How I Got a Tropical Infection in the Arctic Circle
A Traveling Medical Mystery By Erik Trinidad
In the summer of 2019, I was on assignment in Fiji, where I managed to possibly contract a nasty, very mysterious flesh-eating tropical infection—which didn't impact me until a subsequent trip a week later, in the Arctic Circle of all places. The infection seized my right leg mid-journey of an Adventure Canada expedition cruise aboard the Ocean Endeavour, as it travelled from Greenland, across the Davis Strait, and through the Northwest Passage of the Canadian Arctic.
The harrowing military rescue that followed, plus the subsequent three hospitalizations that attempted to find a diagnosis (in Iqaluit, Quebec City, and New York), was written as an epic journey—and posted in real time on social media. This is a compilation of that tale in its entirety.
An abridged version of this epic medical drama was written as a story for Newsweek. However, it was overshadowed and lost in the editorial schedule due to COVID-19. It now appears here, in its original form, as it was on Instagram and Facebook.
Part 1: How I Got a Tropical Infection in the Arctic
Originally posted August 30, 2019
On my last day in Fiji, I'd noticed a weird spider bite or something by my right knee that was more annoying than painful. I'd sent a picture to One Medical, and they prescribed me an ointment beyond Neosporin. The pus went from yellow to clear with the prescription, and I brushed it off as a minor flesh wound.
Fast Forward about a week. Swelling developed around that knee, just after leaving Qikiqtarjuaq (where I'd eaten the seal ribs). After a couple days, I started limping, and a rash started developing. After some more days, the kayakers noticed the limping getting heavier. I thought it was something that would pass, but blistering started developing. Somewhere in between there, during the two days at sea, I ran a 36-hr fever—something I thought was just the virus going around the ship.
I checked into the #OceanEndeavor Infirmary to assess what had developed into a significant inflammation that had now spread down my leg. "That's cellulitis," Dr. Esperanza told me. She gave me some Cipro since I'd only attended to the flesh wound and not what had been developing in me. Cipro takes 48 hours to take effect, so a waiting game began.
Word got around the ship of my predicament, and there was concern from Veronica, the field paramedic on @adventure.canada's Expedition Team. She started doing measurements of the inflammation, marking my leg up with a pen, and eventually started working in conjunction with Dr. Esperanza. Within 36 hours, we noticed that the inflammation and blistering was spreading rather aggressively, and they feared it was going to go systemic since the blistering was already heading up to my groin, towards the core of all my functions.
Dr. Esperanza gave me an injection of antibiotics one morning (ultimately unresponsive) and went to the bridge. As I sat in the Infirmary bed, Expedition Leader MJ's voice came on the PA system: "Sorry everyone, but we have to cease all zodiac operations. Don't be alarmed. I'll explain in a briefing."
"What's going on?" I asked cruise director Brittany who'd come for a visit.
"Are you joking? That's for you. You're getting off this ship."
[BACK TO MENU]
Part 2: Abandon Ship
Originally posted August 30, 2019
"I dont have time to explain ice charts to you," @adventure.canada Expedition Leader MJ argued with my travel insurance company over satellite phone to justify the emergency evac. "We just alert the JRCC [Joint Rescue Coordination Centre] and follow their instructions."
The plans were ever-changing over the next few hours, but it involved zodiacs or a helicopter, and a Coast Guard patrol vessel to get to Resolute, where a military #Herc was on call to jet to the nearest hospital.
"Wow! You get to fly in a Herc!" said Jim, veteran firefighter on the Expedition Team.
"Do you know what a Herc is?" asked Jerry, onboard Explorer. "You know that movie with Tom Cruise and that guy, and the floor of the plane opens up and they try to shove each other?" (I knew the scene he was referring to from Mission Impossible Fallout.) "That's a Herc."
MJ announced that we were heading back northbound up Peel Sound to meet with the Coast Guard because someone needed to abandon ship for a medical emergency. For my friends, it was obvious who it was. They showered me with Get Wells in the form of greeting cards and a surprise menagerie of towel animals, an ongoing theme of the trip of which I never got to be a part of until now. @Jesiannoutdoors' towel narwhal was way better than the ghetto one I'd try to make previously, with a pen for the long tusk.
"Are you nervous for what's about to happen?" Brittany asked me.
I smirked. "Well, something like this has happened to me before," I told her. "This isn't my first rodeo." (Old school bloghogs know what I'm talking about.)
"What happens after Resolute?" I asked. "Do I meet up with you guys in Calgary?"
Brittany wasn't sure, but Jerry had an answer. "Oh no, I wouldn't think so," he told me. "This is a military operation now."
A Canadian Coast Guard zodiac pulled up to the gangway of the #OceanEndeavour and I boarded it with everyone on the ship waving farewell, like the African sailors in "Raiders of the Lost Ark." As the zodiac sped away to disappear into the fog, I knew my #Arctic expedition may not have ended as anticipated, but that the adventure wasn't over just yet.
[BACK TO MENU]
Part 3: La Garde Côtière
Originally posted August 30, 2019
The zodiac brought me two nautical miles to the NGCC Des Groseilliers, hailing from French Quebec. In fact, everyone spoke in French, but fortunately the onboard nurse Edith communicated in English.
"How are you doing?" she asked.
"I've been better," I replied.
Her assistant Luc only spoke French and was happy to hear my occasional "merci's.
Just as the NGCC Des Groseilliers was about to sail away from the Ocean Endeavor, the captain called down to the Infirmary. "A-t-il son passeport?"
"Oh SHOOT." I panicked so hard I couldn't even curse. "Reception keeps it on the boat."
Two Coast Guard officers were going to go fetch my precious travel document, but two guys from the Ocean Endeavor who wanted a piece of the action, had already zodiacked it in.
I'd thought I would have been flown by helicopter to the clinic in Resolute, but there was a thick fog, so we went by sea. Nurse Edith tool my vitals and put me on an IV.
"I will take your temperature," she told me. "It will be rectally. It gives the most accurate temperature."
During my four hours on the NGCC Des Groseilliers, she took it twice. 🤷🏽♂️
It was 3.5 hours of beeps as I was bedridden on IV drip, staring at the wall and trying to sneak in some video footage with my iPhone.
I'd wished I'd been able to continue filming with my GoPro when we arrived within heli range but it wasn't feasible since I was wrapped up in a cocoon and carried out by stretcher. If it'd been on, it'd be a POV, looking up at the hallway, then the outside, then not a hovering helicopter in the air, but one that had landed on the helipad. Edith accompanied me on the short 5-min flight to Resolute, where Rob and Jo of the Canadian Air Force picked me up in a van.
[BACK TO MENU]
Part 4: The Herc
Originally posted August 30, 2019
Rob and Jo of Canadian Forces, drove the van to the Resolute medical clinic, a camp shack from the outside, and a medical facility inside. They lifted me in the stretcher to nurse Catherine. The four of us discussed next steps—until she suggested she see the leg.
"Whoa! You really did a number on that!"
"That's usually the reaction I get."
She ran some vitals, discovered some fluid in my lungs, and made a report for the next caregiver, Qikiqtani Hospital in the Nunavut capital, Iqaliut. She pumped me with Gravol for motion sickness. They wondered if I should have a catheder in case I needed to pee.
"It's four hours to Iqaliut?" Catherine asked.
"About two and a half," Rob answered.
"Wow, that's fast!"
"I can go now and I think I'll be okay," I said. Anything to keep a tube up my peehole.
Rob and Jo wrapped me like a mummy in prep for the Hercules. The straps around me were too tight to sneak a camera out. If I'd had my GoPro on, it would have been a POV looking up at the clinic ceiling, then the nighttime sky, then the van ceiling. When the door opened, I saw we had already backed up the ramp of the Herc. I saw the inside; it was everything you see in movies, the floor that hinges open, cargo nets draping from the sides of the hull, some boxes. They carried me up to basically a shelf on the side of the plane's hull, where I was strapped in tight. I got a headset and a remote. They also put an oxygen mask on me to help with my decreased lung volume.
The Gravol was strong and I kept fighting to stay awake, but it was already 3am and was exhausted anyway. I felt the thrust of the plane and loss of contact with the ground. We were off. I slept the entire flight.
It was daybreak when we landed. The floor of the Herc opened up and I was wheeled into the back of an ambulance.️
"Hey you got that phone of yours?" Rob asked me. "Swipe it to the camera for me. I'll be one minute." A minute later he handed it back to me. "There's some mementos for you."
I was transported to the ER where they ran tests for hours before I was finally admitted as a patient. Little did I know, I wasn't done with medical transports.
[BACK TO MENU]
Part 5: An American in the Canadian Healthcare System
Originally posted September 1, 2019
I was bedridden for days on an IV drip, pumping every antibiotic they knew to throw at this mystery tropical infection that attacked me in the Arctic. I ran fevers, headaches, constipation, chills, aches and pains, as the infection remained resilient, evolving my leg's skin into nasty little translucent scrotums filled with liquid pus—gross and very sci-fi.
The fever passed as I IV dripped back to stability with my trusty pee pitcher at my side from the constant hydration. Then days became routine: three meals, vitals check every four hours, meet a new nurse, blood work over and over. There was no TV, but at least I had a view of a tundra hill. And of course, Netflix.
Dr. Patrick lead my treatment—funny enough, he was on the #OceanEndeavour last month—and was a good guy, with a Quebecois accent hailing from Montreal. In a case like this, after days of IV antibiotics keeping me stable, his protocol was to elevate it to a specialist—Infectious Disease in Ottawa—since I was just in a general hospital with limited resources.
"The infection is still rising in the blood and we have you on every antibiotic," he broke it to me. "Unfortunately it's a very bad infection."
Blood lab reports and a chest x-ray revealed the infection had in fact, gone systemic, affecting my kidney function and respiratory system so far. "That little cough you have? That's this. It's running through your body."
Dr. Patrick's normal protocol was to just put me on the medical jet, which could leave on a dime, but he realized that my American CSA travel insurance would probably only fund one hospital transfer, and it might as well be to one I'm covered on my regular insurance: Mt. Sinai Infectious Disease in New York. We called CSA for the approval and they put us on hold for a long time.
I thought of other scenarios to fly, forgetting that the IV drip was keeping me stable.
"You can't go on a regular plane with THAT thing," he said, pointing to my disgusting leg.
Eventually CSA came on the line and Dr. Patrick made his case, but they required him to send a 9-page document. "They are so slow," he told me. "But they said they will review and call back this evening."
"What are the chances you think I'll fly out of here tonight?" I asked. His face and that of the night nurse frowned. "Not likely."
"It's very frustrating," he said. "We fly people out of here all the time. We did two today."
I was in dire straits, literally on my deathbed if not for the IV drip, with soup dumplings of pus down my thigh—cockblocked by an American insurance company. If I'd been a Nunavut Canadian, I would have been in Ottawa already, halfway to recovery.
With still no call back from CSA, Dr. Patrick gave me a pep talk to snap me out of the morbidity. "I know I told you it's systemic, but it's not like you're an ICU patient. You're very stable. We just need to work on it."
The next best thing to transferring to Mt. Sinai or Ottawa was to just work with Ottawa remotely. A new doctor appeared and extracted out the soupy pus of the saggy blisters—each one had about 1 cc of fluid in it. They did swabs and another blood test and sent the lab reports to Ottawa Infectious Disease. They started doing research of toxins in Fiji, specifically between the main island and Beqa, since people suspected this was from a mere coral poke I barely felt when I was snorkeling. "Every photo is geotagged these days," I said, going through Photos. We also didn't rule out the Arctic. I was also in the hottub, which was just a heated tub of raw ocean water.
At a lull, I was chatting with night nurse Lisa about the situation. "I'm waiting to be transferred," I said. "But I'm not sure I'm ready to go back to the American healthcare system."
"Ha!" she chuckled. "Noooo comment."
As bag after bag of IV meds dripped into me, I went to bed for yet another night in Qikiqtani General—stable, at least.
The insurance company never called back.
[BACK TO MENU]
Part 6: Insurance Limbo, How LOW Can You GO?
Originally posted September 2, 2019
"I guess it's usually pregnant women sitting here," I joked to the ultrasound tech.
Based on latest lab reports, Ottawa tweaked my antibiotic cocktail, which showed signs of improvement. Inflammation down, and no new disgusting pus dumpling blisters. They ordered an ultrasound of all my organs to check their functionality, and were covering all bases. Getting to ultrasound to radiology and back was a breeze, being wheelchaired as I held the IV rack.
"Ottawa is happy with the numbers," Dr. Patrick told me one morning.
I was stable and on the mend, but not out of the water. As charge nurse Ann put it to the insurance company, "He's on a regiment of antibiotics that would be in his best interest not to interrupt."
That was from one of many calls with CSA travel insurance, who had dragged a life-and-death emergency over almost four days. Four days. Fortunately I was calling from a place with sufficient temporary care.
The whole back and forth argument was for next step: getting me to a bigger facility, but which? The logical choice was Ottawa; they already knew my case and had an Infectious Disease center. Second: Mt. Sinai in New York, where they already got word of a possible transfer, and is covered by my home insurance. I used that as leverage: CSA could just transport me there and then stop fronting the bill.
Ottawa was at capacity, so Dr. Patrick and I really campaigned for NYC during a speakerphone call. Regine at CSA kept on reiterating that the policy is to go to the closest facility, and mentioned Quebec and Labrador—the latter of which might only just be at the level of Iqaliut.
"Montreal?" we inquired about the Quebec option. She didn't clarify if she was talking about the city or the province.
Regine went down her pull-down menu. "Quebec... There's Toronto..."
"Toronto is in ONTARIO," I butt in. I continued the geography lesson. "Political boundaries are arbitrary," I said. "If you just geographically looked at what's closer and what's available, you'll see that Mt. Sinai is IN that range."
She said she'd bring it up with the doctor and get back to us within a few hours. I figured my fate was at the hands of some dude on a Labor Day Weekend golf retreat.
"Transfers are so easy here," Dr. Patrick said to me, after another exhausting conference call. "We don't have to deal with any of this."
"I'm gonna have to find a Canadian to marry," I joked.
"At least you're here," nurse Katelyn assured me.
"Yeah, I'm lucky."
More Netflix, more writing, a LOT of peeing. Having the hydration IV in addition to all the antibiotics really kept my bladder going, and my pee pitcher was my best friend. I gained some mobility to go to the washroom myself, but not if I was tethered into the wall with the IV regulator recharging.
CSA called back and insisted that New York was off the table. I assumed there was an additional cost to go internationally or maybe it was a Homeland Security thing. They pushed for Quebec City, but Dr. Patrick and everyone at the nurses station unanimously frowned at the option, knowing there are better ones. Plus, nurse Ann's brother had been there and knew there would be a language barrier.
"But they spoke English on the phone," CSA Regine reassured us.
"No one speaks English on the floor," Ann argued.
Dr. Patrick sent CSA his wishlist of places to send me, alternative hospitals in Ottawa and Montreal. They said they'd get back to us.
Another waiting game, another meal. More pee pitchers flushed. Finally CSA called to reveal that they went down the list and everyone was either at capacity or wasn't taking transfers until after the Labour Day Weekend. Only Quebec City remained.
I put CSA on hold and conferred with the doc. "Given the options," he started.
"The ONE option."
He laughed. "Given the ONE option, I would recommend it. It's a much larger facility. And I'll have a talk with the receiving doctor."
