Can you think of a bigger bummer than getting horizontally ill just before a long-planned trip? I can. Getting abysmally sick during a long, planned trip! For all diseased gall bladders are divered into three parts: before the trip, during the trip, and after you’ve returned “safely” home.
Take the sad but instructive case of my old friend, the Welsh poet/filmmaker John Ormond. When I took the train out from London three years ago to visit him in Cardiff, Ormond seemed less ebullient than usual. Normally, he’d want to immediately fire up his VCR to show me which Welsh poet he had most recently given his loving, knowing treatment. Clearly, something was wrong. John, he explained sadly, had Lyme’s Disease.
The annual high point of his life was making his way down to a vacation retreat high in the Tuscany mountains where he relished long solitary walks. Alas, he’d been ticked for good there. God knows for how many years. But as his symptoms defied the nostrums of local medicine, his friend the Irish poet Seamus Heaney had a tropical medicine specialist from NYU flown over to try to figure out what was ailing the man who has done the most sensitive TV films on poetry in our century. Lyme’s was his fate, diagnosed too late to cure the affliction. Thus it was that two years ago I picked The New Criterion to find Leslie Norris’s elegiac poem to John. He was already gone.
Which brings me back to my “before” and “during” categories. Do a little advance thinking about what specific dangers your planned itinerary will subject your body to. The U.S. State Department (202-647-5225) publishes regularly updated advisories on which perils are where. If you’re really paranoid, the Centers for Disease Control (404-332-4555) will get into even more gory particulars; they’ll fax the details.
Such details are more important than any visas you might need to enter strange lands. Unless of course you want to risk having that Universal Customs Officer in the Sky stamp the River Styx on your passport. And you ought to find out beforehand what specific protections your regular health insurance provides for overseas emergencies. Get it in writing.
And if you have to pay medical bills in a foreign currency, make sure to get a reading on the exchange rate for that day. Pay in Visa or Mastercard if you can, because it’s easier to contest such bills. If you hold a Visa Gold card, you can even seek medical assistance through their 800-VISA-911, an easy number to remember under stress. My HMO, for example, cancels my Medigap coverage if I’m out of the country for more than 90 days. And of course Medicare isn’t valid at all overseas.
If you lack portable medical coverage in emergencies, be sure to get temporary coverage that suits your circumstances at the same time your travel agency is arranging luggage insurance. (Heh, your bod is your most important baggage!) International Assistance Association/TravMed Programs (800-732-5309) will give you limited coverage for $3 a day. IAMAT (International Association for Medical Assistance to Travelers) will help you find an Anglophone doctor if you don’t have Visa Gold (716-754-4883).
When you think luggage, think hernia. Choose washable gear suited to the season of your travels, and limit yourself to three days of changes. Every kilo you add to your suitcase is a permanent drag on your vacation mobility. The Romans knew what they were talking about when they dubbed luggage impedimenta.
Before you go, you ought to make yourself a private little first-aid kit, with duplicates (to be stored in a bag other than your fanny pack or shoulder bag) of all required medications, along with a backup prescription from your doctor in the unlikely event that your two caches simultaneously disappear. Stuff a thermometer in there with a passing prayer that you’ll never need to use it.
And some sun block. As a Hibernian with fair skin who fried himself to a crisp under the merciless Lake Huron sun every summer from 1932 to 1949, I’ve now got to make skin cancer trips to my dermatologist. Only last month did I for the very first time suffer that greasy kid stuff onto my pockety epidermis—while floating around on Lake Powell above the Glen Canyon Dam. I couldn’t believe the state of my skin the next morning: unharmed by the Arizona sun. Don’t you be that tardy and careless. Add a supply of Immodium AD to deal with Montezuma and his minions throughout the world.
And listen to two sad stories of mine so you won’t let your guard down.
I’ll never forget my morning at the Hermitage Museum in Leningrad some thirteen summers ago—neither for aesthetic or anesthetic reasons. For you see, I had the greatest attack of the runs in my life there as I was trying my darnedest to relish a room full of Matisses, a great swatch of Derains, a delectable lode of Kees van Dongens. Alas, every time my spastic colon sent me tight-buttedly into a hallway looking for a crapper, an alert babushka compensated for my lack of Russion with her compassionate eye. I didn’t say a word. I just followed her to a door which she opened silently to reveal a mechanism to relieve me. This happened no fewer than four times.
I could write a familiar essay on the toilets of the Hermitage if it wouldn’t be too traumatic for me to re-run that home terror movie. Finally, I gave up and retreated, solo, to the tour bus—where I huddled at the back until, alas (where was it all coming from!), I had another run! Where, Oh where? Russian tour buses have bars at the back but no toilet. I spied a bucket the cleaning lady had left in the far back corner. Necessity being the mother of violating conventions, I shat in the bucket. And looked innocently away when the rest of the tour frowned at the scent in the back of the bus.
