13Oct2013

The Doctor is Called

The view down from the hilltop where Zac broke his arm.

Like all good travelling families headed to remote parts of developing countries, Zac and I are packing a medical kit stuffed to the gunnels with treatments for pretty much every eventuality bar decapitation. One would think, therefore, that we are equipped to handle a broken arm in Mongolia.

I’ve got ridiculous quantities of various antibiotics I bought for Everest Base Camp, not to mention the mother of all altitude treatments, three different types of anti-malarials (because why throw them out?), water purification tablets, iodine, surgical alcohol – you name it.

In fact, were it not for the fact that the treatment for bubonic plague is injectable and the Ulaanbaatar pharmacist who sold the stuff communicated none too subtly that my request was absolutely mental, we’d probably be packing that too (Mongolia remains a reservoir for the Black Death even today).

All of which is to say that, of course, we have bandages.

All the Westerners have bandages, in fact, apart from Aaron, who boasts the invulnerability of youth.

Not one of us, sadly, has the slightest clue what to do with said bandages when confronted with a child with a broken arm in Mongolia.

And, further, the paracetamol that I bought in the pharmacy seems to have failed to transfer itself to the medical kit, and the super-duper ninja codeine tablets I bought in Vietnam have been dished out to folk with diver’s or sinus headache long ago.

Immediately, in fact, my painfully limited knowledge of first aid suggests that we need five things to manage Zac’s broken arm effectively: fluid, painkillers, sugar, shade and mobile phone signal. This hilltop promises to provide precisely none of the above.

“We need a doctor,” I say to Maahar. Maahar mimes getting Zac back on his horse, and makes to move him. I bodycheck him. “No,” Bill and I say in seamless harmony. “He can’t ride with a broken arm.”

On the plus side, Zac is a remarkably robust and adaptable person, and blessed with a high pain threshold. After a bracing few minutes of vigorous – and remarkably creative – obscenity, conducted entirely sans tears, and only a small part of it directed at me, he subsides into calm.

“We need a doctor,” I say to Maahar.

Maahar mimes getting Zac back on his horse, and makes to move him. I bodycheck him.

“No,” Bill and I say in seamless harmony. “He can’t ride with a broken arm.”

I don’t know how we’re getting Zac out of here, but he’s not going on horseback with a fracture like that. Or, if he needs to go, we’re splinting him first…

Not that I know how to do that, obviously…

The nearest road is at least five hours from here by jeep, and the nearest hospital…. Oh god… I’m not even sure where the nearest hospital is.

Mörön? Say it ain’t so!

“You need to get the Mongolian word for ‘painkilling injection’ out of the phrasebook,” Zac says. “I’m not being splinted without an injection.”

“OK,” I say. “He needs water! He needs water now! And we need a doctor.”

Water, at least, is easy enough. Maahar sends Arthur galloping down to the river, and we feed Zac a few sips of river water.

Then we get the packhorse unloaded, rummage through the bags, and find, oh joy of joys, an orange drink that I bought for Zac in Tsagaannuur.

Zac and I have no painkillers. Bill has something called Aleve. We give Zac one of those, on the principle that whenever we get to a doctor they’ll probably give him something rather stronger, and feed him sips of Goe from the bottle cap.

“You need to get the Mongolian word for ‘painkilling injection’ out of the phrasebook,” Zac says. “I’m not being splinted without an injection.”

I flick through the phrasebook, find a plausible term, and try it on the guys.

“Yes, yes,” says Baatar, completing it for me. “Yes, yes!”

“Has she got it RIGHT?” asks Zac.

Baatar and Maahar help me practise the word for ‘painkilling injection’ to Zac’s satisfaction.

“I want to go to Japan,” says Zac. “Why?” we ask. “It’s the land of the Riesen Sun.”

The sun is beating down. It is quite sociopathically hot, particularly given we left the taiga in down jackets and thermals and haven’t really descended very far at all.

I’m down to my T-shirt, and sweating buckets.