CSA Regine assured me they had English speakers on the floor and not to worry (like she would know). Still, we wondered why they wouldn't just cut costs and send me to NYC for my home insurance to take over? Why keep fronting the bill by sending me to QC?
"Aren't you covering the medical costs for this?" I asked.
"No," she said bluntly. "Not upfront. You can claim it. We only cover the evac and the medical transport."
Huh. After all this, THAT.
I looked up the fine print of my travel insurance policy—and it's foremost a travel insurance policy, not specifically a medical one—and immediately started GoFundMe.com/ErikArctic
(Please share it.)
[BACK TO MENU]
Part 7: The Lear
Originally posted September 3, 2019
"I was evac'd off the ship and brought to the Coast Guard..." I began retelling the saga so far—still a work-in-progress as I write this—to a new face.
"Sounds like quite a journey," said Jeanette. "Have you been documenting?"
"It's worth it then," she said.
Jeanette was my air nurse with Latitude, the air ambulance service that won the best bid when CSA travel insurance added an extra layer of waiting by asking for bids from their roster of contracted vendors—which did not include the medical jet at Qikiqtani General that was right there. Hamilton, Ontario-based Latitude was prompt and efficient though, with Jeanette as the RN and Mahfuzul running vitals.
"The Lear over there," Jeanette directed the ambulance driver from Iqaliut FD as we drove down the tarmac of the airport.
I'd never been on an "air ambulance" before, but apparently it's just a private Learjet with a hook in the middle to hang IV drip bags. They loaded me into the aisle and strapped me in tight—perhaps too tight, until Mahfuzul released the chest one that made me feel like I was in a straight jacket.
"You are now a free man since 1857!" the Bangladeshi-Canadian man joked before realizing it was a bad one. 🤷🏽♂️ "I dont know the history of this country." (Later he told me the Tagalog phrases he uses to impress Filipino nurses, to lighten the mood.)
The Lear took off for the 3-hr southbound flight to Quebec City. Mahfuzul monitored my pulse and BP with the changes in cabin pressure and altitude to 36,000 ft. Jeanette maintained the IV antibiotic regiment. And they both looked away when I used the in-flight pee pitcher.
Jeanette and I faced each other in the Lear, seat positions conducive to those kind of heart-to-heart conversations that people on private jets must have. "So you do this every day?" I asked.
"No, I'm a full-time nurse at a hospital," she answered. "This is just a side job. On my day off. You know it's Labour Day?"
"Well this is my side job," I told her. "I was supposed to be back at a corporate office on Wednesday. I don't think that's going to happen." (Sorry, Steve. But thanks for the donation to GoFundMe.com/ErikArctic )
"So why wouldn't they just fly you to New York?" she asked. "It's not that much farther." (Our pilot said it would have been just another 35 minutes or so to NY/NJ's Teterboro.)
"I don't know," I lamented. "Mt. Sinai even called last night because they were ready for me." (Nurse Ann in Iqaliut told me they called, asking for my vitals.)
Thirty-five minutes shy of NYC—held hostage by an awful travel insurance company—we descended into rainy Quebec City, where two French-speaking guys picked us up in a land ambulance. Fortunately they spoke anglais so Jeanette could relay some of my story.
We arrived at Hôtel-Dieu de Québec hospital (God's hotel of Quebec), where I was, as explained, to receive treatment in the ER ward until a bed opened up. Like everyone before them, they asked for my non-existent Canadian health card, but were open for business once I gave them my American Express card—another bill for an insurance claim.
Jeanette relayed my story to the bilingual staff and was released from duty.
"Happy Labour Day!" I called out as I was wheeled off.
She and Mahfuzul took a taxi back to the airport to fly home to Ontario, while I faced a new bilingual unknown.
One medical intern told me that usually cases like mine go to McGill in Montreal before going to the States. Everyone in the hospital questioned why I was sent to Quebec City instead. At least they'd gotten briefed by Dr. Patrick in Iqaliut and they had a much larger team to tackle my mystery infection.
[BACK TO MENU]
Part 8: Patient Zero
Originally posted September 3, 2019
"What's with the Quebecois and taking temperatures rectally?" I asked my Quebecois nurse Jerome. "The nurse on the Coast Guard ship was Quebecois, and she took it rectally too."
He looked at me in disgust, like, why, would ANYone, take it orally?
"But it's the CENTRAL temperature," he argued. "In the mouth it could be 37, and in the anus, it could be 38."
I reluctantly bent over until I heard the beep.
"Aha! You see?" he exclaimed. "Thirty-eight!"
I was to wait in the ER ward of the Quebec God Hotel (Hôtel-Dieu de Québec hospital) until a bed opened up upstairs. The ER was great because I had my own room.
Turned out I had my own room because it was the Quarantine room with the big HEPA air filter in it, cleaning everything I exhaled. Everyone who came in always entered with a face mask and disposable scrubs that they immediately threw out each time they left. To them, I was Patient Zero.
Things moved fast in Quarantine with lots of people coming in for tests. One quirky doctor came in to extract samples and swabs of the scabs and blisters for analysis. "Do you know you're in the oldest hospital in North America?!" she excitedly informed me. "A little bit of history for you." (It's true if you don't count Mexico.)
Next, a man rolled in a big machine that took up half the room that I thought was a zamboni or large industrial floor buffer. Turns out when you're Patient Zero, you don't go to Radiology, Radiology comes to you. He did chest x-rays.
More blood tests, more analysis of the leg, which was improving. Kidneys were improving, lungs too. The issue was my liver now, which was not in recovery. They weren't sure if it was the infection or a reaction to the antibiotics (but maybe it's because I haven't had a beer in a whole week).
I had a constant stream of medical interns come in for questioning, the longest and thorough investigation by Pauline, who was tasked with getting my story in detail. With date/time-stamped photos and LOTS of documentation on my little ol' iPhone 7, we discovered a pattern in the mystery: every time I had a fever and got over it, the mysterious infection advanced one level. I had a fever on the Ocean Endeavor just before the knee started swelling and rashing. I had a fever just before it evolved another level in Iqaliut, when the pus dumplings on my skin developed. [*files mental note for sci-fi movie treatment*]
Nurse Jerome came in for some more tests. "One up the nose, and one in the anus. I'm sorry."
What is the DEAL with the Quebecois and the anus?
As he swabbed my butthole, he asked me if this was my first time to Quebec City.
"No, I've been here before."
"Good. Because this would not be a good first time to Quebec."
They made me wear a face mask as I was upgraded and transferred to the main hospital, to the 9th floor, where I spent the night. I woke up to a view of the old and new city of Quebec, with the iconic Fairmont Le Château in the distance, on sunny Tuesday morning. It was the first sunny day I'd seen in a week. (It rained the entire time in Iqaliut.)
Things were finally looking up, especially since the LONG Labor Day Weekend was over and I could finally make some calls, one that really gave me some relief: my home medical insurance company (Oscar) assured me that they covered me in emergency situations.
A word of advice: If you ever get hospitalized for a tropical infection in the Arctic, do it during regular business hours.
A huge thanks to everyone who donated! Medical Insurance is confusing. I promise I'll be doing refunds after everything is settled. Although, the way things have been, there's probably some clause somewhere that won't be good. One friend who read my CSA policy in detail said there could be complications since the source of the infection didn't originate at the place of emergency. 🤞🏽
[BACK TO MENU]
Part 9: Filet of Tropical Red Herring
Originally posted September 4, 2019
There's a reason why I was treated like Patient Zero at Hôtel-Dieu de Québec hospital, with everyone dressing like an extra in "Contagion": Someone suspected this was not a bacterial infection, but a VIRUS.
The investigation continued, with more tests, and interviews with different medical people. The first question always seemed to be, "Why didn't they just fly you to New York?" 🤷🏽♂️
The team studying my case, lead by internist Dr. Caroline Riopel, was in constant discussion, looking up patterns with other tropical infections. Nothing really added up based on my body's behavior over the past week. It didn't help that I didn't know what bit or poked me, and the range was pretty wide with Fiji forest foraging, muddy freshwater eel hunting and rafting, and saltwater snorkeling and spearfishing.
Things were more clear on the health insurance front though. With Labor Day over, my medical insurance @OscarHealth—branded as a "different" health insurance company—came into my travel/medical insurance mess like The Cleaner. Not only did they cover me for emergencies while traveling, they took lead to sort the whole paperwork mess out, coordinating with the hospitals and CSA—the travel insurance company that refused to send me to NYC.
"Yeah, travel insurance companies do that 'closest facility' thing," Oscar Caryn told me. She'd heard it before. "At least you're in good hands."
Nurse Roxanne's good hands put me on more IV meds. Nurse Kitenge kept me clean. Medical intern Pauline interviewed me more, but also coordinated some paperwork for Oscar. And an orderly rolled me down to Dermatologie for an exam and analysis with a dermatologiste and four medical interns.
More routine meals, more Netflix, more pee pitchers filled and flushed. Then one afternoon, infectious disease Dr. Natalie Turgeon—who spoke English with no trace of a French accent—introduced herself for her conclusion.
"That," she began, pointing to my scabbed-over Fijian insect bite, "and that," pointing to the rash and scabbed blisters running down the inside of my leg. "Unrelated."
Go on, doctor. 🤔
She continued to explain that the most logical conclusion was that I had a resurgence of the varicella-zoster virus that was lying dormant inside me, and that most of this ordeal was an extremely ill-timed, worst-case-scenario episode of Zona. (In the States, it's nicknamed Shingles, which I always thought was a funny, non-threatening word associated with much older people, so I'll stick to the local lingo. FYI, Zona/Shingles doesn't only strike people in their twilight years; I've had friends who got it in their 30s.)
The varicella-zoster virus is the virus that gives you the chickenpox when you're a kid and when you get over it, it lies dormant inside you. No one knows why or when it can reactivate, but it sometimes does decades later, causing Zona, a severe, burning rash and stream of blisters that makes you feel like you're on fire—a sensation I had through all this.
"A virus like this wouldn't be responsive to antibiotics," Dr. Natalie continued.
⚡️🔙 FLASHBACK: "The infection is still rising in the blood and we have you on every antibiotic." (Dr. Patrick in Iqaliut) ⏭⚡️
Looking up Zona, I fit the pattern to a tee. The big clue on the team was that the rash and blisters were isolated to one dermatome region and the blisters were aligned along a single spinal nerve. Textbook Zona.
"Dermatology already wrote their conclusion in the book and closed the case on this one," Dr. Natalie informed me.
So it was a viral infection all along, not bacterial?
"It was two things," she explained. "This, and another bad skin infection. Did you come in contact with anything when you had the blisters?"
"Well when it was still just a little rash, I was in the hot tub on the ship," I admitted. "But it wasn't chlorinated. It was just ocean water heated by the engine."
Heated, recycled ocean water, shared by many? Cesspool of bacteria.
So just like an HBO show where big moments always happen in the ninth episode, the medical mystery was solved in Part 9: I had an ill-timed, extreme case of Zona, which was "supercharged" by a life-threatening skin infection—a double-whammy freak of nature, like when Superstorm Sandy hit New York City. Hot tub bacteria got into the Zona blisters, spawning cellulitis, which sucked me dry. I was so dehydrated on the Ocean Endeavor, but every time I drank water, I was only fueling the cellulitis to grow larger and swell my leg into a rubbery sponge cake. If cellulitis can also cause blindness, maybe that's why my eyes were bloodshot through all of this? Thankfully it didn't, but the extreme dehydration explains the constipation.
To fight the cellulitis, my body went into sepsis, another life-threatening condition when you have a blood infection and your body's systems go all out of wack in attempts to fight it. Going septic caused the damage to my kidneys, liver, and lungs—fortunately, all on the mend.
During the emergency hospitalization in Iqaliut, the constant pumping of IV antibiotics into me was beneficial, but only to the bacterial threat. As for the varicella-zoster viral threat, my body was alone on that front, without any anti-viral medical assist. My friends joke that I'm cybernetic because I don't get hangovers, but my body really went into overdrive for this one, fighting the virus on its own. It wasn't until I checked into the Hôtel-Dieu de Québec that anyone even thought to give me anti-viral meds. Hotel God, indeed.
"Everyone was wanting it to be a tropical disease," Dr. Natalie concluded. "But there are weird manifestations of frequent disease."
So did the weird bite I got in Fiji, which threw almost every doctor for a loop to research a red herring, remain completely innocent in this action-packed medical emergency drama? Well, it depends who you ask. As Pauline the medical intern hypothesized, "Maybe the bite reactivated the virus."
(Let's believe that because it makes for a better story.)
Insect bite or not, the lesson to be learned here is that this could have been YOU. Yes, you reading this. If you've had the chickenpox as a kid, that means the varicella-zoster virus is already in you, lying dormant, waiting to pounce on you later in life when you least expect it, whether you're in your 30s or twilight years. For me, it just so happened to happen on an Arctic expedition cruise with a bacteria-filled hot tub, that began just a few days after I'd been bit by a bug in Fiji—a very weird, extremely ill-timed, and completely unscripted experience.
[BACK TO MENU]
Part 10: Escape From The Thirteenth Floor
Originally posted September 6, 2019
"Yeah, so the form they faxed, it's handwritten, so it's a little hard to translate," said the CSA guy on the phone in my new hospital room on the 13th floor, after being transferred from Nine. His name was Jason and his tone of voice reminded me of Lumbergh from the movie "Office Space."
"You know, it's in French because YOU sent me to Quebec and not New York after MUCH arguing," I scolded him. I couldn't believe CSA had the gall to complain about a medical report in another language when it was on them to send me to a hospital where English isn't the primary language. However, Jason Lumbergh was new to the file and was just doing a routine call, so I couldn't blame him. He just wanted to get the report verbally and it took me a while to get an English speaker on the line.
But The Thirteen Floor wasn't nearly as bilingual as Nine. I asked the aid attending to my old, coughing roommate to get a nurse, but she got very aggravated when trying to communicate with me. (I can get by on traveler's French, but not hospital French.)
"Did you hear all that?" I told Jason Lumbergh. "This is what I'm dealing with here."
"I can call you back if you want."
"No. You're going to stay on the line. Someone's coming."
Awkward hold. We had small talk while waiting and Jason Lumbergh, calling from South Florida, talked about how they "dodged a bullet" from Hurricane Dorian—oblivious that he was talking to a guy who was on his literal near-deathbed a few days prior.
It took some time, but Pauline the medical intern took the call on behalf of Dr. Caroline—she had better English skills anyway. Jason Lumbergh had some hesitations that he was just speaking with a student, but Pauline assured him she had my file and was with me the whole time.
The rest of my time on The Thirteenth Floor wasn't nearly as hospitable as life on Nine—the transfer happened almost immediately after the Zona conclusion. Gone were Nine's bilingual and photogenic nurses with gentle hands, I was now dealing with a guy who drew blood, poking me and twisting the needle really carelessly to find a vein. 💉 "Fuck, man!"
And it wasn't just him. During a 2:30am IV antibiotic reload, they had to redo the IV lock in my arm and it took four nurses eight attempts of poking me with a needle when trying to find a usable vein on my already bruised-to-hell arms. It took a fifth guy, after his break, to finally do it, after two more attempts. (I reckon it was hard for them to find veins because they always told me to relax my hands and to specifically NOT make a fist, as we do in the States.)
