Sunday, November 30, 2014

When Travel Attacks - Part 2

Ten Days Solo in a Thai Hospital - Part 2

If you read the first half of this article, you already know about how and where I got sick, as well as my rapidly worsening condition after three nights stay in hospital at Ao Nang in southern Thailand. You can read the first part of the story HERE.

Long-Tail boat on the beach in Kamala, Thailand

During that third night in the Ao Nang hospital, World Nomads and my family went to work remotely on my behalf, so that when I awoke, they had arranged for an ambulance to take me to world class Bangkok Hospital in Phuket, about 3 hours drive from Ao Nang. The ambulance picked me up in the early afternoon and we made a run for it. There were two ambulance attendants/paramedics on board as well as the driver. They both spoke fluent English and were not only very professional, but also very personable and friendly.

As soon as the ambulance left the curb, the attendants began asking questions and gleaning information on my conditions, symptoms and general health. Then they began taking readings on blood pressure, pulse, respiration and other things. They also had copies of my health charts from the Ao Nang doctors. We made a pretty fast exit from Ao Nang and Krabi without resorting to the kind of NASCAR driving tactics that ambulances are not only capable of, but legally authorized to conduct. The driver kept the siren off much to my relief, and I'm sure, everyone else on the road. We ended up on the highway and faster progress in pretty quick order though.

Once all the tests and questions had completed, we were left with nothing to do but chat amiably about everything under the sun. However, the topic of conversation inevitably ended up coming back to speculation around what, precisely, was wrong with me. They had all kinds of ideas and theories about what it could be and bandied them back and forth in a kind of paramedic ping-pong match. I acted as line judge and would periodically answer more pointed queries about specific symptoms and such. By the time we reached the hospital emergency admitting area, the albeit very weak, consensus was that I probably had Dengue Fever. Aside from similar symptoms, apparently one of the biggest factors weighing on this was an overall large number of cases this particular season. Apparently as it turned out, they were wrong. However, this wasn't the last time medical professionals would wrongly speculate on cause, based purely on a combination of some (but not all) symptoms along with larger than normal local outbreaks.

The first admitting physician was one more such speculator. He focused heavily on the swelling, blisters and lesions on my feet and hands before telling me I probably had a case of Foot, Hand and Mouth disease. Never mind that there were no symptoms in my mouth or head and that adults only very rarely contract this disease mind you. While painful and kind of hideous to look at, these were hardly the worst of my problems and not at all what was, in most likelihood, quickly killing me. He was careful to remind me that it was only an educated guess and that they'd need to conduct a battery of tests first. More importantly, their top Epidemiologist would be there in the morning to take charge of the case and render a proper verdict.

I met her next morning as promised along with a couple of other specialists put on the case. She was much younger than the others, but she was clearly in charge of proceedings. We talked, they probed and finally ordered more tests to go along with the ones we'd already done. She immediately dismissed all speculation around Dengue and Hoof, Foot, Hand or Paw diseases too. She didn't speculate at all, but I could see her gears working on possibilities here. I think she might even have been enjoying the challenge a little. I don't mean that she didn't care, because she plainly did, but given her skills and training, I could tell she liked solving this type of puzzle. After we were done, I settled back and took stock of the situation as best I could.

I had a large private room with en-suite bathroom and remote TV with tons of channels in all languages. I didn't complain at all, but part of me wondered how much of this was due to an informal quarantine and how much was the result of a westerner with really good insurance. Probably I decided, it was a little of both. Shortly after they left the room, I got a phone call from Mike Johnson making sure I was okay and relaying news from home. It was so great hearing a friendly voice in those circumstances that I can't even tell you. Mike was a fabulous mix of friendly chat and down to business "let's get you well and out of there" brass tacks. It was perfect and I think having him as intermediary helped keep my family from jumping on a plane and coming over right away since we've all known him from the time we were kids. If I'd asked, I think he would have taken a leave and flown up from his job in Malaysia too. Fortunately, that wasn't necessary and besides, he was able to do a lot remotely with his local knowledge and contacts.
The view from my hospital room

My family was also working hard on the other end along with World Nomads to ensure my well being and care. With a 14 hour time difference, this could sometimes be pretty challenging. Just knowing they were all behind me was a huge comfort. I have to say that even with all that, and the top level of medical care I was receiving at Bangkok Hospital, there are times laying in that bed when you feel very alone and vulnerable. The doctors all speak fluent English, but very few others do, and my Thai vocabulary was limited to just a few formal greetings and pleasantries.

