Medical Post Articles

Holidays and a going concern

Malaria musings and diarrhea dreams cloud Dr. Art Hister's visions
of beautiful Bali

Written for The Medical Post on April 21, 2009

When getting ready to go on any overseas trip, I start to worry about all the things I am certain will go wrong when we jet away from North America. My concerns aren’t limited to the obvious worries about flight delays, crashes and terrorists—as a prototypical Jewish male physician, I also tend to suffer strong concerns about potential health issues: the shots I know I won’t bother to get; fears about water quality and food safety at our destination; worries about deep vein thrombosis (despite wearing two pairs of support hose); and a host of viruses I am sure I will catch from other passengers. Add to this the special worry I have about being called on during a flight to attend to an emergency I won’t be able to handle, and my vacation is ruined before it even begins.

But on this latest trip, my anxiety level reached higher levels than usual because we were off to visit Bali in Indonesia. Every time I enthusiastically mentioned that my wife and I were Bali-bound, every person had a similar comment: “But Bali is where terrorists bombed that nightclub and killed hundreds of people. Are you sure you want to go?”

So, my response, which had begun as a simple declarative, “Of course, I’m sure,” soon deteriorated to a more hesitant, “Well, the flights are booked and paid for, so we gotta go.” I also usually threw in the observation that, “Hey, that was many years ago, and terrorists never hit the same place twice, eh?” This successfully aborted negative comments until one of my smug, know-it-all friends informed me, “Terrorists did hit Bali twice, dude; they bombed it again in 2005.” That news drove me to Google “Bali, travel, advice,” a dumb move because the first link I found was an advisory from the New Zealand government about “reliable information of potential terrorist activities in Bali, so if you don’t have to go to Bali, don’t go”—a warning that was from that day!

So, as someone who follows the advice of informed authorities (especially when that advice might help me live longer), I told my wife we were going to Blaine, Wash., instead. However, my wife did her own research and pointed out the Canadian government had no similar advisory about Bali. She laughed off my objections and made it plain it was either Denpasar or divorce, so I reluctantly agreed to go, although I quickly quadrupled my life insurance.

I managed to enjoy the flight from Hong Kong to Denpasar—a little alcohol always calms my nerves, and a lot has an even better effect (although my wife stopped talking to me after my third glass of plonk, a few minutes out of Hong Kong).

Daredevil driving
When we reached our destination, my anxiety level skyrocketed. We left the airport and I suddenly foresaw our fate: getting pulped by an oncoming vehicle on the way to our five-star villa, because Balinese driving is like vehicular Russian roulette. Not only are driving lanes extremely narrow, but for many Balinese drivers lanes and even directions of travel are entirely optional, driving hazards laughingly accentuated by the fact that the preferred mode of transport for most Balinese is a small, noisy motorcycle. The roads are clogged with thousands of these locust-like motorbikes, often piloted by a kid ferrying at least one other passenger (or two or three), and often with a pen containing live chickens on the back, seemingly oblivious to the other, much larger, vehicles on the road.

Thus, soon into our drive to the villa I was sure we’d never reach, I had turned my eyes away from the road to update my will on my BlackBerry until the driver interrupted me by pointing out the reason we had slowed down was that we were at a devastatingly congested six-way intersection where the lights weren’t working, and the Balinese have no concept of alternating lines of traffic merging at such obstacles. I urgently suggested that we find a nearby hotel and bed down until they fix the lights, which, assuming this would be done on “Balinese time,” would take at least a week, by which time we would just have to retrace the mile or two we had driven from the airport.

My driver smiled. “You’re a joker,” he said, mistaking my fearful suggestion for humour, “and in Bali we believe jokers live longer.” At that moment this compliment was not at all reassuring, and while my heart pounded, our driver aimed our van at one of the turns and zoomed into it. Miraculously, we made it, flanked by an army of happy motorcyclists who had used our van as cover to make the same run.

And so it went our entire time in Bali: I had a constant concern about a cardiac arrhythmia—my in-car heart rate averaged over 180 (with many skipped beats)—because you can’t get anywhere in Bali without enduring a two or three-hour adventure in a seatbelt-optional, constantly honking car driven by a totally relaxed smiling man in a huge rush to get you where you want to go. The only alternative is a bus, since you do not want to risk being a pedestrian, but a Bali bus does not leave until it’s full, which is pretty much never since everyone owns at least one motorbike and prefers that to an over-heated, unpredictable bus.

The other reason I could not relax in Bali was my constant worry about my non-motorized well-being, especially about the safety of the food, water quality and over-exposure to the sun.

Ordinarily, I would just have done the wise thing and spent the hottest part of each day (in Bali, that’s 9 a.m. till 6 p.m.) lazing around our private plunging pool, drink in hand and safely out of the sun (I am neither a mad dog nor an Englishman, after all). But since my wife insisted on being out and about, we ended up spending a lot of time walking in the Balinese midday, even though, as I kept noting to no avail, “no Balinese is out at 1 p.m., dear.” So for days, melanoma images invaded my jet-lagged, wine-addled tourist brain, although I managed to override those concerns by worrying that the food and water would kill me before the sun ever got a chance to.

You see, despite my pre-trip determination not to drink the water and to eat only thoroughly cooked hot food, our plans evaporated moments after we arrived at our resort, because while they were preparing our villa (in Balinese time, of course, so it took more than an hour), a waiter served us a “welcoming” drink. Since it was hot and humid, and as tourists we wanted to please our hovering waiter, my wife and I both slurped half our drinks before I shouted, “Yikes, ice!” to which the waiter replied, “Good, no, mister?” So, for the next several days my melanoma musings were disrupted by dreams of diarrhea instead.

The story has a happy ending, however.

Bali is truly magnificent—beautiful, hot, sunny, incredibly friendly, under-crowded with tourists and dirt cheap—so by day five, I managed to ignore the differences between here and there: differences in cleanliness, in food preparation rules (or lack thereof) and in toilets (my wife has the bladder of a camel and I have that of a wee male poodle); the sparse refrigeration and the absence of microwaves in most restaurants (“hot” food is often served at room temperature); and the scrawny, road-kill chickens in my curries. And despite abandoning all my pre-trip rules, we both stayed—to my great surprise—totally healthy.

To my even greater surprise, I managed to relax, largely thanks to the wonderful ambience and the Balinese massages included in our package because, as noted earlier, there’s something about alcohol—and intense attention to my body by others—that always calms my nerves. Bali hai!

Art Hister is a physician in Vancouver.

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