1
It is time to leave Cusco once more. Trung and I check out of our hotel, Hotel Unaytambo, and wait in the lobby for the driver to come and pick us up. We hop into his car when he arrives. He drives us for ten or fifteen minutes along narrow mountainous roads, largely deserted in the early morning hours, before dropping us off near a bus parked along a large street. We hop into the bus and settle comfortably into two seats next to each other. I am looking forward to the journey to Puno, the town nestled on the banks of Lake Titicaca. It is going to be a day-long journey, but it will be worth it. Never in my life had I imagined that one day I would get to see the world’s highest navigable lake. My head is held high.
The bus leaves on time at 7:30 a.m. I drink in the sights that unfold from the window. Everywhere in the city, there are unfinished buildings. Buildings with brick walls, with the skeletons of steel columns jutting from their roofs, aiming for the skies. Eventually the number of buildings becomes sparse. Not long after, they disappear completely. There are mountains and hills in the distance, but they look dark and forbidding. Traveling by bus is letting us see the landscape, largely barren though it is, as traveling by plane never would have.
All the while the tour guide is holding forth on the intercom about the history of Cusco, its geography, and its topography. She is enthusiastic but she is not loud. Her mellifluous commentary lulls me to sleep. A morning nap never hurt anyone. I know I will feel refreshed when I wake up. The relentless travel of the past two days has been a little hard on the body.
The bus pulls over into a parking lot and the tour guide asks us to step out. We are in a place called Andahuaylillas. Next to the parking lot is a baroque church, one dedicated to St. Peter the Apostle and nicknamed the Sistine Chapel of America. We enter it and I admire the frescos on the walls. But I do not feel as enthusiastic about them as I thought I would. There are trinkets on sale in the small street market outside the church. By the wall is a stand full of scarves. Another one displays colorful hats. I do not buy anything but I take a picture of the hat stand. We get back on the bus. I settle into my seat and close my eyes. The bus is once again on its way.
The tour guide enthusiastically describes wonder after wonder that we are going to see at the next stop. “And where will you see it?” she asks us. “Raqchi!” she cries, with a flourish and a rolling R sound. And it is indeed a sight to behold. The most prominent attraction are the ruins of a large temple, the Inca Temple of Wiracocha. We see a massive central wall with several doors and windows and openings. The first few feet of the wall near the ground are built with stone, but the next several feet higher up are built with mud. Or they too are built in stone but are plastered with mud. I squint but I cannot really tell. Atop the wall are the remnants of a roof, sloping down on either side, but just for a meter or two. It is more of an awning than a roof.
Trung and I walk with our fellow passengers from the bus among the ruins with the tour guide. There are hills in the distance but they look brown and blue and barren. There is some vegetation on the ground but it is sparse. There are several white clouds in the sky but the pieces of the sky that poke through them are a bright blue. I feel cold. I am wearing a jacket, a fall jacket, but still.
We stop for lunch at a restaurant in a town named Sicuani. I am not hungry. Yet I fill a plate from the buffet because who knows when our next big meal will be? We sit at a table outside the restaurant, Trung and I and two other travelers from our bus. In front of us is a small pond. A small llama stands next to it, gazing calmly into thin air. Its head is white and so are its feet. But its hair, jet black, is unshorn and almost touches the ground. I have never seen anything like it, not even in zoos. It is a sight to behold. On the other side of the pond musicians people are playing traditional Andean music. The notes played on the pan pipes are uplifting; they remind me of the CD of Incan music I bought more than a decade ago. To my surprise the food is delicious. Before long I finish the plate and get a second helping. After lunch we get back into the bus and continue on our way.
“La Raya!” cries the tour guide, jolting me awake. I must have nodded off. The bus has made another stop. From the window I can see snow-capped peaks in the distance but there are no archaeological ruins in sight, nor is there a museum or a church. The tour guide tells us that we have reached the highest altitude of the journey, the La Raya mountain pass. At over 14,000 feet, it is near the border of the Cusco and Puno regions. The bus has pulled over into a makeshift parking lot by the side of the highway. Many of the passengers step out. I glance at Trung. His face is somehow looking puffed. He says we should also step out with the other passengers. But I am not too keen on it. I feel a little lethargic, no doubt from the heavy lunch. There is little point in stepping out of the bus to gaze fondly at a barren landscape and mountains in the distance.
But I give in to his urging and step out of the bus. It is perceptibly colder. An icy wind cuts into my neck. I zip up my jacket all the way up to my chin. But the wind is in no mood to call it quits. Trung asks me to take a picture of him with the snow-capped peaks in the background. I do, upon which he offers to return the favor. But I decline.
