Just Like Someone Without Mental Illness Only More So (20 page)

When I could hear music again I noticed Coltrane, Monk, Professor Longhair, Billy Strayhorn, Stevie Ray Vaughan, Aaron Copland, and some others like I had never heard them before. They too seemed to be trying to tell the truth to save their own lives, and I was intensely grateful.

Pelotas

(Photo by Mark Vonnegut)

Two and a half years after my last psychotic break, my wife and I were on our fourth marriage counselor. I had moved most of my clothes to the basement and slept there. We didn’t talk about it. She said things were fine.

An emergency-room doc friend named Max mentioned that he was going on a medical/dental mission to Honduras. I asked if I could come along. I’d have to chip in eight hundred dollars for my travel expenses and go to three or four organizational meetings on the Cape.

Max was a tall, handsome extrovert whom I had known from MGH, but we became friends when we met again in AA meetings when I was first trying to get sober.

I know you
, he seemed to yell as he lunged across the room. He was much too big and much too loud. I had kind of hoped that an anonymous program meant that nobody knew anybody.
He asked me how I was doing, and I said I knew I was doing great because I had a ton of alcohol in the house and wasn’t even a little tempted to drink it. Max came home with me and poured my half bottles of this and half bottles of that down the sink so that if I slipped, it would have to be on vanilla extract or mouthwash or rubbing alcohol like everyone else. Thanks, Max.

At the organizational meetings, we were told over and over that the people of Honduras would be very grateful. Most of them would have never seen a doctor before. We would not be dealing with worried well people. There would be lots of previously undiagnosed disease and chances to make dramatic saves. Back home the patients were so thoroughly picked over there were more chances to mess up than to do good. Helping people was easier if they hadn’t already been seen by a million doctors. There would be no forms to fill out and no malpractice worries. We had more than three thousand slightly used tennis balls to hand out, donated by tennis clubs on the Cape.

Dentists could line people up and pull their rotten teeth and make them better without a single word being exchanged. Plastic-surgery teams could come down to Honduras and fix cleft lips by the dozen without necessarily getting to know their patients or even having to speak Spanish. Optometrists were going to do vision exams and match up people with discarded donated glasses. Pediatrics doesn’t involve a lot of one-hit good deeds, like repairing a cleft lip or pulling an abscessed tooth. It wasn’t clear to me that much of what I could do lent itself to people lining up with their kids for one-time encounters. I’m a better doctor when I’m seeing fewer patients an hour and when
I speak the same language they do and when I’m going to see them again. But we did have all those tennis balls to hand out.

Treating sickness as a business opportunity has just about killed the joy of healing, the very reason most doctors and nurses wanted to go into it in the first place. Part of what was so attractive about the Honduran trip was that none of us would be making a dime on it; our care was to be free to the patients. We would be tending to the sick because they were sick and for no other reason. The problem with trying to comply with quality-improvement initiatives and worrying about lawsuits and coding guidelines and all the other stuff we have to do is that doing the right thing for the patient gets buried in all the muck. It’s like trying to be an Olympic high jumper with ankle weights. The Honduras trip would be free of all that other stuff. There would be nothing for us to do but the right thing.

At our last organizational meeting, just before we left, it was announced that we would be staying in a coastal resort, Hotel Villas Telamar, rather than being put up by native Hondurans and sleeping in hammocks. The first two trips had been strictly dental, with less than half as many people involved. Because this was a much bigger expedition, finding enough natives to put us all up in hammocks had turned into a logistical nightmare. Villas Telamar was an all-inclusive beach resort, formerly owned by United Fruit and used as a resort and housing for its executives and their families. They gave us a really good deal. I still wasn’t the world’s greatest sleeper and was frankly relieved by the prospect of a bed in a hotel instead of a hammock in a hut.

We had two hundred volunteers: nurses, doctors, dentists, optometrists, pharmacists, translators, and all-purpose helpers. There were more than a hundred crates of donated supplies and
medicines. We were each paying most of our own travel expenses, with local fund-raising and charities covering the rest. A couple of drug companies were chipping in. We were all giving ten days of our time to help the poorest people of one of the poorest nations in the hemisphere.

Short time here, long time gone. The reason to try to be good, smart, kind, and on the side of angels is because it’s more fun and because there really aren’t any angels.

It took us eighteen hours, on three flights and a long bus ride, to get to where we were going: Tela, Honduras. Gavin Archibald, a dentist from Texas who had recently married his office manager, was in charge of the mission. On the longest leg of the flight, from Houston to San Pedro Sula, I fell asleep and dreamed I was back in junior high. I had no clothes on. Everyone else was dressed. I had a baseball glove. No one else had a baseball glove. It wouldn’t be fair to have figuring out dreams be important to mental health.

There was a physical therapist named Crystal who might have been flirting with me. She gave me a neck rub during the layover in Chicago, and I would have followed her anywhere. Even with my marriage going poorly I hadn’t dared to even so much as flirt with anyone else prior to this.

By coincidence the prime minister of Honduras was with us on the flight from Houston to San Pedro Sula. He and the dentists from Texas were chatting, sipping drinks, in the front of the cabin like they had gone to Andover together. The prime minister made an impromptu speech to us about how important and
significant and needed our mission was and how grateful he was and how grateful the people we helped would be. He mentioned that the Haitians manipulated the data when they claimed to be the poorest country in the hemisphere and that it was in fact Honduras that had the lowest per-capita income and highest infant mortality.

At the welcome banquet, dessert was a flan loaded with rum. Max, who’d been sober ten years, was wolfing down the flan till I grabbed his spoon, interrupting the rapid round trips to his mouth.

“Rum
, Max.”

“What?”

“The flan is full of
rum
.”

“Oh.”

The resort had swimming pools and a pure white sandy beach with a main building and numerous outlying bungalows. Each bungalow had a refrigerator with distilled water. Before I was fully awake, I brushed my teeth with tap water. We’d been told not to do that.

“Remember to brush your teeth with the bagged water,” I told Max.

“Of course,” said Max.

Max insisted that I turn over all my cash and identification to him. He would keep it safe in a brown khaki bandolier money belt under his fresh blue paper scrubs. I would get to wear the money belt the second half of the week. I had forgotten how much fun it was to have a roommate.

“I’ll keep a little pocket money,” I said.

“Sure,” said Max. “Just ask me if you need more.”

I walked the beach early in the morning and found a dead dog, legs up, bouncing in the surf. It could have happened anywhere.