The Final Days – The Incredible Inflating Brain

“If you want to make God laugh, tell him your plans.” – Anonymous because I refuse to credit Woody Allen for anything, let alone this aphorism.

Dear Grampa, 

This story has a happy ending. It’s about things having meaning and happening for reasons. 

I got viral meningitis and returned to the States two months before my service would have been complete.

One morning in April, I was working in the health center garden when I got a sudden headache. I ate some noodles and chugged some oral-rehydration salts. Then, I woke up in a cold sweat twenty minutes later, sprawled out on one of the midwives’ cots with the entire staff peering down at me. The headache was much worse. 

One week prior, my dad – my real-life, blood and birth father in America, also known as your son – was in the hospital. He had, reportedly, “20 hours until total organ failure”. He pulled through, but before I passed out I was still contemplating ending service early to be at his side. He hadn’t gotten better just because he’d gone home.

Vuth got me to the provincial town and into a taxi to the capitol and the Peace Corps office. I burst into tears when asked to perform a urine test because the headache was so bad that I could barely breathe. By the time I was in the Royal Phnom Penh emergency room, I couldn’t feel my arms, legs, or lips. Two episodes of Exorcist-level vomit, a million tiny shallow breaths, and an extraction of murky spinal fluid later, I was admitted. Spinal fluid should be clear. I didn’t stay in that room long before staff noticed how I was a V.I.P. when it came to producing no urine whatsoever. They upgraded me to ICU where three women with a flashlight wrestled a catheter into me. James came and played history podcasts for me and emptied out my pee-bag. But nothing – and I mean nothing – helped with the pain. They airlifted me to Bumrunggrad Hospital in Bangkok by which time the word “meningitis” had been bandied around considerably. It was finally my turn to take some leave time out of the country.

The pain I was experiencing through every minute of the ordeal up until this point was utterly beyond description. The clinical explanation does a decent job, though: the tissues around my brain were swelling which left nowhere for my brain to go except to try and evacuate through my skull by force, the brain itself beginning to swell in the process. I was lucid and hyper-aware for every minute of the hospitalization, but every breath I took forced a modicum of extra blood into my skull which meant that I felt a fraction of a second away from total brain explosion 12-18 times per minute, at least 720 times per hour. For the handful of days in which I was in the Bangkok ICU, the pain only abated from the occasional spinal tap.

It was the greatest healthcare I will likely receive for the rest of my life. Dr. Mustafa was my regional Peace Corps Medical Officer (PCMO). He helped me advocate to complete my recovery there in Bangkok in order to better my chances of returning to Cambo for my final month of service, even though his druthers were for me to get “superior care” in America. My main nurse, Fayee, teased me every other day about not having a boyfriend because I smelled so bad, then she would help me into the shower or even wash my hair herself. The teasing largely began when I proved incapable of pronouncing her name correctly, repeatedly calling her “water buffalo” in Thai. She provoked my first laugh since I had passed out. She smuggled in coconut ice cream when I could finally eat again. This was good medicine for the CNN special that kept airing. It was about Rwanda’s deaf community in which 90% of individuals had lost their hearing due to complications from meningitis.

Two other volunteers – Colleen and Andrew – were also in the hospital, lifted from their countries-of-services like I was, coming from the Philippines and Kyrgyzstan, respectively. Sick of commiserating in each others’ hospital rooms about the sour turns all of our services had taken – and also a bit physically sick from the hospital’s “Western” diet option (i.e. bread and cheese) – we coordinated and requested 3 nervous docents to wheel us down to the food court. Much wheelchair-McDonalds was had by all. Andrew even popped a wheelie.  It was a turning point.

