Fast forward to…now.  Andrew and I are on our grand Thailand adventure, somewhere in the Northern Mountains of Thailand when I look down and see an unusually bulbous stomach.  In the light and shadows of hotel room light I can see the weird outline of one of my organs nestled under my ribcage.  Poke, poke, poke.  I poke at the organ, and it kind of hurts.  I poke at my stomach, generally, and puzzle. “I know we are eating a lot of Thai food, but I just don’t feel like I should look this fat.”  I turn side profile to the mirror.  My stomach looks weird. Two lumps at the top stretch outward, then slide in an angle to “normal” tummy down below.  When I poke, it doesn’t jiggle like a happily chubby belly should. 

“Do you think you are pregnant!?” Andrew lobs this ill-conceived, pin-pulled-hand-grenade question with a tinge of panic and horror – certainly not with the tone of a happily expectant father. 

“No!”  I say, quite certain this isn’t how pregnancy goes.  I take to my trusty WebMD and conclude: “It must be a beer belly.”  I hand over the WebMD article on the firm and bulbous nature of beer bellies.  I mentally add this to my portfolio of nagging repertoire under the tab labeled “Items of Persuasive Support for Drinking Less Beer.”

Andrew snorts, “Nawoo, that can’t be it.”  But he takes the phone in hand and reads it. 

I wish it were just a beer belly.  I up the ante on my exercises, tighten down on my diet, and force Andrew to share halvsies with me for a while, to no avail.  Overthinker keeps poking her head around the corner saying: “I think it’s your Gallbladder.” 

“No, I don’t think so.  I’m not sick or anything. Gallbladders attack you, remember? I don’t feel like I’m being attacked.” 

Overthinker shrugs. 

My mid-back starts hurting.  I up my regimen of Thai Massages (more on that adventure in a later post), and grit my teeth as I lay on my stomach and the massage ladies smash the heels of their feet or the points of their elbows into the slot beneath my shoulder blades.  They roll me over and insist on doing an abdomen massage, through which I am generally miserable and wondering “is this how this is supposed to feel?”   Then, one day, my massage lady pokes my belly and backs away, not bothering to massage it.  Now, that really freaks me out.

“She can see that your pancreas is about to rupture…”  Overthinker whispers. “We have to do something about this. Right. Now.”

I suggest to Andrew that we may need to consult a medical professional. Given his long standing presumption that I am a hypochondriac, he helpfully suggests it is my decision to make.  The night after we deliver visiting friends safely back to the United States, I can’t seem to sleep in any comfortable position whatsoever. The next morning, I find Ms. Sensitivity standing front and center of my consciousness.

“What?” I ask. 

“It is time.”  She waves her hand in the manner of a Sorceress and says, “We shall go to the hospital today, and your gallbladder will be removed. Don’t eat anything for breakfast.”

“How do you know?” I ask.

She shrugs. “I just know.”

I guess Ms. Sensitivity received a message from “Life,” and apparently, it says today is a jolly day for the carving out of my organs. I pack a bag and wake Andrew at the first reasonable hour (7:00 a.m.) with “Good morning, no rush, but as soon as you are ready and awake we are going on a field trip to the hospital.”    We take a taxi.  We are stopped in traffic by a random act of Dragon Parading.   (It’s South East Asia, people.)

We arrive at Bangkok Hospital Phuket where we are ushered straight to the Gastro Specialist through an Intake Screening Nurse.  Within the hour, I’ve had blood work taken and an ultra sound that produces the conclusion (again) that I am filled with rocks. Within the next hour, I’m received by the surgeon who says in no uncertain terms “if I were you, I’d have it out.” This advice was doubly true when I explained to him that we live on a sailboat and harbor schemes to cross the Indian Ocean.  “You are a time bomb.  I could give you antibiotics instead if you prefer.”

“Then what?” I ask him.

“You pray.” He says, as though this is the most obvious answer. “In all likelihood, you’ll be back soon in more distress, have more infection, and possibly have to have a more invasive procedure if things are really going wrong.  When did you last eat?” 

I tell him I haven’t eaten anything today, and he says “well, then there is no reason not to get this done today.”   He instructs his staff to contact my insurance company and get everything ready.  

I consult my on-call medical consultant/childhood family physician extraordinaire and he agrees with the diagnosis and recommendation with one caveat: “If It were my daughter,” he says, “I’d tell her to come home and have it out.” I nod, understanding this advice, but also knowing this option is not ideal for me for many reasons.  Time.  Distance.  And, not the least of which is that my health insurance coverage is significantly more favorable out of the U.S. than inside the U.S. “Do you feel good about the level of care available there?” He asks.

