And the World Spins Madly On

15 12 2011

Tonight I am trying to internalize how truly grateful I am for the life I’ve made for myself, for the experiences I’ve had, and for the people I surround myself with. I was thrown a big, unexpected curve ball last night, and after hours of sadness and defeat I found myself searching for something positive to focus on. I needed to stop feeling like I was trapped, and remind myself that I am not my circumstances; I am a strong, capable, independent woman who is capable of creating happiness for myself.

My thoughts are filled with India, and the moments I had that made me feel more alive than ever before. I stood barefoot, in a temple many centuries old, face-to-face with a beautiful, enchanting elephant, who focused her brown eyes on my blue ones, and laid her trunk across my head and shoulders in a blessing. I felt the bristles of her trunk, and it’s heft and strength and power, and happiness poured out of me. I felt whole. I waded ankle-deep in a monsoon-swirled Arabian Sea, with an umbrella over my head and the clouds wringing out over me. I was completely alone in nature, in life, in my travels, and far away from everything I knew. The horizontal rain and agitated waves washed against me, salt and sand scrubbing me raw. I felt small and insignificant, but in a powerful way that cleansed me: I might not influence the universe much, but I had influenced my life considerably, because I had taken myself out of my comfort zone, thousands of miles out, and I was still okay. I witnessed my first nineteen births in India, and became intoxicated by the powerful emotions that come with birth. Most evenings after a birth, I would sit on the rooftop of my home in Madurai, looking up at the starlit sky and the moon, taking in the universe for the newest member of our planet, feeling overwhelming hope for this new life.

I have been physically and emotionally home from India for months, but now I am reminded to bring the ethereal of my experience home as well. To surround myself with people whose arms, when around me, carry the same power of profound love and support as an elephant’s trunk. To allow the feeling of being insignificant to be a positive force, because it means I have made myself vulnerable, and allowing space for vulnerability means that I am strong. To accept that I have complex emotions and can be bruised, but to let new beginnings be full of hope and light, just as in birth.

Births keep on happening. The rain comes and washes away old perspectives. We meet souls that shake us to our core and change the fibers of our beings. When we’re in life– really and truly there– nothing else matters. The world spins madly on.


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No Right to Complain About Birth in Other Places

1 11 2011

As the world reaches a population of 7 billion, there is a good amount of media speculation that India is the place where the 7 billionth of us came into the world. This has spawned a number of stories on birth in India, including a photo essay and accompanying piece in the New York Times that is worth a read, despite Lynsey Addario’s small swat at midwives. At first I was excited to see the coverage. For the number of births that occur in India, there is shockingly little information available about it on the internet. It was exciting to see images that were so similar to the experiences I had in India this summer. And then I made a colossal mistake: I read the comments.

I don’t know when I will finally learn to stop reading the comments on news stories. I don’t think I have ever walked away feeling satisfied by the snarky responses of anonymous trolls. I want to clarify that the comments on the NYT piece are not terrible, but less compelling articles have far more infuriating vitriol. Though there is one comment from a midwife on the NYT article accusing Ms. Addario of fear-mongering by not capturing all the joy and love in birth which angered me. If only she had seen how joyless and unloving birth in India was. Is documenting a “cold, harsh detached feeling” in birth a disservice to women everywhere if it’s documenting reality? I’d say Ms. Addario is actually doing us a service by showing what birth in another culture is like– empowerment through education! As much as I’d like it, not all births follow the midwifery model of care. It doesn’t make those experiences any less real.

My anger may be heightened by my recent midwifery school application process. I have spent the last month in a stupor, thinking and re-thinking and challenging and questioning my views on birth. One of my courses of thought is about how we as a culture do not talk about birth. We talk openly about pregnancy and babies, but we often step around conversations regarding the actual labor process. Many women would consider it impolite if a stranger asked about their births the way they ask for details about their babies.

As a child, I never really heard birth stories besides my own and that of my older brother. We were both born via cesarean, so that is how I imagined a “regular” birth. I was by no means sheltered. I had a library of books about where babies came from and puberty, my mom and I had regular “talks,” and both of my parents were always happy to discuss absolutely anything with me. I had sex ed in school, starting at the elementary level, and in sixth grade I watched The Miracle of Life along with the rest of my class. (I was the only one who didn’t scream or look away during the birth scene.) Despite it all, birth wasn’t really a topic though. That was fine. Birth seemed very far away. It’s completely natural for children not to have a real interest in birth when there more relevant reproductive health issues to attend to.

Birth is not out there as a topic early in life, and it is rarely a topic of casual conversation until childbearing is imminent. Throughout our lives, we talk about the specifics of death and we discuss illness and medical treatment in detail, but we don’t talk about the particulars of birth. If a celebrity dies, we often hear grisly details about their deaths, and autopsy reports make headlines. If a celebrity gives birth, we learn the baby’s name. We don’t see many images of birth besides the overtly dramatic representations in the movies, or the tales of medical emergency and triumph through invasive medicine seen on daytime “educational” TV. Even most medical residents  have never seen a natural, unmedicated vaginal birth. There isn’t much public discussion about the birth problems the U.S. has, with our staggering cesarean rate and our failure to reduce infant mortality. (I highly recommend playing with this tool on google and comparing the U.S. to other developed countries.)

