Friday, April 24, 2009

Take Root, Stand Tall, and Sway in the Winds.

I would like to start this blog with the explanation of what the title means to me.
‘Take Root, Stand Tall, and Sway in the Winds’ is something my father enclosed at the end of an email he sent me upon the news of what this blog contains. He was very concerned about his daughter; his tree. He was so proud to learn awhile back that the monk's nickname for me in fact means 'tree'. He understands that often in life I am strong as a tree, but under unforeseen circumstances trees break and fall, as do people; he wanted me to ‘Take Root, Stand Tall, and Sway in the Winds’ as to not fall while going through such trying circumstances.

The next morning I woke up for alms, and I felt absolutely miserable. I was exhausted and very very hot. I didn’t really have a way to tell Ma or Pa how I felt, and since it is considered really disrespectful to touch someone’s head, it was difficult to explain why I needed someone to tell me if I felt warmer than normal. I would just have to bear it while we went to the temple as usual for breakfast. Half-way through the ceremony, Ma touched my back and my shirt was fully soaked though, but I barely noticed...actually I was barely aware of anything at that point. She looked worried and began touching my arms and cheeks too. I tried to re-assure her I was okay and kept trying to participate in the breakfast mantras. When it was our turn to eat, I couldn’t bare to eat anything besides watermelon and pineapple because I was so over-heated and frest fruit was nice and cool in my body. Leang came over and brought me water then asked why I wasn’t eating when he noticed the old women were very worried and trying to load up my plate with way too much food saying I need to eat while I kept saying no thank you. I tried to be polite and tell them I just wanted fruit, but with the language barrier and not knowing the word for fever it was impossible. Leang and I spoke, and he became very concerned (as usual) and explained to Ma and the women that I wasn’t feeling well. He was panicked, but the women are mothers and grandmothers, they know about sickness and fevers. They were sure it was no big deal, but sent me back to the house to rest for a bit anyway, and said I would be better soon.

A few hours later Pa came back from the farm to check on me. I was home alone and lying stretched out on the living room tile floor where it was cooler than my bed, and I was in a fevered sleep. He tried to speak to me but then saw I wasn’t doing well and immediately went and retrieved Ma and Nan were they were at the temple helping clean for Songkran. When Ma arrived I still was not coherent and she called Leang over and they checked on me collectively as a group. Later that evening they decided to take me to the hospital since food and water wasn’t helping me. At the hospital my fever was 104.6 F. The small hospital gave me fever reducers, and cold medication. My throat was tight and muscles were hurting. When home, I still wasn’t motivated to eat, but Ma made khao thom (rice soup) for me and I ate a little, then slept a lot. I was still having fevered dreams all day and all night, and when attending the temple the next day the old women of the village decided they would take turns coming to the house to give me ice baths to reduce my temperature as recommended by the hospital. They took blocks of ice and arrange them around my body along my torso, legs and arms, but very quickly the ice became puddles around me as it was melting so quickly.
Day three into the fever I was walking to the temple one evening and surely not feeling well. I approached the common area and a dog ran up to me snarling and growling. He attacked me biting repeatedly on my ankle and legs. I fell to the ground bleeding and the monks rushed over to me when they heard the noise. The dog ran off but was behaving very strangely. I was bleeding pretty badly and so once the monks helped me up, Leang went and gathered Ma and Pa. Ma took me immediately to the hospital on the motorbike. One of the men in the village brought Leang on his motorbike so that Leang could translate for us. I was in poor condition and still not thinking straight due to the fevers. They called an ambulance from the larger hospital to take us there since the small one didn't have the correct medications for a situation like this.