Zac wants chocolate, specifically Riesen. But, since we knew we’d reach Tsagaannuur today, all our chocolate has been gifted.

Even the Haribo’s gone. I got NOTHING.

Baatar has some Mongolian biscuits. Zac doesn’t want those.

“I want to go to Japan,” says Zac.

“Why?” we ask.

“It’s the land of the Riesen Sun.”

While not up to his usual standards, it’s not a bad gag for anyone flat on their back with an untreated broken arm in the middle of nowhere, Outer Mongolia.

I’m not even going to think about transporting a child with an untreated broken arm twelve hours across the Mongolian landscape in any vehicle, let alone one with the suspension of a typical Mongolian jeep.

The doctor, Maahar announces, will be here in 30 minutes. This is, not entirely coincidentally, the precise amount of time that the plane delay which terminates Liz Lemon’s relationship with Matt Damon’s pilot in 30 Rock is scheduled to last.

It’s also highly implausible.

We are four hours ride from Tsagaannuur, where there is, Maahar says, a doctor. Over this terrain, that has to be at least an hour or so in a jeep, even with a fast, expert Mongolian driver who knows the country, and even with the rivers low.

Then they have to find the doctor, and then the doctor has to finish any other urgent business. Finally, they have to bring the doctor back. I’m thinking three hours minimum.

Maahar confirms that the nearest X-ray is, indeed, in Mörön.

“How many hours?” I say. “Mörön! How many hours?”

“Twelve, maybe?” Maahar suggests.

I’m not even going to think about transporting a child with an untreated broken arm twelve hours across the Mongolian landscape in any vehicle, let alone one with the suspension of a typical Mongolian jeep.

I mean, maybe they can just whack a cast on it without an X-ray? They must see broken arms out here all the time, surely? It’s only a broken arm, right?

I catch a Mongolian conversation that includes the words “benzina” and “machina”. “Has the jeep run out of petrol?” I ask Maahar. No, no, he insists. The jeep has NOT run out of petrol. The jeep is TOTALLY fine.

But – lo! – there is movement down in the valley! A jeep, which I had assumed to be largely decorative, sets out from the cabin where we bought the yak cheese. Then it stops, turns round and returns to base.

A motorbike goes out from the same cabin.

I catch a Mongolian conversation that includes the words “benzina” and “machina”.

“Has the jeep run out of petrol?” I ask Maahar.

No, no, he insists. The jeep has NOT run out of petrol.

The jeep is TOTALLY fine.

I can’t help but notice that the jeep isn’t moving.

How long for the doctor?

30 minutes.

Of course. 30 minutes.

30 minutes. Yeah, right.

Time ticks by.

I run down the hill, break some branches off the trees, strip the leaves off them, poke them in the ground and drape a towel over them. This activity is precisely as ineffectual as it sounds.

Shade is now becoming critical. We can’t move Zac. Not with what looks like the mother of all fractures.

But he’s not only injured, young and traumatised, but extremely fair-skinned. If we don’t get shade, he’s looking at sunburn at best, heatstroke at worst.

I run down the hill, break some branches off the trees, strip the leaves off them, poke them in the ground and drape a towel over them. This activity is precisely as ineffectual as it sounds.

The towel droops; the sun’s so high in the sky that the shade it casts is minimal; and I have to work around the existing position of Zac’s body.

My feeble attempt, however, does spark the chaps into action.

Aaron tries putting the pup tent up and using that as shade, but the angle of the hill and the position of the sun is wrong. For the pup tent to work as shade, we’d need to get Zac inside it, which would mean moving him.

In the end, we get the pup tent back into its circular case, prop that up using sticks and bags, and turn that into shade. We can keep it moving, following the sun, all the way through this long, long afternoon.

Ooh! Down in the valley, the motorbike has returned! And it’s headed our way!

I look, beadily, for signs of a medical case.

Nope. It’s not a doctor. It’s the folk from the cabin. Which is nice of them. And – yay! – the jeep is back in action, and on its way to Tsagaannuur.