Even to my untrained eye, the quality of care at Bangkok was way above what I had received earlier. For example, the contraption (official medical term - not) they put in my arm that hooked me up to all the various intravenous medications and solutions was miles better than the rig in my hand at Ao Nang. That one was fairly painful, always seemed like it was coming loose and constantly appeared to have my blood leaking back up the tube. I'm a total medical no-nothing, but it didn't seem to me like that should have been happening. Also the IV stand there was set up in such a way that made trips to the bathroom somewhat akin to attempting a summit assault on Everest. No way am I ever going to use a bedpan - ever - unless I'm comatose, and even then probably not...

IV rig in my hand at Ao Nang - you can see my blood coming back up the tube

Every two hours the nurses came in to check the usual blood pressure, heart rate etc., etc. 24 hours a day. That means at night too, so wakey, wakey, rise and shine for 10 minutes and then back to sleep little rosebud. The nurses cracked me up on occasion too. They were unfailingly professional, polite and good-natured, but sometimes the language barrier made for some interesting terminology. For example, instead of asking if I'd had a pee or a bowel movement, what I would get was "you go poo-poo's yet today Mr. Cody?" Like something someone would say to a toddler. Funny.

It turned out that all the antibiotics and other meds I was prescribed at the first hospital did keep me alive, but also made obtaining a proper diagnosis much harder for the Epidemiologist. She had to do quite a bit of forensic sleuthing to figure out what happened and when along with what exactly was going on now. Her best guess was that it all started with some form of airborne respiratory Legionella (Legionnaire's) disease that opened me up to a massive systemic infection involving several other very serious pathogens. I probably got the Legionella bacterium from a dirty air conditioner somewhere along the way, but hard to prove from where exactly. All in all, some pretty serious business apparently. The tests did not show any kind of parasites or anything either, which was a big relief. Yup, things do grow well in a tropical climate it seems.

Attack of the Killer Bean-Counters

Once the Epidemiologist had the diagnosis and knew what pathogens she was up against, she was able to prescribe a course of treatments that ultimately worked; stopping and then pulling me back from the flaming tailspin I'd been riding toward the hard pack below. I had long way to go and it was still several more days in hospital before I was anywhere near discharge. After that, I still needed some time holed up in a hotel before I was fit enough to go anywhere. All in all, I would need many months rehabilitation to gain most of my health back. Before then though, on the morning of my third day in the second hospital, I got a visit from the bean-counters.

He showed up dressed in a suit, which should have tipped me off right away. The doctors might have worn suits and ties under their medical coats, but I hadn't seen much in the way of suits anywhere in Thailand up to that point, outside the banking and consulate areas in Bangkok. Anyway, he was pleasant enough, but definitely had an agenda. All medical facilities around the world now seem to be driven as much by financial concerns as health and this was no exception. He came into my room, introduced himself and then raised the clipboard to his chest like he was referring to some type of official edict from on high. He apologized first and seemed genuinely pained to be on this distasteful little errand, but he had a job to do.

"I'm sorry" he said, but we haven't received payment yet from your insurance company and we need "X" Thousands of Baht from you now in order to continue treatment. I had only just started the new course of treatment, so I was still really, really sick. I felt like nine miles of bad road and I cracked an eyelid. "I thought they gave you a promise and guarantee to pay" I replied. "Yes they did" he says, "but we haven't actually received funds yet." As ill as I am, even I can't believe we're having this conversation right at my bedside with tubes, monitors and hospital gack surrounding us. "It's the middle of the night back in the States, they provided a guarantee of payment, and it's only been two nights since I was admitted" I'm thinking sort of aloud both to myself and Monsieur Accounts Receivable. "Yes, yes" he says, "but we haven't yet received the actual funds yet" so we need the money from you now. You'll be reimbursed later" comes the (not so) soothing reply.

I came in wearing a grubby pair of shorts and a dirty t-shirt with a small day-pack of essentials only. I can't even recharge the minutes on my Thai cell phone SIM card so I can make calls home or for pizza (kidding). I'm waaaaayyy short of enough cash in my wallet to cover that bill and as pleasant and spacious as my hospital room was, it somehow did not come with an ATM installed alongside the bed. Obviously an oversight on the part of the planning department. They should have consulted the finance department. Besides, the amount would be way past my daily limit anyway. I point out these annoying realities as well as the insurance company's size and reputation as my rebuttal. We go back and forth a couple of times, but ultimately he agrees to wait and leaves my room somewhat mollified. I picture this whole exchange in my head like a cartoon and it totally cracks me up.

