No other traveler gets interrupted during their vacation – and taken out of anonymity – as often as the physician. Although most of the concerns are common and generic to the practice of the internist, the family physician, or the general practitioner, these Good Samaritans respond to any call – some hesitantly, even the general surgeons and dermatologists, with their specialties and expertise uncertain for the task of maladies – 30,000 feet up where simple maladies take on an added air of urgency, or in far-flung corners of the world without the benefits of diagnostic tools, western prescriptions and therapies.
Seventy plus countries and counting, many of them thrice-traveled, I have accumulated a share of travel medicine stories. Although there is that rare travel that is blessed and free of the ill-stricken, most travels bring an occasion or two of human suffering or malady that calls me out of inconspicuous travel and anonymity to reveal myself the Good Samaritan. A fellow traveler limping through Moscow with acute gout. An elderly lady returning to the Philippines, with a look of apprehension, her hands over her chest, waiting for the nitroglycerin tablets to take effect. A stewardess' desperate call after having spilled scalding hot coffee on a man's groin area. A diabetic middle-aged woman passed out from a hypoglycemic attack.
But for the occasion of medical travel story-telling, one place always comes to the forefront: Morocco.
It might have been foreboding, the trip barely started, when i reassured a panic-stricken young man waiting for a flight on an adjoining boarding area, that his bloodied eye after a violent sneeze was a benign condition not warranting a rush to the local hospital that would cause him to miss his flight.
The trip to Morocco was uneventful. In the airport, the travel group of 20 congregated, exchanging cursory introductions and pleasantries. I dined that night, looking forward to an 9-day travel in Morocco, sampling sight, history, culture and cuisine in its main cities - Rabat, Casablanca, Meknes, Fes, and Marrakech.
The first day brought us to the essential travel spots, savoring from outdoor barrels of olives, sampling local delicacies, quenching thirst with local drinks chilled with floating ice.
On the second night, I noticed a fellow traveler, a lady from New York, dining alone, without her artist husband whom I met the night before. "He has taken ill," she said. "With fever, abdominal pains and diarrhea." So, that night, I took myself out of medical anonymity and made a "house call," and provided treatment that must have worked immediate wonders. The following day, the husband rejoined the tour bus, brimming an appreciative smile.
That following day, ambling through the narrow stone-walled streets of the Marrakech market, I saw a donkey, trotting down the muddied cobbled-stone pathway, its wares strapped on its back and precariously balanced on both sides, consuming much of what was left of the walking space, its guide obviously claiming right-of-way and oblivious to the concern of the pedestrians, hurriedly parting a quick path for his ass who was taking more space on one side. I saw the New York lady, with horror on her face, plastering and flattening her back against the wall, her frail arms desperately pushing against the donkey and load as it passed, pressing and crushing on her chest.
An auscultatory exam reassured that the lungs were not crushed; her breathlessness, more from panic and apprehension than pain. The rest of her trip was uneventful, except for the slow healing of a bruised and contused chest wall and discomfort made tolerable by follow-up check-ups, recurrent reassurances and regular doses of Tylenol.
But, alas, by the fifth day, one of the nemesss of foreign travel was increasingly taking toll—more than half of the travel group was already taken ill, with a gastrointestinal malady, mainly diarrheal. By the sixth day, more added to the count, some even projectile vomiting in public places, frantically searching and hurrying-scurrying to public restrooms.
An almost busload-full of tourists, pondering when and how much longer the next heaves and runs, is not a happy sight—it's a quiet, gloomy and dispirited lot. By this time, I was well dug into my medicinal supplies; at the same time, incredulous that this group of travelers was so unprepared and unequipped to deal with the common maladies of Third World travel. I was dispensing from rapidly dwindling supplies of antibiotics, analgesics and antidiarrheals. I wondered if I should leave some in reserve, just in case the Escherichian malady also befalls me. But my martyrdom wasn't tested; Providence must have intervened, and the few days left in Morocco were enjoyed with intestinal - albeit, guarded - calm.
Until. . . the last day, assembled in the lobby, our Moroccan guide was running quite late, and was hurriedly giving last-minute instructions on the etcetera of airport procedures and paperwork. Then, barely finished, the last word still hanging from his lip, he turned around, intent on a fast clip and stride to hurriedly lead his flock of travelers . . .
. . . he walked right into this massive Samsonesque marble hotel pillar. Stupefied, he slowly collapsed to the floor, a wide bleeding gash over his left eye.
It was a gaping enough wound, warranting an emergency room visit - which he refused. A few days earlier, he was making derogatory remarks on the state of local medical care, with concerns about hepatitis and bad blood, and all the reasons why he would avoid going to a local clinic. And this bleeding gash over his eye was not going to change his mind.
"No, No! I'm not going to any hospital," he said. "Please do something;"
He was assisted to a seatee in a corner nook in the lobby. Curtained by a half-circle of concerned fellow travelers, I once again dug into really dwindled medical supplies, searching for alcohol swipes, gauzes, and steri-strips and proceeded to stop the bleeding and do a sutureless wound closure.
Later, in the bus, en route to the airport, i indulged in a moment of self-satisfaction, patting an imaginary hand on my shoulder, watching the moroccan guide, saying his goodbyes in his bloodied caftan and a left eye half closed from pressure bandages and steri-strips.
Inevitably, they came to mind. The Good Samaritan. Hippocrates. The gods, Apollo, Aesculapius, Hygeia and Panacea. And I thought of the trip and this hapless group of travelers. . . and . . . guide. . . Hey! Did I do good or what? I know they were all generic no-sweat problems, nothing life-and-death, no grade-A drama, no one going into cardiac arrest.
Not that I was wishing it on anyone. . . but I thought: Go ahead! Throw in a cardiac arrest. I'm up for it.
A little later, barely settled on the return flight via New York, there came the amplified call.
Anonymity was no longer possible. I was sitting next to the New York couple. And the rest of the Escherichian-afflicted were probably scattered all over the plane. I just hoped the call was not for something gastrointestinal.
The Good Samaritan was led to an 80-plus elderly male, feverish and achy, but with no other symptom accompaniments or findings to suggest anything other than an acute viral syndrome. So, it was reassurances, fluids and acetaminophen.
Barely settled back in my seat, the stewardess came to me and said a woman needed my help and was waiting in the galley. And off to the galley the dutiful Samaritan went, and there, with curtains drawn, was this drop-dead gorgeous French woman, on her way to Canada, in a red floral-printed dress (a detail I strangely remember), holding a vial of antibiotic on one hand and a syringe on the other, pleading in stuttered English that she is hours late on an injection dose, for what i surmised was for a sexually-transmitted disease. My hesitation was three-fold. Here was a stranger (drop-dead gorgeous in a red floral printed dress), with an injectable medicine, and an unknown history for allergies.
And before my hesitation could deepen into doubts, the lady lifted her skirt and pulled her panties down to exposed a full left derriere with visible marks from recent injections, giving verity to her claims and justifiable urgency to her request.
Of course, I gave her the shot. And the gods, they must have had a laugh. And, no, the cardiac arrest did not happen my way, although I did not stop imagining its occurrence until after I have extracted my bags from the airport carousel in Baltimore.
Oh, there was still time, between ministering to
the maladies and miseries, to see a lot of Morocco, a day in Fez, its
medina, its scents and sounds, the souks shops spilling with all imaginable
ware of leather, pottery, carpet, spices and olives, even time to do
colored-pencil drawings of the street theater of Moroccan men and women
in their colorful jalabas and kaftans. In itself, it was one of the
most memorable places traveled, but the travel-medicine part of it makes
it doubly so.