Very Public Healthcare

India, 2010

I had been living in India for the better part of a month before my handlers would allow me to have spice in my meals. I’m not talking capsaicin spice, I’m talking any flavoring: salt, pepper, coriander, cumin, cinnamon, saffron, etc. Anything that makes food–and especially Indian food–tasty was off limits.

Those first few weeks were filled with rice, chapati, and unseasoned vegetables boiled together. The two foods that had any flavor were the chaas (spiced buttermilk) and tea-time chai. The drinks may have slipped under my handlers’ radar. 

I know the cook was placed on strict spice lockdown for me, but I don’t know who prepared the chaas, and I don’t think the spice lockdown filtered to the tea-preparing maid. Even if it did, she was spunky and may have been telling my handlers that she was serving me warm milk.

My handlers told me from the outset that I couldn’t handle spice because I was American. The last American they had hosted ate spicy food on the first day and landed himself in the hospital for several weeks. (I could not verify this story. It sounded like something you told children–my cousin’s aunt’s nephew ate a Carolina Reaper and burned a hole straight through his stomach; he needed a stomach transplant to fix him up.) I tried politely countering my handlers’ beliefs by telling them all the spicy Mexican and Chinese food I like. They were unpersuaded but decided to humor me.

They said after I had adjusted (to what, I don’t know), they would allow the cook to start putting a little spice in my food until I could build up to “full spice” tolerance. They seemed doubtful I would make it to “full spice.” Challenge accepted.   

I ate boiled veg and rice thrice a day for three weeks. It sustained me but was decidedly not delicious, even though my cholesterol and blood pressure were pleased. It would have been easier to enjoy the veg and rice had everyone around me not been feasting on the flavors and colors of my imagination–a rainbow of spiced masalas swirling with cilantro and tamarind chutneys, chili studded kanda poha, and plates of sun-colored spiced Alphonso mangoes–were passed in front of me. 

I felt a bit like a shunned literary character who was served watered down gruel when all those around her feasted; the only difference between me and a literary character is that I wasn’t required to eat in the kitchen. I provided my handlers a great deal of entertainment in my clumsiness in eating with my hand. They told me I ate like a toddler. In fairness, that’s probably when I stopped eating exclusively with my hands, so there was a skill gap. I owned that, and endeavoured to get better. 

On my fourth week of boiled rice and veg, the cook was told to slowly introduce spice. 

I worked my way through salt and pepper, followed by coriander and cumin. A little turmeric meandered into my boiled veg one day, followed by garlic and onion. (Is this the beginning of a masala, perchance???) I was proud that my handlers were keeping note of my food intake and acknowledged that I was eating more as the food became more fragrant.

It was a Saturday when they decreed that I was ready to eat from the communal dishes with full spice. Huzzah! 

It, unfortunately, was a cursed Saturday.   

Saturday nights the group had meat–either fish or chicken. The rest of the week was ovo-lacto vegetarian. Up to this point, I had eaten neither meat nor eggs since arriving in India. Meat on Saturday nights made the meal special, and everyone seemed to look forward to whatever the chef was preparing. 

This Saturday’s meal was going to be curried fish. One of my handlers told me he had biked almost two hours to the fishmonger on the pier. A four-hour bike ride for fish was impressive. I don’t know what raw food in the United States could get me to bike ride four hours to procure. Maybe I’d bike four hours to a restaurant, but with a raw ingredient, I’d come home hot and tired and still have to spend time preparing it.

To compound the four-hour bike ride, heat warnings had been issued. Heat advisory warnings in India are like wind chill advisories for the Innuits; when they’re issued, you had better pay attention. You might die. 

I didn’t ask why this fish was four-hour-ride worthy. The handlers shunned grocery stores and only purchased directly from farmers. I don’t know if this fishmonger was the closest or the best within a half-day’s ride. 

I didn’t get to see the fresh fish from the monger. They were covered in masala when I first spotted them. I asked what type they were, but the word I was told meant nothing to me, so I do not recall what they were. They were small, the size of a bluegill or sunfish, and very pungent. 

I generally like fish. However, these fish were very fishy, like off salmon. The kerala masala did not mask their fishiness. I assumed this is just how these fish were supposed to be as neither the handlers nor the rest of the guests had trouble cleaning their plates and taking seconds. I finished my plate as I had to prove to my handlers that I could handle full spice even if the fish wasn’t to my taste. 

The eaters commented on another good meal, and we headed towards our rooms. 

I tried to turn in for the night, but my stomach refused. It began brewing foul liquids that I tried to ignore. In the wee hours, my body declared the kerala masala incompatible with human life. 

Hot burning from the inside coupled with pre-dawn burning from the 108 degree outside was something new. My body was acclimating to living on the sun. 

No worries. I had been pleased that I had the foresight of going to the doctor before I had left to procure prescription traveler’s diarrhea meds. I told myself that this would pass, and I should hold off on taking the scripts until I really needed them. I would need to feel that I was living on at least two suns before I would consider taking them; I had a long summer and a lot of masalas ahead of me and didn’t want to run out prematurely. 