World Nomads did make good of course and payment was received in full during my stay as well as at its conclusion. I can't thank them enough for all they have done for me, both for this as well as another, later episode on this RTW trip. Bean-counters rule the world though.

Just before discharge from the hospital
It took a few more days for me to improve sufficiently to be discharged from the hospital, but not to actually go anywhere. Normally, this is the part where the doctor tells you to go home and keep getting better. Since I can't exactly go home, my options are a little more limited. I'd been told under no circumstances to attempt travel outside the area until the doctors clear me. Aside from still feeling like a warmed up crap sandwich, my feet were too blistered and swollen to walk very far at all. Once more, Mike came through and set me up with a room in a hotel owned by a friend of his in Patong Beach. I hadn't been to Patong yet, so really knew nothing about it, except there was a mall with a Starbucks about a block away. By now of course, coffee fiend that I am, was dying for a cup of coffee. It had only been about 10 days, but good grief for me felt like an eternity. The food and care in Bangkok Hospital is excellent, but I really needed coffee and fresh air.

Convalescing at Patong Beach

As promised, the hotel owner was a wonderful and welcoming host as well as ex-pat German, so naturally everything was Bavarian themed and most of the guests spoke German as well. The Thai staff were fabulous too and very helpful there as I convalesced. My room was on the ground floor right behind the bar/restaurant so access was easy and it remained surprisingly quiet despite the noisy bedlam a few feet away on an insanely crowded side-street. I thought it would be a good place to hole up and get better. It was for awhile anyway, at least until I was well enough to go out and explore a little. Very shortly after arriving there, my feet underwent the next stage in their not so pleasant evolution. All the skin began sheeting off my feet including the very thick callouses I had built up over the months walking many miles each day in sandals. This left them raw, tender and bleeding in many places. Now I worried about another infection.

Patong Beach madness

Fortunately, I managed to get two pairs of clean socks, some antiseptic and bandages, so I could begin making short forays out into the world. Almost providentially, American Thanksgiving happened just as I was holing up there. I had a lot to be thankful for and felt very grateful to still be alive. I thought if I could find some restaurant catering to expat Americans somewhere in town, I might venture out and partake. Alas, I couldn't find anything, so took a wonderful Thai meal in a nice restaurant next door in the mall. I saw a movie in the theater there and had the place mostly to myself. It was a very nice venue and a delight to sit there watching a movie in English in the cool darkness. I was also reminded me that Thailand is indeed a monarchy and King Bhumibol is much loved by the Thai people. They play a short film before every movie there that portrays the King growing up and becoming benefactor to his country and it's people. Everyone in the theater stands in respect while it plays much like Americans do during the National Anthem before football or baseball games.

Where could this be....??

Once I was able to venture out and explore the town a little bit, I discovered that the beach was only about two blocks away. The whole place was just tourist madness and I hadn't experienced anything like it up until then during my time in Thailand. I'm uncomfortable in crowds and normally take pains to stay off the beaten track, but here, I was sort of stuck. Much as I loved everywhere else I'd been in this beautiful country, I seriously disliked Patong with it's noisy tourist crowded everything, cheesy bars and most especially, all the old white guys chasing young Thai women/girls around. It was the first time I'd really experienced that sort of thing since I'd been there - and I loathed it. I needed to get out and heal somewhere quieter.

A Sobering Reminder of the 2004 Tsunami

Tsunami Memorial in Kamala

With a little research, I found Kamala, a short drive up the coast, yet still close enough to the hospital. I got a room in a wonderful post-modern hotel about half a mile from a gorgeous and much less crowded, but far from empty beach. The whole place was perfect for what I needed to heal. There was a fabulous lap pool with expansive view up on the roof as well as a small gym down the hall. I could stay cool and quiet in my room, or walk down to the beach now that my feet were healing - or at least as I grew accustomed to the discomfort. One day I discovered, quite by accident, the memorial to the victims of the 2004 tsunami that devastated the coastline here and killed more than 227,000 people in all affected areas.

Long-Tail Boat on the beach in Kamala
It was a sobering reminder how fragile life can be and how quickly it can be taken away from us. It made me doubly grateful to be alive in that marvelous place and time. Suddenly my own trial didn't seem quite so monumental and spending 10 days in hospital minor by comparison. I promised myself not to ever forget that fact.

