I haven't been posting to my blog of late because I've frankly been very busy pissing off the gods. I don't know what I've done to anger them, but apparently something really bad, otherwise how does one explain how shit my last two months have been?
Since I haven't posted it a while, let me first update y'all as to my friend Jean's condition. After she slipped back into a coma towards the beginning of February, some of her other friends and I worked hard to get her transferred out of her horrible hospital here in Kunming. We originally were trying to get her to Thailand as the medical facilities there are close, cheap, and on par with US standards. I will remind you that Jean had no medical or evacuation insurance which made this a tricky situation. We got a bid from SOS to get her to Thailand that was over US$50,000. Luckily we started talking with a Bangkok hospital directly who does their own medical evacuations--their quoted price was only about US$34,000. We tried desperately to scrape the money together. I spent a day with the head of the Foreign Affairs Office at our university trying to convince them to loan us the money and to negotiate terms of the loan. Of course, that whole plan came crashing down when the university came back saying they would only loan us about US$20,000—not an insignificant amount, but not enough for us to get her out of here.
Meanwhile, Jean festered in the ICU. Her condition remained stable, but it was obvious she was in a deeper coma this time than before. Jean's boyfriend, Ben, works for the Clinton Foundation, and they agreed to send some of their doctors to take a look at Jean. I stood there in the room as they performed the reaction tests to see how deep of a coma she was in. Watching them scrape a q-tip across her eye and seeing absolutely no reaction was one of the hardest things I've witnessed in these last months. Given her incredibly limited responsiveness, those doctors feared that she had serious brain damage but couldn't be sure without an EEG, a CT scan with contrast, and an MRI. There was also a concern that she was in status epilepticus (a constant state of seizure) without motor response (in other words, she wasn’t shaking). Of course, the hospital couldn't perform a bedside EEG (so they couldn't confirm or deny if she was seizing), the MRI couldn't be done because we didn't have a portable respirator (which meant we had to use a handbag attached to a metal oxygen canister. No metal is allowed in the MRI room because it works based on magnetism.), which meant that we had to try for the CT scan. We had been asking for a CT with contrast for over a month and a half, but the doctors kept refusing because the contrast, which I assume is some sort of radioactive isotope, could potentially cause kidney failure (her kidneys were just starting to recover as it was). But, with lots of pressure we convinced them to do it.
The CT scan found four potential abscesses in her abdomen (something likely caused by her original disease) and a potential thrombosis (blood clot that travelled from somewhere else) in her brain. It was not good news, but at least we couldn't see any structural damage at that point. The severity of the case convinced the Clinton Foundation doctors that she did indeed need to get out of Kunming, and so they started talking with their principle financier to see if he could help with a loan. Meanwhile, the decision was made to have Jean evacuated to the US instead of Thailand. It was a risky move due to the length of transit, but in terms of long-term expenses, we hoped it would be better. Now that she potentially needed brain surgery, going to Thailand, where we would have to pay all medical expenses, was no longer an option. In the US she would qualify for Medicaid, so we decided to take her back to Albuquerque in her home state.
I started contacting medevac companies again and got a quote from SOS of almost US$190k! Luckily we were able to shop around and found a company that would do it for only US$120k (still an enormous sum). We secured funding through the Clinton Foundation (for which we are eternally grateful. Vote Hillary 2008! :o) ), and the evac was set for the 28th of March. I would be accompanying her.
Of course, I got a call that morning saying the plane had technical difficulties, and that they were sending a new plane, but there would be a further delay of about 24 hours. It was a bigger plane though, a Hawker 800 as opposed to a Lear Jet, which meant that Chesa could come along as well. We arrived at the hospital at about 4:30 in the afternoon on the 29th. The medevac team arrived and the Chinese staff jumped to life, there was an energy, an almost grotesque festivity, in the ICU as they wheeled her to the ambulance. Because the Chinese doctors from the hospital wanted to see the plane, there was no room in the ambulance for Chesa or me. We were "banished" to follow behind in a taxi. As we got in the taxi, I stressed the importance of following the ambulance to the airport very closely, as otherwise we wouldn't be able to get in to the airport. Of course, the first instant the ambulance did something "illegal," like driving in the bus lane, the taxi driver stopped following closely. I started to yell at him, but it was too late. He was caught behind another car, and the ambulance ran a red light in front of us. I sat there yelling at the driver as the ambulance siren's blare died away. I apparently put the fear of God in him, as he finally started driving at full speeds with reckless abandon to rush us to the airport. We actually arrived before the ambulance, which amused me to no end, and I tipped the taxi driver well.