I ejected hot brown liquid for two days. I passed my audition for the role of Sister in the Aristocrats. I was able to get food and liquids down, but they wouldn’t stay inside for very long. Dehydration became a concern, so I took a script.  

And nothing happened. 

My body was no better or worse on account of American pharmaceuticals. They were either the wrong drugs, not strong enough drugs, or didn’t stay inside me long enough to take effect.

In any event, I was on my third day of unwellness before I mentioned it to my handlers–I have a talent for hiding discomfort. They immediately blamed the spice I had eaten on Saturday, despite the fact I was eating full spice for the three days since the Saturday night fish. Eating hot masalas may have been dumb while my sphincter was already raw, I refused to give up the progress I had made on full spice. My spirits needed full spice.

Arrangements were made and we went to the doctor. 

I was worried on the drive that I only had $50 on me. I asked my handler whether we should stop at a bank first. He clucked his tongue at me, which was lost in translation, but we didn’t stop at an ATM so I got the jist. 

We arrived at the clinic. There was a long line of unwell looking people sitting along two walls in folding chairs. 

The woman who received us said something in Urdu. My host then prodded me to state my name and the reason I was at the clinic. I said it in a whisper so only the three of us could hear. “You have to say it louder. This is public health.” my handler commanded me.

Announcing my name and that I had diarrhea to a small crowd was a new experience. And luckily, I did not die of embarrassment. I apparently had done a good enough job at informing the public of my condition because we were ushered to sit at the next two available folding chairs. 

I scanned the clinic. 

In the middle of the poorly lit room sat a well dressed man at a folding table talking to a woman opposite him. A corner of the room was curtained off with a sheet on a shower rod affixed to the wall. 

I gawked at the processession; it was public health afterall. It was my Indian right to know what was going on. A patient would get up, walk to the table, and discuss their ailments. Nosy people paid attention. Those of us who didn’t speak Urdu added funny bad lip reading to the scenes that were unfolding. 

On occasion, a patient would get up and walk to the curtain in the corner. Going behind the curtain was always to undress. At first, I thought it could have also been to receive bad news out of ear shot, but I was wrong. No one came out crying as I would imagine one would do if their doctor told them that they had cancer behind the curtain. The curtain didn’t touch the floor, so I watched these patients take off their shoes and slip garments over their feet. 

When a physical exam wasn’t needed, the doctor would write a note on a small pad, hand it over, and gesture towards something outside and to the right. 

Each time a patient was seen, we’d shuffle to the next set of chairs, as if playing a slow round of musical chairs that someone screwed up because there were always more chairs than people. 

It was my turn after two hours.

The doctor took a look at me and immediately switched to English. It was impressive how he flipped mid-sentence. He told me he was pleased to have me in his clinic. I got the feeling that I, being white, American, or both, was adding credibility to his practice. My handler told me as much. It made me uncomfortable, but there wasn’t much I could do about either of those adjectives, apart from going stateless, and that wasn’t going to happen while I had the stomach gurgles. 

Doctor: What are your symptoms? 

Me: Diarrhea

Doctor: How long?

Me: About three days.

Doctor: Vomiting?

Me: No.

Doctor: Fever?

Me: I can’t tell. I’m always hot here. 

Doctor: You have dysentery, 

Doctor, scribbling on a prescription pad: Take these.

He motions outside and to the right. 

Doctor: The pharmacy is next door. Eat apples if you can find some. That is all. 

The receptionist motioned for me to get up, and my handler and I walked next door. He ordered me to stay outside while he went in to get my prescriptions and pay my doctor’s bill. 

In India, I am ordered to stay away from all business transactions. It started when my first handler couldn’t negotiate the right price for a rickshaw ride. It then occurred several times at an open air market–anything from grilled street corn to shoes and trinkets. They all had a premium attached. I don’t blame the vendors. They were seizing opportunity, and I was none-the-wiser paying few more cents. 

My handlers got annoyed at my Westerner surtax, though. When I was with them, I learned to stay outside of stores and a half block behind at markets. 

On our way home, my handler spotted a stall that may have sold apples (which weren’t particularly popular nor in season in this part of India). We didn’t stop because I think he believed that the cost of the rickshaw would go up if the driver had to wait. He may have also realized that I was still unwell and hadn’t used the bathroom in several hours. My insides sloshed, but my resolve (and sphincter) were set on waiting for a Western toilet back at home. 

I knew from a year in Japan that squat toilets took skill to use and strong thighs even on my best days, and I really didn’t want a mishap in my weakened state. I couldn't rely on having water or paper products to assist me with any unintended consequences, and I had only one napkin with me. 

We arrived home and I took the antibiotics (or at least I think they were). It didn’t matter what I had taken. They were miracle pills. My insides dried up within hours. 

It was, and continues to be, the best $3 I had ever spent. 

Epilogue: I was banned from eating spicy food for the rest of the summer. My tongue cried.