Therefore, it left me furious to read all these disparaging remarks about birth in India. Certainly many of the anonymous posters have not seen births in their own communities, let alone in developing countries. We are not the ones to judge the birth practices of individuals on the other side of the world. Yes, I saw a lot in India that made me angry. But I have seen a lot in Brattleboro that has made me angry too. There are injustices everywhere. Yes, birth in India is different. That’s only to be expected. It’s a developing country with a huge poor population. Most women in India have safe births and healthy babies, just like in the U.S. They have a place to go, and trained medical attendants, just like in the U.S. Frankly, I’m surprised the medical care I witnessed in India was as advanced as it was. As phenomenal as immediate skin-to-skin contact would be, these babies will survive being separated from their mothers for a few minutes, just like billions of babies before them. That nurse holding the baby by one leg is doing the best she can, and what she was trained to do. She probably works longer shifts every single day than most nurses in the U.S. are ever allowed to do in their hospitals. They do their best with what they have, while some practitioners in the U.S. take shortcuts that increase risk to both mothers and babies, and demean their patients in the meantime. It’s sad, but it happens every day in hospitals in our own communities. Who are we to judge a different culture for doing their best when we have so much work to do at home?


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The Doula Book: What a Doula Can Do for You

1 09 2011

Yesterday I raided my local library’s shelf of birth books (not for the first time). It’s times like these that I’m grateful my friends and family recognize that birth is my career interest, and therefore do not panic when they see me schlepping around a cache of baby books. Because September is promising to be my busiest doula month in the birth center yet, the book on the top of my pile was The Doula Book, by Marshall Klaus, MD, John Kennell, MD and Phyllis Klaus, CSW, MFT. I’ve flipped through this book a few times before, but had never really sat down to read every word.

I plowed through The Doula Book in two sittings. While it’s full of noteworthy information, it’s also a strangely angled book. I’m still pondering who the authors expected their audience to be with this book. The subtitle is How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth, somewhat of a contradiction to the main title, which seems to indicate the intended audience are doulas. Only a small fraction of the content seems geared towards expectant parents wondering whether they should employ a doula, some of it is tips for doulas, and the rest is scholarly information on exactly how doulas aid women giving birth.

The most interesting chapter for me personally was Obstetric Benefits of Doula Support. As a doula, I’m constantly having to explain what I do, why the position exists, and why my job is important, especially if a mother has a supportive birth partner. Klaus and Kennell, in addition to authors of The Doula Book, are also Principal Investigators of several studies of birth outcomes in women who have continuous labor support (doulas) versus those who have “traditional” obstetric care, with providers leaving the laboring woman alone for segments of her labor. They combine their data to present their findings here. The results are truly spectacular.

Perhaps the must stunning data comes from investigations of lengths of labor. During my doula training, we learned about what is often referred to as “The Guatemala Study” (Sosa, Kennell, Klaus, et all, 1980). In Guatemala, just as I experienced in India this summer, friends and family are excluded from the labor and delivery room, and women are left without continuous emotional support. In the Guatemala Study, one group was provided with a doula, while the other group was left without continuous labor support. In the no-doula group, the average labor was 19 hours (women came to the hospital early in labor, before the cervix had dilated past 1-2 centimeters). In the women who were given a doula, the average labor was 9 hours. The only difference in care was the presence of a doula throughout the woman’s labor. Had I not experienced similar results first hand this summer, I might have balked at this data. The results though, are so significant that they are glaringly obvious in person. During my own internship in a country where women are left to labor alone, it was obvious that labor sped up as soon as I established a supportive relationship with a mother. It wasn’t unusual for women who had been stalled at five centimeters all day to be pushing within half an hour of my holding their hand and promising to be there for their delivery. After the incredibly rapid delivery of one infant, the nursing staff adjusted their practice to be sure they kept a closer eye on a laboring woman when I or another supportive intern was helping out. While I’m not sure of the particular investigation, a childbirth educator I know told me about another study, I believe also in Central America, in which the investigators were able to show that there was a signficant difference in the length and ease of labor when a woman was simply sitting in the same room as the laboring woman, not even speaking to or interacting with the mother. The most important thing we can do for laboring women is to make sure they know that someone is there for them.

These results have been duplicated in the United States. In 1991, Kennell, Klaus, McGrath, et al, published what is referred to as “The Houston Study.” The study took place in a large, public hospital in which medical residents cared for mothers with a uniform care philosophy, with guidelines as to bed confinement, fetal monitoring, artificial rupturing of membranes, Pitocin use, etc. First-time mothers were either provided with a doula or not. In the study of 416 women, the 204 women who were not provided with a doula had labors averaging 9.4 hours. The 212 women who were given continuous labor support by a doula had an average labor of 7.4 hours. This is a statistically highly significant difference. (The shorter overall length of labor compared to the Guatemala Study can be attributed to differences in care, such as the use of Pitocin to speed labor, and when women were admitted to the hospital: four centimeters compared to one or two.)