It occurs to me that this is one of the highest altitudes I have been to, just a hundred feet shy of the summit of Mount Evans in Colorado. My gosh, that was fifteen years ago, in the summer of 1997, although it feels like yesterday. I had gone to Denver one weekend to see my friend Puru, at the same time as the G-8 summit that was being held there. In fact I had even stayed at the same hotel in which the Russian President, Boris Yeltsin, had stayed. Puru had taken me for a drive to the summit of Mount Evans along the highest paved road in North America. We had stepped out of the car, only to be surprised by the bitter cold and the light flurries. From the summit it had felt surreal to see Denver, with its sunny summer warmth, in the far-off distance, down on the plains. Never before had I seen so many contrasts at once: of altitude, temperature, precipitation, climate and season. I had felt a little out of breath then but I feel fine now.
I can hardly wait to get back into the warmth of the bus. From now on it is going to be all downhill, all the way to Puno at 12,500 feet. We get back into the bus and it rumbles on. I peek outside the window a few times. There are mountains everywhere. Barren, because we are still well above the tree line. I doze off. The sound over the intercom wakes me up. The tour guide is talking excitedly about Pukara. It must be our next stop. I wonder how many more stops there will be on the way before we reach Puno. I hope this is the last one.
The bus pulls off the highway and makes it way through the narrow alleys of a town. Within minutes it stops. We get off and enter a single-storey building. It has a sloping roof and it appears to be a museum. It contains gallery after gallery of small rooms with pottery and fabrics and stone statues and artifacts displayed along the walls. The tour guide excitedly tells us about the various civilizations showcased in the museum, when the artifacts were created, and where they were found. In ordinary circumstances I would have held onto her every word, absorbed like a sponge all the details she is telling. But today is a little different. I am not quite in the mood. I do not take any pictures. I simply cannot bring myself to. Enough is enough. Half an hour passes before we are back in the bus.
It is evening. The bus rounds a bend and cuts through a gap in a mountain. It is going downhill. To the left lies a vast expanse of buildings, no more than three or four stories high. Beyond them is a narrow body of water, reaching all the way to the horizon. With a big smile I point it excitedly to Trung. It is our first sighting of Lake Titicaca, the lake I had never imagined I would one day get to see in person. Our itinerary of the next two days promises several such sightings, but the first one is always special. I make up my mind to always remember this moment.
The bus pulls over into a bus depot. We have arrived. Finally! The journey that had seemed to be never-ending has come to a welcome end. Trung and I get off the bus one last time. We enter the waiting room but all the seats are taken. The person who was supposed to pick us up (his name is Oscar, Trung tells me) is not here. We have no choice but to wait. We step outside. I lean against the wall of the waiting room. It is a little chilly, a few degrees above freezing, far chiller than Cusco. The jacket I am wearing is not up to the task. I feel a little nauseated, although I am nowhere close to throwing up. Perhaps it is from the cold. Or perhaps the heavy lunch is not sitting well with me.
At least fifteen minutes must have passed since we got off the bus. But it shows only five. I find it hard to believe. It must have stopped working. But the digits of the seconds are still advancing. It must be correct because either it always shows the correct time or it stops working abruptly when the battery dies, like a person dropping dead from sudden cardiac arrest. I can hardly wait for the wait to be over.
Oscar finally shows up. Slim and a little dark skinned, he is holding a sign with our names written on it. Trung beckons to him. He flashes a smile and apologizes profusely for keeping us waiting. He says he went to the wrong bus station, the other bus station in town. I look at my watch. We have been waiting for half an hour. We hop into his car. The roads are similar to Cusco’s; narrow and filled with people and vehicles. But the terrain is not hilly and people are wearing thick sweaters. Red and blue and green and yellow, their garments are multicolored. I am eager to reach the hotel and lie down in bed for a few minutes. Resting in an inclined bus seat simply cannot compare with lying down flat in a bed, even if the bus is a luxury bus.
Trung and I check into our hotel, Hotel Qelqatani. It is in the middle of the town, nestled among congested streets and narrow alleys. We go upstairs to our room. It is warm. We freshen up. I start feeling better; I no longer feel the need to lie down. Trung suggests we go out for a walk in the neighborhood. I am not all that keen on it, but I need to withdraw some cash from an ATM for tomorrow’s trip.
We step outside. The street is filled with people. The sunlight has waned and the day is dying but the festive air is unmistakable. Perhaps Cusco was just as festive in the evenings but I never got a chance to see it. I come upon an ATM and take out some cash. We walk around town for a few minutes, drinking in the sights and the sounds before walking back to our hotel. People are wearing brightly colored clothes and neon signs are flashing from storefronts. Yet the colors do not look vibrant. An inexplicable haze has settled over the town. Perhaps it is a mist, a harbinger of a heavy fog that will cloak the town later that evening. The people walking in the streets do not look energetic. They are trudging. They do not look happy. I cannot imagine why I thought the atmosphere was festive.