The care team released me to stay in a hotel across from the hospital for two more weeks of monitored recovery. Some weeks previous in the initial hours of The Headache, I had packed for what I thought would be an overnight stay in Phnom Penh. Thus, upon release from the Bangkok hospital, I had only a T-shirt crusty with some old vomit, sport shorts with elastic worn out from hand-scrubbing, and hospital slippers. I checked out in the morning ahead of the currency exchange offices’ operating hours and ended up stranded at my train stop without a penny/baht to my name. A young woman approached me with a smartphone angled upward. She had intended to ask some questions for a Thai-magazine survey but performed an obvious re-calculation of my condition once in close proximity. I tried to explain myself in a sane-person voice while being eyed like the textbook psych-ward escapee who I resembled. Out of the goodness of her heart, she lent me some baht and gave me recommendations for the nearest cafe and beauty (read: hygiene) supply shop. I thanked her and I figured it out.

When I finally got in touch with someone in my village, Seiklin told me that Yaay Meng and some other grannies hosted a seance behind the health center. They asked for forgiveness from any spirits I may have disturbed while building the garden. Pa said that the day of the seance was when my medical officer in Cambo relayed the news that I was finally moving out of the ICU. Pa also couldn’t help but mention that I had fallen ill suspiciously soon after a walk that I, a female, had taken in broad daylight with James, a definitive male. My sins coming back to haunt me, indeed.

*****

I won the battle to complete my treatment there in Southeast Asia. I would lose the battle to complete my service. 

When I had both myself and my care team well-enough deceived that I was no longer experiencing any pain, I hopped on a little plane to Phnom Penh. Nothing has ever felt so sudden and violent as Phnom Penh did right after landing, swirling around outside of my tuk tuk to the hotel. A follow-up appointment with a French ENT nearly ended in a bloodbath when she inexplicably tried to get me to admit that I had likely fallen ill after being drugged by a casual sexual encounter given my probable promiscuity (inextricable from American citizenship). My Peace Corps doc stepped in right as he saw me on the verge of blowing a gasket.

I stayed in a hotel room in the city for a few days of follow-up and assessment. I tried not to resent the country around me for what felt like a united front to shame me into submission. I ignored everyone and thought of what it would feel like to pull up to the village, take a long nap, and cap off the gardening project with Vuth. James – the ultimate friend – came to meet me while I was trying to brave through those rough days. Fine one minute, walking from cafe to hotel, and on the curb the next minute with nauseating vertigo, James called a tuk tuk and gently reminded me that I didn’t have to do this. My Medical Officer went over with me the statistics about residual symptoms associated with meningitis recovery. She told me to prepare for up to a year of lingering or sudden headaches, blurred vision, vertigo, etc. I thought of trying to cope with all of that during the peak of hot season, back in my host-mother’s home.

I quit. Over about 48 hours, I dotted all the possible I’s, crossed all the T’s of my service, then went back to the village for an indelicate, flawed, blurry goodbye. I can barely think about it even a year later. Stumbling from stall to stall in the market, house to house on the main drag to say goodbye and give my paltry thank-yous. Even typing it feels thin and false. When I expressed this feeling of inadequacy to Vuth, he stopped me and said I had been and done “lmoam”. Enough. I had done just enough. It was time. Vuth, Leakkna, Pa, and Seiklin wouldn’t accept my goodbyes. They made plans to see me off at the airport.

Vuth brought me a handful of dirt from his front lawn. Mr. Dad until the very last.

 

 

*****

More than a year later, we still don’t know what caused the meningitis. Some errant pathogen found its way into my spinal fluid and short-circuited my motherboard. Whether it was from tenacious garden soil microbes, latent Mondulkiri elephant bathwater germs, menstrual cycle (Diva cup) related, or disturbed spirits, we will never know. But this is the part about things having meaning and happening for reasons.