The Thirteenth Floor was turning into a torture prison. Although I was now able to physically walk around, I'd be scolded if I walked in the hallway because of my contagion risk to other patients. So I was trapped in my room, getting itchy because I hadn't taken a real shower in a week, plus I couldn't Netflix anymore because I'd reached my data limit—there was no wi-fi at Hôtel-Dieu de Québec. (Canadians may get free healthcare, but they don't get free wi-fi.)
It certainly didn't help that behind the curtain was a coughing old man, plus there was another crazy old man who came to my room who mumbled to me ad nauseam in Quebecois French. (French in Quebec is near incomprehensible "old French" that people in France don't even understand.) He was harmless—until he came into my room, stole my antibiotic ointment, and scurried down the hallway and through a door that closed behind him.
I pushed the nurse button repeatedly. "That old man stole my cream!"
Thankfully I got it back, but the whole ordeal only added to me wanting to get the hell out of there.
Despite all this, the good news was that my routine blood reports were gradually trending to a good place—so much that Tuesday evening, Dr. Natalie said I could book a flight home for Thursday evening, which I did. Travel insurance-wise, Jason Lumbergh said I might be able to claim it.
Everything was good to go—until Thursday morning. I had chills and a fever. It was a mild fever though, similar to ones I get some mornings when I'm super tired, that go away in a couple of hours with some Tylenol. That's what I told myself anyway, so as not to ruin my chances of getting discharged. But to confirm the fever, one nurse took my temperature orally. "Thirty-eight." To be super sure, she told me to roll over to redo do it rectally. 🤦🏽♂️ "Thirty-nine."
"You may feel like you don't have a fever, but you have a fever."
The anus doesn't lie. Stupid butthole.
Dr. Caroline stopped by with Pauline. "I have bad news," the internist said. "Your white blood cells have spiked up." It was a telltale sign that my body was no longer trending good, but suddenly relapsing back into fight mode. She told me she was recommending no discharge. "Even if you were in New York, they would not discharge you."
"But I have a flight this evening! I have people waiting for me!" I pleaded. "I've been alone for eight days."
She said she would wait on the second opinion from Dr. Natalie, but it didn't look good.
I paced back and forth in the limited space I was allowed, waiting for Dr. Natalie to get out of a meeting. Eventually she came and apologized for being 90 minutes late due to a patient—she knew the clock was ticking towards the point of no return on making it to the airport.
She was skeptical on a discharge. "Thing is, we can't let you leave without finishing the job."
I pleaded to her like I did with Dr. Caroline and she was open to a discharge only if she could speak with the doctor who would receive me ASAP and continue the treatment.
Now I would've been wary if I'd had an impersonal "patient-factory" doctor, but I pay extra for better healthcare with @OneMedical, which gives me a whole comprehensive medical team at my disposal, reasonable response and wait times, an app with a direct chat function to doctors (plus all my medical history in detail), and a PCP I've actually developed a good healthcare relationship with. It was certainly worth the membership fee this time because the transfer of information and medical data was a simple doctor to doctor phone call. It was only after that call that Dr. Natalie was okay to release me from the prison on The Thirteenth Floor. She ordered a rush prescription for oral meds to last me until my 9:20am appointment the next morning.
Excited, I finally put on real clothes after eight days of hospital gowns. I organized my bags, including the tote bag I got from the NGCC Des Groseilliers. Inside one of my boots, something I hadn't worn in a long time, I found a "Escadron Squadron 435" sticker from the Herc. On the back, the studly military paramedics wrote, "Good luck with you recovery. –Jo and Rob."
The hospital definitely wouldn't let me go without paying the bill, so I rushed to admin since the airport clock was ticking fast. I charged $11,976 to my Amex (thankfully with no pre-set spending limit), a general hospital fee that did not yet include medical specialist fees that were still TBD.
I picked up my meds and discharge papers and was off. I called an Uber.
One step back into the real world of Old Quebec, things were not as good as expected. My calves had atrophied so they really felt the burn on the slightest of hills. And definitely had a fever now. My anus didn't lie.
The language barrier was gone though; my Uber driver Kevin listened to an MMA podcast in English on the 35-minute drive to the airport. The airport formalities would have been a breeze if I didn't feel like death, and I was wary of having to walk through one of those biometric chambers they have in some airports. If they had one, the rest of this story might have been told from a federal quarantine room.
Not only was I now feeling a really bad fever, but every time I got a chill, the Zona wave of fire went down my leg. Death. I felt like death in the airport lounge. I felt like death at the gate. I felt like death in Seat 21A. But at least I was going home.
Global Entry expedited things stateside, and as soon as I got my checked baggage I was back on familiar ground: Terminal C of Newark Liberty International Airport. My brother @markyt1030 and friend Terence were waiting for me.
"I want two things right now," I started. "One, I want an American cheeseburger, and two, I wanna set up a press conference. Cheeseburger first."
My brother failed to realize I was quoting Tony Stark in the first "Iron Man" after he'd survived the ordeal in Afghanistan that inspired him to be a superhero. And even though he said he was recording it, he only accidentally took a blurry picture of my foot. Regardless, I was glad to see him.
@Markyt1030 got me that American cheeseburger, as I rested up at my parents' house in New Jersey. I had the house to myself since I'd insisted to my mom not to cancel their vacation to Russia during a Facetime call in Iqaliut. "It would make no difference if you stayed home. Just go." I insisted.
But my parents' house eventually became a little house party, with my brother, friends, aunts, and an uncle nearby for support—in fact, my cousin @brittanyr_34, a new graduate of Seton Hall's nursing school, spent the night to care for me. They all had a laugh together, discussing how many times I got my temperature taken in the butt.
My fever started to dissipate and I was finally in good spirits. However, when I got to the doctor the next morning, medically-speaking, things had gotten a lot worse.
Next: a new potentially life-threatening issue, plus Fiji might not be so innocent after all.
[BACK TO MENU]
Part 11: The Promised Land
Originally posted September 8, 2019
My premium healthcare provider, @OneMedical, set me up for a rush appointment—as requested by Dr. Natalie in Quebec City—not to my regular PCP, but to their infectious disease Dr. Laura Guderian at the Flatiron office in New York City. To my surprise, the signage at the entrance read "One Medical with Mt. Sinai." (Apparently they'd struck a shared resources deal in March 2019.)
And so, after days and days of calls, arguing with travel insurance company CSA to send me to New York—a bureaucractic part of this whole 12-day mysterious tropical infection medical emergency that began in the high Arctic—I'd finally made it to Mt. Sinai, like a Bible story or something.
Dr. Laura was just getting caught up on my file and the latest numbers, including my worrisome spike in white blood cells—a sign that I was relapsing. "You're lucky to be alive," she told me. "Your body is just reacting to a near-death experience."
She took some vitals, including my temperature tympanically (via ear) 🙌🏽, until she noticed something alarming when she saw me scratching my arm. "You have a rash?"
"Yeah, I thought it was because I haven't taken a real shower in eight days."
Her tone of voice went from conversational to alarmist. "No, no, that's a drug rash. You have a drug allergy," she told me. "A drug allergy can be as life-threatening as all of this," she continued in all seriousness, waving her hands around my infected leg. "I'm talking you could stop breathing, cardiac arrest, ICU..." (True, earlier this year when my mom was hospitalized and was accidentally given a drug she's allergic to, she went into cardiac arrest.)
Taking my shirt and pants off, the rash was all over my body. Things were not good. Just when I thought I was out, they PULL me back in!
"Your white blood cells are up because of the drug allergy," she deduced.
I was smart to defy the Quebecois doctors' orders to stay in QC; they would have continued to pump me with an IV antibiotic my body couldn't handle—an intravenous version of one that they prescribed me orally. If I hadn't checked out of the God Hotel of Quebec, they might have killed me, unknowingly pumping me up with the very drug that was relapsing my body back into fight mode.
Dr. Laura sent me to Bianca the phlebotemist for blood tests, while she scrambled on the phone. She called Dr. Natalie in Quebec to pinpoint the offending drug. She deduced which drug of the four I was on, that was doing the heavy hitting—it would have to do more now, since that the allergy-producing drug was out of the loop. She sent out my prescription and even called the pharmacy to ensure they had it in stock. And she called my insurance company to fight them on its necessity. "This [drug] is the heavy hitter, but it's not cheap," she told me. "It's like a hundred a pill and your prescription could be two thousand dollars. Insurance companies don't like paying for those."
We even swapped personal cell phone numbers so she could continue to monitor my progress, now that the supposed offending drug was out of the picture. (In fact, she confiscated it from me.)
Dr. Laura did all she could for me (and more), at least for the time being. She sent me on my way, back to a CVS in New Jersey, and I was off—but not without taking my brother @markyt1030 and nurse cousin @brittanyr_34 to lunch. In addition to Dr. Laura's unheard of TLC, I definitely felt better with a turkey reuben, and a bowl of matzoh ball soup—New York's quintessential panacea—at nearby Eisenberg's old-fashioned sandwich shop. (The Popeyes fried chicken later that day helped too.)
The next day I was still itchy with rashes when I saw my regular PCP, Dr. Noah Canlas in One Medical's Meatpacking District location. He had been briefed by his colleague, Dr. Laura and it helped that they were on the same page—they'd both read my medical drama saga thus far, on my social media. "You look good for someone's who's gone through all this," Dr. Noah greeted me.
He took vitals, and temperature tympanically (via ear), and assessed my infected leg. The Zona part of my hospitalization was nearing an end, and would heal in a week or two with continued topical ointment treatment. "I'm happy with this," he told me.
"But you're coming in at the tail end of this," I said. I showed him photos of my leg in its worst state.
"Yeah, I get to be a part of the happy ending."
The rest of my exam was pretty routine; I was just looping in my regular doctor because he should know the medical state of things, after such a crazy ordeal.
"If I taught a class, you'd be a WHOLE lecture," he told me. "You're the hero of the Arctic." He told me things could have gotten really bad at anytime during the whole ordeal, but it apparently didn't because "you were rather quite eloquent in your story."
He was tag-teaming with Dr. Laura on my case, and they both agreed that my body didn't exactly go into sepsis; I had a very rare case of "toxic shock syndrome" that sent my kidney, lungs, and liver into failure—thankfully each organ almost all back to normal.
As for the newer issue of my allergic drug rash, "Unfortunately the drug that is giving you the allergy is the one that's doing all the work," Dr. Noah told me. I'd have to suffer the rashes and itchiness for the rest of the antibiotic treatment, but at least it was better than cardiac arrest.
So I was on the mend but not out of it yet. Plus Dr. Laura, who I'd see again, was keen on solving the mystery of how the "superinfection" started in the first place—it might have not been the hot tub after all.
"This," she had said, pointing to the scab of the weird bite I got in Fiji, "is definitely a factor in all this."
Coming up next (unless something unusual happens again for another plot twist), the Epilogue: No Sleep 'Til Brooklyn.
[BACK TO MENU]
Part 12: The One Where Something Unusual Happens Again for Another Plot Twist
Originally posted September 9, 2019
Things were supposed to be normalizing—in fact, I was striving for it despite my drug rash and the fact that I was still limping from my swollen knee. I ate normally—Filipino arroz caldo from my mom (now back from vacation), plus White Castle during an (abnormal non-alcoholic) beer session with friends Terence and @frangios3000. There was even a family send-off luncheon at Rosa Mexicano in New Jersey before I'd made my way back home in Brooklyn.
I'd sublet my place out while doing back to back to back assignments, and with my apartment back in my possession, I began the hauling of my things back in, to the way things were before any of this tropical infection in the Arctic ordeal began. I continued the oral drug regiment, the topical antibiotic ointment regiment, and the regiment of Netflix.
Monday morning I went back to @OneMedical for a follow-up with infectious disease Dr. Laura. It was supposed to be a routine visit to confirm I was on the mend. Instead, things went south.
"This isn't looking as good as I'd hoped," she said, as she opened up my wound dressing. Even with that super expensive heavy hitter drug I'd been taking, I should have been at least 90% visibly recovered, and that wasn't the case. My leg was still deformed from the pitting edema (Silly Putty texture) and the Ace bandage compression. I was still having mild fevers that wouldn't pass. The leg, especially around the knee, was still generating heat. Most alarming was that my knee swelling never went down; it was the same it'd been for weeks.
"Did anyone ever take an x-ray of this?" the doc asked me.
"No, everyone only took chest x-rays."
After all that had happened to my leg, not one hospital had taken an x-ray to see what's going on inside the knee where this all began. With it still swollen and deformed, my right leg was definitely not a mirror image of the left. In fact, I feared it was going to heal back deformed.
Dr. Laura deduced that the infection was still hiding in me, buried deep underneath all the layers of swollen tissue and liquid in the knee that was making me walk funny. There wasn't enough bloodflow to the area, so it was hard for my oral meds to make any difference, no matter how heavy-duty it was.
"I think you should be put back on IV," she told me. "I'm sorry."
I didn't see that coming, but was open to it. "Does that mean the hospital?"
"Yes. I'm sorry," she said. "With intravenous, there are a lot more options," she told me. She began the procedure to admit me into Mt. Sinai Hospital with infectious disease center on Manhattan's Upper East Side—the fastest way via the ER. "They already have a file on you."
"You mean go to Mt. Sinai now?"
She called ahead and wrote me a note for my arrival. One Medical sent an Uber for me.
Almost an hour of sitting in midtown traffic later, I checked myself into the ER, for another round with the mysterious infection. 🥊🥊
[BACK TO MENU]
Part 13: The Case of the Mysterious Infection, Reopened
Originally posted September 11, 2019
"So tell me, what's going on, how did this happen?" asked Mt. Sinai ER Dr. Rustin Zoromodi.
"Uhh, the whole story is on social media," I told him, hoping he could just read the previous 12 parts so I didn't have to retell it verbally.
"I don't think social media is going to help."
And so, I took a deep breath... and retold the tale: Fiji. The weird bug bite. LA, New Jersey, Toronto. The Arctic cruise. The knee swelling, the fever, the rashing, the cellulitis. Dehydration. The evac, the Coast Guard ship. The check-in at Resolute, where I remembered the nurse astounded at the sight of my leg with my unusual lack of fever. The Herc. Iqaliut. (It's the capital of Nunavut. [It's a province in Canada.]) All the IV antibiotics. The fever before the pus dumplings. The side story of the travel insurance company dragging out the emergency transfer. Working with Ottawa. The Lear. Quebec. Their conclusion of Zona/Shingles plus a superinfection. The fever on the flight home. One Medical. The drug allergy rashes. Dr. Laura. Mt. Sinai. [*Inhale*]
Dr. Rustin was fascinated at my whole ordeal; not everyone comes into the ER with a story like that. My case was certainly a lot more involved than what was in my ER nurse's initial notes: man with swollen knee.
The ER was a crowded mad house. Imagine a parking attendant with a garage that could hold 50 cars, but instead there are 100 cars. Now swap the valet for a nurse and cars for rolling stretcher beds. Some beds were double-parked, and in order for one in the back to get out, a whole ballet of moving beds to any available space just to make way for it had to be done, each time—over and over. Add to that the despair, the misery, the moaning and wailing of an ER. One woman just sat in her bed and wailed repeatedly, and sounded like a goat.
That being said, I took the option to just remain in the hallway, outside The Wailing Room, in the small row of beds along the wall. "You're better out here," doctors and nurses told me. Nurse Naomi drew blood for tests, and reinstalled a new IV lock, right in the hallway where there was room to breathe.