An Amazing Act of Kindness and a Happy Ending

Before I left Thailand and while I was convalescing at the hotel, I managed to get an email through to Elke, the ex-pat owner of the climbing shop next door to the cafe where I left my pack and climbing gear. Long story short, she contacted Chai, the cafe owner holding my belongings and he returned everything to me exactly as I had left it nearly two weeks earlier. Incredible, as he had no reason by then to believe I was ever coming back, or even alive for that matter. He only asked for payment to cover transport (which I arranged of course) and two days later a guy in a car showed up at my hotel and placed the backpack in my room. I gave him a tip and some more money to pass back. I also donated all my climbing gear to Elke. It wasn't nearly as much as I would have liked to give them, but they also have my undying gratitude. One day I will return and thank them in person.

Finally I got the okay hall pass from the doctors to travel again. Just in time too, since I had tickets already for the next leg of my journey to Bali, Indonesia. Before I left however, I found a couple of pendants being sold on the beach that caught my eye. One of them was a turtle, which is one of my two personal animal totems. It's simple, but I haven't seen one exactly like it since. It reminds me everyday of what I went through and how lucky I was to be alive. I flew out on December fifth, the same day as the King's birthday. I felt a little like it was my birthday too.

Friday, November 21, 2014

When Travel Attacks...Part 1

Surviving Ten Days Solo in a Thai Hospital

It's been a year now since I got sick while rock climbing at Tonsai beach near Krabi in southern Thailand where I spent ten days in the hospital as well as many weeks afterward recuperating. I wrote a very detailed blog post about it at the time, but for some reason decided to hold on publishing it. I'm glad I did. A lot of things have happened to me in the subsequent year including the death of my amazing Father and a lot more time on the road living nomadically. Having the extra time to reflect on this event and others, has given me a slightly different perspective and I want to share this now.
Beach & cliffs at Tonsai in Southern Thailand
I knew at the time, my situation was pretty precarious, but I think it was probably much more severe than even I suspected. At the risk of sounding melodramatic, I feel I am very lucky to be here now. There is great irony in this for me as well. As a long-time adventurer and adrenaline junkie, I always thought that if something was going to kill me, it would be some sort of sudden, violent accident. A fall perhaps, or a plane crash. Running out of oxygen on a dive or being bitten by a venomous animal maybe, but certainly not illness. I eat well and have exercised virtually everyday of my adult life. I seldom get sick and aside from a very serious battle with Scarlet Fever as a child, have never been really seriously sick my whole life.

On the other hand, I think I've already used up all of my allotted nine lives in other ways. For example, I survived a head-on crash at highway speeds with a loaded semi-truck, a helicopter crash, two near plane crashes and some long scary falls climbing among other things. I really thought that if my number was up, I would check out in some similar fashion. Nowhere in my mind did I imagine passing away quietly in some foreign hospital wracked with pain and fever, swollen and covered in lesions and blisters; trying to catch my breath just laying there inert. But that is what almost happened and I count my blessings everyday that I'm still here and thankful for all the people who made it possible. Here then is a short account of what happened as I remember it.

Rock Climbing at Tonsai Beach Near Krabi in Thailand

 A couple of months in to what I had planned to be a year long round-the-world (RTW) trip, I was in southern Thailand living out a long held dream to rock climb the amazing surreal cliffs and rock formations on the coast there. Tonsai is not far from the famous James Bond Island, probably first seen by most westerners in the Roger Moore episode "The Man With the Golden Gun." The rock here is very steep and often rockets right out of the sand on these fantastically beautiful beaches. In fact, most of the climbing is on overhanging rock, but this is the kind of landscape I like most given my ability to do lot's of pull-ups combined with a generally inelegant technique.

Steep starts to steep climbing right on the beach - me fighting gravity before fighting the microbes 
I felt fit and healthy despite a small annoying cough and some minor chest congestion I'd been experiencing for more than a week after leaving Kanchanaburi farther north in Thailand. That location was the scene of the famous Death Railway immortalized in David Lean's masterpiece film "The Bridge on the River Kwai." It's where 90,000 Asian forced laborers and more than 12,000 Allied POWs died during its construction in World War Two. In fact, my visit there culminated in one of the singular most powerful and inexplicable episodes I've ever personally experienced. But that of course, was all discussed in a post I wrote at the time. You can find it in the Archives here.

