype with my son Gabriel, providing entertainment for the Indonesians in the clinic as I talk into my computer with someone halfway around the world.  My kidneys are working great, so they put me in an all white room with an all white machine made by GE that makes whirling sounds as it emits radiation.  Under the arch of the powerful white mechanical eye that can see into my body, into the very vessels of my heart, I must lie completely still, breathe and hold my breath upon instruction, all the while keeping my arms in a specific position above my head.  The dye moves from my arm into my head and down throughout my body, a warm, weird, liquid sensation.  I hear Beatles songs playing in my head... all you need is love... It feels like science fiction, reminding me of the movie “Sleeper” and I expect to have someone walk in next with an orb.  Instead a baby faced doctor informs me they will not have an analysis of my imagery until late that night.  Time for further exploration of Jakarta.
If a beautiful section of Jakarta exists, we didn’t find it.  We did find a spiffy mall with a better movie selection.  It was a treat to be in a movie theatre.  We saw “The Company Men” where Ben Affleck loses his job and then his upscale house; I didn’t know the theme of the film in advance or that it would hit close to home.  Watching the movie I felt some pain in my heart and understood clearly the emotional component of my symptoms.  Later Michelle and I stroll on a boardwalk over a bay while in the distance a live Indonesian band plays their version of “What A Wonderful World”. 
Returning to the hospital late that night, the results of the testing are astonishing: my heart is not just okay, in working condition; it is spotless, pristine, perfect.  Every vessel registered zero calcification.  Not a hint of any blockage.
When we meet with the cardiologist the next morning he acknowledges that he has never seen a scan as clean as mine.  He expresses an interest in visiting the Green School and learning about raw food, confiding that his personal scans do not look like mine.  As for an explanation of my symptoms, he only offers that “symptoms are subjective” and writes me a prescription for Xanex, assuring me that these tranquilizers are not addictive at a low dose and further confiding that he pops one himself before he has to speak at a medical conference. I am relieved, elated and slightly mystified.  I am not surprised that the tests give me a clean bill of heart health.  I am somewhat amazed at how the symptoms, both physical and emotional, seem to have lifted off of me and floated away.  I try to fill the prescription but the response at the hospital apotek (pharmacy) is “habis”, in other words they are fresh out.  (I never try again but carry the prescription around for weeks in the filing cabinet called my purse.)
Later I receive further confirmation of my radiant health.  Some of the blood test results are in, showing all levels normal except one; the HDL cholesterol (good guy pack men that gobble up the not-so-good cholesterol) is off the charts high and the score is in red.  That’s a good thing.  Michelle says she has never seen scores so strong.  I am more convinced than ever that eating raw food is youthing my body.  Most important to me, the results are self-affirming; I can indeed trust my intuitive knowing about my body and my life.
We dig around a few more Jakarta neighborhoods, finding some stylish food in a swank setting and a few trendy stores, but no outdoors beauty.  Then we catch our flight back to Bali.  Louie Armstrong is still singing “What A Wonderful World”. 
It is indeed a wonderful life.  All of it.  I am blessing every intense, glorious, mundane, romantic, trying, mysterious moment of it.  I am noticing an increase in my ability to be grateful for things as they are.  
What is it that has been happening with me?  What are these heart episodes and eruptions of terror?  They are my path to freedom.  They are an evolutionary impulse stretching and shaking the roots of my old paradigm, cracking through the mud of old fears that have held me back.  My previous life has cracked apart, decomposed and vanished.  My every cell, the very fibers of my heart, the wiring of my entire system has been shifting, up-leveling to carry more voltage.
My spiritual explanation has not been sufficient for many friends and family members close to me.  Well meaning voices want a doctor to discover what is wrong with me and fix it.  That mindset is exactly what is wrong for me!  All my life thus far I have carried, buried in a tiny, secret corner of my heart, the belief that I have something wrong with me.  What I have been doing is letting that go.  What I need to know in my belly, in arteries, in my blood cells and my bones, is that everything is right with me.
Like an athlete, I am developing the muscle, the persistence and the endurance to make it through the transformation ultra marathon.  Like a musician, I am practicing my focus over and over, moment by moment; focus on what feels good, focus on what I know to be true, my inner ear finely tuned to hear the cosmic song.  It takes great power of focus to remain positive regardless of what is happening, no matter what.  Like an artist, I am dreaming my design into form, observing as the pieces of my new life come together like a mosaic, one tile at a time. 
The colors of the rainbow
So pretty in the sky
Are also on the faces
Of people going by
I see friends shaking hands
Saying how do you do
They’re really saying
I love you
I hear babies crying
I watch them grow
They’ll learn much more
Than I’ll ever know
And I think to myself
What a wonderful world