I was in good spirits, given that I was just on the perimeter of misery. My buddy Terence stayed with me, to continue cracking jokes with me about all this—"I get a tropical infection in the Arctic, what do you do, get a frozen margarita?"—and to help out with the charging of devices since I didn't have a permanent power outlet nearby. He'd also gotten me some Taco Bell 🌮 in addition to stuff from my apartment. It would be a waiting game in the ER ward until a bed opened up in the main hospital, which had a wait time of "5 to 47 hours."
In the meantime, I had a steady stream of doctors come to visit. Internal medicine. Infectious disease. Orthopedics. Each time, I'd wished everyone just read Parts 1–12 of this saga you're reading, but I had to retell the tale verbally over and over again. When I retold the story to dermatologists Drs. Jeffrey Roth and Benjamin Unger, they stopped me at the part about Quebec's Zona/Shingles conclusion. Dr. Jeffrey rolled his eyes.
"That's not Shingles," he stated.
"But Quebec said this was a textbook case of Shingles and closed the case on it."
"If it was Shingles, the rashes would have gone across the thigh," he said. (I'm paraphrasing.) He pulled out his phone to show me a map of dermatomes—what I had didn't quite fit the map.
Later, the Orthopedic doctor even said, "I'm a bone doctor, and even I know that's not Shingles." (He also cleared me of an infected joint since I could put weight on the knee.)
So if Quebec said I had a textbook case of Zona/Shingles, they may have been reading the wrong book—probably with thermometers up their buttholes.
Waiting in the ER hallway continued, but it was still better than being in The Wailing Room with the goat woman. From the hallway, I went to radiology—they finally x-rayed the knee—and ultrasound.
ER Dr. Rustin checked in again, this time with Dr. Meti Gebregiorgis, Instructor of Medicine. Without her reading my social media, I retold the story yet again, the action-packed medical mystery that even I wanted solved. "*I* wanna know what it is!" I told them, as curious as all of you reading this.
Dr. Meti had three theories of the bacteria that may have caused all this: perhaps one, or some tag team of Staph(ylococcus), Pseudomonas, and/or Mycobacterium marinum, which is very rare—something she'd only studied but not seen.
"So I'd be your first?" I joked.
Dr. Meti would continue to research the case while waiting for me to be admitted upstairs. She asked when I'd be up there.
"They tell me anywhere between five and forty-seven hours."
"That sounds about right," Dr. Rustin said. "But we want to keep him because he's so fascinating," he joked.
Infectious disease Dr. Deena Altman came down to the hallway and was immediately not impressed with the crowded parking lot madhouse situation of the Emergency ward. "Oh, this is NOT good." She asked for a private room to interview me and we wandered to find one—but it was a race of the clock to conduct questions and answers before a patient checked into it. I quickly retold the story to her, adding in additional details to what I'd done in Fiji, from muddy freshwater eel hunting to seawater spearfishing. She too was mesmerized; stories like mine are why doctors like her go into infectious disease study in the first place. "It's so interesting," she said. "I hope they get a whole medical team involved with this."
"I've already reached my deductible," I told her. "Bring it on."
She inspected my infected leg—"It looks deformed," she commented—and then wished me well in haste. Our time in the empty room had gone over; the patient was already waiting outside to get to bed.
"Have you seen my wife?" asked a tall gentleman whose spouse also opted to be in the ER hallway.
"I just got back here," I told him.
He went through the Doorway of Despair to look for her. "Man, you've got a story," he told me.
"You overheard all that?"
"Yeah. Good luck to you."
He walked into The Wailing Room, where he guessed his wife had been moved into. I was happy not to be in there myself—until a nurse surprisingly rolled me in in the middle of the night, right near the woman who wailed like a goat.
[BACK TO MENU]
Part 14: The Junior Mints
Originally posted September 12, 2019
"Man, it's crazy in here!" said a familiar voice as he found me in the middle of Mt. Sinai's crowded and chaotic ER Wailing Room "parking garage" situation. Post Terence, my first surprise guest was longtime friend @rayzorraygram, uptown for a visit. He beared a greeting card and his signature smile. "You know there's a Taco Bell outside?"
"Yeah my friend brought me some last night," I told him. "Let's go to the hall, it's crazy in here," I suggested. With a slight limp, I walked to the hallway to chat, wearing a bedsheet around my shoulders, looking very hipster Gandhi.
"Man, you got me scared of going anywhere now," he told me. I caught him up on the latest, and he filled me in on New York life—something I hadn't had in over six weeks. He raved about this handheld classic videogame emulator he had, and after our powwow, he went off to Brooklyn to get it for me—perhaps stopping briefly for a taco. (I would have.)
Back to the middle of The Wailing Room parking lot I went, but it wasn't my only spot during my stay in the ER. When I originally got there earlier in the morning, I was near the woman who wailed like a goat. Eventually I got an official "parking spot" nearby, 10A, with curtain partitions on the sides. During my brief time there, Goat Woman was replaced by some new woman, but then I was sent out for another ultrasound for my problematic kidneys. (Elevated creatinine levels were preventing me from getting an MRI, so that had to be monitored.)
When I returned, 10A was taken up by oxygen tanks for the new woman, now on a respirator. So I was moved to the worst spot, perhaps in the whole hospital: right in the center of the ER "parking lot," with my bed up against a sink adjacent to a support column. To my left was a woman complaining about how someone put their used urine pad on her bed.
"Nurse! I just want to understand WHY this happened."
The whole ER was a chaotic New York City scene, with NYPD cops and FDNY paramedics, and doctors wandering the sea of beds through the slivers of areas to walk. It definitely didn't help that there weren't any nurse call buttons, so there was yelling. Surprisingly, nurses said this was a "good day"; it's sometimes a lot worse.
Dermatology Dr. Benjamin came down to the chaos to do a biopsy.
"We're going to need a room."
He managed to sequester a private room for half an hour. With local anesthetic 💉 and TLC, he punched two 3mm holes in my swollen knee for tissue samples, before patching me up to stop the bleeding. Two samples: one to pathology, one to microbiology, so they might both help to crack the case of the mysterious infection.
"We don't even have a diagnosis yet," infectious disease Dr. Deena said, during her drop in.
Back in The Wailing Room, ER Nurse Joseph played up our Filipino connection and found me a newly-emptied spot to move me into, 6A, with curtain partitions that did nothing about the phone calls from the guy to my right, blabbering about lawyers and jail sentences or something. But the move to 6A was timely because my next visitor stopped by, fellow #travel writer @jennyjhart (my plus one on the Kentucky press trip I'd done just before Fiji).
She'd stopped by my apartment to get some belongings Terence couldn't find, plus my deck of cards with Erotic Chinese Art on them. We played some intense games of Spit for a few hours, only interrupted once by Assistant Professor of Medicine Dr. Olga Prystupa from my medical team, who had some follow-up questions and private comments.
Shortly after @jennyjhart left, two more doctors, Dr. Gabrielle Goldberg and another from the Icahn Medical Institute team came to request yet another retelling of my story. It was with them that I finally convinced doctors to just read the whole story online. "It's all linked at GoFundMe.com/ErikArctic."
After work, my good friend @mwwwhahaha stopped by. "Sorry I'm late," she apologized. "I stopped for a Mexican pizza. There's a Taco Bell outside."
She didn't bear tacos but a bag full of goodies—the sweet kind—including cookies, Skittles, and boxes of Junior Mints at my request. The little chocolate mints were on my mind because I had literally rewatched the classic "The Junior Mint" episode of "#Seinfeld" on Hulu the day before, just before I went to the @OneMedical appointment that sent me to the Mt. Sinai ER in the first place. (If you haven't seen it, a #JuniorMint falls into the body cavity of a man having an operation at the hospital, which ultimately staved off his infection.)
"Want one?" I offered @mmwwwhahaha.
"I actually don't like #JuniorMints," she admitted.
I was surprised (like Kramer). "But they're DELICIOUS."
"I know," she said, before quoting @JerrySeinfeld. "They're very refreshing."
(Footnote: The ending of Part 11 and title of Part 12 is actually a nod to the sitcom "#Friends.")
@Mmwwwhahaha was soon joined by my next visitor, my old college friend Theresa, who brought another bag of goodies—the salty kind—including Pringles and Combos. Between the two of them, I was fully stocked on junk food across the flavor spectrum. We sat around and joked about the story thus far, and we theorized what was buried underneath the infected lump in my right knee. "An alien's gonna pop out," I said.
"Like in the movie."
"Yeah, it'll have a top hat," Theresa suggested, like in "#Spaceballs."
Overall, my stream of visitors to the chaotic ER Wailing Room was a good distraction from the chaos. The only real downer, given the circumstances, was what Dr. Olga had told me in private (which, after much internal debate and some doctors' consultation, I've decided to reveal): On top of everything that has happened to me thus far, she'd discreetly informed me, "Preliminary blood test results are showing that you're HIV positive."
Literally speechless. After all that, THIS.
"The team is very shocked," she'd continued.
"*I'M* shocked," I'd added. "I tested negative after my last partner." (I get tested regularly.)
She went down a list off the top of her head of possible ways I might have contracted it, and assured me that these are only preliminary results that don't mean anything solid yet—final answers wouldn't come for a couple of weeks. "But as your doctor, I felt you should know," she'd said before wishing me well.
"What was that about?" @jennyjhart had asked me.
"Nothing," I'd answered. "Just routine stuff." We just continued playing cards.
That night I tried to sleep in 6A amidst the 24-hour chaos, but couldn't. Around midnight I had finally dozed off, only to be tapped on shoulder around 2:30am. "You're going upstairs."
I was rolled to the elevator and transferred to the 8th floor of the Guggenheim Pavillion of the main hospital, where I'd still have to wait another 15 hours for a bed to open up. In the meantime, I'd wait in the hallway, behind some privacy partitions, with more questions than answers.
[BACK TO MENU]
Part 15: Nine Eleven, 2019
Originally posted September 13, 2019
I was in and around Union Square in New York City on Nine Eleven, 2001—one of the craziest days of my life, stuck in the Manhattan lockdown, as the horrific devastation unfolded. Eighteen years later, I was on Manhattan's Upper East Side, again in a dire situation, on Day 31 of an unsolved mysterious tropical infection that attacked me in the Arctic. (I first reported the initial bug bite to @OneMedical on August 12th.) I watched @NY1's coverage of the annual reading of names on my iPhone (after @patkiernan read me the papers), until I grew tired and focused on the immediate matters at Mt. Sinai.
Drs. Gabrielle Goldberg, Robyn Jordan, and attending physician Jose Fefer leading my case, stopped by my little corner of the hallway on the 8th floor of the Guggenheim Pavillion. They had hoped I'd be in an official hospital bed already, but had to make do with my constantly moving makeshift stretcher situations.
I'd finally met Dr. Jose, the doctor whose name was on my wristband, who made sure I'd received the disturbing HIV news from Dr. Olga the day before. He was optimistic though, telling me that preliminary results sometimes produce false positives. "It's too little worry, so don't worry about it."
"I'm not." 😬
The team inspected my body and leg, and discussed if my status was good enough to finally get an MRI done. It helped that all my routine lab results were all on my One Medical app, and they saw that I was trending towards my baseline creatinine levels. Later, nurse Michael came over to help me fill out the medical questionnaire for the MRI department.
I could do most things behind the hallway partitions—i.e., discuss with friend @lcmcheng about building a case against CSA travel insurance, nudging friend and lit agent @canonizer about how all this may translate into a book after the fact—but really, I couldn't wait for that bed.
Minor discomforts aside, life in the hallway was heaven compared to the ER. Gone were the cries for "NURSE!" and "Who put their pee pad on my bed?!", I was now in a relatively quiet corridor, outside the room of a voice reminiscent of RuPaul, who said things like, "I did NOT know a celebrity chef was making me lunch today!" and "Guess I'll put my wig on! 🎶Girl you know it's true...🎵"
Ah, New York.
My first visitor came in the form of a phone call from Sausalito, CA, my SF Bay Area outdoorsy partner-in-crime @id_rather_be_flying, wishing me well and sending good wear coast vibes. SF-turned-NY friend @elliana_s called me from work with get well wishes. We also had a recurring conversation about the other sidestory in an ordeal like this: Mom Management. There could be a whole substory about managing worried mothers in a such a crisis (in the book version that is, @canonizer), and it was probably best she got the "light version" of events via my texts when she and my dad were on vacation in Russia.
To my surprise, one of my privacy partitions opened early afternoon to reveal not one of my nurses Nolla or Michael, but my buddy Terence, peering through the panel.
"I needed to get out of work, so I told them I had to go to the hospital."
I appreciated being an alibi to his playing hooky. He brought my spirits up and helped me get to the bathroom in nearby 309, which already had two patients in it. He kept me company until the office started bugging him for some answers and he left to go handle it.
The great thing about knowing a bunch of freelancers is their flexibility to visit, and next was friend and neighbor @teva_k, who pulled up a chair to the edge of the privacy partition, like a therapist. She'd brought me a bag of donuts from renowned Moe's Doughs of Greenpoint, which I opened right away as we caught up.
"So you haven't had a drink in weeks," she told me. "Just tell the doctors to pour beer on your knee." Perfect therapist's advice.
Our time as kids in the hall didn't last forever because around 5:30pm—a whopping 52 hours(!) since I arrived at Mt. Sinai—I finally got an official hospital bed. Finally, a motorized inclining bed, a bedside table, and "Shelves!" @teva_k pointed out.
"Wow, shelves!" All this time, I'd been schlepping two backpacks and other bags from place to place like a hobo. Room 301A also had a TV and I turned on "South Park."
@Teva_k had to go to handle her own Mom Management situation, but soon came my friend from my Al Jazeera days, @debrakhoo.
"You can't just get a cold like everybody else," she joked to me. "You have to get some Tom Cruise-level sickness."
She beared more gifts than the Three Wisemen: therapeutic cold face masks, eye masks, leg heat pads, a USB fan, and a whole long sheet of #bubblewrap.
"It's to relieve stress or annoy your roommate," she told me.
She also brought me a box of #friedchicken from @DavidChang's @Fuku, with sides. To top it off, she brought her Nintendo Switch, so we could play some two-player sidescrollers.
Mom Management came next with my parents and brother visiting from New Jersey.
"I can see [the bulge of] your stomach," my dad told me. Anyone with Asian parents knows that no matter how dire a situation, they'll point out how much weight you've gained. (It was expected with my regiment of junk food.)
My mom took the chair to question me while @markyt1030 and my dad went to town on my Fuku leftovers. Eventually we went for a walk to the atrium so I could stretch my legs. It was good to see them visiting in my new room and NOT the ER; no level of Mom Management would have been equipped for that.
Finishing out visiting hours was friend and neighbor @mxn4621, who brought me a Brooklyn Bagelsmith #bagel, and a catch-up session of the past 4-6 weeks. Needless to say, what a difference a month makes.
At the end of the day, I survived another Nine Eleven. Eighteen years later, I again found myself at night feeling a little shaken, a little loved—and with plenty of questions still unanswered.
[BACK TO MENU]
Part 16: Probing For Clues
Originally posted September 14, 2019
Dr. Benjamin from Dermatology came to my room to fill me in on the preliminary findings of the two biopsy samples he took from my swollen knee.
"One basically confirms you had an infection," he told me. "That may not be helpful, but it's good to confirm."
As for the other sample, "Nothing is growing in the tissue now, but it could take four weeks for some of the slower microorganisms to show."
I was unsure of any optimism that anything would actually grow, but it would just be a waiting game.
