Saturday, July 16, 2005

Urinalysis, A Love Story

My friend Michele wanted me to write about more boring things, like what I eat and where I'm staying. I can't touch on those just now but hope this accommodates. This was written yesterday, so all the present tense action refers to yesterday.

For a few reasons I've been loitering around Dharamsala: For one I have a cold and was told that going higher, to my next two stops Manali and Leh, could be uncomfortable. For another I'd heard the Dalai Lama's next round of teachings might be much more comprehensible, and apparently they are--he is actually teaching, and slowly, rather than "merely" reading--but the idea of sitting in the open air temple isn't appealing. Also, there's a new Iyengar yoga center here I wanted to examine. And I am enjoying my daily 2-hour yoga class, nothing special but a fine class that's returning me to some old stronger place.

But mostly I have been waiting to see the Dalai Lama's doctor, who is right in the center of town and the doctor to anyone who wants to go; you pay just for the medicine (mine today was 80 Rupees, about $1.80). The main reason I wanted to go wasn't my cold but the fact that I have a perpetually stuffed nose; it is never ever unstuffed. I can breathe just a little through my nose but usually have to supplement it through my mouth. It's been that way since 1998, I think, after I lived with a series of serious smokers--or maybe I took too much Afrin, do I know? Anyway, a Western doctor in the states said it looked like an allergy (to air?) and recommended that he burn the insides of my nose to widen the pathways, and then I could breathe despite the allergy. When I asked if he might instead refer me to an allergist, he said, yeh, we could do that too. In the end I didn't do anything but buy this water pipe thing that supposedly cleans out your nasal passages, but which provided the same happy sensation as inhaling saltwater.

But breathing through your nose is important; the cilia weed out pollutants for which I believe we have nothing comparable in the mouth. And in yoga there are all these ideas about how nose-breathing is preferable to mouth-breathing, which makes you angry and fiery or...something. Particularly in hyperpolluted India, I don't like breathing through my mouth. So it matters to me.

I went to the doctor one afternoon and was told I would need to show at 5 am to get an appointment for the same day. I was having a hard time waking up for that.

But today I had luck. Woke too late but went anyway and the gates were locked; there was a sign saying the clinic was closed for the morning teachings. I had breakfast at the vegetarian restaurant next door, which Matt had told me is run by the doctor's wife. I asked her when the doctor might open; she said, he is open, ignore the closed gates. I went back, and behold the gates were open, I got the number 38 and since most of 1--37 was at the teachings it appeared I might see him within an hour.

The Dalai Lama's doctor, Dr. Donden, shuffled in and out of the examination room taking people's numbers. Dr. Donden is a shortish, wideish, old and somewhat sour-faced man who, with his shuffling inertia (poor circulation?), looks as if he is staying alive for the sake of the Dalai Lama. If the poor DL expires, I imagine the doctor will expire minutes afterwards. I don't recall quite what he was wearing, it looked somewhat monkish and with the male Tibetan skirt few laymen wear daily. Dr. Donden looked at me and my number, said, "Harumph harumph harumph" and held up his fingers in the shape of a canister. I said I didn't understand. "Pee-pee", he said frustratedly, and harumphed as he shuffled away, flapping his hand at me. I'm such a fool I didn't know the word for "urine" in Tibetan.

When people don't know your language and act annoyed, you never know if they're mad at you or themselves. This more than anything is hardening my soft skin; I too have been repeatedly pissed at some or another language barrier and taken it out on my innocent fellow citizens.

But I did realize at "pee-pee" that he had been asking if I had a urine sample. I asked at the front desk if this was necessary--there being no previous mention of it--and the receptionist, a serious-looking man who skillfully adds up and doles out Tibetan medicine balls all day (but whose shirt happened to have a stick figure of a wacked-out pirate and the words "Born to Be Wild....New York") said it depended on what was wrong with me. I asked what one would bring it in: A water bottle. (No sanitized container, nothing fancy, just a urine sample damnit!) I asked if there was a bathroom; he said, "But it has to be the first urine of the day". It was already ten o'clock in the morning, but by some completely strange luck I hadn't attended the bathroom yet and said as much. He looked at me as if that were very, very, very odd, and no doubt indicative of any number of other peculiar and possibly unspeakable habits in which I must routinely engage--but he handed me a keychain and motioned me around the wall to the bathroom.

Around the wall was a dark hallway lined with four locked doors. My keyring contained three keys. Fucking Alice in Wonderland. I'd already done my bit of courageous acts for the day: I'd interrupted the doctor's wife at her busy restaurant to ask about her husband's work, and I'd said the word "urine sample" aloud more than once. There's evidence that my brain has a quota for the number of nervy things it will do in day. I don't know what the quota is; only my brain knows. So at that point demanding that the busy pharmacist point me out the correct door didn't even occur to me, and I decided it couldn't be that complicated.