At that point, the Chinese doctors were kicked out of the ambulance, and the airport doctors took over. We drove to the side entrance of the airfield only to be stopped short. The guard wouldn't let us in because we needed to pass through security. The airport doctors were trying to assure them that security was waiting for us at the plane. He wouldn't let us pass, so we just sat there for almost twenty minutes as the calls got made and he finally let us through so that we could get to security that was indeed waiting for us by the plane. Ben had to leave us as we entered the airport as he would not be accompanying us on our trip, so Chesa and I became the official translators between the American evacuation crew and the Chinese doctors, security personnel, etc. We lifted Jean on to the plane, loaded supplies...and sat there for another hour waiting for clearance from Japan. Due to the long distance, we needed to make three stops during our journey: Osaka, Japan, Petropavlovsk, Russia, and Anchorage, Alaska. Japan is very strict about its landing policy and we couldn't take off because they hadn't cleared us for landing. We departed about two hours behind schedule, but due to a 215mph tailwind (the fastest our pilot had ever seen) we arrived in Osaka just about on time in a mere 3.5 hours.
The rest of the journey was mostly uneventful. Arriving in Petropavlovsk, a city tucked away in far-eastern Siberia, was one of the most beautiful sights I have ever seen. We arrived just around dawn, so the sun cast a rosy hue over the snow covered hills that broke from the barren Siberian plane. As we landed we circled around the city and got a fabulous view of the nearby active volcano puffing steam into the morning haze. Petropavlovsk being next to water, we also caught a glimpse of the jig-saw of ice blocks as they freed themselves from the shore.
The landing itself was a bit bumpy as the airport was originally a military base converted for public use. We taxied past several MIGs and were presented with a most stereotypical picture of Russia. We were greeted with large, beefy military types with shaved heads and large coats shouting at us for oxygen tubes and passports. Our “handler” sauntered over in her fur-lined parka to escort us to a Communist-era bus not unlike some I’ve seen in China which made it’s way carefully over the icy ground to the “terminal,” and toilets without lids/seats (though they were not squat pots) and paper that disintegrated when you touched it. I loved it so much, and can’t wait until I have the opportunity to actually visit Siberia. I’ve never seen anything so beautiful in my life.
Then it was on to Anchorage and finally Albuquerque. Again, there was not enough room in the ambulance for either Chesa or me, but luckily there was a wonderful man who worked at the private terminal for the Albuquerque airport who drove us to the hospital. We, again, arrived before the ambulance, and made our way to the ER. Of course, they didn’t know anything about it and were under lock-down due to a security breech, so we waited there for a bit until they told us Jean was being taken up to the ICU.
That is where she has remained ever since. They effectively started from scratch trying to diagnose and treat her. We finally got the much-needed EEG and discovered that she had indeed been in status epilepticus for probably a long period of time. Suffice it to say that this was not really good news, as it indicated massive brain damage again. She got a CT scan, an MRI, a lumbar puncture (to see if she had an infection of the spinal fluid), and a whole battery of tests. We had to wear masks, gloves, and scrubs to go in and see her, which I can understand, but which I thought ridiculous at that point considering I had been in an enclosed space with her for almost 24 hours, and had seen on countless occasions before when she was in the ICU in Kunming without taking such precautions.
They think they discovered an e-coli infection more serious than they had ever seen in the US before, and have been giving her experimental drugs to help control that. But really, that’s not the problem with her. The doctors in the US strongly think that she has diffuse brain damage caused by the hypoglycemic shock that the stupid, incompetent nurses here in Kunming accidentally sent her into when they stopped her food but not her insulin. To think there is basically no likelihood for repercussion for such an abhorrent mistake makes me sick.
In the end, the doctors have decided that there is effectively no chance for a meaningful recovery given the severity of her brain damage. Her family thus made the difficult, but necessary, decision to step her off the respirator last week. She has mostly been breathing by herself, but goes through short periods when she stops breathing. This is likely either caused by a) the brain damage itself, or b) the anti-convulsant medication that she must take to stop her seizures. They spent this week building up her strength for yesterday when they took her off the respirator for the last time. At this point, if she stops breathing, that will be the end. And so, now begins the waiting.
As for me, after we dropped her off in Albuquerque, and assured a smooth transition, got her son to come visit her in the hospital, and whatnot, we left for Colorado. We left Alburquerque around 1:30AM one morning and a friend’s mother (who had also just gotten back from Kunming the weekend prior) insisted that no matter what time we were there, that we must stop at her house in Santa Fe for chili, which we did at 2:30 that morning. It was good chili, and an interesting conversation—I learned for the first time about Germans who think they are Native Americans and spend their lives recreating the Native American way of life there. I mean, after all Sioux are Aryan too…
We made it fairly uneventfully to my hometown of Fort Collins, where I got to see my half-demolished house (we’re in the process of renovating the kitchen and dining room), got to see family and even surprise one of my best friends for her birthday. The next day it was off to the Bay Area to visit my mother who has recently moved there for work. We spent Monday eating sushi and wandering the Union Square area shopping. Yay for H&M! I even found some really good clothes which I was in desperate need of. Then my mom and I met up with Chesa and her mom and family for dinner at a lovely Moroccon restaurant.
I got back to Kunming early Thursday morning, just in time to… take another friend to the hospital (the topic of my next post, considering the length of this one). Seriously, what’d I do to deserve this?!
Labels: Favs, Personal Updates, Sinosisms