"So it's still a mystery," I said.
"Yeah, it's mysterious," he agreed. "Hopefully the MRI can shed some light."
My name had finally come up in the MRI queue after 16 hours (there's no FastPass at Mt. Sinai), and I was off to Radiology.
"Ever have an MRI done before?" the tech asked.
"No, but I've seen it in the movies." I was actually a little excited for it.
However, it wasn't thrilling when they taped my problem leg to my good leg to keep it steady, in an awkward position that hurt my swollen knee joint—which I had to grin and bear for 45 minutes. 😬 Loud noises of magnets, sounding like old dot matrix printers, scanned all sides and layers of my knee, so there could be a better picture of what's going on inside.
Back upstairs, Dr. Jose, with Drs. Gabrielle and Robyn, came for their daily report. They had called Dr. Patrick from Iqaliut (remember him?) for data from the pus dumpling samples they collected for Ottawa, but that was a dead end because they were collected after I'd already had tons of drugs pumped into me.
So nothing new on the mysterious infection front—the MRI wasn't ready yet—but Dr. Jose informed me there was a higher chance for an HIV false positive. He played by the book though and wouldn't confirm. "We still have to wait a couple of weeks."
I told him I was sure that on my end, with my behavior and non-behavior, I wouldn't have gotten it, plus "There's no way I would have survived the past two weeks if I did have it."
However, Dr. Jose stood by his two week waiting game—having never read this Insta/Facebook blog saga, and what I'd really gone through.
The last place for clues to the mysterious infection was the fluid in my knee, and so I was sent down to Ultrasound.
"Are you from California?" ultrasound tech Semo Siljavic asked me. "You've got this laid back thing like you're from California. Or Vancouver."
I was unusually calm for someone who was about to be conscious while a 4-inch needle was going to probe around my swollen knee to collect liquid samples.
"Can I take pictures?"
Unusual request but "Sure."
It was a rather involved procedure. Dr. Usama "Sam" Hasan had to maneuver the ultrasound transducer in one hand, searching for dark patches on the screen (pockets of liquid). His other hand would be on the syringe that would suck the infected juice out.
"This won't take long," Dr. Sam told me. "I'm leaving in two hours to the airport, so it won't be longer than that... I'm going to Banff."
"Banff!" Semo chimed in. "I'm jealous."
"You should go to the Grizzly House in downtown Banff," I recommended. (It's a former 70s swingers club-turned-iconic fondue restaurant.) Despite the fact I was talking to the guy with the big needle who was about to stab me in the knee, I still doled out travel advice.
With local anesthesic, it was wild watching—and feeling—it all happen. I felt the pressure of the giant needle as it went in and out, up and down my layers of tissue. I watched the needle's sharp tip on the screen move through the layers of tissue, gunning for the dark patches. I didn't cringe at all as all my bleeding was just congealed by being trapped in the ultrasound gel.
Dr. Sam described my knee as "super complex" with the sandwiched liquid layer as so "compressed" that he couldn't do it alone. Dr. Etan Dayan had to come in with the assist. Between the two of them, swapping syringes as the needle tip remained in me, they extracted 5 cc's of what looked like bloody turkey drippings.
"Take care, man," Semo told me as we rolled me back to the Ultrasound lobby. "We'll figure it out."
Longtime friend Lana was already in my room when I returned, bearing the sparkling water I requested, plus a bag of gummy bears. "Family Guy" was on TBS. "You and your cartoons," a passing nurse commented. (Earlier I had been watching classic Tom & Jerry's.)
Lana and I caught up about most everything since I last saw her right before I'd left for my back-to-back-to-back August trips. We talked about life, this saga, Mom Management, and above all, I pretty much convinced her to just spend the $16.59/month to join @OneMedical.
Speaking of One Medical, it was them I turned to when trying to get harder confirmation on that unexpected HIV-bomb that really a put a monkey wrench—and unexpected plot twist—in all this. It was my third mentally-draining day of keeping my composure, living with Dr. Olga's news and no definite answers. A Google search told me that HIV tests aren't based on detecting a presence of the actual virus, they're based on the elevated presence of antibodies developed to fight a virus, such as HIV. Anyone who would have just read even just the first half of this now 16-part medical mystery saga (and counting) would know my body's been through the wringer and back, and definitely had more than enough antibodies built up to fight anything. 🥊🥊
I used One Medical's secure chat function to reach out to my PCP Dr. Noah, and my infectious disease Dr. Laura. In little time I already got replies; Dr. Noah assured me it was very unlikely I contracted the virus based on my medical history and consistent non-risk behavior. Dr. Laura went the extra mile and started snooping around Mt. Sinai (via telephone) for some hard answers. She called me once to tell me that based on her conversation with ER doctors, this was a "classic false positive." She called me again about half an hour later, after talking with my infectious disease Dr. Deena. "The preliminary was positive, but the confirmatory was negative," the gumshoe reported. "I would cross this off your list of worries."
With that said, I decided to mention the whole HIV scare in the story, to share the anguish I went through with it, even with Dr. Jose's two-week textbook waiting time. If you look back at Part 14, I'd written that I chose to reveal Dr. Olga's private news "after much internal debate and some doctors' consultation." One Medical was that consultation.
Soon after, another visitor arrived. "I don't want to touch you, I don't want to get some alien disease," said old friend @dsainthilaire, only partly kidding. With a pregnant wife, he was tasked with not bringing any illnesses home. What he would bring home were some of the big batch of empanadas he bought for me at my request because, well, hospital pot roast is... hospital pot roast.
As my last visitor of the day, he caught me up on the past couple months. He told me how his wife, reading all this, wished I would just get on with the answer to the mystery.
"I told her, I think he's still in the hospital," @dsainthilaire said. She didn't realize all of this is being posted in real-time (or close to real-time, as fast as I can write them on my ol' iPhone 7.)
By the time visiting hours were over, Part 14 was already out on the interwebs for about an hour, and the messages and comments of concern started coming in. My friend @boxser jumped the line and just called me from LA in response to the HIV bomb.
"It's a shock to you, just as it was a shock to me," I told him. "That came out of nowhere."
More comments and messages of support came throughout the night—only interrupted by the routine vitals and blood tests. I finally slept with some, but not all questions answered—feeling a lot loved.
Thanks guys. 💖
[BACK TO MENU]
Part 17: Crazy Retired Asians
Originally posted September 15, 2019
Dr. Jose came around 10am as he always did, with Drs. Gabrielle and Robyn, with the daily report. "There are no organisms in the culture for now, but it will take days," he informed me, speaking of the liquid extracted from my infected knee.
On the HIV front, he updated me, "It's more and more likely to be a false negative."
"Don't you mean, 'false POSITIVE?'"
"Oh yes, yes. I meant false POSITIVE. Sorry."
(I can't make this up, folks.) 🤦🏽♂️
After managing to take my first real shower in weeks, with water-sealed plastic coverings over my knee and IV lock, I had a visit from Gina Basara, who represented Mt. Sinai's Office of the President. She came as a courtesy to see if I had any questions, to offer services as an advocate.
She'd gotten wind of One Medical's Dr. Laura calling around the hospital for answers on my behalf—an unorthodox way to get information, but it worked—and she told me the usual way to go about it was to contact their office. I asked her why the departments weren't talking to each other, why Infectious Disease has a confirmatory negative, while School of Medicine is still dragging out the two-week thing. She said she could find out, but I told her I'd just get the same answers. "They're just going by the book."
Nevertheless, infectious disease Dr. Deena stopped by anyway, confirming her stance. "Don't even worry about the HIV thing," she told me. "You shouldn't be concerned." She was more focused on the original problem that got me in the hospital in the first place—the mysterious infection—and got things back on track.
Not that Dr. Deena had any answers for me. "It's baffling," she admitted, inspecting my leg. Instead of answers, she only had more questions. "Why wouldn't the infection be on the leftside of the knee, where the original bite was? How did it transfer to the other side?" The cultures extracted from the knee weren't giving her any clues. "Something should have been growing already, but it's not."
I told her how my story was starting to get media attention, with an audience of many curious readers wanting the mystery to be solved—including myself. "You HAVE to find an answer," I told her. "There NEEDS to be an ending to the story." Hopefully that put a little pressure on her to figure it out.
Shortly afterwards, Dr. Aakash Keswani, orthopedic surgeon, stopped by to assess my knee. "You're looking good," he complimented me on my overall health, with my illness now just confined to my right knee. He did some flex tests—it was bending, just very tight from the inflammation—with the only real soreness coming from the tenderness and the superficial incisions of the biopsy and extraction probe. He said he'd get back to me.
With all my healthcare managed by lunchtime, I had to switch into Mom Management mode for an upcoming visit from the rents.
Now it may be good to give a little background on Filipino parents if you aren't familiar with them. To outsiders, Filipinos in general have been widely-known across the world as amongst the friendliest people on the planet, if not THE friendliest. However, within the Filipino community, they are amongst one of the most gossipy, a people filled with "chismosa."
It was best when my parents were on vacation in Russia during my early hospitalization; they are not on social media, and I could give them the "light version" of my medical saga play-by-play. Of course, that didn't prevent family and friends who are on social media to text them the latest gossip coming from my dramatic (and hopefully entertaining) feeds. It's very much like that early scene in "#CrazyRichAsians," where gossip spreads almost instantaneously across the globe with modern technology.
I didn't think my hospitalization would extend into a third week, i.e. extend into the time my parents would be stateside to receive gossip in the same time zone. The source of it always seemed to be from my aunt, @bienriveralau (my mom's sister), who is always on Instagram. If I was once Patient Zero in this whole story, she is "Chismosa Zero."
With the HIV bomb of Part 14 out there, I was already stressed with managing the narrative to my mom. I'd started by texting them about the false positives.
On top of this primer of Filipino culture, it should be known that I've often compared my parents to the (#Seinfeld) Costanzas, as they live their retirement years. Like Frank Costanza, my father gets more curmudgeonly with age. Like Estelle Costanza, my mother gets more neurotic. And I am their son, George Costanza, who has to deal with it all, in ways that may seem nerve-wracking, but could be considered funny to anyone else observing from the outside. (That's the genius of Larry David comedy, right?)
"Here's your curry," my mom greeted me, after hugs and kisses. She told me they were going out to get pad Thai for lunch and could bring me something, and I was really looking forward to my favorite Thai dish, green curry with chicken. However, when I opened the bag, I found a container of dry-style stir-fried noodles.
"This isn't what I ordered." 🤦🏽♂️
"Well that's what they had." My mom mentioned they got it from a restaurant with "Saigon" in the name.
"Saigon is Vietnamese." 🤦🏽♂️ [cue laughtrack]
"Well, I don't know," she said. "This is the curry they had." 🤷🏻♀️ [cue laughtrack]
Eventually I let it go and appreciated their kind gesture—it was good and anything was more flavorful than the hospital food.
Coincidentally, my long-time friend Lana came by for a second visit. My dad gave her the second visitor seat in the room—i.e., the hot seat.
In less than 60 seconds, my mom was talking Lana's ear off. I'd been conditioned to it though. Whenever I've brought a girl or friend home to Jersey, my mom would talk their ear off—often about what it's like to be my mom, but really just about anything random. Extremely garrulous, she'd ramble to the point that I'd always have to apologize to my lady/friend after the fact.
Before I knew it, my mom was rambling to Lana about my niece's (her granddaughter's) piano teacher's financial woes, and his plans to go back to school, and how you have to take your shoes off in the house of the new (Japanese) piano teacher, and that sometimes she lets people just wear their shoes in the home, although customarily Filipino households have the Asian no-shoe rule... and I thought, "How did we even get here?" 🤷🏽♂️ [cue laughtrack]
Lana left for a yoga class and I texted her later to apologize. She was happy in the realization that it wasn't just HER mom that also behaves like this. (Her mother is also retired and Asian [Korean].)
With Lana gone, it was just me and my parents—and the lecturing began (after of course, requests on how to fix something on her iPad).
"You shouldn't be mentioning the HIV," she told me. "People are going to talk." She continued about what that meant, and the social implications it could bring to me and the family—very much like the substory of "Crazy Rich Asians." My parents are immigrant Boomers and are surrounded by peers who may or may not still have archaic views of HIV from the 70s and 80s, how it was once conceived as a shameful disease of a certain orientation.
"But HIV is for everybody!" I exclaimed to bring her up to date.
(There was probably a better way to say that.)
She continued the lecture, about the stigma and shame—not even once mentioning concern that, I dunno, MAYBE I had a virus that has killed millions of people around the globe. (I'm hoping it's because she just took me on my word of the false positive.) The conversation just swirled around the archaic social implications of having HIV. Meanwhile, everyone else off and on social media had been sending unconditional love, thoughts, and prayers.
(Sidebar: First generation Filipino-Americans like myself not only have to deal with the Crazy Rich Asians generational family integrity thing; pile onto that a whopping layer of Catholic guilt, brought to the Philippines by Spanish conquistadors. Holy shit, dude. If you don't already carry all this, you don't want to.)
My parents' parking meter had reached its end, and they bid me farewell. I kissed and hugged them goodbye, assuring them that I was in control of the narrative. Soon after their departure, still stressed from Mom Management, my routine vitals check revealed that my systolic blood pressure (upper) number had jumped about 20 points into the 140s.
Thankfully I had visitors come later that afternoon, friends who put the "Crazy" back into Crazy Rich Asians: Terence, @frangios3000, @djlingo, and @jasonsalesgonzales, who brought a bag of Papaya Dog and a bag of White Castle so we could do a "bang-bang," an idea I got from the old LouisCK FX show, where you eat one meal immediately followed by another meal. I knew I shouldn't be overloading on junk food, so I limited myself to just one hot dog and just one little slider—okay, maybe two—while the guys went to town on the rest while bringing my spirits up in the patients' lounge at the end of the hall.
Everyone, minus @jasonsalesgonzales, had to leave before the final visiting hour. @Jasonsalesgonzales hung out, back bedside in my room, and we compared notes on parents and hospitals. He particularly enjoyed the detail I'd written in Part 15, about how Asian parents will always remind you how much weight you've gained, no matter how dire a situation. "I can see your belly," he mimicked his dad, just after he had an intensive surgery.
Meanwhile, my iMessage was blowing up on my phone because my parents were back in Filipino Costanzas mode, awkwardly asking me, "Is your last partner a man or woman? We can take it." 🤔
"Woman" I replied furiously, as if George Constanza had an iPhone in the 90s. They and all my friends have always known I've always just been a heterosexual male—as boring as that may be in today's day and age—and I was so insulted and livid they would even ask such a question, that my systolic blood pressure spiked to 157. 🤯
"They're still harping on the HIV thing!" I ranted. @Jasonsalesgonzales was joined by my lifetime friend @moebocop, and eventually my brother @markyt1030, who feasted on extra White Castles. We had a good catch-up on stuff—me and @moebocop, @markyt1030 and @jasonsalesgonzales—until I got another text from my mom, a former nurse just trying to be useful again, about her Lyme Disease theory—something I never showed symptoms of.
"They can't stop being nurses," @moebocop told me. His mother, also a retired nurse, was the same way.
(@Moebocop is of Jamaican descent, so this wasn't just an Asian thing. Exhausting parents are for everybody!)
I texted my mother the hard truth, that her comments were raising my blood pressure, and she left me alone.
The next morning, I had to explain to my puzzled medical team why I had that unexpected spike of high blood pressure in my chart. Thankfully with some peace and quiet—and a break from Mom Management—I started to recover.
