98.6 Degrees

Getting sick is annoying. It’s annoying no matter what the circumstances are…whether you’re young or old, coughing, sneezing, sick to your stomach or suffering from a stuffy nose, getting sick is something most people would, quite obviously, rather avoid. But getting sick in a foreign country is definitely more inconvenient and frustrating (and sometimes even scarier) than getting sick in the comfort of your own home. It can also be quite amusing, though, if you live to tell the tale.

I’ve been lucky enough so far that I haven’t had to seek treatment at a hospital in a foreign country, but I’ve gone along as a friend a few times, and what I’ve seen has stuck in my mind. When I was studying abroad in Spain I went to the hospital with a friend when her roommate kicked in a glass door (another long story in and of itself) and was very thankful that I hadn’t had to spend any time there as a patient myself. Although the benefits of socialized health-care in many European countries mean that everybody is guaranteed a certain degree of treatment, that doesn’t necessarily guarantee the kind of treatment that many Americans are accustomed to. Hospitals are generally dimly lit and they don’t appear to be quite as clean as the bright, sterile hallways and private, curtained-off rooms that most Americans expect on a visit to the hospital. A friend of mine recently went to the hospital here in Ukraine and had a few surprises there–the bathrooms didn’t have soap or toilet paper and she had to go to the in-house pharmacy to buy all the necessary medicines for her treatment. While this wasn’t a problem (Peace Corps takes care of all our medical needs either with Peace Corps doctors in Kyiv or through reimbursement), she noted that if she hadn’t had enough money to buy all the medicines that she’d needed, she simply wouldn’t have received treatment.

Now, add a little cross-cultural confusion and the language barrier into the mix, and you have the potential for hilarity or disaster when falling ill in another country.

About a month and a half ago, I came down with a nasty cold. I had a nose that couldn’t decide whether it wanted to be runny or stuffy; a deep, hacking cough; and general discomfort and malaise. I recovered after about two weeks, but unfortunately, I must have given my cold to my dear site-mate Shelby, who became sick about a week after I did. At first our symptoms were the same–runny and stuffy nose and a nasty cough. After about two weeks though, Shelby wasn’t feeling better. She had terrible pressure in her sinuses and her cough was getting worse and worse. Finally, after three weeks of feeling sick, she called the Peace Corps Medical Office and took a trip to Kyiv to visit the Peace Corps doctors. They took some x-rays, prescribed her a variety of medicines, assured her she didn’t have TB, and told her to call back if she wasn’t feeling better in about three days.

Three days came and went and, although she was feeling better at first, she took a turn for the worse this morning when she was on her way to school. The cough was back, the sinus pressure was back, and she was beginning to feel like she’d never get better. In frustration, she went to visit her former-host family (she lived with them for the first two months at site and visits them almost every day). They’d been concerned about her for several weeks, and the fact that she was now so tired of being sick that she was on the verge of tears really pushed them over the edge. They called her host-uncle, a doctor, and had him come over to look at her and give his professional opinion. The only problem with all this is that as Peace Corps volunteers, we’re only allowed to receive treatment authorized by Peace Corps and Ukrainians love to try to give us advice, home remedies and medicine that we’re not supposed to take.

I stepped in the door just as Shelby was getting her face examined by Kolya–her host-uncle. Her host-mother and host-father greeted me and shook their heads at me gravely–as though I were somehow partially responsible for letting Shelby get this sick. “It’s a big problem….it’s not okay,” they pronounced. “I know, I know,” I replied. Shelby and I were prepared for the onslaught of advice and hyper-paranoia.

We now live in a country where people compulsively close all the windows on steaming hot busses because they’re truly concerned that a draft might cause serious health problems–leaving travelers to sweat profusely while crammed together in their sticky hot jail-cell of a bus. One of my students told me that her neighbor’s face was paralyzed because of the cross-draft on a bus–she was standing in the middle aisle and windows were open on both sides of the bus, allowing the air to cross back and forth, which, apparently, led to her subsequent paralysis. During the swine-flu scare, stores sold out of lemons and garlic because people slice them up and put them out on plates, believing that this will absorb the bacteria and viruses that cause the flu. Since she got sick, Shelby’s host family has insisted that she shouldn’t drink juice or cold water (actually, cold water is generally speaking a no-no under any circumstances). And it goes almost without saying that if you don’t wear a warm hat, warm coat, and warm boots during the winter, you will probably catch a cold and die.

Of course, all of these deep-rooted fears and traditions stem from this country’s complicated, often incomprehensibly unfortunate history–a history that Ukrainians remember very clearly. Between the years of 1932 and 1933, millions of Ukrainians (the numbers are disputed…somewhere between 2.6 and 10 million) died in a forced-famine instituted by Joseph Stalin and unsurprisingly, this incident–the Holodomor (literally “murder by hunger”) left a lasting impression on Ukrainian culture. Thousands more died during WWII and countless others were sent off to gulags for crimes committed against the Soviet government. You’d be hard-pressed to find a Ukrainian today whose family wasn’t affected directly by the Holodomor, WWII, or the Soviet Regime. Consider all of this, and then take into the account that receiving appropriate health-care in Ukraine is still a complicated issue (one that I really don’t have enough knowledge about to comment on more), and it actually makes a lot of sense that Ukrainians are all about preventative health-care.

That Shelby had already allowed herself to suffer for three or four weeks was unfathomable to her host family. They were trying to convince her to go ahead and take the medicine that her host-uncle would recommend (you don’t really need a prescription for most things here. As long as you have enough money you can go to the pharmacy and buy what you need). We tried to explain that, as Peace Corps volunteers, we’re only allowed to take medicine given to us/prescribed by our Peace Corps doctors and that violation of this could actually get us “administratively separated.”