Climbing in the big cave right beside the best bar in town
Tonsai sits just over a small forested knoll from Railay East and West beaches, which are generally more posh and also where you're likely to encounter a slightly more affluent type of traveler. Tonsai is where the more hardcore and transient voyagers congregate to climb, base jump and seek adventure. As both a lifelong climber/traveler and design professional, I am as comfortable living a dirt-bag existence in a jungle hut or wilderness tent, as I am in a 5-star hotel.  Things are much more spartan in Tonsai, but the atmosphere is energetic and jovial as people from all over the globe come to play on the cliffs and paddle in the warm green sea. The only way to access Tonsai and Railay beaches is by long-tail boat, and usually from Ao Nang. There is no airport and no roads in or out. Electricity seldom runs anywhere during the day, WiFi is hard to come by and getting a cell signal (for me at least) seemingly impossible. I thought it was all perfect though.

Getting Sick

It was the evening of the Loi Krathong festival and I was watching them float candlelit paper balloons off the beach in Railay. They formed this ethereal parade of softly flickering lights slowly drifting out to sea in the near total darkness. To my mind, they looked like little souls journeying off in a vast expanse in order to be reunited with loved ones and the cosmos. It's difficult to describe just how beautiful it was to sit there and watch this from a breakwater on the beach that warm autumn evening.

After it was over, I began the walk back to my hut further back in the jungle where most accommodations are in Tonsai. Navigating down the path in the dark was a little challenging, but by now I knew it well enough to ignore my flashlight. Just after the darkness enveloped me, I felt suddenly and terribly sick. No nausea or anything that would indicate a food borne illness, but whatever it was hit me like a truck. Every joint and muscle in my body began to ache and I felt a fever building. My head ached. The chest congestion was flaring up and my throat hurt. I was stunned and alarmed by how fast it was all happening. It really only took about a hundred feet of walking to feel a significant difference. No boats left Tonsai in the dark and no medical facilities were available there either, so regardless, my only choice at that moment was to go back to my room and await the dawn.

Sunrise did not come quickly or easily as it turned out. It was a terrible, painful night and by morning my joints and muscles burned, my fever left me alternately sweating (even more) profusely or shivering with numbing cold. I grew dizzy and delirious. By morning I was having a hard time staying upright or remaining conscious. I passed out briefly several times and at some point I noticed these weird little lesions here and there on my arms and legs. They looked like something between a bug bite and a boil. I'd never seen anything quite like them and began to wonder whether I had been bitten by something. Some of the symptoms seemed a little like Dengue (Break-Bone) Fever to me, but really I had no idea. I was only mildly nauseous and my stomach was one of the few body parts seemingly unaffected, so I was pretty certain by now it was not food poisoning.

Self-Evac from Tonsai to Ao Nang

At dawn I knew I had to seek medical attention right away, but also knew I was too weak to carry my backpack and climbing gear out with me. With some difficulty, I put together a small day-pack with a few essentials including my passport, phone and small laptop, leaving all else behind in my room. Then I walked down the dirt road parallel to the beach and into the small cafe place where I ate breakfast most mornings. I was hoping to run into the three climbers that I had most recently been hanging with in hopes they could assist me. One of them, Chris, was a doctor from Finland, so his help would have been especially welcome at that point. Maybe they weren't up yet, but for whatever reason, they weren't there.

The owner of the cafe/coffee place took one look at me and his eyes widened in obvious surprise. "You look sick" he said immediately using his limited English. My command of the Thai language was pitifully poor, so English remained the Lingua Franca for our exchanges. He felt my forehead and drew his hand back like he'd been burned. "You really sick man" he said with wide eyes. "You should go hospital" was his follow up and I totally agreed. He hadn't seen my climbing buddies yet this morning and I couldn't delay seeking medical attention any longer.

"Restaurant Row" in downtown Tonsai - really great food actually!
He agreed to keep my main backpack and climbing gear at his little shop until I returned and asked one of his employees to take me down to the beach in one of their little three-wheel motorcycle gizmos. Sort of a cross between a Tuk-Tuk and a wagon more or less. I could sit on the small platform on the back to be ferried down to the beach like a load of groceries. It meant I didn't have to make the walk there with unsteady legs and foggy brain.

At the time he agreed to watch my pack, I'm sure both of us thought I'd probably be back next day. I had no idea that I'd be spending the next 10 days in hospital. In fact, no idea that I wouldn't be able to return at all. I'm not sure what that bit of foresight would have done to the equation at the time could it have been known.

We arrived at the beach just in time for the next long-tail boat to leave for Ao Nang (Krabi). This was phenomenally great timing since the wait times can be up to hours depending on how fast they can fill the boats. You have to wade out into the water and then climb over the sides to get on the boat. Normally it's trivial, but I was really having a tough time of it. You have to love the irony, in that the previous day, I was climbing on overhanging rock down the beach. Fortunately a group of departing Dutch tourists noticed my distress and came to my aid. They got me on board and gave me water to drink. Sometimes the kindness of strangers, however seemingly simple can make all the difference. Lifesaving even. In the short time since dawn that day, I was the grateful beneficiary of two amazing acts of kindness like that. I wish I knew their names so I could thank them personally. The shop owner's name was Chai.