Beyond the length of labor, there were other remarkable differences in how women fared with or without a doula. Of the 204 women who delivered without the support of a doula, 25, or 12%, delivered naturally (in this study “naturally” means a vaginal delivery without the use of anesthesia, artificial oxytocin or other medications, or forceps). Of the 212 woman who received continuous labor support, an astounding 116, or 55%, delivered their babies naturally, a statistically highly significant difference. The use rate of artificial oxytocin (Pitocin) in mothers with no doula was 44%, compared to a rate of only 17% for women who had a doula, a statistically highly significant number. The cesarean rate in mothers without a doula was 18%, while women who had a doula needed cesareans only 8% of the time, a statistically significant difference. It is amazing that the only difference in care between these two groups is the presence of a supportive stranger. Frankly I’m surprised that this study (and the dozens like it) haven’t completely changed the face of obstetrics over the last twenty years. The true medical (and financial) outcomes far outweigh the difficulty of setting up doula programs.

The benefits of having a doula even went beyond the mother and to the baby. In infants whose mothers had a doula, only 10% were kept in the hospital for longer than two days. In infants whose mothers did not have a doula, 24% stayed for more than two days, a statistically significant difference. When the investigators examined why the differences may have been present, they found one main reason for the disparity between the infant groups: maternal fever. Maternal fever developed in 10% of women with no doula, but only 1% of women who had a doula again a statistically significant difference. Interestingly, a British study (Fusi, Moresh, Steer, et al, 1989) showed that when a woman receives epidural anesthesia her body temperature surely but steadily rises, and if her labor is long enough (and births with epidurals are often longer) her temperature will eventually become a bona-fide fever. And how do we lower the epidural rate? Use a doula!

There are also many long-term results of a doula-supported birth. Multiple studies have indicated better results in breastfeeding, less postpartum pain, less postpartum depression, fewer infant health issues, better mother-infant bonding, higher self-esteem in the mother, and higher rates of mothers reporting their babies as less fussy, more clever, more beautiful and easier to manage than an average baby.

Everybody wins with a doula. The mother has a shorter, easier birth and comes away with more confidence and fewer complications. The baby is less likely to have complications, and has the added bonus of a more relaxed, attentive mom. The father or birth partner is relieved of some anxiety, and able to provide more loving, personalized support to his partner and child (more to come on that). Studies have even shown that the relationship between the parents often improves when a doula was present at their child’s birth, but remains the same when they labored alone (Wolman). Nurses are relieved of emotional support duties, and are able to better focus on the medical aspects of birth that they were trained for. Doctors and midwives are more likely to be dealing with simple, natural births that are faster and require less monitoring. Financially, even with the cost of doula services, reducing the cesarean and epidural rates in hospitals would save billions of dollars a year, and save individual families about a thousand dollars per birth. Best of all, there are community doula programs, like the one I work through, that offer doula services for free! How could you say no to that?


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Categories : Birth, India, midwifery, Reproductive Health

Homeward Bound

18 08 2011

Home, sweet home! Last Friday I had one last day in Madurai, then a long, sleepless trip home and I’ve needed a few days to recover before sharing.

Friday morning I was in a flurry of packing when the phone in my room rang, scaring the beejezus out of me. I answered and the man at the reception desk asked if I had called for a rickshaw. I hadn’t. It was very confusing. And then he said “Pondy is here for you?” and suddenly I knew that Amma had sent him to get me. I threw some things in a bag, abandoned my packing and rushed downstairs to Pondy, who grinned ear to ear when he saw me. He drove me home to Amma and Achie who both gave me huge hugs and were so excited to see me. After catching up a little bit and promising to spend the afternoon at the house, I left with Pondy to go to a tea shop he knows of in downtown Madurai. On the way back to the hotel, he pulled over to buy me another coffee. What a sweetie.

With only half an hour until check-out left, my leftover packing was disastrous. I tend to be a very meticulous packer, and with the amount of stuff that I had, the nature of my backpack and the fragility of some of what I owned, it was a complicated job that would probably have taken me two hours under ordinary circumstances. Instead, I had to go with the “jam it all into the bag as fast as you can” method of packing, which caused anxiety throughout the day as I failed to remember where little things I needed had gone.

Back at Amma’s house, I re-settled in and met all of the new volunteers, who are great. They are all relatively new (since they’d all arrived after I’d left two weeks before) and had lots of questions about living in Madurai and my travel experiences. The new volunteers had yet to visit the local ice cream shop, and asked if I knew where it was, so we all went out for ice cream. It was a nice afternoon. While the others took naps (still a big jetlagged) I finished my book so I wouldn’t have to carry it all the way home and spent some time with Gifty. At six o’clock, Pondy showed up to take me to the airport. It suddenly started to sink in that I was leaving. A big lump developed in my throat.

Amma has hosted over two hundred volunteers over the last several years. She’s had over two hundred goodbyes. The first time she cried saying goodbye to a volunteer was when Fahad left at the end of June. And then she cried when I left. Knowing that I was a high score made it incredibly difficult to say goodbye, though I was still fighting my reflexive “I’ll be back” feelings, since I’d already had one set of goodbyes. Pondy piled all of my things in the back of his rickshaw, and I climbed in. We waved goodbye until we turned the corner at the end of the street. It was a long, sad ride to the airport. It’s amazing how well you can get to know roads in just a matter of months, and I swallowed back tears as I thought about how I would probably never be on those streets I knew so well again. Just before we turned onto the airport access road, Pondy pulled over to buy me one last coffee.