Upon arrival there was a doctor that spoke English enough for me to explain to him what happened. Over the next hour we sat in his office while I explained to him how important it is that I get the immunoglobulin and Rabies vaccine. He had one of the nurses bring the vaccine into the office and I took out the package insert. I began explaining to the doctor how to administer the medicine to me since he clearly hadn’t done this before. He began writing up the slip for the nurses and eexplaind in English what he was writing. I stopped him. He had written down that they were to give the vaccine under the skin. I told him it needs to be given IM (intra-muscular) as instructed on the package insert. I also explained the schedule of the vaccine according to the insert. I had to correct him on how to mix the medicine, as well as how to administer it. We then went into the emergency room to wait for the medicine to be given to me. The nurse approached me and told me they were ready for me. I then went to the bed appointed to me, and waited along with Ma and Leang. The nurse and her assistant began preparing to clean my wounds, but as they neared me with the gauze and antiseptic in hand, I stopped them. They were not wearing gloves. I am now a possible carrier or Rabies. The nurse yelled at me and said 'This is Thailand, no America! Different style! This is Thailand! If you don't like, go away!' Leang tried to calm me down. I told him to tell them that my blood is dangerous to them, and they need to wear gloves. The nurse kept yelling at me in Thai and eventually the doctor arrived. He explained to them the significance of Rabies. They then reluctantly wore gloves but were not happy about dealing with me. They said, 'You not important, just dog bite. People here emergency. You worry no need!!'
When they prepared the immunoglobulin, they incorrectly calculated the dosage. I stopped them before administering it. The doctor came back this time with the hospital director. I was not feeling well still, was very hot, and becoming upset. It was taking all of my energy to stay focused enough to catch their mistakes. Leang was becoming very stressed with me being so worried. He kept telling me that they are doctors and they know what to do. He told me that I should relax and let them do their jobs. Ma tried to also tell me to relax. I was crying and panicking. The doctors were not doing their jobs correctly; the hospital director thought I was over-reacting. I had the package insert for the medications, and it was clearly explained in English on one side and in Thai language on the opposite side. I kept trying to explain how important it was that I correctly receive the medicine, if done wrong, I will 100% die if the dog does have Rabies.

The next 2 hours were even more trying for everyone. Eventually I convinced the hospital director to call the pharmacy to ask for verbal instructions for the medicine according to my body weight. She agreed and they received the dosage. The doctor wrote it down, but after he left, the nurses and I debated again over the correct dosage of the immunoglobulin. The nurse became so mad at me and told Leang if I think I know how to do it, then I should do it myself. So I did. I gave myself 2 of the 6 shots. After I finished the first two, the hospital director and the doctor returned and they spoke with the nurse. The doctor apologized and said he is sorry and needs to help other patients, but the hospital director will remain with me to help until finished. I thanked him and I fell asleep in a fevered state when they left the room to help other patients before finishing my shots. They had to wait to finish the shots as to make sure I didn’t have an allergic reaction to the immunoglobulin. About a half hour later I awoke as they were administering the last of the immunoglobulin. I asked the director once again about the dosage as to confirm it was done correctly. Leang didn’t want to translate and said he is sure they did it correctly. I begged him and said I need to know, and I am very terrified it’s done wrong. He asked. The director, sure enough gave me 4 units too few. More arguing ensued. Eventually they appeased me as to just get me out of there. They gave me the rest of the immunoglobulin saying it was ridiculous and I don’t need it and this is not a big deal, people get bit by dogs a lot. I didn’t care; this isn’t about them it’s about me and my safety. I needed to be sure. I was certain everything that I was awake for was done correctly, but I was still very scared since I was still not thinking clearly from the fever and maybe I missed something. It's not supposed to be my job to treat myself when I go to the hospital full of doctors and staff that are supposed to know how to do this. However, I was very thankful my degree was in Biology/Zoology and I have lots of experience in vaccinations and medicine-including Rabies-thanks to working in veterinary clinics throughout high school and college.
Pa and Nan arrived at the hospital as we were finishing up, and Pa joined in with everyone else trying to help me feel better, clam down, and stop crying. Like I said before with this fever, I was frightened more easily than normal, and this was so incredibly scary to be going through- I was crying hysterically. Pa had borrowed a car and we all went home in it, I immediately went to bed.

I awoke the next day and we went to the temple. I was really scared the dog may come back, but Ma was sure not to let me out of her sight. The villagers had heard of what happened and were very worried about me and everyone was sure to keep all the dogs away from me. Not only now was I dealing with the fever, but now also being attacked by a dog. I love dogs, but after all this, as soon as I would see one, I would become panicky and cry and climb on top of the nearest table or chair because I was afraid. The fever had a lot to do with my sense of proportion to things, so I was more easily frightened than normal. After breakfast, Leang told me that Lout from Chiang Mai would be arriving that afternoon. A few days before Leang had told me that they talked and Leang told him the Abbot here really needed more monks to help out with Songkran since Jerry had to leave early to go home. I had forgotten all about it since other things were now plaguing my awareness, but it was a nice reminder, and I really looked forward to having him here with us very shortly.