Long-Tail boats on the beach at Tonsai
On the other side in Ao Nang, my kindly Dutch benefactors helped me up to the road and into a cab for a short ride to the medical clinic. The cab driver wanted an exorbitant sum to drive about 5 blocks and I wasn't in a position to argue (or walk). This was one of the only times I ever had someone in Thailand blatantly try to take advantage or rip me off in any way. In all my other dealings with the Thai people, they were unfailingly honest and generous to a fault. At any rate, he did get me to the clinic and I managed to stumble inside without falling over.

The First Hospital Stay in Ao Nang

By this time, my difficulties breathing had grown steadily worse and I was panting rapidly, trying to oxygenate my lungs sufficiently. It felt like I was suffocating. At the reception desk, I attempted to convey my situation, but only got a few sentences out before I collapsed at the foot of the counter. The next several hours were a foggy haze of imagery, sounds and sensations as I went back and forth between conscious and unconscious states. At some point I realized I was in an emergency room hospital bed with an oxygen mask and IV tubes sticking into my arms; feeding me saline and antibiotics intravenously as it turned out.

Eventually, I regained some semblance of clear thinking again and then talked with the doctor on duty. He couldn't say much until test results came back, but he seemed a little perplexed by the potpourri of symptoms I was exhibiting. I'd get this reaction a lot in the coming days it seems. He told me I'd be staying there over night and then added a bunch of oral medications to the intravenous ones I was already receiving. I guess I was getting the full meal deal and that was fine by me. Later in the day they moved me up to a private room and I made first contact with my travel insurance company back in the States - World Nomads.

This was the first time I had ever purchased travel insurance and I thank my lucky stars everyday that I did for this trip, and that I chose World Nomads. They went to work immediately behind the scenes arranging payments and assuring the clinic that I was not some kind of indigent bum ready to skip town without paying the bill. This relaxed everyone and I think ensured that I received the best care they could offer.

It was so nice to lay in a comfortable bed in an air-conditioned room under the care of medical professionals. Although I was still in a lot of pain and distress, at least I felt like I wasn't going to die or be tossed into the street. They put a more permanent injection port into my hand for all the IV meds and antibiotics they were administering, at which point, I was tethered to a big metal stand via the gravity-fed tubes, bags and syringes that poured various stuff into my system. Later on, this made getting up and going anywhere like the bathroom, a small challenge in strength and logistics.

My hand with IV rig inserted
As it turned out, my condition was much more serious and perplexing than anyone thought at first. It was apparent that I was fighting a very complex and massive systemic infection that mimicked symptoms from several diseases. It soon became obvious I wasn't going to be discharged the next day as I had initially hoped. In fact, I would spend three nights in that first clinic before being moved by ambulance to world class Bangkok hospital in Phuket.

While bedridden, I managed to contact my family back home using the dwindling minutes remaining on my phone's Thai SIM card. They went into overdrive looking for ways to help and managed to contact long-time family and childhood friend Mike Johnson, who came through as a true champ over the next days and weeks. Mike was married to a Thai gal and had been living in Thailand for many years. He knew the system and had lot's of contacts that proved immensely helpful for me. Unfortunately, Mike was in Malaysia at the time working and unable to be there personally, but he still worked magic from afar.

I knew my worried family would hop on the next flight out if they truly knew the severity of my condition, and although I would have loved to have them there, several factors weighed against this for me, so I purposely downplayed things and worked to talk them out of it. First, I still didn't think I'd be in the hospital all that long and figured by the time they got here, I'd probably be out. It's a very long and expensive flight, or more correctly flights, from where they live. Second, my Dad was not only in the early to middle stages of Dementia, but had also just been diagnosed with what turned out to be cancerous tumors in his liver and pancreas. My Sister and her Husband had just opened a new business after quitting their jobs and the holiday shopping season was critical to their business' survival. Lastly, none of them had had ever traveled abroad and although I would dearly have loved to see them do so (still do), this was not the time or place to get their feet wet. Just knowing they were there supporting me and working behind the scenes provided an incredible boost in my spirit, determination and morale. I am lucky to have the best and closest family anyone on this little blue dot could ever ask for.

Things Turn Worse...