(Still love you, Mom. ❤️)
[BACK TO MENU]
Part 18: Spider-Leg and Wolverine
Originally posted September 17, 2019
My infected knee has been swollen in a way that it looks like I have two kneecaps on one knee, adjacent to each other. In the middle of the night, I had a dream in which one kneecap (the actual patella, not the inflammation), slipped and slid down my leg, under the skin, and I had to find the lump with my hand to slide it back up to where it belongs. So weird. Thankfully, I woke up to the vitals associate, ready to do my middle-of-the-night BP and pulse check.
Dr. Robyn from my medical team often paid me a visit around 7am, before returning around 10am with her team, Dr. Gabrielle and attending physician Dr. Jose Fefer (the doctor on my wristband). This being a weekend, Dr. Robyn was my persistent doctor between the weekday team and my weekend attending physician, Dr. Francesca Cossarini.
Dr. Robyn gave me an update, i.e., a lot of no real news. I'd continue the IV antibiotics until she got an assessment from Orthopedics.
"Ortho was here yesterday," I told her.
"They were? They didn't add anything to the chart."
I went through the meticulous notes I've been taking on my iPhone. "It was Aakash Keswani," I told her.
"Oh, we know Keswani. I'll follow up with him."
The fact that there was a lack of communication between hospital departments was a little disconcerting—just like how Dr. Deena's infectious disease department had a confirmatory HIV false positive, and my core team was still unsure. They were some of the many little dysfunctions of the hospital, like when Dr. Jose bumbled the whole "false positive" / "false negative" thing, or maybe even perhaps that they threw in an HIV scare on top of everything else in the first place—without context or sufficient enough tests to even blurt the phrase "HIV positive" to me—as I was already in the hospital for a mysterious infection.
Another dysfunction was the fact that, I attempted to use Mt. Sinai protocol to contact Executive Services for interdepartmental complaints (instead of circumventing the system with Dr. Laura of @OneMedical), but calling their number only put me in an automated voice loop to "wait for the next available associate" for twenty minutes before the line went dead. Dr. Laura actually texted me that morning for an update—I told her about the disconnect between my team and Ortho—and she got right on the phone to call the hospital for me. Soon after, Dr. Robyn stopped by with Ortho's assessment: since this isn't a joint fluid thing, a surgical drainage was not their job. Dr. Robyn told me she'd ask Vascular for a "wash out."
I could commiserate about hospital dysfunction with my weekend nurse Eileen, middle-aged mom of two, who was one of only two nurses over the past three weeks that was more personable than the average nurse just doing her/his job. (The other was Ann in Iqaliut.) It was actually Eileen that brought up hospital dysfunction during a redressing of my knee, and she held my interest.
"You know how they say a doctor sees you for 41 seconds?" she said. "You talk for 11 seconds and then the last 30 seconds he explains things as he's already walking towards the door." She emphasized her observation by walking away from me, towards the door.
Eileen hadn't gotten my whole story, so I retold the whole thing again—I had nothing but time. She too was curious as to what I had; every story needs an ending. "You can't sell the book without an ending," she told me.
Knowing I had someone on the inside, on my side about hospital dysfunction, I felt a little better maintaining the course of my stay, which had become routine. IV antibiotics every twelve hours. Three mediocre meals a day. A redressing of my knee once or twice a day. Vitals check every four hours or so. However, I started breaking the streak of just sitting in bed; Eileen encouraged me to walk around, especially since I stopped getting anti-clotting shots and I was mobile enough to get the blood flowing. I started taking walks to the 7th floor atrium of the Guggenheim Pavilion, a peaceful indoor courtyard with trees and big windows to make you feel like you were outside.
Breaking up the routine was my first weekend guest, @originalscottyk, longtime friend from my days in advertising who's transcended beyond, as he's now well integrated in the motion graphics scene of film and television when he's not producing/directing films of his own. (Sidebar: @Originalscottyk has continued to use my nickname "Pappy"—a name I got at Digitas in 2005 [which is a whole other long sidebar]—and now almost the entire film and television industry of New York City, from actors to crew, only knows me as "Pappy.")
"Pappy, I figured it out," he greeted me. "You're a mutant. We all know your super power is never getting hungover, but you're a mutant."
He gifted me the Uncanny X-Men graphic novel with Wolverine on the cover, "Quarantine," where the X-Men (and women) get a mysterious mutant flu.
@Originalscottyk and I caught up on our lives, mostly his life because my past few weeks were an open book. "I kinda want you to tell me how it's going," he said. "But I also kinda just want to read it."
We chat about possible superhero-related results to my infection, from Spider-Man to Wolverine. One of my theories was that I'd get the Spider-Man climbing ability, but only in my infected right leg. I'd have the ability to climb walls, but only with my one leg, so I'd always be awkwardly flopping vertically up a wall like a fish, dragging the rest of my normal body—which would actually be hilarious. Your friendly neighborhood Spider-Leg.
Eileen stopped by for a check-in and I mentioned that Dr. Robyn was asking Vascular for a "wash out"—whatever that is. She told me that was a surgical procedure, where they'd cut me open and essentially scoop and scrape out all the infected pus.
"They're going put some adamantium in you," @originalscottyk said. "That's why it's surgical."
I pointed out that all the hospital beds were actually made by a company called "Stryker"(!)—and if you don't get all these Wolverine references, you should ask one of your comic book nerd friends.
The timing of the Wolverine references were actually uncanny. Just half an hour before @originalscottyk's visit, I looked down at my knee and noticed a stain on the rolled gauze, a red spot surrounded by yellowish liquid, right at the spot of my adjacent biopsy holes. I assumed it was the iodine-looking stuff that dermatologist Dr. Benjamin put in when sealing me up. I showed nurse Eileen.
"That biopsy was two days ago," she informed me. "That's not iodine. That's pus."
Mysteriously—and in a very Wolverine-like way—my body had popped off the scab of one of my biopsy holes and just started releasing yellow, infected pus. It seemed as if, on my own, I was just getting rid of the toxins with a slow, but steady stream of blood and pus dripping down my leg. It was exactly like any movie scene you see of a self-healing superhero—like Wolverine—where their bodies expel poisons from a bullet hole or something. In my case, it was just in very, very slow motion, but the same image more or less.
Nurse Eileen gave me a fresh and clean dressing of my knee, but hours later a new red and yellow stain would appear. More draining. More self-healing. Eileen noticed that the hardened abscess behind the infected area was actually softening as it drained. The inflammation was very slowly going down, and there was less pain—so less that Eileen could even squeeze down the skin and tissue to squirt out more pus, like a flaccid bottle of mustard.
My Wolverine powers continued throughout the weekend as I continued to receive visitors. Friends @Reenao and @richardtsai21 came by with McNuggets, mostly for themselves because they hadn't eaten. (I had a few.) College buddies @madcaliban and @sby2199 came by Sunday morning with Sunday-fresh cha siu bao and shrimp ha cheung from Chinatown. Longtime friend and former ad agency "work wife" @mrsroacha came later with tacos and spicy tuna rolls from @tacodumbo, followed by @teva_k again, this time with @jeffrey.porterfield, bearing lamb dumplings from @xianfoods. I was careful to just nibble on things and never eat a whole dish—not even half of it, which I'd save for later—because I didn't want outside food to affect my blood pressure. With plenty of drinking water, my strategy worked; by Sunday evening I maintained a systolic BP in the 120s–130s, after my family-related spike from Part 17. (Sidebar: Contrary to popular belief, I'm not a huge junk food addict, although I do appreciate it occasionally. As a self-proclaimed "social carnivore," I actually maintain a vegetarian household.)
Weekend attending physician Dr. Francesca stopped by twice for progress reports, essentially giving me those eleven seconds to talk before slowly walking out during her analysis for the next thirty seconds. Vascular surgeon Dr. John Cordero came by for a consultation as some point—also with the same in-and-out doctoral behavior—and ultimately his colleague Dr. Shivani Kumar informed me that they were not suggesting a surgical wash out because there would be more damage than good. The infected pus is not really in one central area they could just cut open and drain, it was in scattered pockets that they'd rather not make multiple incisions for. Dr. Shivani actually gave more than 41 seconds—something my friend @reenao noticed.
"Damn, she's a hot doctor," @reenao told me. "Did you hear her? 'I'm Dr. Kumar, but you can call me 'Shivani.'" @Reenao was afraid that she had inadvertently cockblocked me though, because she was in the bedside chair in a very girlfriend-like way, while her boyfriend @richardtsai21 was in the bathroom. "Why did you have to be in the bathroom!?" she scolded him. It didn't matter because Dr. Shivani was gone in 60 seconds.
By Monday morning, I was still draining blood and pus—even more so, now that my body popped off the other scab from the second biopsy hole for double the drainage. More poisons expelled. Less swelling, less itchiness, less pain. After a week in the hospital, perhaps I was just racking up a huge bill for something my Wolverine body was just going to repair on its own. I want to believe my body got the assist from all the friends and family who came by visit (thanks guys!), and maybe a little bit of all that outside food. The regiment of IV drugs every 12 hours may have been a factor too, but I'd been on so many IV drugs over the past few weeks, that it's unclear of their effectiveness.
I was definitely on the mend. However, if and when I would get out of the hospital was yet to be determined.
[BACK TO MENU]
Part 19: A Severe Case of the Mondays
Originally posted September 18, 2019
Dr. Robyn came by around 7am at the beginning of a new work week. I was usually awake anyway from my 6am IV antibiotic treatment.
"Nothing has grown in the cultures, which is a good thing," she informed me. "That means whatever this is, is out of there."
I groaned. "But then we won't know what it is," I told her. "I REALLY want to know what it is."
She didn't know, but as a resident, she focused on my HEALTH, instead of the mystery. She assessed my leg, and the new developments in the Wolverine-like self-healing drainage of the pus. "Sounds like it's self-draining," she said. "Vascular may not be necessary."
She was optimistic about a discharge later that day—there was no physical reason to be there anymore since everything was just pending lab reports, knee redressing, and oral medicine. However, she would have to wait for a regroup with Dr. Jose and the team. And so it was a waiting game—and I could NOT wait to get discharged. After three hospitals in a row, enough was enough.
My anxiety of whether or not I would be discharged was one thing, but then anxiety—and blood pressure—took another spike when my aunt, @bienriveralau texted me about how offended she was about the whole "Chismosa Zero" comment I made in Part 17. It came as a shock to me; I only mentioned her because I thought she'd get a kick out of seeing her name in the story. I labeled her "Chismosa Zero" because I'd already referred to myself as "Patient Zero," and in fact, I used it as a term of endearment, like she was always the first one on the scene, getting the scoop, like TMZ. Alas, she took it the wrong way, and inadvertently added to the mounting stress of my possible discharge day.
In terms of Mom Management, I had my mother read Part 17 with the caveat to read it with an open mind—it would also give her context as to why her sister was livid at me. My mother took the read pretty well, but somehow slipped the phrase to me, "Your generation is so self-centered."
"I disagree. But no arguing now."
My Case of the Mondays was starting to get worse. 🤯
Dr. Robyn returned with the bumbling grey-haired Dr. Jose, fresh after a weekend break. With his charming Latino accent, he was back to his questionably professional behavior, you know, after he mixed up "false positive" with "false negative," and this one time he actually chuckled when he saw my MRI images and pointed out that he saw the little bit of calcium and urate crystals in my knee joint—a result of me not taking my gout maintenance pills for most of my hospitalization. (Sidebar: Gout runs in my family, but I haven't had a flare incident in years with maintenance pills, an active lifestyle with frequent long bike rides, and as I mentioned before in Part 18, keeping a vegetarian household despite being a "social carnivore.")
Dr. Jose started his spiel with an HIV update, which he was still dragging along. "The results are pending," he told me. "But pending means it's a good thing." Then he inspected my leg and was very pleased with the progress. It was almost as if he was taking credit for it all—his name was on my wristband after all—even though he got wind of my mysterious Wolverine-like self-draining of the weekend, in which I apparently just started to heal myself. He was impressed with how less swollen the knee was, how much softer. "Your body wanted to get rid of it," he told me.
Great diagnosis, doc—but at least it was good enough for him to suggest a discharge. "This looks so good, I don't even think we need oral medicine," he suggested.
I finally took lead. "I would," I advised him. "Maybe the drugs are what are making the draining happen."
Without referring to my chart, he debated on which antibiotic I may be sensitive to. He guessed maybe it was the Cipro.
"It's not the Cipro," I advised him. "I've been on Cipro many times. It's not that."
Eventually Dr. Robyn said they'd just put me on the oral version of the IV drug I'd been on the past four days. She called to place an order with my pharmacy in Brooklyn, and checked with my insurance for coverage.
My medical team's visit was a bit longer than 41 seconds, but eventually they left me to wait. I grew more anxious with the waiting, so I took a shower and put on street clothes, and packed my bags in anticipation. I thought I was out of the clear on additional vitals checks, but they did the routine inspection anyway. Not surprisingly, my heart rate and blood pressure was up. "They're not going to discharge you with that heart rate," the medical associate told me. "There's no discharge papers yet."
I sat and tried to calm down. I checked e-mail on my phone, which turned out to be a bad idea. One editor wrote back to me about a piece I'd submitted the other day, about how my draft was all wrong, that I didn't understand the assignment, and it would have to be redone. 😣 One friend messaged me, asking me to promote him online since I was in the social media spotlight. 😒 (Later he realized the severity of the situation, apologized, and told me not to be bothered.) An email from my friend and literary agent @canonizer told me that, at least with his literary agency, "Sadly, you need to be on tv more often before we can sell your memoir, most likely." 😖
A severe case of the Mondays was truly escalating, and at the worst possible time. Serenity now!
A new face appeared. "Are you here because I'm getting discharged?"
"No, I'm the nutritionist," she answered. She was just making rounds, doing a survey on eating habits in the hospital. "Have you been eating well?" she asked. "Eating at least half of your meals?"
"Yes, and to be honest, my friends have been sneaking me in a lot of outside food."
She was shortly followed by a social worker, who was also not there to discharge me. She just wanted my insurance information. Still no news of an actual discharge, and my stress was just mounting.
I tried to meditate, using that technique where you visualize a flowing stream and you're conscious of everything around you—even the bad stuff—and you just let them slide passed you. Didn't work. I watched some TV, didn't work—although I did notice that Shaquille O'Neal is in a LOT of non-basketball-related daytime TV commercials. I tried to just sleep it off, which helped. I was so damn tired anyway.
Dr. Robyn, probably the most competent resident on my team in my opinion, returned with an update. The oral prescription was approved and available, and insurance would cover most of it. Most importantly, she broke the news that from her department's end, I was officially declared HIV negative. 🎉🙌🏽🎊
She was about to get the discharge papers in order, but it was coincidentally time for another vitals check. Moment of truth. Discharge or not, here we go. I strapped into the arm cuff, and let the machine do its thing, pumping air around my arm to release slowly.
(A drastic spike from my 134 from the night before.)
"Are you anxious or anything?" Nurse Bella asked me, in front of Dr. Robyn (who knew of my family drama, but not the e-mail drama).
"Uh, I have a bunch of drama going on on my phone right now."