As soon as I returned to the States, I made getting a job my job. Like a tractor-beam from outer space, the small community hospital in Taos, New Mexico, lassoed me right in and put me to work. My co-workers and I enjoy work that makes small positive differences in people’s well-being as the Sangre de Cristo Mountains watch over us. Last week my boyfriend, doggie, and I stood in our backyard to take in the commotion of a Taos Tigers home game to the west, coyote cackles to the north, and a blazing full moon rising to the east. I live and work in another place full of culture that will never belong to me but has shown me only love, a place immersed in traditions and history to which I could devote a lifetime and never fully divine. But in that lifelong attempt is where the best living occurs. There are still parades and puppets and elderly patients who call me granddaughter. There are still trees bowing with fruit and rainbows.

They say in Taos that the Mountain accepts you or it chews you up and spits you out. One of the greatest challenges I anticipated about Peace Corps was the staying, being in one place beyond that point when I would historically become restless and insecure. On the worst days of service, Peace Corps was a job. On the rest of the days – from the mediocre to the cream of the crop – service was an adventurous lesson in the most simple, crucial parts of life taught by the kindest people I have ever met. If I hadn’t gotten sick, I would have kept country-hopping, striving for more and more and more, running always toward being everything at once when what I needed was to be lmoam – to just be enough. Enough of a daughter, enough of a friend, enough of a sister, woman, and community member.

I have wondered early and often about if I will visit the village again. In my heart of hearts I don’t think I will. By the time that I left, I felt wholly woven into the fabric of the community. We had routines and expectations of one another. I knew my coworkers’ babies’ favorite snacks and they knew mine, so we treated each other. When someone was rushing to the shop for more cellular minutes or data, I knew the sibling, spouse, or child they were trying to reach in Korea or Thailand. If my host-dad or Vuth weren’t in their offices on Saturday morning, they were watching boxing at Aunty Chhennda’s cafe. Even through our walls, my gentle neighbors’ honey-hurry-up-dinner-is-ready tone and her honey-you-had-better-explain-your-most-recent-impulse-purchase-right-this-second tone had their subtle, substantial distinctions. While my abrupt exit was painful, I imagine it would pale in comparison to the voyeuristic exclusion I would risk by trying to re-insert myself into the village apparatus. So much love from one place for so long makes tourism seem, conceptually, sour.

Regarding living at home: I want you to know that I tried. For the entirety of service, I boasted of my plans to move back to Oklahoma, turn your tool shed into a tiny house, and tend to our several generations across the metro. I want you to know that I wanted that and that there are days, still, when I want it more than ever. When the job search began, I had the bulls-eye set right on the 405. I can remember staring at the map of borderline-insulting Oklahoma City prospects (“Master’s degree required, starting pay $15.65 an hour”) when dad reached out with encouragement to widen my search radius. That’s when the Taos job popped up and everything tumbled into place from there. There was something bigger at work, then, and I had to respect that. I hope you have understood, too. May my frequent sojourns on I-40 to-and-from Oklahoma be my penance.

It has taken me this long to reflect deeply on my service and life in Cambodia because of the bottomless longing that comes with that retrospect. Even on the heaviest days, it was a chapter free from clocking-in and out, from car payments and looking for contractors, endless Outlook calendar items, telephonic parleys with my student loan servicer. Everything was more special. The books I read then were the Books I Read During Service, a kind of literature I will never read again. Now there are only books.

When Vuth Facetimes me while bored at work to ask how I am doing, I want to say, “well, but saddled with a debt to you and our village which I will never repay because you loved me and let me leave, you taught me how to trust people and love myself and take chances and eat frogs and to sit with pain and look for the bright spots in a messy world and everything else that makes me strive to stay worthy of the Mountain Mother here in my new village”. But my Khmer is slipping, so I say “good, I am bored at work too.”

And that boredom is more than enough.

If this was too long and you didn’t read, Grampa, feel free to watch the video below. It pretty much sums it up. Or you can wait for me to show you on my phone or Mac since I’m just a car-ride away.

I missed you every minute. It’s good to be back. Love you all the time.

– Kelsey, Returned Peace Corps Volunteer

P.S. Much Bangkok-photo credit to M. M. who made a lot of mistakes but has a great heart and a gifted eye.