We pulled into the airport at sunset. Pondy refused to let me carry my own backpack, and went on an excursion to find me a luggage cart. He loaded my things up for me, and wheeled the cart all the way up to the main door, where only ticketed passengers can continue. He pulled out a notebook and asked me to write my name in it. And then I went through the doors, taking one last breath of Madurai air (which is really not good air, but felt it at the time). I turned to look back out the doors one last time before I turned a corner and saw Pondy still waiting. We waved goodbye one last time.

The flights home were pretty uneventful. Madurai to Chennai, Chennai to Brussels, Brussels to New York, New York to Boston. I tried to sleep, but managed to only get about two cumulative hours. On the flight from Chennai to Brussels, I had a mission to check under seat 36E to see if there was a note for me. Siri and I had the same flight from Chennai to Brussels, and as an experiment, she tucked away a note in a place where we thought it might be safe. What she hadn’t anticipated though, would be how difficult it was to get back there! Row 36 is almost at the back of the plane, and about twenty rows behind my assigned seat. Swimming upstream in a plane is difficult, though I did finally manage to get there. No note. Oh well. In Brussels, I had to change my rupees back to dollars. Ideally, I would have done this in Madurai, but I got my deposit from my SIM card back too late in the day, and there were no currency exchange places open in either of the Indian airports. But because I was in the European Union, in order to make the exchange I first had to change my rupees to euros, and then the euros to dollars, paying commission on both exchanges and losing a lot of money in the exchange from euros to dollars. But I suppose that’s better than having a few thousand rupees in the US.

In New York, I learned that there were weight restrictions on my flight to Boston, and they were offering a travel voucher to anyone who could take a later flight. I figured that after thirty hours of traveling, another two hours of sitting in the airport couldn’t hurt, so after counseling with my dad/chauffeur I went up to volunteer to take the next flight, two hours later. The voucher increased from $300 to $500 while they looked for more volunteers. It was thrilling. I had already mentally spent my voucher. And then a big party of five never showed up, and they ended up putting me on my original flight, no voucher in hand. I should have been happy about it, but instead it left me grumpy. I wanted my free trip!

In Boston, I found my dad, and he drove me back to Brattleboro. It’s nice to be home. I actually haven’t been jet lagged at all, so I’ve settled well. I weighed myself the morning after I got home. I felt like I had maybe lost three pounds, but it appears I lost more than that, at about eight pounds. I think re-assimilation to my Western diet will fix it. It’s been really nice to things like vegetables and cheese that I missed in India.

Now I’m settling back into life in Vermont. It’s been good to reconnect with my friends, and coming home has made me feel hugely popular. My pictures are up on Facebook, my laundry is done, my bags are unpacked. Now all there is to do is plan for my next adventure!


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Reflections on India

12 08 2011

It is my last day in India. I’m both incredibly sad and relieved to be going home, especially after being sick. (I’m better today. My current temperature is 97.6, which is my normal and invoked a happy beep from my thermometer!) Saying goodbye to this amazing country and this even more amazing experience is very bittersweet. It also brings about a barrage of self-reflection on the last few months.

People keep saying how proud they are of me, and not just the obvious ones like my parents, but people I don’t usually even talk to, like my brother’s childhood best friend. I’ve been struggling to comprehend why anyone should be proud of me. Sure, I’m doing an internship, but people do internships all the time, and in large party my trip to India has been a vacation. So why would anyone be proud of me for this? I’m starting, at least a little bit, to get it. Because I feel a little bit proud of myself. For me, it’s less about the journey to India, but more about how I’ve changed; not specifically in India, but in the 26 years leading up to the trip that allowed me the courage to do it.

When I was a little girl, I acted more like a tumor on my mom’s leg than as a child, at least in social settings. I sobbed whenever my parents went out and left my  brother and me with a babysitter. I didn’t speak to my kindergarten teacher until I had seen my best friend Cathryn interact with her for weeks, to no ill effect. I wasn’t capable, or didn’t think I was, of ordering my own food in restaurants until I was nine (?) year old, when my parents refused to do it for me anymore. I still remember the first time they refused; it was in a tavern in Colonial Williamsburg. I cried and I don’t think I managed to order anything, and it was just awful.

But amid my fear of social situations, I was also blatantly myself. While my friends in dance class wore their girly ballet pink, my favorite outfits were a black leotard with silver fish scales, and a turquoise leopard print unitard. I idolized Laura Ingalls Wilder, and spent hours in the small Vermont woods pretending they were the Big Woods of Wisconsin. I was obsessed with The Sound of Music and my favorite make-believe game was “hiding from the Nazis,” which involved sitting silently behind a couch with all of my stuffed animals and keeping them from panicking. Last year I admitted what this game was to my mom, who had no idea Nazis were involved, but she wasn’t about to interrupt silent play to find out what I was doing. My stuffed animals, aside from being survivors of a mock World War II, were all given names, ages, birthdays and other personal information that was carefully stored in an extensive Excel spreadsheet. I loved playing dress-up, and invented an alter-ego named Bemily who was a total grump but had an awesome outfit that included a red wig, purple glasses and silver high heels. I was a little strange.