How long for the doctor? 30 minutes. Yeah, right.

Maahar demonstrates the technique. You stand on tippie-toes on the very top of the rock, hold the phone vertically above your head, and shout up into the phone. When the other person needs to talk, you bring it back down to ear-level. There is a high wind.

The mother of the lovely baby and one of the chaps from the cabin arrive, on motorbikes, and there’s more Mongolian conversation.

“You go with them! Call Ganbaa!”

Great! We haz phone signal!!!!

I look at Zac.

“He’ll be fine,” says Bill. “You need to talk to Ganbaa.”

“I’m fine,” Zac confirms.

I leave Bill feeding Zac sips of sugary liquid, Maahar takes the second bike, I hop on the back, and we follow the family up the hill.

This is unusually scary. I’m very aware, now, of how sharp the rocks are, I’m not wearing a helmet, and if Maahar flips the bike and I hit my head we have not one but both of us out of action. A clunk, and the chain goes on the bike. We dismount. Maahar fixes it.

Finally, we make it to the top of the hill, and the Magical Rock of Phone Reception. It looks no higher or larger than any other rock, but, clearly, it’s the go-to rock for locals in this and neighbouring valleys.

Maahar demonstrates the technique. You stand on tippie-toes on the very top of the rock, hold the phone vertically above your head, and shout up into the phone. When the other person needs to talk, you bring it back down to ear-level. There is a high wind on the top of the rock, and the connection keeps dropping.

Now would be a good time to state clearly that I am phenomenally grateful for the kindness and the patience of everyone around us. One of the main lessons I’ve learned in over three years of travel is that people, the world over, are overwhelmingly good and kind, particularly where a child is involved.

Yet, at the same time, as the Mongolians sit down to patiently, systematically swap around batteries, phones and SIM cards until they find the one combination that provides good battery, good reception and (I suspect) adequate credit on the Magic Rock of Phone Reception, the process absolutely does my head in.

“Try making a fist from time to time, to keep the blood flowing and the nerves active,” I volunteer, hopefully. I have no clue about first aid. And we are a long, long way from the embrace of Uncle Google, and further still from phone-a-friend.

Back down the hill, framed by a backdrop of horses hobbled together in a tight circle, Zac is cracking lame gags.

There’s a steady ache in his arm, and the odd spasm of intense pain when the muscles start to clench involuntarily, but his baseline pain is reducing with the Aleve.

“Try making a fist from time to time, to keep the blood flowing and the nerves active,” I volunteer, hopefully.

I have no clue about first aid. And we are a long, long way from the reach of Uncle Google, and further still from phone-a-friend. Believe me, you don’t realise how reliant you are on the internet until you hit a medical emergency out of reach of it and (frankly) even if I had international phone coverage and reception I wouldn’t be panicking a friend.

Ya know.

“Hi!” [insert friend and medical advisor’s name here] “Long time no speak! But we’re on a hilltop, in northern Mongolia. There’s supposed to be a doctor coming, but in the meantime Zac’s broken his arm, and I just wanted to know if spasming was normal… Oh! An X-ray, you say? Yeah, I don’t think they’ll have those facilities here… No, no, totally fine! Don’t worry!… Is there anything you can do? Well, you could look up my travel insurer’s number for me…. Yeah, Tsagaannuur…. No, I don’t have a number… No, I’m not sure you’ll find it on a map…. There aren’t any roads, you see…”

Nah.

Baatar beckons me. It seems they’ve patched a functional phone together. I hop on the bike and head back up the hill to the Magic Rock of Phone Reception.

We’ve been out on this hilltop for over two hours now, and there’s still no resolution in sight.

We spot the glint of moving metal over the other side of the valley.

“Is it the jeep?” I ask.

“Nah,” says Matt. “Another bike.”

“Does it look like a doctor?” I ask.

“It looks like it’s stopping at the head of the valley.”

Bugger.

Baatar beckons me. It seems they’ve patched a functional phone together. I hop on the bike and head back up the hill to the Magic Rock of Phone Reception. It takes three goes to get us through to Ganbaa, but the connection holds.

