It Might Get Messy

When I went to China twice in the early 1990s, I spent a lot of time hiking around local neighborhoods in cities, and visiting (via auto and foot) isolated villages in the countryside. At the time, I noted that even in the most impoverished places, where huts improvised from cardboard, fiberglass, and corrugated sheet metal fed onto streets lined with closet-sized shops and one, two, or no-table restaurants, there was always a focal point, a gathering place, a pub, or shop, or lean-to that had a television (always), and a computer (sometimes). 

Of course, even in my most casual western clothes, I stood out like a DEA agent at a Dead concert in Golden Gate Park. But people were invariably genuinely friendly and welcoming. Often, I’d get pulled deeper into densely populated side alleys, mud footpaths between pasted-together one-room shacks and ramshackle two or three story apartment houses. I got to observe, intimately and at close range, the grinding poverty. And the spirit—often expressed in honest and cynical humor—of the locals. But something nagged at me regarding those shared-resource television sets and computers. 

Same pattern—septic neighborhoods with islands of electronic connectivity—pertained as I had opportunities to explore the middle east, Pacific islands, and the Caribbean. 

Eventually, the source of my discomfit occurred to me. These people—thousands and thousands of them, in cities and rural villages around the world, live in intense poverty. And at the same time, they see, on CNN, BBC, Al Jazeera, and via AOL and Yahoo, how the rest of us live. Their screens showed the hygienic, comfortable, easy, safe life that we in the temperate zones of the developed world live. 

And this bothered me. Why, I have wondered for more than 20 years, don’t the impoverished billions in the developing world tropics rise up, grabbing bottled water, knives, and shovels on their way out of dodge, and pour into our world? What was holding back tsunamis of poor people from sub-Saharan Africa, India, Southeast Asia, Southwest Asia, China, and Latin America? Why were we in the clean, healthy, wealthy expanses of Europe and North America not engaged in desperate battles with southern masses intent on putting our heads atop spikes in killing fields stretched from California to Montreal to London to Berlin to Moscow and Sydney? 

It remains, to me, a conundrum. Three billion people struggling to survive in the impoverished tropics, watching us eat, drink, and play on TV and computer screens, ought to, it seems to me, be sharpening up those shovels, cleaning the residual heaps of Kalashnikovs (did I mention that Mikhail Kalashnikov died recently? He did, and he died knowing that weapons of his design have killed more human beings than any other. Although that design is so simple and so robust that it can be—and is—replicated in hand-tool workshops around the equator. At the same time, high-end versions are valued in the most sophisticated weapons circles. Cross-reference the first movie RED, where John Malkovitch explores Bruce Willis’ weapons stash and breathes admiringly “a Swedish K…”) left in the wake of ubiquitous civil conflict, with intent to kill.

There are many parameters that could trigger such a mass mobilization. Nutrition—the basics of sufficient quality and quantity of food—is among the most likely. It is obvious to anyone living in poverty that every single individual on-screen for CNN, the BBC, and Al Jazeera have plenty to eat and do not lack for potable water. And it is also obvious that the audience for round-the-clock international news feeds have plenty to eat and abundant safe water. Basically, it is obvious that there are places where people do not have to deal with mud streets, improvised housing, festering water, rats, tainted (biologically and chemically) food, scarce food. 

So if I project a little, I can imagine myself inhabiting a plywood and corrugated fiberglass shack in a hot, wet, septic hell hole, maybe on the fringe of the enormous garbage dump serving Cairo, say, or maybe Mumbai where similar improvised dwellings are crushed together around a single, shallow water table well. And what I imagine next is that I’d really rather be inhabiting a dwelling in whatever slab of real estate Wolf Blitzer and Christiane Amanpour call home. 

Then I imagine that I’ve sharpened up a shovel just in case and I’m hoofing it down the mountain of festering trash in the Cairo city dump and heading for Paris or Amsterdam or Berlin. And I imagine that when I get there, it is indeed the tidy, orderly, sanitary, place of my dreams, packed with shops and restaurants purveying food, water, unadulterated beverage alcohol, and all manner of goods from clothing to big screen TVs. And I imagine myself and the many hundreds of others that took up shovels to walk with me as I passed their hovels will kick some overweight wealthy ass and take some healthy hygienic names. 