Despite my somewhat eccentric childhood ways, I struggled to put myself out there, always the shy one. The winter I was fourteen, the shy and the stubbornly anomalous sides of myself clashed. I decided, with serious conviction, that the following summer I wanted to go backpacking in Yellowstone, the Tetons and the Sawtooths of Idaho. I had never backpacked before. My parents used to have to lure me up mountains with M&Ms. And yet, it was what I had to do. Getting on the plane, my first solo flight, was terrifying, but it was okay. I didn’t miss my connection in Denver, or get lost or feel terribly alone. I had an amazing month, and the confidence I gained began to open doors for me. The next summer, I took it a step further and backpacked in Spain. The summer after that, I did 300 miles on the Appalachian Trail. I kept becoming more independent. I went to Kenyon, a ten-hour drive from home, a feat that would have been unrecognizable to my eight-year-old self, who cried daily with homesickness during one week at a summer camp only thirty minutes from home. I grew up, and became self-sufficient and my own adult self.

And then I came to India. While I was a little nervous, it didn’t feel like a big deal.I’d heard stories of women traveling alone in India having some problems, but I’ve been cautiously optimistic and haven’t encountered any issues that left me feeling more than slightly uncomfortable. Not only was I okay traveling alone in a developing country, but I felt comfortable during my solo time. I felt so comfortable in fact, that sometimes I wondered if I was going about worrying in the wrong way, like there was some big unknown danger lurking that I had never considered. I think one of my biggest strides over the last several years has been realizing that asking for help is a sign of strength rather than weakness. It can be difficult to admit that one is struggling, but it’s even more difficult left fighting alone. A few days ago I asked a man with an assault rifle for directions (he was a guard, not an ordinary citizen… I wouldn’t be that bold). Asking for help? I wouldn’t have done that ten years ago. Talking to a stranger? Fifteen years ago that would have been absolutely terrifying. Facing a deadly weapon? Okay, I can’t say I’ve experienced that before, but it wasn’t an obstacle. I’ve changed, a lot, and I’m proud of my growth and my ability to remain true to myself in the midst of it.

I’m also proud of how I’ve taken advantage of my opportunities. I’m proud that I had the tenacity to realize that I wasn’t living up to my ambitions, and to completely change my plan, carving the life I want for myself from the endless maze of choices. I sought out opportunities to become more involved with midwifery and to travel, and combined them into one amazing trip to India, surrounded by birth and the wondrous sights, culture and people. Professionally, it was incredibly satisfying to confirm that I do really love being around birth, even if it is particularly loathsome here. I can’t adequately describe how much these past few months have meant to me, and I’m the one who made it happen.

I’m proud at not only how I’ve changed and built opportunities for myself, but how I’ve done it with kindness and dignity. I could have witnessed more births, but instead of being number hungry, I opted to find more satisfying birth experiences, and to fully commit myself to one mother at a time, sticking to my promises of being there for her delivery. This wasn’t required of me, it’s just what felt right. It was also important to me to give back to this marvelous country that continues to struggle with issues in poverty, healthcare and human rights. A little goes a long way in India. I couldn’t bear to walk away from the leprosy hospital without buying some of their handmade goods. The patients didn’t choose their fate, and their disabilities are the result of the failure of India’s public healthcare system more than anything. After meeting the boy whose family had abandoned him, I also couldn’t leave India without supporting him and others like him. I’m saddened and frustrated by the results of overpopulation and parental irresponsibility, but like the leprosy patients, these children didn’t choose to live their lives this way. If I have the capacity to help, why wouldn’t I?

This has been a wondrous journey. I don’t know if I can wrap it up better than just saying that. I will be forever grateful for the experiences that I’ve had, the incredible friends that I’ve made, and the sights I’ve seen, both beautiful and grotesque. Thank you to everyone who contributed in some way to my being here, and for helping me become the kind of person that could do it. I’m filled to the brim with gratitude and gratification.


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Then My Body Said: “Go Home!”

11 08 2011

I have an absolutely miserable last twenty-four hours. Apparently, my immune system has decided its had enough of being in India, and I’ve been left sick as a dog (a very sick dog). This is definitely the lowest point of my entire ten weeks in India. I felt mildly unwell all day yesterday, just feeling a little rundown, which was understandable given the amount of traveling that I’ve been doing. I had a minor headache which I chalked up to dehydration, and some mild tummy trouble which is all but normal here. When I got back to my hotel in Ernakulam yesterday and laid on the bed, it became quickly apparent that I was actually genuinely sick. All of a sudden I was completely exhausted and my whole body started throbbing. I took my temperature. I didn’t feel particularly feverish, but I have a serious infatuation with my digital thermometer. I love the way it turns red and makes an angry beep when I have a fever, and the way it turns green and makes a happy beep if I’m healthy. The beep was red and angry, and I had a fever of over 101 degrees.

As soon as I knew I had a fever, all the symptoms kicked in. I felt utterly retched, and with only two hours until my check out time, and an overnight train to Madurai six hours after that, I panicked a little bit. I swallowed some ibuprofen and tried to sleep, but couldn’t. I read the medical section in my guidebook, but instead of mentioning normal viruses, it only mentions the likes of malaria, Dengue, etc. And so, of course, I became convinced that I had malaria. (I’m also having a weird loss of pigmentation on my back, which I became convinced was vitiligo, the thing Michael Jackson had that turned him white, thanks to a phone call to my brother who googled my symptoms for me. Since then I’ve done my own googling and think it’s only an ordinary infection. A doctor’s appointment has already been made.)