“We understand, we understand,” they said. “But this medicine the doctors have prescribed you isn’t strong enough. This medicine isn’t even strong enough for a small baby. It won’t fix your problem. It will just treat the symptoms…not the infection.”

“We understand, we understand,” we said. “But we’re really not allowed to take any other medicine. The doctors in Kyiv told us that if Shelby didn’t feel better in three days, to call back and they would tell her what to do then.”

They shook their heads and shook their heads mournfully, pleadingly. This conversation went on for about fifteen minutes until we were interrupted when the Peace Corps doctors called from Kyiv to give Shelby their advice. This advice only fanned the flames and the conversation raged on.

“Nobody will know if you take the medicine, Shelby.” they insisted. “Just take the medicine. It’s not okay for you to have been sick so long…if you stay sick, it will only get worse. Maybe you’ll even have to go back to America because you won’t get better. Don’t you want to stay here two years??”

They insisted on taking her temperature again–something we knew would immediately be another point of contention. Just a few days before, they’d taken Shelby’s temperature and gotten those tragic, concerned looks on their faces when they read the thermometer–37 degrees Celsius. At first we were concerned too. They told us that 37 was very high…not normal…not okay. So we grabbed our cell phones to do a quick Celsius to Fahrenheit conversion. 37 degrees Celsius is 98.6 degrees Fahrenheit. Completely normal, as far as we were concerned. We laughed a little bit about this, but Shelby’s host family was very serious.

“It’s not a joke! 37 degrees is not normal!”

We tried explaining that 37 degrees is exactly a normal temperature in America…that back home this would be nothing to worry about. But imagine if a helpless foreigner were sitting in your kitchen with a hacking cough and congested sinuses and a temperature of 100 degrees. You’d tell them that this was definitely a problem…that they definitely had a temperature. And imagine if this poor, coughing foreigner tried to insist, with the vocabulary and language skills of a five year-old, that a temperature of 100 degrees was really nothing to worry about…that it was completely normal where she came from. You’d pat that poor little foreigner on the head and try your hardest to get her to take some medicine that you knew would help.

Situations like this make you realize just how arbitrary certain aspects of cultural logic are. The three Americans sitting at the table were shaking their heads and laughing at the Ukrainians, secretly rolling their eyes a little bit…and the Ukrainians were rolling their eyes at the Americans and looking at them like they were completely insane. Of course, a temperature actually isn’t something all that arbitrary, but things like not drinking juice when you’re sick and washing and drying your hair in the morning (another no-no…apparently your head can’t handle the shock and it’ll give you a cold) are superstitions that might be rooted in some sort of logic, but are now far enough removed that they’re difficult for people with different cultural values to truly buy into.

So when Shelby’s host-mother stuck the glass thermometer under her arm, we braced ourselves for another long, drawn-out conversation about how 37 degrees is a completely normal temperature in America. Sure enough, Shelby had a temperature…37 steaming hot degrees. Shelby and I, slightly exasperated, laughed and began to try to explain ourselves again. Then Shelby’s host-uncle decided maybe we should try an empirical study, for concrete proof. They shook the thermometer and handed it to me–perfectly healthy–to stick under my arm. We waited about five minutes and then I pulled out the thermometer. The whole family crowded around in anticipation.

36.9…they were shocked! Shelby’s host-mother jokingly accused me of sticking the thermometer into a cup of tea. We passed the thermometer to the doctor himself–Shelby’s host-uncle. His temperature read 36.4 (normal, apparently) and then we handed it off to Shelby’s host-mother, whose temperature was 36 degrees. Shelby and I shared a short-lived victory laugh. Shortly thereafter, the conversation turned serious again as Shelby’s host family did their best to convince Shelby that it was definitely in her best interest to take the medicine her host-uncle would prescribe for her and that she needed to tell the Peace Corps doctors to listen more seriously…that they needed to give her stronger medicine.

In the end, Shelby was able to placate her host family (as much as possible, anyway) by speaking with the Peace Corps doctors and deciding to go to Kyiv to see a doctor there. They were still disappointed that she didn’t take the medicine they wanted her to take and they were still extremely concerned about her health, but they were mostly just relieved that she’s going to get the medical attention that they think she needs. Even though she and I both know full well that she’s going to completely fine, it was both unnerving and somehow endearing to see how concerned her host family was. It’s nice to know that they truly worry about her health and want what’s best for her, but it was a little awkward at times to see how completely our attitudes about health varied, thanks largely to the way we were raised to think about health. I suppose when you know that if you get sick, you’ll be able to go to a nice, clean, brightly lit  hospital, where doctors and nurses will take care of all your problems and you’ll have all the medicine you need, you don’t really worry too much about the common cold or a pesky case of bronchitis. For those of us privileged ones,  it really is mostly just an annoyance–something we know we’ll be able to treat and take care of. We don’t go about slamming windows shut and putting out plates of garlic and lemons…but then again, health-care for many of us in America is adequate enough that we don’t need to bother with superstitions and extra precaution. Going to the doctor is enough to ensure that we’ll be more than just safe, rather than sorry.

So Shelby’s on her way to Kyiv to get lavished with medical attention from the doctors there, and hopefully in a few days, thanks to the miracles of modern medicine, she’ll be back to normal. Before she hopped on the train, though, we both took our temperatures, just for good measure. 37 degrees–on the dot.