Dr. Robyn sympathized with me and ordered the discharge, despite the numbers. It took about an hour for me to get the physical discharge documents, but at least I was cleared to leave. I was wheeled out in a Stryker branded wheelchair to Fifth Avenue, across from Central Park, where my mother and father eventually found me with the orderly. After a few moments of my dad weaving around New York City traffic to loop the car around the block, I bid farewell to Mt. Sinai—and hospitals in general for a long time.
My parents drove me to Brooklyn, where we first stopped off to get my prescription, and then stopped off at my local Thai restaurant so I could finally get the green curry with chicken I had craved since my parents mixed up the whole Thai/Vietnamese lunch thing. It was at this late lunch that we finally had a civil conversation to make amends, one that for my sake and sanity, I will keep private. (Some readers may have interpreted my mother to be an insensitive monster in this story, but I would just like to say that despite the whole HIV reaction, both my parents are an extremely loving and supporting couple, and perhaps more open-minded that your average immigrant family.)
My mother and I came out of our private conversation with one goal: how to handle apologizing to my aunt. We were to tag team on Aunt/Sister Management because my mom emphasized that "there can NOT be a rift between me and your Tita Bien" because, in a nutshell, in our family, @bienriveralau truly is Caregiver Zero. ❤️
"Are we good?" I asked my mom.
"Yeah, we're okay."
There was some street construction right outside of my building, inhibiting a good parking situation, so I just had my parents drop me off so they could beat the traffic back to Jersey. The only issue was, I couldn't find my keys. After all that I'd been through—a mysterious infection, an Arctic military evacuation, three hospitals in three regions, tons of intravenous drugs, a misdiagnosis, a drug allergy, countless doctors and nurses, and even an HIV scare—I was LOCKED OUT OF MY APARTMENT. 🤦🏽♂️
If anyone had a Case of the Mondays, it was me.
Thankfully my good friend, neighbor, and self-proclaimed travel writing "work wife" @jennyjhart was already on her way. I told her I'd expedite her commute by paying for an Uber if she brought my spare keys. Shortly after, I was home. 🎉🙌🏽🎊
Of course, that didn't stop visitors from coming by, and I kept a hospital gown for it too. @Jennyjhart was joined by my longtime friend-turned-editor @emilyjsaladino, who brought the strangest (but very welcomed) get well gift, a game that was sort of a cross between basketball and beer pong, but attached to my head.
Eventually @teva_k came back for a third visit, this time with non-alcoholic beers. @Mxn4621 came for a second visit, this time with goodies from her job at Pepperidge Farm, including a bag of freshly-made Milano cookies, straight from the manufacturing plant. @Mmwwwhahaha came by for a second visit with a bunch of Chinese food, a Golden Girls jigsaw puzzle, and some unexpected guests: lifetime friend @moebocop, and @boxser from LA, who'd I'd seen during my LAyover between Fiji and the Arctic, in town for a meeting.
After everything settled down, I finally had time for myself. I could finally get a good night's sleep without any interruptions—without a snoring roommate (301B was a bulldozer), without vitals checks in the middle of the night, without IV drug rashes, without Quebecois nurses poking me nine times to find a vein because they don't believe the patient should make a fist. (They are what the French call, "les incompetents." #homealone) Lying in my own bed, with a bandaged knee still draining slowly, I could finally lay my head down to rest.
No sleep 'til Brooklyn, indeed.
The outstanding issue of course, was, what did I have that started this whole ordeal? What was the mysterious infection? And how did it get inside my leg? The questions still remained.
As the person closest to all this—and someone who'd been taking meticulous notes—I had a VERY formidable hypothesis that I needed a little more clarification on to make any solid conclusions. For that, I made an appointment at @OneMedical's Flatiron location for the following morning, to meet with the only doctor I truly trusted in this whole mess.
[BACK TO MENU]
Part 20: The Hypotheses
Originally posted September 19, 2019
"Erik! You're back," greeted the receptionist at @OneMedical in New York City's Flatiron district. Oddly enough, after all the notes of names I'd been jotting down, I never got hers, but she remembered mine—probably because I was on the schedule on her computer screen.
"Yeah, I just got out yesterday," I told her.
"Yeah, remember when I Ubered out of here?" I said to jog her memory of an entire week ago, plus a day. "I just got out of the hospital yesterday."
Our conversation switched back to formalities. "Any changes in your insurance?" she asked.
"No. Except that I probably have a giant bill in there."
I had gotten to the office about ten minutes early, and merely waited ten minutes. It was during that moment in the waiting lounge that I'd read my aunt's acceptance of my apology on my phone, so at least there was some catharsis on that front. As for wrapping up other kinds of emotions, I decided to get Dr. Laura a well-deserved thank you card at a Duane Reade—I'd found the perfect one on my way to the office—which I personalized with a pen at the bank next door.
At 11:30am on the dot, Dr. Laura showed up and grinned at me from across the waiting room. "I'm sorry all of this is happening," she consoled me. It had only been eleven days since we'd met, but what a long journey it had been.
Dr. Laura Guderian's doctorate degree, specializing in infectious disease from Louisiana State University's School of Medicine, hung on the wall as my post-hospitalization check-up began. I unzipped the right leg off my conversion pants—"for easy access"—and she unwrapped my latest dressing to reveal that my body was still steadily draining pus out the double-sized biopsy hole. A fair amount of the yellow liquid had collected in the two hours since I'd dressed my knee with gauze at home.
"This is looking good," she told me. The swelling was significantly down—not completely, but noticeably smaller—and my skin's post-rash discoloration was fading. All of it would eventually revert back to the way things were before any of this tropical infection in the Arctic saga began—knock on wood. The source of it all was still a mystery, with nothing turning up in the cultures of the biopsy or knee liquid extraction yet. There was little chance there would be any answers there at all, because the samples were taken way too late in the game, after I'd been on every heavy-hitting antibiotic under the sun. Maybe if CSA hadn't wasted four days of my time in Quebec City—the place that gave me a misdiagnosis and an allergic drug reaction—there'd be a slight chance, but even before that in Iqaliut, I was already on too many culture-tainting antibiotics to get a true sample of whatever bacteria I had inside me.
I did have an educated hypothesis of how this medical emergency originated and persisted though. As the closest person to the whole ordeal, I deduced a solid theory after having a few flashbacks of the past few weeks, and by doing some research on the internet.
"Let's assume Fiji's out of this," I said to Dr. Laura, starting off my "House"-like diagnosis, despite actually never having seen a full episode of "House."
I had a flashback of Mt. Sinai's Dr. Deena, baffled in Part 17, that the supposed bite was on the outer left side of the leg while the entire infected area was on inner right side. I recalled Dr. Natalie's Quebecois conclusion in Part 9, that the tropical bite was a red herring.
"Based on what you saw in the picture of the worst state of this," I began, "could I have gotten this from the hot tub?" I reminded Dr. Laura that the hot tub on @adventure.canada's #OceanEndeavour was just filled with heated Arctic sea water that wasn't chlorinated.
"It's possible," she answered.
"Is it Staph?" I asked. I flashbacked to Dr. Deena inspecting my leg in the temporary room of Mt. Sinai's chaotic ER (Part 13), how she saw the worst-state picture and called it "very Staphy." (If you haven't seen this worst-state picture of my leg—and have the stomach to see it—it's was buried in a Facebook comment from Part 5, but is now here.)
Staph, short for the Staphylococcus bacterium, is commonly found and typically causes minor skin infections—unless it enters the bloodstream and then becomes life-threatening, producing fevers, cellulitis, boils, and oozing blisters (a.k.a. "pus dumplings" in my vernacular)—all things I had.
"It could be Staph," Dr. Laura answered. "Or Pseudomonas."
Her answer flashbacked me to Part 13, when one-appearance-only Dr. Meti hypothesized that the possible bacterias were Staph, Pseudomonas, or Mycobacterium marinum.
"Mycobacterium marinum is pretty long-lasting," Dr. Laura informed me. "If it was that, we would have seen it in the labs."
"Okay, so let's rule that out," I said. "So Staph or Pseudomonas."
"Or both. They could have been working together," she said. (I'm paraphrasing; I forgot the term she used when something like that happens with two or more bacteria.)
"Is it possible they got into me through a gout rash?" I asked. (Gout resurfaced in my mind after Dr. Jose chuckled at the sight of crystals in my MRI in Part 19.) Gout flares are typically in the big toe, but in my past history with gout (before getting treatment), I've had also had them in the inner side of my right knee.
"Skin irritations CAN get infected," she answered.
Behind the scenes of Part 1, I had initially told Dr. Esperanza of the Ocean Endeavour that I thought maybe I was having a gout flare—which was unusual because I've had gout under control for YEARS, with maintenance meds, closet personal household vegetarianism, and an active lifestyle—in fact, I was one of the few active kayakers of the entire Arctic expedition cruise. Dr. Esperanza immediately dismissed the possibility of gout—which is why I didn't mention it—because I clearly had a case of cellulitis by the time I saw her, as my leg was swelling up like a spongy balloon filled with Silly Putty.
[Sidebar About Gout: Gout, known as "the disease of the kings" or the "rich man's disease," is when a diet filled with "rich foods" high in uric acid—including alcohol, seafood, and main offender red meat—causes a build-up of calcium and urate crystals in joints, typically in the big toe but not exclusively. The result is a sudden "flare" of extreme pain that some have described as "like being stabbed with knives," in addition to redness and, in my former knee cases, a skin rash. Treatment involves maintenance meds to keep uric acid levels down, in addition to a healthier lifestyle.
Perhaps the most prominent person with gout that I can think of is the late food journalist, author, and historian Josh Ozersky, author of "Meat Me in Manhattan: A Carnivore's Guide to New York" and "The Hamburger: A History." During my Fancy Fast Food days (which, if you don't know about, you should check out FancyFastFood.com after reading this), Josh and I were colleagues. He was one of my early editors as I was a burgeoning food writer. He was a celebrity contestant in a game show that I hosted within the food episode of Nat Geo Channel's "Brain Games." The last I saw him was at the "Sandwich Invitational" in September 2014, a competition of chefs at the annual Feast Portland food fest in Oregon, where he was a celebrity judge amongst all participants (including me and @emilyjsaladino) to sample 20 sandwiches within two hours to formulate a vote.
Josh was such an outspoken character as a carnivorous food writing celebrity that he publicly admitted his gout in 2009 vowing, "I won't be altering my lifestyle at all, and that you can continue to expect the up-to-the-minute coverage of the city's dining scene that only total bodily dedication can bring." In May 2015—just eight months after I'd seen him last—he was found dead in his hotel room in Chicago, in town for the James Beard Awards. (Shortly after, Anthony Bourdain tweeted, "When they are done talking shit about Josh Ozersky, I hope they remember he wrote truly beautiful sentences. #RIP." Three years later, Bourdain was found dead in his hotel room in France.)
But I digress.
In a nutshell, if you have gout, change your ways.]
So, if I HAD changed my ways, how was it possible that I could have gotten a gout flare in the high Arctic, which possibly opened the door to a Staph and/or Pseudomonas infection?
And then it dawned on me. I did some research on the internet, which led me to a graph at the bottom of www.seadna.ca/nutritional-facts/.
The answer was there all along. Right in Part 1, there was a clue.
"Is it possible that I could have gotten a gout flare if I had over 591 [milli]grams of calcium in a single sitting?" I asked Dr. Laura. "And a bunch of iron?"
Gout crystals are partly made of calcium. Iron is a big contributor to gout flares. And one protein has 16886% the amount of calcium vs. red meat (the typical gout offender), plus 3370% the amount of iron.
"This all happened right around the time I ate seal," I admitted to Dr. Laura.
I had seal ribs for lunch—likely baby seal, a.k.a. "the veal of seal." It happened when the @adventure.canada expedition cruise had a land excursion in the Inuit town of Qikiqtarjuaq, off the coast of Baffin Island, where willing participants 🙋🏽♂️ got to sample the local meat. (This was six Facebook/Instagram posts prior to Part 1, although I did mention it in Part 1.)
"It's not a crazy theory," Dr. Laura told me. "But we can't say for sure without any evidence."
With the unlikeliness that lab reports were going to reveal anything new about the mysterious infection, this is what I was going to go with, to provide closure for myself, and to all of you reading this.
"It's a very reasonable theory," Dr. Laura reiterated. Again, she couldn't confirm my hypothesis without any scientific proof. There's still the possibility that bacteria got through the scab of my tropical "bite" on the other side of my knee, but that just brings up the question again of why didn't the infection happen on that side?
My Final Diagnosis of the Mysterious Infection (until proven otherwise): This entire medical emergency originated not because of a tropical bite in Fiji, but by an intake of seal meat—a protein exponentially overly rich in iron and calcium—causing an unexpected gout flare rash, which opened the door for a worst-case-scenario Pseudmonas and/or Staphylococcus bacterial infection (most likely the latter). This infection was contracted via an unchlorinated hot tub filled with heated and unfiltered Arctic seawater, shared by many. The contracted infection then entered my bloodstream, spawning an extreme case of cellulitis, fevers, toxic shock in my liver, lungs, and kidneys, and eventually pus-filled boils and blisters. My body had additional complications with the overdose of antibiotics—some of which I probably didn't need—which also affected my liver, lungs, and kidneys in different ways. Additional complications included an allergic reaction to one or more drugs administered, plus mental anguish caused by an unnecessary HIV scare and some family drama.
(I racked up over a million dollars in travel evacuation and medical insurance claims, to survive and just come up with that conclusion on my own.)
"How are you doing emotionally with all this?" Dr. Laura asked me. In her line of work, she'd dealt with a lot of people with emotional breakdowns over contracted infections, particularly HIV.
"I'm okay," I answered. "It helped that I was writing a story about all this."
"I think the only good that came out of this," she said, referring to my arguably dysfunctional stay at Mt. Sinai, "was the incision in your knee."
"You mean when they took samples with the needle?" I asked. "They only took 5 cc's."
"It probably stirred things up and got the flow going," she hypothesized—again, something that couldn't really be proven without hard evidence.
(Comic Book Nerd Alert!: If Dr. Laura's theory is plausible, that means that after this hospital stuck a metal probe in me—a facility which has beds, wheelchairs, and other equipment branded "Stryker"—I started displaying a Wolverine-like self-healing mutant ability. 🤯 )
I set up follow-up appointments with One Medical and Dr. Laura for blood tests and a knee inspection for the following week, hoping that this would be all behind me soon—especially since I had some plausible closure.
"I hope you never have to talk to the medical community for a long time," Dr. Laura said, bidding me farewell.
I took the train back to Brooklyn to be an outpatient at home for a week—a period of rest, non-allergic oral antibiotics, and a continual redressing my knee, which was still draining pus slowly and steadily through my biopsy hole. Friends continued to visit, bearing gifts of food, and even if some of them brought meat into my home, I'd let that slide for now—provided no one brought me seal meat.
To Be Continued (hopefully in an epilogue, unless Something Unusual Happens Yet Again for Another Plot Twist)...
[BACK TO MENU]
Epilogue I: Between Two Trips
Originally posted September 24, 2019
"Can I give you a call to clarify and chat about a few things?" wrote Alana, VP of Operations at @Adventure.Canada, shortly after I posted "Part 20: The Hypotheses." I had a feeling they'd eventually reach out for some damage control about my theory. However, her message spawned a temporary game of e-mail and phone tag, and I waited while she was "it."