The only other thing I could do was call my mom, in the hopes that she had some special mom-cure that could be administered over the phone. Sadly, she did not, but she did convince me that I did not have malaria, and that even if I did I shouldn’t panic because I’m about to be back in the US where there is excellent medical treatment available, and I already have a doctor’s appointment scheduled for next week anyway. She also suggested that my body probably knows it’s about time to go home, and called it quits on India a little bit early. I buy it.

I decided my best strategy was to ask the hotel if I could stay in my room until I needed to leave for the train. The best they could give me, even with an offer to pay, was one extra hour. I took it, laying in bed practically comatose, watching but not absorbing anything from some program on the Discovery Channel about bears. And then I was out on the street, sweating from both fever and climate, and hauling my luggage around. My plan was to kill a few hours at an internet cafe, but the one I knew of that was close turned out to be closed. I decided my next best bet would be to sit in Cafe Coffee Day. I thought it was close by. I walked for half an hour before I found it– closed. I double-backed looking for somewhere else to sit. Finally, after an hour of walking, I saw a Pizza Hut. I hate Pizza Hut and would never, ever go in the US. But in India, it’s a rather posh place with funky decor and guaranteed AC and a soundtrack featuring the likes of MIA and David Guetta. It would do. I must have looked like quite a sight when I stumbled in. I think I was the sweatiest I’ve been in India, thanks to the fever and the exertion of walking in hot temperatures. They seated me in a corner away from everyone else. I stretched my time there for as long as I could, and then headed for the train station.

The train station, it turned out, was only about 500 meters away (yes, I use the metric system now). I was feeling somewhat better after sitting in the AC at Pizza Hut, so I figured I could walk it. It felt alright in the process, but as soon as I reached the station my body had one of those haha-yeah-you-think-you’re-alright-but-take-this-sucker reactions, and I spent the next few hours slumped over in a chair, worrying about how I was going to fare on the train that makes me feel awful even when I go into it feeling well, and feeling like I was sweating disgusting pizza out of all my pores.

The night on the train was the longest of my life, no exaggeration. If Kovalam was my heaven, this was my hell. The sounds of the train usually wake me up, but this time they woke me up with a pounding headache. Sleeping in a cramped, hard seat usually makes my joints ache, but this time it was paired with a fever ache, and I winced whenever I tried to move. I had to climb down the ladder in the dark to rush to the bathroom to vomit down the toilet hole onto the tracks. I took my temperature again and saw that my fever had gone up. The family who was in my little compartment had a baby that started to cry, and to make it stop crying, they clapped and banged on things and they kept turning the light on. They woke up at 5am (I got on the train at 11pm) and were so loud I quit trying to sleep. And then they all fell asleep, leaving me awake and without a place to sit, so I had to climb back up into my cramped little space, where the heat had risen. It was miserable. A true test of fortitude. I nearly cried with relief when we arrived in Madurai after twelve hours on the train. I could hardly walk off of it.

My original plan was to take a rickshaw straight to the Projects Abroad offices to pick up the baggage I’d left there, and then to go from there to my hotel (my host family is at maximum capacity right now with other volunteers; they offered me floor but I opted for a hotel instead). I couldn’t imagine having to carry even more luggage, and standing in the sun bargaining with rickshaw drivers. I could hardly even imagine walking to the exit of the train station. I bought a Coke and a 7-Up, since water wasn’t staying down, and sat on my backpack on the floor, sipping one and holding the other against my head for a while. Eventually I managed to peel myself off the floor, and found a rickshaw straight to my hotel. I had planned a few weeks ago for this last night in Madurai to be my big splurge night in terms of accommodation, and I’m so glad I did it this way. It was such a relief to crawl into a seriously comfortable bed with a big fluffy comforter after a sleepless, feverish night. I fell asleep immediately. I woke up a few hours later still feeling like ass, and terribly confused about where I was. I laid in bed for a while, and then forced myself to take a shower. It helped a little bit. I called Amma to tell her that I was in Madurai, but that I wasn’t feeling well. It turns out she’s in Chennai. Oh well. She’ll be home tomorrow, which is actually fantastic because if she was around tonight she’d be trying to convince me to go out. Feeling somewhat stable and less feverish, I rickshawed to the other side of the city to collect my bags at the offices. I survived. And now I have my macbook, so I can take full advantage of my hotel’s wireless internet, and google the symptoms of malaria. Because, you never know.

 


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Nose Oil and Evacuated Tombs