Like most people who work in the tourist industry in the horse-riding areas of Mongolia, Ganbaa seems fully au fait with the rich variety of Western horse riding injuries that strike during the summer season.

“Hi!” I say, or rather bellow. The balancing act required by the Magic Rock of Phone Reception is not conducive to easy conversation. “Zac’s had a fall, he’s got a broken arm. It’s looking like he may need to go to Mörön.”

“Ah,” says Ganbaa. Like most people who work in the tourist industry in the horse-riding areas of Mongolia, he seems fully au fait with the rich variety of Western horse riding injuries that strike during the summer season. “I’m sorry to hear that.”

“Ah, he’s alright,” I yell up into the phone, through the wind. “These things happen. It’s not anyone’s fault. Your helmets worked really well. Do you have my travel insurance details?”

My travel insurance details are on my email, with my parents in the UK and on a piece of paper at Ganbaa’s camp. They are not, however, on my person, although given my Mongolian SIM doesn’t work this far out of town and isn’t set up for international calling, this is only one of a series of basic errors that I will anatomise at some point.

“I’m not at home at the moment,” he says. “And I’m not sure my wife can find the paper.”

I remember the piece of paper. It’s a standard A4 piece of computer paper with names, passport numbers and insurance details squiggled on it. Not the kind of paper that’s easy to find unless someone’s filed it systematically, which Ganbaa clearly hasn’t.

“I do have a couple more numbers that might be useful for you,” he says. “The first is for the British Embassy in UB…”

“Can you text it to my phone, please?” I shout, performing a neat pirouette on top of the rock. “I don’t have a pen here, and I’ve got no reception, but once we’re in Tsagaannuur I can do all that stuff…”

“Sure,” he says. “And the second is for Doctor Shirley in UB. She has a helicopter.”

They have medical helicopters in Mongolia? Result!

I LIKE the sound of this Doctor Shirley. She sounds like Mongolia’s answer to the Milk Tray man. “Yes, please text me her number. I’ll send Baatar back to you with all your gear.”

Baatar suggests various splinting solutions. My guidebook? Too big. Cover? Too flimsy. Maahar catches on, heads down to the treeline, grabs some sticks, and sits there, cross-legged in his del, whittling patiently with his hunting knife.

I hand Ganbaa to Baatar, and head back down the hill on the bike to Zac, who seems remarkably zen. We alternate between chit-chat, looking down the valley to see if the doctor’s on the way, and asking Maahar how long the doctor will be just to see if he changes his estimate from 30 minutes. (He’s Mongolian. Of course he doesn’t.)

I begin a priority list of things to do once we reach Tsagaannuur and Zac’s patched up. Find Riesen and a bed for Zac, call Doctor Shirley, get my travel insurer’s emergency number and call them (somehow)… Maybe the British Embassy can help?

And… We wait. We banter. We crack gags.

Baatar suggests various splinting solutions in sign language. My guidebook? Too big. Cover? Too flimsy.

Maahar catches on, heads down to the treeline, grabs some sticks, and sits there, cross-legged in his del, patiently and systematically whittling them with his hunting knife.

Bill, Matt and Aaron need to continue the trek, but want to wait with us and move out the second we’re on the jeep. That means there are practicalities to be addressed.

I rifle through the packhorse bags, and distribute all foodstuffs but coffee (lord knows one needs one’s coffee at a time like this, especially in a tea-drinking culture). Then I separate out the utensils that are Ganbaa’s, the utensils that are Baatar’s and the utensils that came with Bill, Matt and Aaron.

Then everything goes back in the bags and onto the horse. And still no jeep!

Maybe that’s just how they do things here?” I say. “Whenever the doctor comes this far out, every single cabin in the valley calls them out to have a look at their ulcers?” “They’re probably just stopping for a cup of tea,” he says.

More than four hours after Zac broke his arm, a glint of metal blazes over the head of the further edge of the valley.

“It’s the jeep!” says Matt.