My feet beginning to swell & blisters from nowhere...
While I seemed to make good progress the first couple of days, by the start of my third night in hospital, I knew I was in deep trouble and the doctors there were in over their heads. Quite rapidly, I not only began feeling worse, but new and alarming symptoms popped up like prairie dogs in the sun. My legs began to swell up like balloons and hideous blisters and lesions covered my feet and hands before showing up everywhere else. Thankfully they never really made an appearance on my face, but everywhere else was fair game. I still have many of the scars they ultimately left behind.  All the other stuff came back too and I started getting pretty concerned I might be losing this battle. After all, I'm in the hospital being pumped full of everything they could think of to help me, but whatever it was took a small shuffle back and then stepped back into the ring like a freight train to finish the job.

This is where my little cadre of family, Mike Johnson and World Nomads came to the rescue. That night they arranged for an ambulance to take me 3 hours by road to Bangkok Hospital in Phuket where some of the top doctors and epidemiologists for a zillion miles around could help me out. With hindsight, this probably came not a moment too soon. The third night in the Ao Nang hospital was a tough and very uncomfortable one. Normally I'm an extremely optimistic person, but little bits of doubt began to creep into my thoughts that maybe modern medicine and my usually more than capable immune system had found something we couldn't beat here. The doctors weren't even able to identify what it was that was rapidly killing me, so how could we even fight it effectively?

Next - Bangkok Hospital and a long recovery...

Tuesday, November 11, 2014

Appalachian Autumn - The Ocoee River

The Ocoee River at the Dawn's First Light

On Sunday I went with a group of friends to kayak the Hiwassee River, just across the North Carolina border in Tennessee. I had a totally fantastic day paddling this beautiful watercourse surrounded by all the glories Autumn can produce. When we left the cabin before 5 am it was about 30 degrees Fahrenheit. By late afternoon it was in the high 60's. I was so inspired by what I experienced there, that I got up before dawn the next day and drove two hours to the Ocoee River to take pictures when the sun came up. I was not disappointed.

Again, I drove in the dark, but this time I was alone with my thoughts and the slow break of day. Full moon was just a few days prior, so I had this beautiful moon to keep me company and partially illuminate the passing landscape.

As the sun's first incipient rays reached the hills and mountain tops surrounding the Ocoee River canyon, the contrast between the dark, flat lower regions with the warm full spectrum, fully saturated color palette painted by the Autumn leaves was incredible. The mist rose from the still waters between more turbulent stretches of river and gave the whole scene a wonderful quiet grace and soft nurturing mood.

Aide from light traffic out on the road, I had the whole beatific scene to myself. I feel so quietly blessed by the sublime majesty of the world around me.

The growing light revealed new perspectives and visual treasures with each passing second and this slow evolution informed and directed my artistic inspirations. It led and I followed, but not passively. Nature put me in this play to participate and be a part of it all.

I drove and hiked quickly, but with focus so as not to miss any of it. When I took my gaze away from the water and up into the forest I saw things in a whole new way. One of the things that really fascinated me was the juxtaposition and contrast between the vivid colors of the changing leaves and the obvious signs of decay already eating into and corrupting their beauty. The first blush of entropy and death necessary for rebirth and growth. The way of all things.

Though the water levels were low for the Autumn and Winter seasons, you could still see the power these rapids would have at higher volumes. In fact, it was here on the Ocoee that the 1996 Olympic Kayaking events were held. The course ran between two bridges and still mark the upper and lower boundaries. Several rafting companies run the river and it's not hard to see how exciting it would be running at full steam.

I really loved the patterns and sounds the river made in its present state, though. Like a bear going into hibernation - all coiled sleeping power and dormant carnivorous appetite. This aspect of the river is every bit as appealing to me as the adrenaline producing rapids engender. I love and appreciate both aspects. Balance.

I noticed the fallen leaves in the river, some still floating and some waterlogged, drowned and resting on the bottom. Embraced and honored by the river, they made fascinating imagery as they interacted with the currents, patterns and textures of the water and rocks. I also loved the complex interplay of bright light reflecting off the surface while illuminating the depths below. I've always been fascinated by that sort of thing in water, store windows and car paint.

It's so easy here to interpret that Autumn beauty as marred by decay, but I don't see it that way. I see a new kind of aesthetic being created by the process and interplay of water, sky and earth. By the cycle of growth and evolution.

Friday, November 7, 2014

Learning Cherokee Via Letterpress Workshop

Cherokee Letterpress Workshop

I think many, if not most, designers will tell you that at some point in their careers they had a fascination, or flat out love affair, with Letterpress. If you love typography as I do, then I believe this is especially true. Dell and I have been taking a series of workshops that combine Letterpress printing with the Cherokee language and syllabary. It's just a fascinating and totally enjoyable experience in all respects. I'm learning so much.