10 08 2011

Monday morning in Kovalam, I woke up with a cold and the distinct feeling that I had had too much sun the day before. Instead of heading to the beach, I opted to head to an ayurvedic treatment center first for some R&R. I opted for three treatments lasting one and half hours. First, an hour-long massage. This one was far better than my first ayurvedic massage in Kumily in June, mostly because I had not one, but two practitioners! It felt kind of like going through a car wash, in the best way possible: four hands doing a variety of strokes, rolling up and down my body. While my massage preference is definitely for deep tissue, painful body work, this was very nice and relaxing. Next, because I had mentioned my chronic low-back pain, I had elakkizhi treatment, in which “fomentation is done by the application of medicinal leaves processed in medicated oils.” Basically, they take little sacks of herbal leaves, dip them in hot oil, and alternate thwacking them against your body, or scrubbing your skin with them. It was actually really nice, and I liked it better than the massage. There were two downsides though. First, in the great tradition of all things medicinal, the oil absolutely stank. This was no aromatherapy massage. I don’t understand why grape Dimetapp is the only medicinal product out there that has a decent smell/taste (so good that when I was little I used to pretend just to have a cold… strangely it’s the only thing with an artificial grape flavor that I’ve ever enjoyed). Second, they told me to keep my underwear on, which was very different than my first massage in which the woman demanded that I not wear anything, and then watched me undress. It was nice to feel like I maintained some modesty, but my underwear was drenched with the disgusting smelling oil, and stained an awful brown color. It went straight to the trash, along with the clothes I had to put on afterward, which had hems with dark brown stains and heave-inducing smells. Sadly, Siri, this included your star shirt. I tried to keep it in a plastic bag, but the smell was permeating through the plastic and it had to go. At least it will get to live in Kerala… My third treatment was a quickie, to treat my cold. In nasyam, they first do something magical with steam and a really soft cloth. It felt like all the comforts of a bubble bath were butterfly kissing my face. And then I had to snort medicinal oil to clear my nasal passages. It was fine until the oil began sliding down my throat and into my mouth. It tasted absolutely awful, and vaguely of idly, my food nemesis (fermented rice flour cakes… need I say more?). It also made me want to sneeze uncontrollably. The lead practitioner insisted that I leave the oil in my nose and on my body for at least twenty minutes, but the moment I hightailed it out of there, I blew my nose and spat relentlessly, and took and immediate shower. And then I had to buy a Coke to wash the nastiness in my throat away. It was very un-ayurvedic. The practitioner would have been horrified. Regardless, the oil up the nose did seem to improve my quality of life. And my total bill for all three treatments? 800 rupees, or about $18. Not too shabby.

Feeling better, I spent the rest of the day on the beach again, this time staking out my own space and paying for a lounge chair. It became obvious how wonderful my bargaining skills have become when the girls next to me paid 300 rupees each; I paid only 40. While it took a while to get used to, I’m going to miss the bargaining bit. It’s really helped me get in touch with my inner curmudgeonly old man, muttering “that’s too much, I get it for less all the time!” and other such grumpitudes. And then getting my way.

It was said to say goodbye to Kovalam yesterday, since it was there that I really found my solo-traveler stride. I’ve discovered the serious virtues of getting to call all the shots. It’s been nice to set my own schedule, and to not feel ashamed when I really just want to eat in the same two restaurants over and over again. And apparently when you travel alone as a woman in India, the offers roll in. I was offered hashish five times in 24 hours, and was sincerely asked to have a date with an Indian man (who incidentally is only the third Indian man I’ve ever found attractive, not counting a certain Bollywood star who has two thumbs on one hand, though that part is not attractive). All offers were declined. Traveling by myself has also allowed me to explore and expand my new favorite hobby of lying to Indian men who ask too many questions. Over the course of the last few weeks I have been engaged, Canadian, traveling with my dad, on my way to Delhi, hurrying to meet my friends, and a professional writer, among other things. It’s great fun, and makes being stuck in conversation with pesky people far more enjoyable.

I had one of these conversations on the bus from Trivandrum to Ernakulam yesterday. For much of the five and a half hour ride, the bus was nearly empty, and I and my backpack both had our own seats. And then came the creeps. The first kept poking me. At first I couldn’t tell if it was purposeful or not, as it seemingly coincided with the lurches of the bus. I slid over as much as I could. The poking continued. I remembered a passage from my Lonely Planet guide about how as a single female traveling in India, if you feel like someone might be invading your space, they probably are. I gave him a sharp elbow to the ribs. It continued. It was a creepy kind of poking too. He didn’t want my attention or anything, it was just like he neglected to remember that I actually have nerves and am capable of feeling other people touch me, and he wanted to try to get away with touching me as much as he could. Eventually I caught him with his finger out, so I pointed and snapped “STOP TOUCHING ME” in a very harsh way, audibly enough that passengers around us could hear. He pretended not to hear, but looked somewhat embarrassed and the poking did stop. Asshole. After he left the bus, another man squeezed in next to me, despite my blatant spread over the two seats, and numerous available seating options. This one gave me my personal space, but pestered me with questions. I made up stories. I ignored him. I pretended not to understand what he was saying. I put on sunglasses and tried to read. He wouldn’t stop. It was a terrible hour. Eventually he got off, and not much later I arrived in Ernakulam.

Ernakulam and Kochi are basically one in the same. Ernakulam is the mainland and the commercial center, and Kochi is it’s historical and culture island counterpart. While Kochi is known for its better accommodations, my hotel is in Ernakulam because that’s where I’m arriving and departing from. This morning I took the ferry to Kochi and have been wandering around. It’s a really cool place, with lots of fun little independent cafes and bookstores. The two big draws are teh Chinese fishing nets, these massive contraptions that require multiple people to operate, and St. Francis Church. St. Francis Church is the oldest European built church in all of India, constructed in 1503 by the Portuguese, following Portuguese explorer Vasco de Gama’s arrival in India. Vasco de Gama died in Kochi, and was entombed in St. Francis Church for fourteen years, before his remains were exhumed and returned to Portugal. The church, aside from being impressively old, is not that interesting to look at, though I did see Vasco de Gama’s original tomb.