Sitting in the breakfast hall resting, Ma and the women in the village returned shortly after cleaning up the food and dishes. Leang came in as well, and Lout was following. I was so happy to see him and have him here during this hard time for me. I greeted him and paid my respects. Leang had mentioned what has been happening and he was very worried about me. As we spoke I explained to him how I was doing. Leang, Lout, the women and children of the village made a ceremony of tying sting to my wrists and blessing me, wishing me luck and good health. In turn we tied a few to the monks as well for good luck and good merit.

They said I have had really bad luck, and I must try to improve my karma when I get better. I guess I should have listened to my fortune back at the temple in Laos...because that's exactly what it said.































The men in the village kept a watch out for the dog that attacked me and after a few days of setting food lures they finally were able to trap it in one of the bathrooms. The government came and took the dog away, and would report back to us and the hospital as to weather the dog was positive for Rabies or not.

The women took turns keeping vigil over me over the next few days because my fever was still very high and I was in dangerous condition. On day 3 after the dog attack (day 6 of since the onset of the fever) the monks, Ma, and Pa's niece took me to the big hospital in Korat to get a follow up vaccine for Rabies. After checking my fever (it was still the same....about 104.6) and having Leang and Lout translate to the staff what happened and as well as how upset I was, they retrieved an English speaking doctor. He informed us all that what I did and how I reacted was absolutely correct. He said that if the doctors at the other hospital did what they had intended to do, then I would be in very bad shape and others would now be at risk as well. He explained to me that the location they gave part of the immunoglobulin was incorrect. In fact, because part of it was given in the same arm as the Rabies shot, they counter-act each other. They said it is considered to not be safe since the immunoglobulin needs to bind to the Rabies virus in my body, not with the Rabies vaccine that was given in the same arm. I gave myself the shots in my leg and butt, they gave the ones in my arm, and they said I would have to get the full set of shots again....all of them. I received 6 more shots, a bandage change, and they checked my fever's progress, and gave me IV fluids for a few hours. It was a very long day. They told us I would need to get bandage changes every day, and could go to the smaller hospital near the village…not the one we went to that did things incorrectly, but the one we went to first that called the ambulance for us. The doctor said we would need to come back here to Korat in 3 days again for the next vaccine.


This is a photo of me resting on the floor of the hall at the temple where we have breakfast every morning. Because Ma was afraid to leave me home alone while the whole village was at the temple preparing for the festival, I spent half the time at the house and half the time at the temple. There are simply more people to look after me if I came to the temple during the days, and it’s only across the street, and Leang needs to translate frequently for us all. Someone always walked with me to and from the temple so I wouldn’t be frightened by the dogs. Now that the dog I was attacked by was gone, I was not so frightened, but I was still leery since before that dog attacked me, he was always nice and playful so it was surprising what had happened. Going to the temple during the days was good for me because when sick I hate to be alone. Fevered dreams are terrifying and lonely, and I wish them on no one. Most of the time I was awake I was hallucinating and disoriented. I had no idea where I was, Leang told me I spent hours of every day crying and saying I want Lucky-my squirrel-apparently saying squirrel in random languages that no one could understand. Leang wrote some of the words down to ask me later what they were, and he eventually realized I was saying ‘squirrel’; I find this to be pretty funny. Some of the time I felt normal, then there were hours of each day I cant even remember where I was or what I was doing. Sometimes I would be sitting talking to someone and then the next minute I was hallucinating, and don’t really recall much. I remember portions of the fevered dreams, but I still to this day can’t make sense of the hallucinations and I don’t remember most of the days that went by.