The Cherokee syllabary has 84 characters compared to the 26 for English and each glyph is a small work of art. Some of them resemble English letters, so this can sometimes be confusing to noobie learners like me.  For example, there are three Cherokee letters that look similar to an "S" for my untrained eyes and other glyphs that look like a "J" facing left and right.

To create text and words in Letterpress, you have to assemble each metal letter called a "sort" backwards on lines using a metal composing stick. This is so they will print correctly when inked and run through the actual press. Each line or text is spaced or separated using a thin bar of metal called leading. So, for those of you out there familiar with typography, these will be familiar terms. Letterpress it turns out, is the genesis for many terms we commonly use today in design, word processing and printing.

Assembling the letters/glyphs on the metal composing stick
Another common term most people are familiar with are Upper and Lower Case to denote capital letters and their regular smaller counterparts. This comes from the wooden drawers separated into little compartments that hold and organize the metal "sorts" representing the alphabet. These are the "cases" and are organized so that each letter is easy to find and put back. Hence, Upper and Lower Case letters and the like.

Frank, the instructor, is wonderful and makes it all easy and fun to learn. Even for those native Cherokee speakers in the class, Letterpress is new, so we're all learning something and helping each other out. Last week we printed our own names in English and Cherokee, and this week we picked animals and assembled the words using Cherokee glyphs, English translations and just plain  English. You can see an example above where Dell is using Dragonfly. The Cherokee word is pronounced "Waduduga" in English. All three variations can be seen above.

Letterpress is a very old method of printing and has its genesis in the same sort of technique used by the Gutenberg Press. Despite a massive improvement over older methods, such as hand writing, where all text had to be created by individual scribes, it is still a time consuming and laborious process to design, assemble and print multiple pages or documents. When Letterpress was replaced by newer and faster methods such as Offset Printing, many artists and craftspeople found they could obtain these presses extremely cheaply and so a small dedicating following still employs Letterpress to create fabulous short run projects to express their creativity and love for typography. There are other things you can do with it too, but more on that in another article.

One of the cool historical things that Frank had to show us were copies of some original news sheets printed in the Cherokee nation before forced removal by the USA government that resulted in the Trail of Tears (1838 - 1839). My knowledge of the persons and events surrounding this terrible tragedy are only in their infancy, but I still recognized the names of some well-known people connected to this event at the time. To read their articles in tribal papers written prior to, or during these tragic events brings a much more personal face to them.

Mixing the thick blue ink before applying to the press cylinders

A more complex text assembly 

The press showing the inking cylinders and part of the bed with single line of text

My name spelled backwards using sorts and ready to print. The wood holding it is called "furniture." Inked rollers at far left.

Once you've finished assembling your type on the composing stick, they are then transferred onto the
press and secured in place by essentially building a little fort around them made from various little wooden blocks called "furniture." You can see the type spelling my name above, inked and ready to print. The cylinders are blue because that is the color of ink we were using to print with.

You apply a thick ink to the rollers with a small palette knife when they are not moving and then turn the press on using trip mode. The cylinders move back and forth against each other smoothly distributing the ink across the printing roller's surface. Then you clamp paper into the press and crank it over the rollers turning around as it goes. The ink is then transferred to the paper via the raised surface of the metal letters (sorts) and voila! you have your print.

Cherokee and English words for turtle and dragonfly backwards in the press & ready to ink

My name in the composing stick

The two words I chose to print were "Turtle" and "Dragonfly" because these are evenly split as my animal totems. The Cherokee word for turtle is "Daksi" and pronounced more like "Dakshi." Dragonfly is "Wadaduga." My computer keyboard is not set up for Cherokee right now so I can't type it here, but you can see them in some of the photos above. I did manage to get the Cherokee syllabary set up on my iPhone so I am able to type in the Cherokee language with that. Unfortunately I still only know a few words so not much I can do with it yet. Soon though I hope.

Next week we are going to print our own drawings using the same presses, but a different technique for etching and printing. I'm looking forward to drawing both my animal totems and seeing what they look like using these old and venerable techniques.

The moon and clouds were just incredible when we left the workshop that evening and I'm including one of those pics above that I took with my iPhone. Halloween was the week before, but this seemed like such a perfect spooky night sky for Autumn. Stay tuned for more from the Southern Appalachia as well as some stories from other places I've visited recently.