Trung suggests we have dinner in the hotel’s restaurant. I tell him I am not hungry. I might not feel nauseated anymore, but nor do I feel like eating anything. But I know I must have a decent-sized meal, or else pangs of hunger will gnaw at me and keep me from sleeping soundly at night. “Order a dish and eat only as much or as little as you want,” he says. It is sound advice.
The waiter seats us at a table. My friend and I are the only patrons. I order a vegetable soup with rice. I take one sip and it tastes very good. I take another, and yet another. Before long, the bowl of soup is empty. I am glad I took Trung’s advice. I felt full before dinner but I feel just as full now. Strange are the ways of the world.
2
We head back upstairs to our hotel room. A chill has crept in; gone is the warmth that welcomed us when we first entered it. I check the windows. They are firmly closed. The thermostat’s temperature setting has not budged. The outside temperature must have dropped. It is the middle of May, the onset of winter. Perhaps the heater is not powerful enough. Or maybe I am being too picky. Big meals tend to suck the heat out of me, leaving me cold.
Fortunately I know exactly what I should do to feel better. I take a long, hot shower. The heat enters my body through every pore. I wear pyjamas and a sweatshirt and a hat and go to bed. Trung also takes a shower and calls it a day. We have to wake up early the next morning to head out to the lake, the lake of my dreams!
Oddly enough, I start feeling cold again. I wear another layer, a second sweatshirt on top of the first one. With a vest underneath, I am clad in three layers. I feel warm and snug beneath the blanket. I can finally fall asleep. But the cold returns with a vengeance. The second sweatshirt might as well have been made of paper. Worse, I have started shivering. Perhaps the forecasted low of a few degrees below freezing has already been reached outside and the cold is somehow leaking into the room.
I glance at my friend. He is fast asleep in his bed. Clearly he is not feeling cold, or else he too would have tossed and turned. Maybe because he is younger than me, a decade younger, and is in better shape. In fact just about anyone is in better shape than me; no one comes even close to being as skinny as me.
I get up and wear the jacket on top of the two sweatshirts. I cough a little. My head has started aching. I debate whether I should take some medicine or wait for the headache to go away on its own. If the past is any guide, it will probably get worse if I take no action, robbing me of a few more minutes of precious sleep between now and when I ultimately take the medicine. I bite the bullet and take the pill, the medicine that I always carry with me when I travel. The headache should be gone in around half an hour. I settle back into bed.
But I wake up coughing every few minutes. I make an effort to cough softly so as not to wake up Trung. An hour has passed since I lay down in bed. The cough is not dry anymore. I go to the bathroom and spit out the sputum. It is thick and yellow. It must be a head cold, from not drying my hair sufficiently after taking a shower. I pee before heading back to bed. My thoughts start turning into dreams. But before I can slip away for good into a world of dreams, I am seized with a bout of intense coughing. I head back to the bathroom and spit out the phlegm. It is thick. It is yellow. It is vomit-like. And it contains streaks of red. I wonder if I am throwing up in slow motion, tiny amounts at a time. I cannot be, as I am not feeling nauseated in the least. I must have got a cold. A sudden one, a severe one. I pee once more. Perhaps I drank too much water before going to bed. Perhaps the soup I had for dinner had too much sugar in it. Or salt. Or both. I head back to bed, feeling relieved from clearing the chest congestion and from peeing.
I cough violently a few minutes later. Trung is fast asleep. Another trip to the bathroom, another clearing out of the yellow-and-red discharge, another round of peeing. I must have got a bloody nose from the dry weather. My headache has reduced but it has not gone. I am still feeling cold, although I am no longer shivering.
It is 2 a.m. I must have made at least half a dozen trips to the bathroom, perhaps a dozen. Honestly, I have lost count. I have a feeling more are on the way. It is getting to be a little stressful. How will I be able to wake up at six in the morning and spend the entire day going sightseeing with so little sleep? And how on earth will I be able to spend the next night on a traditional floating house on the lake when the forecast calls for another night of below-freezing temperatures cold enough to chill a person to the bone?
I have another bout of coughing. When I come back from the bathroom, Trung asks me if I’m okay. I have an epiphany. I tell him he should go sightseeing with the tour group in the morning without me. I will stay in the hotel room. All I need is a day of rest and I will be back on my feet by the evening. I will miss the overnight stay on the boat, but he can go on his own. Once I start feeling better, I will do some sightseeing on my own. I apologize to him for bailing out on him. He looks incredulously at me, a hint of worry on his face. Both of us go back to bed.
