It is imperative that before I can jet off to the backside of the globe for an extended period of time, to live in an impoverished and disease-ridden, third-world country, I have to be reasonably confident that everything and everyone at home will be hunky-dory in my absence. To get my maternal ducks in a row, if you will. My husband has already given me his blessing. Now I just need to have my household responsibilities covered in my absence. Our children are alternately proud and excited for me but concerned about my well-being and their dad’s loneliness while I’m gone. I promise them we’ll all have many long, reassuring heart-to-hearts prior to my departure. My eighty-six-year-old father is facing open-heart surgery and there is no way I’ll take off for parts unknown until I know his condition is stable. That’s about it. Well, that and the fact that I want to generate the funds, by myself, that will be required for me to take this journey. This desire is less a financial necessity than a personal imperative. I need to feel that I am assuming this risk on my own. Being a writer is an a-vocational enterprise until you get published, sometimes even then. I do not want to add any additional strain to an already thinly spread family budget.
I place an ad in the paper for my services and am quickly contacted by a family who needs assistance. These folks have a parent, an elderly, retired scientist from the local oceanographic institute who is struggling with dementia issues, mostly forgetfulness and intermittent episodes of uncomfortable confusion. I begin to spend mornings with this fine gentleman, making him breakfast, reading the paper with him, urging him to tell me stories from his glorious past . . . to remember. We become friends and I honestly believe that I get as much from the relationship as he does, maybe more, as he soon forgets my name and why it is that I magically appear in his kitchen each day. Through his pension, the family is able to compensate me. So in that respect I am set.
Next I need to secure my airfare. I assume that since I am getting several months’ jump on the departure date, I’ll be able to find deals. As it turns out, there are no deals. This is Africa we’re talking about, not the French Riviera, and $1,800 is the best rate I can find. My husband and I have one major credit card and it gives us frequent-flyer miles on one airline. As anyone who has ever tried to use his or her miles to fly free will tell you, the evil demon “black-out dates” eat up the bulk of any given calendar year. Consequently, my family has amassed a steamer trunk of unused miles, enough to actually get me all the way to the Dark Continent and back gratis, if I can find someone to choreograph the logistics for me. Subsequently, as anyone who has ever tried to use their frequent-flyer miles will also tell you, getting an agent to speak to you civilly in English in complete sentences, let alone not forsake you for one entire afternoon, is nothing short of miraculous. Booking agent Sue at Northwest Airlines, as promised, I proclaim to you, “YOU ARE MY HERO!” This superhumanly patient woman spends hours on the phone with me piecing together what will constitute a roundtrip airplane ticket from Los Angeles, California to Nairobi, Kenya solely with frequent-flyer miles. Three days, four countries, and five flights, and I am going to Africa. She even manages to get Joe’s flight to join me some months later half-covered as well. We should be careful what we wish for.
Then I secure my travel insurance, paying particular attention to policies with a clause that reads, “Includes emergency evacuation.” I use International SOS as recommended by Nan because it gives a discount to students. I don’t know why I keep setting myself up for this humiliation, but “You do not qualify for the discount,” keeps coming down the pike at me. I pay the full amount and get the comprehensive SOS Global Traveler package with 24-hour alarm centers accessible worldwide. They’ll even ship my dead body home, thank you very much. Next I begin the process of making sure I am fit for the venture. I schedule the full complement of medical exams. Somewhere in the conversation with my internist, the issue of inoculations comes up. “Well, Pam, what have you gotten and what do you need?” my doctor asks me.
“Dunno,” I shrug.
“Dunno what you’ve gotten or dunno what you need?” he teases, somewhat earnestly.
“Both?” I answer, embarrassed. I am a bear where my kids’ health is concerned, one of those mothers from hell who is a physician’s worst-nightmare types. Much to my children’s chagrin, there is positively no part of their anatomy that has been left unturned. But I have lost track of my own personal health assessment, anything not related to my obligatory, annual OB/GYN routine. Truth be told, the bulk of my mass (mass of my bulk?) has been complying with gravity, going with the flow bravely down the path to its inevitable perpetuity. And less has become more as far as close examination is concerned. So I have literally let it slide.
“Well, let’s start with your shot record,” my longtime friend and only cursory personal physician compromises. I am, in fact, sitting on the exam table in his office, fully dressed.
“I’ll come in, but I’m not taking my clothes off,” I tell him. I have one of those irritatingly conscientious health plans where each section of your body is relegated to some medical specialty that has a special department, with specialists that are trained to see that special part of you. But you can’t see the specialist unless your personal physician refers you and they won’t do that without seeing you first. My doctor friend is seeing as much of me as he is going to. But he’s fine with it.
“OK, then I’ll take my clothes off,” he cajoles. “Seriously, I’m sure there’s a butt-load of shots you’re going to need but we should make sure of what you’ve already had first. Can I have your card?” he asks like he’s requesting my dry cleaning stub.
“What card? You mean the little yellow cards my kids have had since they were babies? The ones that they need to present each time they go to a new school?” I ask innocently.
“Uh huh.”
“I have one of those?”
“Should.”
“Are you sure?”
“Yes, Pam,” he groans, looking puzzled. “What’s the matter?”
“I’m certain that I have absolutely no idea what you are talking about,” I insist and then dodge him with, “Okay, you can’t tell me that I am the only fifty-something, healthy woman out there who doesn’t know that she has a little yellow shot card. And even if everyone else is somehow bizarrely aware of having one, no way could they just whip it out upon request one day while visiting their friend/doctor’s office.” Then I test him, “So what if I don’t have one?”
“We’re going to have to access your past records before you were a patient with this group,” he sighs and then pleads, “You have to request that they get sent over to me so that we can get going on this before you leave.”
I reassure him that I have a few months yet. He tells me he’ll go ahead and set up my referrals to the sacred specialists, enough doctors to treat the ailments in an inner-city hospital’s E.R. Then I can come back and get all my inoculations and prophylactic medicines from him and hopefully be fully dosed and shot up with time to spare.
All my tests come back fine and my ancient history of inoculations is excavated from the tombs of the HMO my family had used for the previous decade. I am up to snuff for general life in the civilized world, having received my diphtheria, measles, mumps, rubella, and polio vaccinations when I was a child—a “bazillion” years ago. But I learn that boosters for diphtheria, measles, and tetanus are currently being recommended. (Polio should have been as I saw its ravages everywhere in Kenya. And we’re just learning that Salk’s neat little vaccine-laden sugar cube that was popped into the mouths of my generation of kindergartners is probably now null and void.) However, I’m told, for “where you’re going,” the World Health Organization and the Centers for Disease Control and Prevention list inoculations against the full range of hepatitises A to C, yellow fever, cholera, meningococcal meningitis, rabies, and typhoid, as “highly advisable.” I know of no more surefire way for the reality of one’s travel plans to begin to sink in