It's been a week since the events of Part 20, in which I hypothesized a diagnosis of the mysterious, seemingly tropical infection that I attacked me in the Arctic, for a sense of closure—an ending to this 21-part travel medical saga. In that span of time, seasons have literally changed (at least on the calendar), and my health has slowly transitioned into the range of normalcy. It's been a week of self-treatment at home as an outpatient, with non-allergy oral antibiotics and plenty of gauze pads, rolled gauze, medical tape, Ace bandages, and saline solution for a regiment of knee redressings. My knee has been cleaned and re-wrapped every few hours, as it continues to expel pus from my biopsy hole. The intervals between bandaging sessions have increased over time as the drainage is eventually waning, like a mustard-filled water balloon going flaccid. That metaphor being used, said balloon—i.e., my swollen knee—is deflating back to some sort of a normal shape, with the help of occasional warm compress sessions. I'm finally back to looking like I might have just one kneecap on my right leg again.
As for issues with my kidneys and liver—brought on by sepsis, toxic shock, and/or an overdose of antibiotics—all of that seems to be improving. And somehow after weeks of hospitalization—with all that sneaking in of outside food into Mt. Sinai—I'd managed to lose the ten pounds I'd been trying to get rid of. Perhaps if I'd stayed at Mt. Sinai I might have gained more, but it's good that I got discharged when I did; a couple of days after I left, the hospital was in the news for being evacuated for a chemical spill. 😳
My day-to-day life has also started a return to normalcy as I'm back in rotation as a contractor at my corporate day gig, while freelance writing as my side hustle. I'm back to my no-longer-secret personal household vegetarianism, offset by being a "social carnivore" when eating amongst my omnivorous friends. Being temporarily housebound, my stream of visitors still continued, some bearing food, some bearing non-alcoholic beer, some just being great company to binge Netflix with.
Those who didn't physically come visit me still gave support over internet lines. Some friends came forward with their own stories of gout, that "rich man's disease" which afflicts gourmands who really know how to eat well—perhaps too well. I also had a number of people empathize with me with stories of their own family drama. It's not just my family, but many others who have tension when it comes to sensitive subjects—it's not so much of a cultural divide as much as it is a generational one. Boomer Filipino parents—or any immigrant parents—aren't the only ones that often cling onto archaic ideas; some White Americans have those issues too.
Other than receiving e-support, plenty of seal jokes and memes came into my message windows, both about seal, the marine mammal, and Seal the musician—or sometimes a combination of both. Jokingly I've said that my final diagnosis to the mysterious infection was that "I got a Kiss From a Rose."
On the subject of seal—and local game meats in general—I'd like to reiterate something that I've said and written before. Seal meat isn't "exotic"—because just what is "exotic" anyway? I try not to use that word when it comes to cultural traditions because what's "exotic" to you is "normal" to a whole lot of other people. Seal meat is a staple in the Inuit diet, as it's high in protein and low in cholesterol. As I described, it has a taste like mackerel or very well-done tuna, which is surprising when a red meat tastes like fish. (Seals eat fish, so that makes sense.) As for my gout-y reaction to it? It's on me that I sampled it with a pre-existing condition, not knowing its exponentially high levels of iron and calcium when compared to mainstream animal proteins. Everyone else who sampled seal meat that day in Qikiqtarjuaq has appeared to have been okay.
Addressing the cultural sensitivity of consuming seal meat was one talking point of @adventure.canada's VP Alana, when we finally connected on the phone. Firstly, I praised her adventure expedition cruise company for everything they'd done, despite everything that happened with me medically. From beginning to evacuation, @adventure.canada had been a true class act in every step of the way, even months before departure, always behaving in a professional and quintessentially Canadian-friendly manner.
"I have friends who've read the whole thing," I told Alana. "And even with everything that's happened, they STILL want to go on a trip with you guys." Friends have told me that they were still impressed with the images I'd taken in Greenland and the Canadian Arctic before this medical saga began. (Also, I'd seen images coming from the second half of the trip that I'd missed, which were even more impressive. Check out the photo carousel of polar bears and walruses at @jaymemoye on Instagram.)
"I just want to clarify something," Alana said, getting back to damage control. "The hot tub water IS treated," she informed me. She even forwarded me the log of when exactly the hot tub was regularly treated, with graphs showing levels of the chemical treatment to curb bacteria from surviving in the communal jacuzzi.
@Adventure.canada had in fact, covered all their bases. I had only been led to believe the tub was untreated because it didn't smell like chlorine, and, when soaking my sore knee in the bubbling water with my kayaking guide, he suggested, "Salt water's good for that."
"Well, then I guess it's going to be back to being a mystery again," I told Alana. If the hot tub water was in fact treated to prevent bacteria from surviving, my hypothesis starts to falls thin.
However, my friend @rmwallace commented to me that he has a friend that still got a similar staph infection from a hot tub filled with treated water. "Staph and even MRSA can live in treated waters," he commented. "This is why most places advise bathers to shower before using the facilities. I'd wager you had the gout flare and it could have been anybody's germs that were in the hot tub."
Shower before using the hot tub? No one, including myself, did that on the #OceanEndeavor.
I should point out that @rmwallace is NOT a scientist, so his words might be taken with a grain of salt. So I started doing research with the American Centers of Disease Control (CDC) and dug up some more official facts.
To summarize the CDC website pictures that I included along with this post, Staph(ylococcus) is a common bacterium that just lives on people's skin. It's generally harmless, unless it enters the bloodstream, causing serious infections that "can lead to sepsis or death." Staph, or its antibiotic-resistant relative methicillin-resistent Staphylococcus aureus (MRSA), can NOT survive in properly treated recreational hot tub water for long, but it can be brought into recreational water facilities by people and then exist until the chemical treatment kicks in to kill it off. While the CDC claims "there have been no reports of MRSA spreading through contact with recreational water," it does say that Staph can be spread by simply using shared facilities (with people who haven't showered it off, I may add).
In conclusion, while science says I might not have gotten a near-fatal Staph infection from a treated hot tub, I could have accidentally gotten it from the ship's sauna, or by accidentally using someone else's towel. Or maybe from using the kayaking drysuit that enveloped my entire body, which was only rinsed on the outside after each use. Of course, none of this can be proven without hard evidence, so it's up to you to decide or deny it.
On top of all this ambiguity, it may also be significant to point out something else I read on the CDC website: that the pustules and boils of an MRSA infection may be "mistaken for spider bites."
Fijian spider bites! 🕷🤯
If you're wondering why it took a whole week for symptoms to start appearing on my knee, it's not unheard of that an infection could have secretly developed inside me, between the two trips of Fiji and the Arctic. Old school blogreaders may remember that when I got stung by a Portuguese man-o-war jellyfish in Ecuador, it took a whole week for the rash and lesions to visually appear on my skin. So perhaps it was something like that.
While I still believe I probably got a seal meat-induced gout flare that opened the door for a Staph infection, which I somehow contracted on the ship, I'm still not going to rule out the possibility of everything happening because of a tropical spider bite—mostly because, to get a "tropical infection in the Arctic" is just so epically ironic. The @plausiblyridiculous #situationalirony of it all is just so... ridiculously plausible.
In the end, this whole travel medical saga ends with an ambiguous finale, open-ended for interpretation, like "The Sopranos" or "Lost." That being said, I'm open to any leads out there for how to translate this story into a episodic show (heyyy #Netflix), a podcast, a book deal (other than one with @canonizer's literary agency and their apparent interest in only TV celebs), news/magazine articles, an exposé of travel insurance and/or the Canadian or American healthcare system, interviews, speaking gigs, or any media projects that this story may be suited for. (If you know anyone, please DM me with solid leads. I already see that readers from @cnn, @cnntravel, @nytimes, @bbc_travel, and @cnbc—including @allenxkim, @lilitgoes, @wonderdj, and @kschoolov—have been following me.)
In the meantime, my life will get back to normal, and I'll get back to being a freelance travel journalist with another press trip just around the corner (next week): the Spanish region of Castilla y León—a destination without tropical spiders or seal meat or the possibility of a daring high Arctic military evacuation. Going to central Spain is definitely a far less risky trip than the other prospective one in November that I recently turned down: an expedition cruise... to Antarctica.
The End (?)
THANKS AGAIN for everyone's support! For updates on the post-infection financial front, check out the latest at: GoFundMe.com/ErikArctic
[BACK TO MENU]
Epilogue II: Return of the Sinai
Originally posted September 29, 2019
I thought I'd seen the end of Mt. Sinai hospital on Manhattan's Upper East Side, but I found myself back there again—exactly one month since cellulitis commandeered my right leg and swelled it up like a Silly Putty-filled balloon. They were to investigate the fact that the inflammation in my knee hadn't gone completely down, especially since the pus drainage through my biopsy hole had finally run dry after ten days.
"I spent 37 hours in the ER, and then another fifteen waiting in the hallway, before I got a bed," I told Carlos Calle, the MRI technician, who was a far more personable tech than the deadpan Asian MRI dude I got the previous time. Conversations were pleasant with him, given the circumstances that I would be slid into a confining MRI chamber.
"I say if you can survive the ER here, you can survive anything," Carlos joked.
Mt. Sinai's Radiology Associates department—where MRIs are done for outpatients—was more clinic than hospital, but I found myself disrobing and getting back into a familiar hospital gown as I'd been in for three weeks. Laying in the gurney, Carlos tried to make the MRI session as pleasant as possible by way of a two-way headset to communicate. When conversations weren't happening, the headset pumped my ears with music from the oldies 80s station, 101.1 WCBS-FM. "No dancing," Carlos instructed me—my knee had to remain completely still for the imaging to be sharp. Fortunately, unlike last time, my legs were in a comfortable position, untethered from each other.
"Everything okay?" he asked as he put the headset on me. The music started playing.
"It's Gloria Estefan."
"Remember, no dancing."
The Rhythm was Gonna Get Me as I slid into the MRI machine for an electro-magnetic session that lasted about 45 minutes. The audible pulses of the machine were drowned out by Def Leppard, Paul Simon, and Simple Minds. The 80s playlist continued longer than usual though because there was a snag with my insurance, right in the middle of the claustral MRI session.
"There's some miscommunication between insurance, your doctor, and here," Carlos told me via headset. "Hopefully it won't take long." There was a discrepancy if I was to get an MRI with contrast, in addition to the one I just got without, and whether or not that would be covered by insurance. Since Part 6, the hold up is ALWAYS because of insurance.
So, I just waited in the tight-spaced MRI chamber for fifteen minutes—all so my knee would be in the exact position for the comparison between two MRI scans. Fifteen minutes turned into at least half an hour as I just laid there in the chamber with the headset on. 🎵 Don't you... forget out about me... Don't don't don't don't... 🎶
Carlos Didn't Forget About Me and decided not to let claustrophobia kick in, so he just released me to wait in the waiting room until the latest insurance mess got cleared up. I was reunited with my phone, where the approval for both types of MRI scans—along with the insurance authorization code—were right in my @OneMedical app. However, the three-way phone approval situation was wrapping up anyway, and soon I had another familiar procedure—one I'd had many times over this entire ordeal—getting poked in my arm for yet another IV lock.
Back in the MRI, back in the headset. "It's Michael Jackson," I told Carlos.
"Remember, no dancing."
The King of Pop Didn't Stop 'Til I Got Enough of the superconducting magnets, first for another un-contrasted scan (in my new position), followed by an injection of the gadolinium contrast dye for another scan. I changed back into street clothes and left Mt. Sinai and the Upper East Side, hopefully for a while—or at least until I got back from Spain. On my way back to Brooklyn, I was sure to check out that Taco Bell that @rayzorraygram, @mmwwwhahaha, Theresa et al. had all been talking about in Part 14.
Despite not yet being 100%—I'd put me at 88%, a solid B+—I'd been easing back into my regular New York City life in this interim between two trips, with events, parties, and the occasional Sunday lunch with my parents (the Filipino Costanzas of Part 17). At one rooftop press dinner, I met @PhilipBStark (no relation to #IronMan), forager and Associate Dean at UC Berkeley, who reminisced with me about living in the SF East Bay. He empathized with my medical situation, but also put things into perspective for me: he too had been on IV antibiotics for MONTHS (not just weeks), combatting a spinal infection that almost paralyzed him—brought on by a dental procedure. 😳 At Evil Twin Brewery's soft opening, publicists @ndanyeats and @cortney.lynnn were surprised that I even showed up, straight from Mt. Sinai. "We've been following you on Instagram. How are you even here?!" That surprised sentiment was also shared by @007louiseob and others at @lilitgoes' rooftop birthday/bon voyage party.
At @jennyjhart's 10yrs-in-NYS soirée, I ran into friend and former editor @sameifling, who gave me solid advice on how to approach a book or media deal with my medical saga.
"Everything that's happened to you are just empty calories now," he told me, which I agreed with. "You need the vitamins." Unlike the story-turned-movie of self-amputee Aron Ralston—the "127 Hours" guy—a story isn't complete without transformation, which hasn't happened yet.
"Please don't cut your leg off," colleague @devontleaver begged me back at the office of my corporate day gig. She concurred with others that maybe @nytimes'/@netflix's "Diagnosis" was a fit for my story, but "I kind of like it having an ambiguous ending," I told her. I knew that the only way my mysterious infection would be 100% solved is if cultures were taken in the early stages, but the first samples were taken in Iqaluit two days AFTER I'd been pumped with the antibiotics that probably saved my life—and therefore no good, scientifically speaking. (Both Hotel Dieu de Quebec and Mt. Sinai called Dr. Patrick at Qikiqtani General to confirm this.)
Furthermore, my story is more than a medical mystery; it's a very much a travel story as much as it is an exposé of the dysfunctions of the travel insurance and healthcare industries, both in the US and Canada. (Canada may have universal healthcare, but they can give you a misdiagnosis and an allergic drug reaction.) It's also a story about how blogging on social media in real-time can actually affect the story as it progresses in real-time. Throw in an HIV scare and some family drama and collectively, this is all a story that's more creative non-fiction than a mere case for a medical journal columnist/show—to be told by a passionate storyteller 🙋🏽♂️ (that would hopefully get paid for said narrative).
Speaking of this self-referential story, I didn't think a second epilogue would happen, but then I was sent back to Mt. Sinai. Hopefully this is the end of it all for a while. That being said, this two-part Epilogue wouldn't be complete without a visit to my nomination for Doctor of the Year, @OneMedical's infectious disease Dr. Laura. (It was after my follow-up appointment with her that I ended up having to get an MRI in the first place.)
"Your labs came back," she informed me. "Your kidney function is normal. Your liver function is normal. Your white blood cell count is normal." Everything was trending to a better, albeit untransformed me, except my red blood cell count which was off. "That doesn't surprise me because you've had so much blood drawn."
Inspecting my leg, with its slightly swollen ankle and undeniably swollen knee, Dr. Laura warned me, "There's a possibility that you aren't going to be the same, that your leg may just be like this—"
"Oh, I thought you were going to say that there was a possibility that I was going to have super powers," I interjected. She laughed.
"I'm not going to rule that out," Dr. Laura told me. "If you're sitting here talking about all this, you've got SOMETHING."
Dr. Laura gave me a prescription for thigh-high compression stockings to encourage blood flow through my slightly swollen leg during my upcoming flight to central Spain. I got a pair, custom fitted with specific mmHg compression, at a local pedorthic supply store. The black compression stockings even enclosed my feet, and would serve as my superhero tights for my upcoming press trip to Castilla y Leon... and beyond.
Until further notice, we now return you to your regularly-curated travel- and food-focused @theglobaltrip Instagram/Facebook feed...
[BACK TO MENU]