Let me note that this is one of those moments when the stereotype of the west as having no time for you is annulled by an Indian's hasty vagueness; oh, some may give excellent directions, but others will say "Just go there" while motioning at an entire city.

All the locks here are the same style and a bit awkward--hard to get the key into and turn it--and they must be opened and also closed with a key. Doors are all fitted with corresponding deadbolts. I tried the first door, fumbling around for a while in the shadowy light. Meanwhile old Dr. Donden shuffled into the hallway: Harumph harumph harumph. He pulled up beside me just as I got the lock undone, and he kicked open the door forcefully: Boiler room, no toilet. Okay. He didn't motion further, looking perhaps bored with me, but a nice monk gestured kindly in the direction of the other three doors--in one of these was the bathroom. Isn't this some sort of gameshow?

I'm not sure why I didn't ask; they make it seem so obvious...so easy. I tried the next door, unlocked the lock and shifted the deadbolt but couldn't manage to shove open the door, and then couldn't manage to find the key to relock the lock. There were only three choices of key to choose from, but two of them looked painfully similar and I must have been using the same two again and again. Maybe I really had to go to the bathroom. Leaving that door be for a moment, I tried the next door, managed to undo the lock, drop it and shift the deadbolt--but not far enough. COuldn't shift it further, couldn't open the door. I turned to the previous door and, although I hadn't been able to open it, I at least managed to re-lock it while a woman turned on the hall light, shining a happy glow over all my ridiculous maneuverings.

The woman came over and gestured that the door I couldn't open was the right one to the toilet. I said I couldn't open it. She shoved the deadbolt hard, successfully--all Tibetans are stronger than all Americans--and kicked the door hard. Behold the toilet. Somehow Dr. Donden reappeared and gestured to me, I should stand out of sight. But I did notice that he managed some fancy skirt work in order to use the facilities without closing the door. Meanwhile I emptied the water bottle I was carrying into a nearby water fountain in preparation. Then he motioned that I was allowed to proceed.

By the time I proceeded to fill my bottle I must have been either overconfident or overwhelmed; I knew I was having a hard time aiming but it was impossible to me to imagine that most of the 12-hour store wasn't going into the bottle. The rest just went, oh, everywhere. I was sorely disappointed when I held up my meagerly filled bottle, only a centimeter of precious pee in it. I was very embarrassed to show my tiny reward to the Dalai Lama's doctor, who might send me home yet again.

When I came back into the waiting room with my sample tucked modestly into my backpack, I saw a much older woman, perhaps 70, carefully tightening the marmalade jar containing her very substantial sample and placing it, rather tenderly I thought, closely by her feet as if protecting a good cup of hot coffee. The next woman who came in, also very old, had her jar nicely wrapped in a transparent brown plastic bag. What a prude I am.

Anyway, my number finally came and the doctor took my sample, made no mention, blissfully, about my humble amount but motioned me into his little room, which had a couple of images of the Medicine Buddha on the wall, and, thank God, four framed diplomas. It also had a very excellent translator. The doctor took my pulse (as I'd been told was all he would do), the translator told him my problems and then wrote out a complicated prescription that involved taking five different kinds of pills four times a day. The translator said they wanted me to come back in a week as, he said seriously, the nose thing is very chronic. He also insisted pointedly that I come in with a sample of the first urine of the day, as if he didn't believe I'd done so before. I was so, so happy to have them take my stuffed nose seriously that I was beside myself. It gave me a lot of energy. So most likely I will take some sidetrips but be back in time for reinspection.

Before leaving I wrote a nice sign in English about how important it is to bring to your appointment the first urine sample of the day, and the receptionist allowed me to post it on the bulletin board outside.
Comments:
This was a hoot! I laughed to tears. Too many great segments to list. Your "thank God" is particularly outstanding amidst all this Buddha-Dalai- meditation stuff.

But my obvious question, considering my, harumph, modest medical background, is why the urinalysis for a stuffed nose?" Must be some Tibetan medicine connection or you've got another problem you're not telling us about (and that's OK).

Love,
Da'
 
Da', I was so hoping you would crack up. This was definitely a I-hope-Dad-loves-this-one tale. I think the urinalysis is a Tibetan medical connection, as is the sole test of your pulse. Tibetans doctors study for 12 years I think, during which I think they learn to glean a LOT from your pulse. A friend told me she had stomach probs, a Tibetan doc took her pulse and told her she had amoebas, gave her meds and she was cured. (No doubt her description of her symptoms would also have been helpful to the diagnosis, but evidently there's a lot in the pulse itself.)

That's funny that you liked the Thank God; as you may have known I meant it especially to indicate that I have no idea what the diplomas would mean to me in that office or in the presence of the DL's doctor; when I go back I'll try figure out where they're all from.
Much love!
Ga'
 
"Fucking Alice in Wonderland" made me weep.

I learned to diagnose someone by holding their inner thigh for 20 seconds. It's limited in that I can only detect one very serious condition.
 
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