Chinese fishing nets:

St. Francis Church:

Vasco de Gama’s former tomb:

And now, not particularly interested in any of the other historical sites, I’m spending my afternoon wandering around Kochi before I need to check out from my hotel in Ernakulam this evening. Tonight I take the night train back to Madurai. It’s really difficult to comprehend that my time in India ends the day after tomorrow!


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I Think I’m in Heaven

7 08 2011

Kovalam, Kerala. Back to India’s sweet south, and oh I am so happy to be here. Yesterday I fled Candolim earlier than necessary, heading to the airport in Vasco de Gama in order to fly to Trivandrum, only 15 minutes or so away from Kovalam. I must say, flying in India is a delightful experience. It’s disheartening to see how well airports and airlines can run, in a developing country no less, when American airports and airlines suck so badly. The check-in process is smooth as can be, and security procedures are equal to, if not more intense, than in the US (everyone gets a pat-down). My flight from Bangalore to Trivandrum was ten minutes behind schedule, and they updated the monitors to say that it was delayed, and made announcements about exactly why, paired with profuse apologies. In the US, they likely would have just rolled on their merry way, content to pretend that everything was running normally. Both of my flights lifted off the runway at the time they were scheduled to depart instead of leaving the gate at the departure time and then inevitably cruising around on the tarmac for a while. And free meals! Who knew they still existed? My flight from Vasco de Gama to Bangalore was only an hour-long and left around 3pm, but they still served lunch, and we even had a choice of what we wanted. I had already had two lunches (a small one in Candolim, and then another when I was still hungry at the airport) but not one to decline “free” food, I happily accepted my meal.

Reaching Trivandrum, I found a taxi to Kovalam and headed on my way. Kovalam is primarily settled around two beaches, and my hotel is on Lighthouse Beach, which is only accessible by foot. The taxi dropped me close the lighthouse, and I walked down the boardwalk until I found my hotel, the aptly named Beach Hotel, which is just about heaven. I’ve been trying to think if I’ve ever stayed in a hotel room I’ve liked more than this one, and I don’t think I have. The room is like me personified. The decor is really lovely, simple and natural but also a bit arty and funky, with lots of warmth from its yellow and red hues. The floors are terra cotta tile, and the walls have texturized paint. The wood furniture is dark, but lightened by the beautiful batik bedding and live palm fronds in earthen jugs. There is an enormous closet, and a nook with a desk, and a big airy bathroom with modern appliances and shelves and towel racks and an ayurvedic soap wrapped in palm husk in lieu of the standard green, overly perfumed soap all hotels seem to have. Outside of my door is a private porch with teak furniture, and then… the Indian Ocean. Right there, in all it’s glory. It makes for magnificent sleep sounds. Right above the Beach Hotel, which is a small boutique hotel of only eight rooms, is the German Bakery and Waves Restaurant, owned by the same people, and equally as funky and amazing. This morning I had coffee delivered to me on my private porch, and then went upstairs for a really incredible breakfast (whole grains!), overlooking the waves. Also on the property is a bookstore that only sells books, but rents and allows for trades too. This is pretty much my heaven.

This morning, after my coffee and breakfast, I walked up and down the beach to scope out the town’s offerings (mostly beachy clothing shops and massage places… not too bad) I scoped out a spot on the small stretch of sand to make my own. Wearing a bikini is tricky business in India. In many places, you really just can’t do it. Indian people will yell at you, and give you horribly dirty looks. In more touristy areas, like Kovalam, it’s okay, but you still risk getting stared at and/or photographed, and if you’re alone Indian men will come up to you and try to make small talk, probably just so they can get a closer look. It’s all harmless, but it’s really annoying. Up the beach I spotted a couple of white girls in bikinis, and settled in beside them, hoping that if I looked like I was with other people I’d be left alone. It turns out they didn’t know each other either, and had settled near each other with the same idea. It totally worked, and as the morning wore on we gained a huge crowd of scantily clad white girls. After not seeing or talking to other travelers for the few days in Candolim, it was really nice to find some little-while friends. A day of sunshine and camaraderie was exactly what I needed.

The beach itself is small, but it packs a punch. During the off-season (now) the water stays pretty high, and the beach is narrow, stretching between rocky promontories, one housing the red and white lighthouse. The sand is black and fine: gorgeous, except it gets absolutely everywhere and is impossible to get off. The water is clear and green, with enormous waves. The water curls into big green, misting tubes in a way that I’ve only ever seen in surfer movies. They’re quite thunderous and unpredictable. More than once rogue waves crashed all the way up the beach, reaching the boardwalk. I was always lucky and able to scramble out of the way with my things dry, but others were not so lucky. Clothes,water bottles, sunscreen and shoes were scattered everywhere or carried out to sea. Tomorrow I’m leaving all of my electronic devices in my room.

And so now I’m a degree more blonde and a few degrees tanner, not lonely at all, and pondering how I should spend the rest of my afternoon. My only options are walking on the beach, laying on the beach, yoga classes, massage, eating good food, shopping for nice things at incredible prices, reading on my private porch, or napping in my amazing room. It’s a really, really tough life here in Kovalam.


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