Archive for March 29th, 2012

No bite: public versus private health up close

As we were settling down in our seats at gate E5 at Schiphol yesterday, an elderly Indian couple sat down in back of me. As soon as the woman sat down she started coughing, a rough deep cough not like one that comes with a cold. “TB,” flashed through my mind, not that I know what a TB cough sounds like, but my mind had put India and coughing together.

The woman occupying the seat next to her asked to be reseated and indicated her concern about having a serious cougher in a plane that would be circulating air for the next 7 hours. Other people in the neighborhood agreed with nodding heads. A purser was dispatched and he asked the woman how she was feeling. Fine, she indicated, and her husband confirmed. The purser asked her to put her hand in front of her mouth as she coughed. The couple agreed.

But no one sitting around the couple felt comforted by this attempt at containment.  The head flight attendant was called in. She listened patiently to the complaints, walked up to the couple and said in the sweetest voice, “I hear you are not feeling well.” This was of course instantly denied.

A woman next to me, who was studying Stata, a statistical software package used among others by epidemiologists told me the woman should be taken off the plane as she was a public health risk. And just as she was saying this I was reading the chapter about American public health systems losing their bite sometime in the second half of the 1900s in Laurie Garrett’s book ‘Betrayal of Trust.’

In the end the Indian woman was given a painter’s mask and told to keep it on during the entire trip (she didn’t really) and the crisis was, at least for the duration of the trip, averted. I saw the ‘no bite’ approach of public health in America, demonstrated right before my eyes, along with the terrible dilemma of public versus personal health.

Up north again

Although I slept about half the flight time from Johannesburg to Amsterdam, that still left about five hours of not sleeping in a completely full plane. Knowing that I was not continuing to Boston, another 7 plus hours, helped to see me through the waking hours. I don’t do this enough, this breaking of the trip in Amsterdam – something I am entitled to as per our travel policy. On my way out, breaking the trip in Europe means leaving home a day earlier, and so I don’t. But now the break was very welcome.

I stayed at my adopted Dutch home, near the airport which has a lot to look forward to: a friendship that dates back to the 60s, a long walk with one or two dogs, unlimited great coffee from a machine that never tires of making good coffee, freshly laid eggs and always a good glass wine.

We went to the shopping street of my childhood, a melancholy experience filled with memories of riding there on my bike, or going shopping for the Saturday meal with my father. He would go to the ‘traiteur’ and stocked up on French cheeses and French bread, good wines. He would not think about buying staples, that was my mom’s job. Our French Saturday meals were more memorable than all the other weekly ones my working mom or the help prepared. He would also take us on Sundays to museums around Holland, also memorable, while my mother rested from doing three jobs at once. Life’s not fair for working moms.

I stocked up on Dutch goodies (cheese and licorice) and helped S. pick out a baby shower gift for Sita and Jim in a wonderful toy store that reminded me of Newburyport’s Dragon’s Nest, a place where Tessa lost her ‘lapje,’ a tiny dirty and smelly strip of a crib sheet that served as her safety blankie. The drama ended with picking the piece of cloth out of the garbage can of the toy store a few tense hours later.

After our shopping we went to see S’s 94 year old mom who still lives by herself in the house I remember from the 60s, entirely unchanged. We sat in the kitchen with its (old Dutch) tiled kitchen table and the antlers from various members of the deer family hanging on the old wood paneling. We drank tea and ate thin slivers of New York cheese cake while talking about ‘koetjes and kalfjes’ (cows and calves). I would like to be as sharp when I am 94. Nearly a decade ago we had hosted her and her late husband at Lobster Cove and ate, of course, lobster, an experience she remembered fondly. She asked about Axel’s lobster traps, and she asked about the girls who she first met when they were the same age I was when I first met her all these years ago.

The rest of my time was a blur as my tiredness was setting in. I remember the meal, the first glass of wonderful wine, but hardly the second. I woke up in the middle of the night, wondering where I was, where the doors I was seeing led to, entirely disoriented. Maybe that is not so surprisingly after sleeping in so many different rooms for the last 6 weeks.

And now I am home again, and re-acquaint with my hubby, sitting by the fire because it is still winter in the northern hemisphere, even though high temperatures, in the US and in Holland, fooled everyone, including the flowering trees.


March 2012
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