But so that you can try to fathom just what it was like to have a sustained fever of 104.6 for so long, I will attempt to explain what it feels like mostly being confused and not have any coherency of what is happening to you…
If you were to take 20 books and line them across the floor in front of you, then open them up randomly and highlight a random sentence from that page, and then continue to do that to all of the books, you would then have 20 sentences from 20 different pages of 20 different books. If you were to start at one end of the book line and read that highlighted sentence and then proceed to read all of the highlighted excerpts from each book, back-to-back, and repeat this every minute of every day and every night, and continue to do this for 7 days straight…that is what my hallucinations and fevered dreams felt like. I had absolutely no idea what was going on. The more I tried, the more frightened I became. I don’t remember most of those days….Leang and Lout has since updated me on the events of what happened and things I said or conversations I had with people. They were really freaked out by all this, and were very attentive with my care.
Apparently I even was teaching English to 2 little girls that heard I was sick and wanted check on their teacher. They came with Lout and Leang one afternoon and Leang said I told him I felt bad for lying around lazy like this so I wanted to teach them since they came all the way to America to see me and learn English. I insisted on giving them a lesson. I don’t recall any of this.

Regarding what it felt like to be in such a state, I was scared all the time…about everything, anything…the lights being on, the lights being off….a butterfly going past, a bird making noise….then silence. Once I was convinced I was dead since I was in a room with a blanket over the window to help me sleep. It was so quiet and dark and I was extremely weak so I couldn’t move, and because of this I thought I died. Since I wasn't hungry or thirsty at that moment, I panicked and began yelling that I was dead, Leang, Lout and Ma rushed into the bedroom, and I freaked out thinking I was seeing things since I was dead. They thought it was funny...but frightening at the same time. I was out of it.

Over the next few days, I still didn’t want to eat, I tried to drink, but I was so hot that I felt it was boiling inside me the moment liquid entered my mouth. I cried a lot. I was soaking wet all the time, and I could barely bathe on my own. In these rural villages there aren't western showers...you use a pan to scoop water out of the basin and then pour it over yourself. But while ill like this, I would go into the bathroom with the intent of showering with the bucket of water in the bathroom, but would often be so weak I would end up falling on the floor from over-heating, but then once on the floor, it would be so much more cool I would just lay there for awhile until I had the energy to get up and go back to bed again. Sometimes I would become cold from being wet, and begin to shiver. Bathing became a chore to be endured and try to just get it over with.

We went for the follow-up shots at the hospital in Korat on day 6 of the fever/day3 of the dog attack. It was a faster process getting the vaccine and bandage change this time, but my fever was the same so they gave me more fluids. The next day I began feeling slightly better, and those terrible 7 days were so long and tiring, but it was nice to have Leang and Lout with me helping explain things. Apparently the government reported back that the dog did in fact have a confirmed case of Rabies and it is important that I get the full treatment as to not be a risk to society.

That evening Ma, Leang and I went to the temple to see the Abbot to inform him of how I was doing regarding the dog attack and the fever. He made a ceremony as well to wish me good health, protection and safety.

These are photos of a big cloth with Buddhist drawings on it and mantras in the Pali language.







These are amulets that the Abbot makes at this temple. He takes soil from the temple grounds, herbs, flowers, stones, bones, and other things, grinds them up, mixes it with clay and holy water and then fills them into the molds to make these bird figures and Buddha figures. These things are then given to the people of the community, visitors and given out at ceremonies. He gave me a few of them also to bless me.

The next 5 days held substantially more understanding. I am not sure if I became more accustomed to having such a high fever or if maybe it was a different part of the virus and my body reacted differently or what, but my fever was just as high, but I was able to focus and understand more things at this point. I was able to go to the temple more, walk around a little and get some fresh air. That comprises the first 12 days of the fever where my temperature hovered around such a dangerously high level. On day 13, it dropped to 102.5 and my body was still fighting hard to get back to normal, so everyone was thrilled for this achievement. I stayed at that temperature for another 3 days and then it dropped to 99.9 for another week.

I was still going daily to the local hospital for temperature monitoring and bandage changes, and to Korat for injections. They tested me and it became clear that my fever was not just a regular fever. They determined it was H5N1 avian flu. It took time but eventually I pulled though. This is the basic story of what happened to me so that way later while I am explaining more events you will be able to grasp some sort of comprehension of just how terrible of condition was that I was in, and how close I was to death.

I have learned so much more about life, Buddhism, peace, loving kindness, and what it means to be a part of a community by being in this small village where no one speaks English besides Leang. You have to walk the walk to know what each step entails, and I am thankful for every step that has brought me to these people and to this village.

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