It is 3 a.m. I have not slept a wink. To say that I am fatigued would be an understatement. I am dead tired. Barely have I emerged from the bathroom and laid down in bed than I have to rush back inside to clean out the thick liquid. It does not have streaks of red anymore, but it has started looking pink. I do not know whether that is good news or bad news. I think I know where it is coming from. It must be gastric reflux. The soup I had for dinner must have been quite acidic, although it did not seem spicy. I should have probably avoided it. In fact I should have skipped dinner. I take an antacid tablet. I am glad I have brought some basic medicines with me from the U.S.
It is dawn. I am still tossing and turning, coughing and sneezing, discharging the thick liquid and peeing every few minutes. For once I have a clear-eyed moment. I am going to need medical attention. And I am going to need it right away. I wake up Trung and tell him. He asks me to call the hotel’s front desk. I do but the person who answers the phone does not speak English. I do not speak Spanish and neither does Trung. I ask him if he can go to the front desk in person and tell them.
He does so and returns in a few minutes. A doctor is on his way, he tells me. I am immensely relieved. The front desk person did not understand him either, he tells me. He went into the office and fetched his manager. The manager spoke English and understood Trung.
Twenty minutes pass, maybe thirty. There is a knock on the door. Trung opens it and two men walk in. I sit up in bed and greet them. One of them is the hotel manager, while the other one introduces himself as Dr. Sardon. Dr. Edy Mercado Sardon, he says, cardiologist. I am pleasantly surprised that a cardiologist has made a house call to my hotel room. I cannot imagine such a thing happening in the U.S.
He examines me with a stethoscope and checks my temperature. He says I am running a high fever and my heartbeat is high. Fever! So that’s what made me shiver and feel so cold during the night. I cannot imagine why I did not suspect it, though. He tells me I also have altitude sickness. I gasp. I feel like I am experiencing a death, a death by a thousand cuts, delivered all at once. How could I possibly have altitude sickness? Isn’t this my fifth day at a high altitude? I did have it on the first day, the day we first arrived in Cusco, but didn’t my body get acclimatized within a day? How else could I have felt perfectly fine on the following days?
Dr. Sardon asks me about my symptoms. I tell him. I also tell him I took an ibuprofen for the headache and a famotidine tablet for acidity. He asks me whether I am allergic to any medicines and whether I have any underlying conditions. I say no to the former but for the latter I tell him I have a chronic heart condition called bundle branch block. I am pleased that he speaks fluent English.
He says I might also have an infection. The phlegm and the fever point to one. I am not surprised that I have an infection but getting it along with altitude sickness is a double whammy that I have not bargained for. He gives me two or three pills. I take them immediately, feeling relieved that my health is going to be on the mend. All I will probably need to take is another pill or two for the Acute Mountain Sickness I think I have; the mildest of the three variants of altitude sickness. I can easily spend the day in the hotel room while my friend can go sightseeing.
But Dr. Sardon has other plans. He tells us it would be best if I were to check in to a hospital or a private clinic. But the clinic is expensive, so he recommends the public hospital. I am taken aback. The situation is a little more serious than I had imagined. It is still dark outside; it is around 5:30 a.m. I figure I can always go to the hospital after daybreak, maybe after having some buffet breakfast in the hotel even though I am not hungry.
Trung asks the doctor when would be the best time to go to the hospital. “As soon as possible,” he says. “The sooner the better.” Trung and I exchange nervous glances. We had no idea the situation was so dire. Dr. Sardon asks me to choose between the hospital and the clinic. I choose the former. If I am going to need more medical attention, a hospital with its army of doctors and nurses would be a much safer bet. He says he will call them and let them know I am coming. He gives us his business card and writes down the name of and phone number of the hospital on a piece of paper. Hospital EsSalud, it says.
The two men leave. Trung tells me to get ready and wait. He says he will have a quick breakfast and make arrangements to take me to the hospital. The long night has come to an end. I might be alone in the hotel room but I do not feel lonely anymore.
3
“Wake up,” says Trung. “It’s time to go to the hospital.” With an effort I get out of bed. I feel groggy. I must have nodded off. I make another trip to the bathroom. I take my backpack and we leave the room. He says we will check out of the hotel once we return from the hospital. I tell him I can go to the hospital on my own; he should not miss the sightseeing tour. But he says he will stay with me.
