Shangri-La

After much tribulation, nearly ending in divorce, we’ve survived the stress of packing up all our belongings, hauling and storing them away for six weeks in various corners of the city, and finding a temporary home for our lunatic cat. We’ve now landed in an island paradise.

We’ve been here two weeks. I have internet access again, and we’re settled in for the next month, trying to enjoy ourselves while paying exorbitant tourist prices for life-saving sunscreen and other daily necessities.

The island has at least three distinct cultures: The Locals (subdivided into indigenous people, Caucasian, and Philippine), the Tourists, and the Japanese. Why separate the Japanese? Because they operate apart from the rest of us. They have their own chartered buses, their own sections in the grocery, and there are clubs and businesses which cater directly to them (namely the gun club, which offers Japanese men and women a chance to shoot a wide array of handguns and assault rifles at an indoor shooting range; something they can’t easily do in gun-restricted Japan. In fact, the barkers handing out business flyers for the range don’t even give the flyers to whites. They know who their customers are). So the Japanese create and occupy a space that belongs to them alone. There’s something industrious about that, without being inherently aggressive or obnoxious.

For the most part, the clients at the clinic belong to none of these dominant cultures. They are what Michael Harrington, in 1962, called “The Other America.” The other America is still here in 2009, sicker and crazier than ever.

There’s the guy I saw yesterday, whose life took a nosedive when his lover died of AIDS and then he subsequently tested positive. He smokes “a little meth each morning, just to wake up.” My preceptor asked him if he’s tried coffee.

There’s the woman who seems pretty unremarkable, until she tells you she prefers living in a storage unit to a real house.

There are broken hands from gay lovers beating each other hard enough to displace bone.

There are coughing fits violent enough to cause emesis, from a man who says incredulously, “But I haven’t smoked in a week!” This, after a lifetime of lighting up.

There’s the sad sack loser who expects you to believe his puppy took his bottle of pain meds out in the yard where they got rained on, and now he needs another 90 vicodin.

And there are the voices--Heard inside the minds of some of the sickest individuals.

Schizophrenia lives at this clinic. I’ve seen someone nearly every other day who hears them. After the description one man gave me, I just shook my head. He blames a baptism gone wrong, when as a baby his soul was connected to his also-disturbed Auntie instead of his god. Doing a ton of drugs didn’t help either, he said. He hears them outside his window at night. They cough at him. They slyly suggest he hurt himself, by asking what would happen if he just happened to step out into traffic at a certain moment. Sometimes they’re inside his head, and sometimes farther away, but always working on him.

There’s not much I can do about all that. It’s for the psychiatrist he sees to sort out. The problem for me is that his understanding of cause and effect is so distorted, that it’s tough to get him to work on his hypertension, high cholesterol, and diabetes. Pharmacology means nothing to him. The pills are imperfect amulets, and he wants to know which single medicine is the best protector. I try to explain that this one is for your pressure, this one is for your cholesterol, and … forget it. He’s already asking, again, if mixing them can make his neck hot, and whether eating rice can increase pressure in his brain. I ask when his next psychiatric appointment is and excuse myself. I head out the room looking for my preceptor, the voice in my head is asking me what I’ve gotten myself into.