I go into the gory details to impress on you that even a colon-coddling paragon of recta-rationalizing like me can let his guard down. How? The day before I had driven myself to thirsty exhaustion looking for the Finland Station, where Lenin had arrived sealed in his train but ready for revolution. My motive was its reputation as top-of-the-line Art Nouveau. Which it was. But when I plopped down on my bed in the Hotel Leningrad, I discovered that our supply of bottled water had run out. Rats.
Get dressed. Go down and talk a barman into selling me a few bottles to tide me over for the night. Too pooped. Rationalized that a first-class hotel wouldn’t have unsafe water in its taps. Right? Wrong. It only takes one false step to start you running. Call it the Mensheviks’ Revenge. Up to that point in my three-week “Arts of Russia” tour, I’d been meticulous to drink only watery beer or bottled water. One misstep, and floooom.
You’d think I’d have learned for good that lesson, right? Alas, just last year I flew up from the hot dry clean air of Oaxaca to the hot polluted air of Mexico City to take part in the Winter Symposium, a ritual during which the writers of Latin America blame all the evils of the last 500 years on—you guessed it—the U.S. of A. But I was willing to put up with this vicarious abuse masochistically because it was being held at that architectural showplace, the University of Mexico City.
I stumbled upon a poet architect in the parking lot of the architectural faculty who volunteered to drive me around and show me the high spots of Mexico City architecture the following day. Agreed, with pleasure. But as I went from meeting to meeting, with side excursions to the luminous Central Library, a combination of the hot dry clean air I’d been baking in for several days in Oaxaca and the hot dry polluted air of Mexico City made those glasses of freshly squeezed orange juice on sale in the kiosks that dot the campus irresistible. The thirstier I got, the more of the ambrosia liquid I consumed.
I barely made it back to the Holiday Inn/Airport. Talk about the Halls of Montezuma. I spent the next day ruing the O.J. I’d thoughtlessly imbibed the day before instead of taking the promised architectural odyssey. It was obviously those insufficiently washed glasses that carried the pesky bacteria my insides were unaccustomed to. And doubtless you’ve heard of how the purest-looking ice cubes can be just as lethal as they melt conspiratorially in your (very) mixed drink.
Staying healthy isn’t just a matter of keeping your liquid intake uncontaminated. The sickest I ever got in my travel life occurred fifteen years ago when I was Eurailing across Europe to spend an Easter in Greece.
When I got off the British ferry in Dieppe, partly to go native, partly to save money (this trip was to last three months), I stocked up on cheese, sausage, bread, and wine to last me the three days or so my dawdle would take. I love French bread, and I was really getting off on making these little French sandwiches, and washing them down with a very ordinary rouge.
It was heavenly until halfway across on the ferry from Brindisi to Patras. Hell hath no fury like a colon scorned. I thought I was going to die right on the spot. I staggered off the boat and up the main street and into the first hotel I saw. For twelve hours every major orifice in my body, inferior and superior, Vesuviated. By noon the next day I was fine enough to hop on the train to Athens.
Moral of the story: Eating bad food is only a temporary hell. Hole up and let Nature take her courses.
And it isn’t only eating native that can foul you up. The second worst such encounter came in Hiroshima, when I’d tried to compensate for several nausea-inducing Japanese breakfasts by spring for the familiar sign of Dunkin’ Donuts. Except the coffee was vilely undunkable. And the donuts were crazy. So it wasn’t the terrible trauma of going through the museum about the atomic bombing at Hiroshima that made me deathly ill by noon, but pseudo-Americana.
As I lay crapped-out on a bench in front of the museum, the curator who had just been attending to my intellectual needs asked me why I looked so sick. Because I was, was my simple groan of an explanation. Kind lady that she was, she saw to it that I got to a nearby house of two American missionary friends, who gave me a sack to recover on.
Every once in a while you’ll have a real emergency, not just a passing inconvenience. That happened to me in Nashville some eight summers ago.
About two o’clock I got the worst stomach cramps and started passing blood. Uh oh. I grabbed a cab to Metropolitan Hospital, and asked Emergency what was going on. Nothing to worry about. A mild prostate attack. Take this Bactrim and call your doctor in the morning when you get home. They took my HMO card for payment, but HMO played pingpong with Nashville for several months until I shrieked at someone in Blue Bell. Just a reminder to keep all records from such encounters, no matter how trivial-looking.
Heh, my traveling isn’t country-to-country calamity. I just tell you the low spots to encourage you to be prudent. Don’t over-drink or over-eat on your way over. Attend to your circadian rhythms. (Crapping out in a hotel the first day is the best insurance you can take out for not messing up your trip with a lot of pesky illnesses.) And listen to your metabolism. When my rear end starts dragging on a trip, I look for a quiet, blue-collar café and order a bowl of soup. Nothing like home-made vittles to calm the old system down. Dawdle creatively. There are a few pleasures I relish more than, say, having a café and croissant in the Gare de l’Est while reading the Trib after an overnight train from Zurich or Vienna.
And when you get back, think of unlucky John Ormond, who didn’t know what hit him until it was too late. Check out any peculiar symptoms with your doctor. Traveling healthy just takes a little extra care before, during, and after your trip.