We sit in the back of a taxi, Trung and I. It is cold. I hold a paper towel in my hand and keep dabbing my nose. My cough has reduced; I do not have to keep spitting out the sputum anymore. I lean against the seat and close my eyes. But I do not sleep. The vehicle is a ramshackle one but the driver drives it at a breakneck speed. It’s hard to imagine why he is in such a hurry. I open my eyes. The taxi has approached a roundabout. Several streets feed into it but they are all deserted. Patches of dried grass poke through the brown earth in the roundabout. A statue of a general astride a horse sits on a pedestal in the middle of the roundabout. The sun is casting tentative beams of light in the frigid morning air. The sunlight is kind. My mind is at peace.
The ambulance could not make it, Trung tells me. It was not ready. The hotel manager advised him to take a taxi. It will be much quicker, he said. I nod absently. The ride to the hospital is taking forever. The buildings have thinned out. The taxi enters a campus. EsSalud Hospital Base III - Puno, says the sign above the entrance gate. Behind the campus is a sprawling rocky outcrop. It is more of a gently sloping hill, stretching for miles and miles and dotted with several houses and buildings. The taxi comes to a stop. Two people approach the vehicle. Americano, Americano, I hear them say. I wonder whether they have been waiting for us. I give Trung my passport and ATM card. The two people usher us into the hospital. Trung walks over to the reception desk and checks me in.
I am helped onto a gurney. It is wheeled indoors into a large room, large enough to act as a hangar for small planes. There are several other patients in the room lying on similar gurneys. Someone covers me with blankets. A warmth begins to descend over me. Another person raises the back of my bed, so that I am no longer staring at the ceiling. A nurse places oxygen tubes onto my nostrils. Another checks my blood pressure and my temperature. She takes my right arm and rubs the crux of my elbow a few times. She pierces it with a needle but no blood comes out. She pierces it in a different location a few millimeters away but the result is the same. It hurts. My veins are not in the habit of popping out. The nurse succeeds on the third attempt. She takes two vials of blood to perform blood tests.
She also pierces my arm with a hollow needle. She says it is for an intravenous drip. But she does not start one; she tells me she will do it later if it becomes necessary. A doctor examines me with a stethoscope. He gives me three medicines: one to reduce altitude sickness and another to reduce respiratory inflammation. He tells me what the third one is for but my mind does not register it. Perhaps it is an antibiotic for the infection. High up above my bed the monitor confirms what Dr. Sardon had measured when he called upon me in the hotel room at dawn. My pulse rate is quite high. I am tachycardic.
A middle-aged man approaches my bed and starts talking to me. He is bespectacled, pot-bellied, and quite friendly. But the Spanish he speaks is Greek to me. No hablo español, I tell him. He promptly switches to English and asks me why I am in the hospital. Soroche, I tell him. Ah, soroche! he goes. How do you know the Peruvian word for altitude sickness? Dr. Sardon told me, I tell him. He asks me how I got it. I visited Cusco and Machu Picchu for three days before I came to Puno, I tell him. Yesterday, the fourth day, was a travel day from Cusco to Puno. He asks me whether I exerted myself in Machu Picchu. I tell him I hiked for a good three to four hours on each of the two days I was there. And the cocoa tea? Did I have any cocoa tea? I had some in Cusco. But not much because I doubted whether it would be of any use. He says altitude sickness is not uncommon among visitors, especially among foreigners.
Dr. Sardon comes to the hospital and stands by my bed. A nurse tells me I will soon have a chest x-ray taken. She helps me get out of bed and into a wheelchair. Another person holds the oxygen cylinder. It is made of gleaming steel and has a dome-shaped green top. Trung and Dr. Sardon push the wheelchair to the x-ray room.
But the door is closed. A medical assistant tells us it is closed for renovations but will open shortly. I can hear some banging and shuffling on the other side of the door. We bide our time in the hallway. I have started feeling cold. There is a blanket wrapped around me and a cap on my head but sitting in a wheelchair in an unheated hallway is no match for the comfort of lying in a hospital bed.
Dr. Sardon is oddly quiet. I am surprised he is standing by my side all along. I would imagine he would have other patients to see, more important things to do. In my mind I salute his devotion. I strike up a conversation with him. I tell him I have bundle branch block. I remember telling him the same thing when he visited me in the hotel room, but it never hurts to remind him of it again. He smiles. I also spill the beans about my family’s health history. I tell him my mother got a heart attack at an early age, fifty-one. It was almost fatal but luckily she survived. Both my parents have high blood pressure and high cholesterol. I too have high cholesterol but luckily my blood pressure is normal. Both my grandfathers were diabetic and died from its complications. He nods and smiles but does not say much. I wonder why he is nowhere near as articulate and chatty as he was in my hotel room. I am more of an inflictor of a one-sided monologue on a reluctant listener than an eager contributor to a mutually informative back-and-forth conversation.