I’d started this analysis hours ago.  I sent out an inquiry on the Sail South East Facebook Page asking my network of sailors if any had experience at this hospital.  It was a resounding thumbs-up with the only complaint being it can be kind of “expensive” – this from the French contingent who have fully free medical care in their home lives.  The rankings of the hospital are the highest in South East Asia, and as I look around everything is of the same quality as any hospital I’ve visited in the U.S. if not higher.  The place is relaxed, organized, clean, and everyone has been astute at handling their jobs.  What else could I want?  Would I know any better about a hospital in the U.S.?   Unlike a handful of other medical facilities we’ve visited in our travels, the waiting room is pleasantly free of free range chickens.

“It’s just going to get worse,” Andrew says.  “May as well get it over with and this is the best possible scenario: we have time, Sonrisa’s nearby, and you didn’t have to get plucked out of the ocean by a medical helicopter.” 

Exactly.  Let’s do this.

While we wait for the insurance company to pre-approve the procedure and at least a day afterward in the hospital, the insurance administrator joins Andrew and I around a small table and hands us a fully sketched out budget with an expected cost range between $10,000 and $14,000 depending on the number of nights I must stay after the surgery. This quote includes everything, including all pre-diagnositc tests we have taken, the surgery, the anesthesiologist, the room, the medicine, the nurses, and three nights stay. “Wow! You’d never pin anyone down on something like this in the U.S.”

“Okay, I just need you to sign here, to indicate you will pay anything over and above what the insurance doesn’t pay.” The admin tells me. I hesitate with years of American conditioning behind the idea that medicine is an impossible service to itemize with an “any-amount-can-happen” result, I am terrorized by the possibility that costs could run sky high beyond these he has quoted.

“Up to this $14,000 quote?” I ask. He says that is right unless something happens and either Andrew or I approve higher amounts to assist with unexpected, worsening medical conditions. What choice do I have? I take a deep breath and put pen to paper. By hour four, the insurance company has pre-approved the procedure and at least a day afterward in the hospital, up to $6,000 after I pay my $2,500 deductible Andrew and I were expecting in any case.

We meet with an anesthesiologist who goes through the key questions about lung function, prior surgical history, walks me through the expectations for this surgery, etc.  She is professional, calm, and everything I could want in a person ushering me into a voluntary coma.  It is only as they are seating me in a wheelchair and installing the IV into my hand that I have even a moment to panic: Surgery.  In Thailand.  Thousands of Miles Away From Home. 

A voice from Leslie-past visits and says “Once you are on the table you are nothing but a slab of meat.”

“Maybe I should call my mother.”  I think, but then realize (a) it is 1 a.m. where she is and (b) such a call would help no one.  “I’ll call her once I’m awake again.”  When the nurse asks if she can remove my toe nail polish I tell her “yes,” but wonder for a minute why this is necessary.  I involuntarily envision my toes poking out of a morgue freezer, freshly wiped of their sparkling purple nail polish.  I shudder.

“Yep, nothing but a slab of meat.” Ghost from Leslie-Past.

At this point, my face starts leaking despite my best efforts to locate a tissue.

“It’s like flying in an airplane.  Once the door to that cockpit is closed, you are completely out of control. Schmoop!” Ghost from Leslie-Past swings his hands together imitating the cockpit door closing. 

I smile.  That guy has a funny way of making you feel better.  Damn it, I need a tissue.

“Good luck!” Andrew says as he gives me a kiss and sends me whirring off for a quick chest X-Ray.  I wave and look at him behind me.  The face is still leaking, and I am straining to use the short-sleeved hospital outfit as a substitute tissue before anyone notices.  Damn.  Where is the waist belt, maybe it’s long enough to just reach…”don’t be a ridiculous baby,” I tell myself.   

They put me on a bed and wheel me down a long hallway with square lights placed every 5 feet or so.  I count my breaths trying to turn my attitude positive.  They push me feet first through double swinging doors into a room that is freezing – just like a meat locker.  It looks like every other surgical room I’ve visited: stainless steel, clean, those giant spotlights positioned above you with 25 or more smaller lightbulbs arranged in larger and larger circles. They take a flat board, slide it beneath me and pull my meatsuit onto the table.  There are so many people in the room, and they are all bustling around getting ready for business.  A mask lands over my face and a soothing voice says something I cannot recall.  Go time.  No more fooling around, I’m going out as happy as I can muster:

I breathe.  “Life is good.”

I feel cold liquid rushing into my hand through the IV. 

I breathe.  “I love my people.  All my people…”

I feel the warm relaxation of fading out.

I breathe.  “It’s all good…”

Nothing but a slab of meat on the table.