In the real world, it turns out that my sociological daydreams are beginning to play out. Israel is embroiled in a controversy involving several thousand residents of various African nations who became environmental refugees and walked from the hellish slums of their origin to the shining ecologic and economic heaven of a modern functioning state. 

Nutrition is a powerful motivator. And lack of nutrition is a powerful constraint. I’m just finishing a detailed account of the World War Two battle for what was then Stalingrad between the Russian defenders and the German invaders, where nutrient deficiencies hastened the awful nightmare of the doomed German soldiers. 

And nutrition is a big deal in the aftermath of cancer diagnosis and treatment. Especially so when the cancer wars were fought on battlefields of the mouth and throat, critical infrastructure for feeding and hydrating. 

In my case, the food-related functions of component parts of my head and neck have been obliterated. I am unable to eat or drink via the pathways my corpus is evolved for. 

And this is a problem. From a number of perspectives. For me, a lifelong cook and food person, not being able to eat is a depressing condition. I’m only now, well along in my recovery (such as it is), regaining the pleasures of cooking for families and friends. And of course, lacking the ability to safely taste what I’m preparing, my cuisine is getting a little erratic. 

More problematic are struggles with the plumbing that stands in for a functional oral cavity, and with the medically concocted “food” that I ingest via said plumbing. I take a high-calorie, carefully formulated for complete nutrition, liquid. I dump it into a tube that opens in my stomach via a 60 ml syringe and some aquarium pump tubing. 

The “food” comes in 250 ml cartons. To maintain my weight (an imperative for recovery—if I’m not getting maintenance calories, I can’t heal and my immune system will under-perform, dangerous for a body prone to sprouting cancerous cells spontanteously), I need to pack in 7 cartons of the liquid food. But here’s the problem. Seven of these things dumped into my stomach is a hefty challenge for my digestive tract. When I do manage to get all 7 boxes into my gut, it tends to just sit there, acting grumpy. I get acid reflux (lacking the epiglottis, stomach acid regularly rises into my battered oral cavity). I get nauseous (and I’ve run out of Zofran, peerless anti-nausea drug, and we haven’t been able to reach the doctor to get a refill dropped on the nearest pharmacy). I feel sluggish. And having to fight the nausea is exhausting. 

I’ve been working with the dietician assigned to my case to try to find some way for me to ingest and retain (that is, to not vomit it right back up) the calories I need to function. We tried a high-calorie additive. That didn’t work. We tried different ways to space out pouring the seven cartons down the pipe. Now I’ve got several boxes of supplemental extremely high calorie liquid food. If I can keep a couple cartons of the latter down per day, along with four or five cartons of “regular” food, I might be able to recover some weight. 

But today, I felt good in the morning. I packed in all seven cartons of food over the course of 3 or 4 hours. Then, when I mobilized to head for the grocery store to get stuff to cook for supper, I had to fight the urge to vomit. And I had to fight that battle all day. I’m still feeling bloated and nauseous now at midnight. I took the seventh food pack around three in the afternoon. 

So, I gotta find a way to come to grips with my digestive system and get it to accept sufficient calories on a daily basis. This is a very uncomfortable process. When I’m having a bad day, I can hardly look at a carton of “food” without gagging. When I’m having a good day, and I dump in the full ration to take advantage of same, I get tummy aches and chronic nausea. 

Sigh. I’m sure I’ll work this out. Since the alternative is to slowly starve to death, which engenders a host of discomfiting symptoms, I expect I’ll battle the U.N. emergency rations to a standstill. 

It just might not be pretty when I get there. And it certainly won’t be comfortable. But, given the alternatives, this is again something I can live with. Trading gastrointestinal discomfort for being alive is a bargain deal. I’ll work it out. And I promise to stop whining about food…umm…let me rephrase that. I’ll do my best to stop whining about food. 

And enjoy the things that make life worth living, from picking a guitar, to cooking for the family, to reading, writing, listening to music, watching movies, photographing birds, and riding along with my children as they blossom into the adult world. 

Thanks for being here, everybody. My love to you all. Be here next week for another installment of this cancer-driven confessional soap opera. And take this lesson to heart: enjoy every bite of food and every sip of beverage that you take. If you should find yourself unfortunate enough to be stumbling down this path behind me, you’ll need the memories of those steaks, fish, shellfish, fruit, vegetables, and grain products to keep yourself sane!