The x-ray room opens and I get a chest x-ray. Afterwards I have to pee. A medical assistant leads me to a restroom next to the x-ray room and hands me a plastic cup to collect it. It is yellowish-brown; the color of worry. I have heard of dark urine being mentioned in TV health dramas but do not remember experiencing it.
Trung and a medical assistant wheel me back to the bed in the emergency room. It is 10 a.m. Dr. Sardon has vanished. I ask Trung where he is. I told you that was not Dr. Sardon, he says. It was Oscar. I give him a blank look. It is the person who picked us up from the bus station last evening, he reminds me. I laugh at him. Clearly he is mistaken; he must be confused. I know Dr. Sardon when I see him. He is dark skinned and of average height.
A doctor comes to my bed and tells me that the x-ray results are out. He says I do not have an infection. I am pleased. But I have a considerable amount of water in my lungs, he adds. The description rings a bell. It sounds similar to a condition I had read about on the website of the Center for Disease Control before I left for Peru. “Do I have High-Altitude Pulmonary Edema?” I ask him tentatively. I have a feeling he is going to say No. But he nods solemnly. “You should leave for Lima as soon as possible,” he advises me gravely.
I am chilled to the bone. I know that the pulmonary edema variant of altitude sickness is rarer than the most common variant, Acute Mountain Sickness, but is far more deadly. Unless I return to sea level that very day, even the world’s best medicines cannot keep me alive at a high altitude for another night. The only way I could spend another night alive at the altitude is if I were to enter a hyperbaric chamber, one pressurized to a lower altitude. But it would be presumptuous to assume the hospital has one and would make it available to me. I cannot see how I can get back to sea level that very day. If the travel by bus from another high-altitude town, Cusco, took an entire day, the trip to a lower altitude would probably take longer. Would I be able to survive two days or more of bus journeys? I am positive I will not be able to.
I am sure Puno does not have an airport. If it did, wouldn’t we have flown to it from Cusco instead of taking a bus? Even if there is an airport in a nearby city and it has flights to Lima, they are in all likelihood fully booked by now. It would be impossible to get a flight for the two of us at such short notice. Trung says he will let Oscar know. He steps out (to call him on the phone, I suppose) and returns by my side in a few minutes. He tells me Oscar has started working the phones, trying to get me out of Puno that very day. I offer to pay Trung for his flight to Lima and any expenses that might arise because of our change of plans. Trung does not refuse. I am so glad he canceled his sightseeing and accompanied me to the hospital. I cannot imagine what I would have done without him.
I must prepare for the worst. I decide to give Trung the contact numbers of my parents and sister and my boss at work. Much of it is already printed on a sheet of paper in a list of emergency contacts that I carry in my backpack along with my travel documents. I also give him my email and social media passwords and my ATM’s PIN. I tell him where my writings are located, the short stories and the reminiscences I have written but not yet published. I urge him to get them published posthumously in case I do not make it.
I am thankful for being given a chance to put at least a part of my house in order even if I cannot wrap it all up cleanly. It is a welcome contrast to the situation six years ago when I nearly died in an accident. I did not get any advance notice then, did not get a chance to say goodbyes to my loved ones. Mercifully this time is different. I am in high spirits, full of smiles. But Trung’s face is ashen.
Eventually he asks me what I would like to eat. A last meal of sorts, I tell myself. But I tell him I am not hungry. But you told me a minute ago that you were, he says. I deny it with the vehemence it deserves. I am sure I have said no such thing. I tell him I said he might be hungry. I might be lying sick in bed but my friend’s imagination seems to have run wild. Or he must be confused.
I have to pee again. I go to the restroom and collect it in a clear plastic bottle. It is yellow. I lie down in bed once more. I feel better. The oxygen, the medicines, and the rest must have helped. Especially the medicines. I have stopped coughing and the thick yellow phlegm has long stopped oozing out.
A nurse comes over and checks my blood pressure. She is the same nurse who tended to me when I got admitted. She beams at me. She tells me she is old, all of forty years old. She asks me my age. I tell her I am three years older than her. She does not believe me. She tells me I look much younger. She asks me whether I am married and have kids. She had asked me the same question earlier in the morning. Once more I tell her I am neither married nor do I have kids. She asks me why I have not yet tied the knot. I do not tell her, partly because my life is in her hands but mainly because I have little energy to answer the volley of questions that are bound to follow. I am in no mood to tell her that my physical desires do not lean towards women. She speaks a few sentences in Spanish to me even though she knows that I do not speak the tongue. She switches back to English and tells me her shift is ending. She comes close to me and plants a big kiss on my right cheek. I give the air near her cheek an equally loud kiss.