“No way!” I say. “Seriously?”

“Oh, wait,” he says. “It’s stopping at the cabin at the head of the valley.”

“Maybe that’s just how they do things here?” I say. “Whenever the doctor comes this far out, every single cabin in the valley calls them out to have a look at the minor medical issues they’ve been meaning to see a doctor about for the last few months?”

“They’re probably just stopping for a cup of tea,” he says.

“Probably both,” I say. “Tea, a bit more tea, and then a look at grandma’s corns, the daughter’s pregnancy, weigh the baby – do their house calls while they’re on the way.”

The jeep sets out from the top cabin, and stops at the cabin that hosted us two nights ago. And then…

Be still, my beating heart! It’s a jeep! With a doctor! And, under five hours after Zac broke his arm, it’s heading up the hill and coming our way!

It is at exactly this point that I realise I’ve been in this broiling sun for at least five hours without protection and my face, arms, even my lips are blister-hot.

“How do you say ‘painkilling injection’ in Mongolian again, Mum?” asks Zac.

I repeat the phrase. And, satisfied, he awaits his fate.


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15 Comments

  1. Pratibha says:

    That truly is one brave young man. And you describe it beautifully – feels almost like I’m right there with you guys.

    Am glad it all turns out ok. Safe journeys ahead!

  2. Ainlay says:

    How did you call the doctor in the first place?

    Zac is one amazingly brave boy. My oldest daughter crushed her ankle when her ATV flipped over in the desert in Dubai and that was pretty bad but at least we had a jeep able to come out to us pretty fast because we had phone reception.

    • Theodora says:

      We didn’t call the doctor. The jeep went to go to find them.

      Bad title, damn. Really bad title.

      Crushed ankle sounds horrid — a lot worse than a broken arm. I don’t look at ATVs the same way after this horse-riding incident, and I’m looking at them with new eyes again now that I’ve heard that from you…

  3. Jenn says:

    I’ve been reading this story mesmerized. I’m so glad a second email post came because I was worried after reading the first one (even though I know he must be ok by now). Zac is so brave and so are you. Continued healing vibes to him.

  4. Compellingly written – as was part one – with just the right mix of adrenaline, grit and humor.

  5. 1. ” …It’s the land of the Riesen Sun.” Might just be me, but I was amused by Zac’s insistence on “riesen” which is German for “giant”/”gigantic”.

    2. What *is* “painkiller injection” in Mongolian?

    3. Your son is a total champion.

    • Theodora says:

      1: We’re not polyglots, so sadly the extra humour was unintentional.
      2: I gave the phrasebook back to Bue, so I don’t have access to that now — it’s gone back into what Zac calls the linguistic soup kitchen…
      3: Yes! He rocks…

  6. Aktar says:

    Awesome write up Theodora…… this is the first time I’m visiting ur site but found very interesting articles. Your blog is very nice.

  7. Riwar Tumid says:

    You have many wonderful travel tales but it would be amazing if only you are just as wonderful at telling the stories. Your writing irritates most times. There’s no flow in your writing style. Im sorry but Im just being honest here. I really want to see someone like you improve their writing. You have so many great tales to tell.

  8. rchi says:

    Really Riwar!? Really!? You have the balls to complain about her writing when your comment is delivered with grammatical errors. Review what you write before offering a critique.

  9. rchi says:

    By the way, Theodora, I came across your FB page what seems like a couple of years ago and your adventures have planted seeds. Totally inspired! I like your writing style. It’s fine by me. As another commenter posted, I felt like I was there in the baking sun and balancing on tippy-toes struggling for a signal.

    • Theodora says:

      Hey, that’s great to be inspirational… And, thanks for standing up for me. That comment *did* rile me a little, but I publish all comments that aren’t spam. And, TBH, I think part of the problem with flow might be that they came through my feed rather than on the page. I just moved my RSS feed away from feedburner, so the style I’ve been using to pull out the quotes doesn’t copy across, which means it looks at the moment as though I’m repeating myself…

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