4
A doctor comes to my bed and checks my vitals. He says I am lucky that I got altitude sickness today rather than tomorrow. I am puzzled. “The medical staff will be on strike for four days from tomorrow,” he explains. “This hospital will be closed. You would not have gotten treatment tomorrow.” I heave a sigh of relief. Otherwise it would have been four strikes and I would have been out, so to speak.
Dr. Sardon comes back into the room and tells me and Trung that a flight to Lima has been booked for us. It leaves at 1 p.m. from the neighboring town of Juliaca. The news is music to my ears. The light at the end of the tunnel is visible. But we are going to have to hurry. It is already 11 a.m. We will also have to stop at the hotel on our way to the airport to pick up our luggage.
A young doctor comes over to my bed and advises me to travel by plane only if I get full oxygen support during the flight. Somehow the message gets communicated to Oscar and he promptly tries to arrange such a flight. But I learn from Trung that both the airlines he calls, TACA and LAN, tell him it cannot be done on such short notice. I am crestfallen. The light at the end of the tunnel was simply an oncoming train.
A few minutes pass. Dr. Sardon offers me and Trung two other options. We can travel by road for five hours to the town of Arequipa and take a flight from there. Arequipa is at about the same altitude as Machu Picchi, much lower than Puno. The other option is to spend another night in Puno and take a flight to Lima the next morning. I reject the second option outright. I am convinced that I cannot survive at such a high altitude another night.
Dr. Sardon strongly urges me to travel by road to Arequipa. He says my altitude sickness will largely vanish once I reach Arequipa. I take him at his word because after all he is a medical doctor. But I do not feel comfortable choosing this option. I am feeling fine at the moment but once I leave the confines of the hospital, I am not sure whether I will survive the road trip to Arequipa, even if it is for just five hours, given how miserable I felt during yesterday’s day-long bus journey from Cusco. But I cannot muster the courage to tell him an outright no. He is, after all, an esteemed cardiologist.
I am told that my checkout from the hospital is getting delayed. I do not know why. There goes the possibility of taking the 1 p.m. flight out of Juliaca. My chances of reaching sea level on the same day are getting slimmer by the minute. Trung says he is hungry, but the hospital’s cafeteria is closed. He will go out to have lunch.
Two doctors and a nurse approach me. They tell me the young doctor’s opinion is an extreme one. I should disregard it. It is perfectly okay to take a flight with basic oxygen. My spirits are lifted.
I look at the bed adjacent to mine. It is occupied by an elderly woman. She is also being given oxygen. I wonder if she also has altitude sickness. Our glances meet. She asks me a question in Spanish but soon switches to English. She asks me where I am from. I tell her I am originally from India but have been living in the United States for a few years. She has nothing but praise for Indians and Indian food. She says she is a chef by profession. She is from Amantani Island. She knows about the cultures and histories of different countries, including India. She has even traveled to Vietnam. She is jovial and she is plump. She advises me to consult my doctor after returning to the United States. She says I should not trust the doctors in Puno because they keep disagreeing with each other. She tells me she has come to the hospital for oxygen. My sickness has kept me from spending the night in a floating house on Lake Titicaca, but I am glad to have met, however briefly, a resident of an island from the Peruvian side of the same lake.
It is noon. The patients are being served lunch. For the first time in three or four days I am hungry. I sit up in bed and gobble the food placed in the tray before me. I cannot smell it, as it has been almost six years since I lost my sense of smell in the very accident that almost killed me. But I am sure the food smells just as good as it tastes.
Trung returns from his lunch. Dr. Sardon will be coming soon, he says. But I pay no attention to it, for it is not news. Was he not here all morning, even waiting with me for the x-ray room to open? But then he strides in. He tells me he has seen my x-ray and blood test results. He says, quite authoritatively, that I should leave for Lima as soon as possible. I notice that next to him stands the very person who kept me and Trung company much of the morning. Both of them are dark skinned and of a similar height. The truth sinks in. Trung was correct after all. It is Oscar, the very person who picked us up from the bus station last evening. I am deeply embarrassed. Why did I waste my breath telling him the minituate of my parents’ and grandparents’ cardiovascular disease while we were waiting for the x-ray room to open? Why did I flaunt my medical knowledge, limited though it is, and name drop a few medical terms? Why did I make a fool of myself?
Dr. Sardon moves on to see other patients. Trung tells me Oscar has his own tour company. He learned it when the two of them had lunch together. Oscar once again urges me to make a road trip to Arequipa and take a flight from there. But I tell him, with a brusqueness that surprises me, that I want to go to Lima that very day, even if it means flying on a flight with basic oxygen or even no oxygen. Now that I know his word is no longer the word of God, I have no qualms overruling him.
He says he will see what he can do. He steps out for a few minutes. He returns and tells us he has booked tickets for me and Trung on the 4:40 p.m. flight from Juliaca to Lima, the last flight to Lima for the day. I am pleasantly surprised that there was not just one but two seats available on it at such short notice. But I must temper my delight, as the tables could turn again in the blink of an eye. I cannot be sure unless we board the plane and it takes off.
A medical assistant offers me a choice between an ambulance and a taxi for going to the airport. The ambulance will cost 300 soles, but he recommends it because I will be provided oxygen throughout the ride. It will also be quicker, he says. I choose the ambulance. Its cost is a little over half of what I pay for the trip to the hospital, 530 soles, but I think it is worth it.
I am still lying in the hospital bed as the check out from the hospital is taking time. When Oscar steps out, Trung suggests that we give him a 50-soles tip. I tell Trung that I too have been thinking of giving him a tip of the same amount. He has been with us all morning, almost eight hours. Trung suggests we bump it up to 100 soles. He says he will contribute half of it. I think 100 soles is too big an amount for a tip but I go along with my friend’s suggestion.
I have to pee. I go to the toilet and collect it in a jar. It is now clear. Gone is the yellow color, and gone, most importantly, is the brown.
It is 3 p.m. I am wheeled out of the hospital and into an ambulance. I lie down on a bed in the back of the vehicle, breathing oxygen from a cylinder. Trung sits next to me while Oscar sits next to the driver. Sirens blaring, the ambulance makes its way through town. I am tempted to get up and sit down so I can look out of the windows. But wiser sense prevails and I remain lying down. All I can see from the windows are pieces of the blue sky and the tops of buildings and trees rushing backwards.
It is the second time I am traveling by ambulance but it will be the first time I can consciously remember it. The first time was six years ago when I suffered severe head injuries in an accident. But I do not remember the ambulance ride to the hospital even though I was conscious at the time because the head injuries destroyed my short-term memory. I might have remembered it while it was happening but I have no memory of it. It feels odd to lie in an ambulance sick and weak but the thought of the vehicle running red lights and forcing other traffic out of the way makes me feel powerful.
The ambulance heads north and makes a stop at Hotel Qelqatani. Trung checks us out of it within minutes. A hotel attendant gives him our luggage. He had already packed it for us per Trung’s request. Trung gives him a tip and we are on our way, further north to Juliaca. The ambulance stops before the boundary of the airport, the Inca Manco Capac International Airport. We get out of it and Oscar hails a taxi. We get into it and cover the remaining few hundred feet to the terminal building. Oscar does not want us to draw attention to ourselves by arriving at the airport in an ambulance as it can cause problems while checking in.
Oscar requests the ticketing agent for a wheelchair, which she promptly provides. I sit in it and wait for Oscar and Trung to finish the check in process. They come back and tell me that not even basic oxygen is available in the flight, as we did not make advance arrangements. I have a hint of trepidation but I swallow my fears and tell them I will take a chance. We thank Oscar for all his help. Trung gives him the 100-soles tip and we bid him farewell. Trung pushes my wheelchair and we breeze through security. When it is time to board the plane, an officer on the tarmac pushes my wheelchair the final few feet to the steps of the plane. I climb the steps to the plane on my own.
Trung and I both have middle seats in consecutive rows. He sits behind me. My seat number is 13B, much to my amusement. I do not know how I would have reacted if I were superstitious. In no time the flight takes off. I lean back and close my eyes. But I do not doze fall asleep. My mind has started crowding with thoughts. If only I had taken the altitude pills that the doctor in Washington, DC, had advised me to take! Why oh why did I not even bother to take the prescription from him and get it filled? Just because I thought his persona was a little odd when I met him to get a yellow fever vaccine? Why did I read in great detail about altitude sickness on the website of the CDC before coming to Peru but not follow any of the advice? How did I manage to become the epitome of willful ignorance? What was I thinking when I figured it would never happen to me? What made me think I was invincible?
I count myself lucky that Trung called the doctor and got me admitted to the hospital, for my condition was life-threatening. Had Trung gone sightseeing, leaving me alone in the hotel room to rest and recover, like I urged him to, I would have fallen into a coma and perished within a few hours.
The plane lands in Lima, back to where we were four days ago. A designated person picks us up from the airport and drives us in his taxi to a hotel, Hotel Monte Real, in the city’s Miraflores district. Trung and I check into it, freshen up, and walk to a nearby Italian restaurant to have dinner. My walk is slow and labored but my head is held high. It feels good to be alive. The sea might not be my best friend but the sea level is.
