Wednesday, November 6, 2013

Raising Jungle Children

We ARE Jungle Kids.
I had an epiphany recently while on the back of a small Honda 50cc motorcycle.  I was clutching my son between myself and the driver while the bike weaved dangerously between cars at the peak of Bangkok rush-hour traffic. There was not enough room for the three of us on the small seat so I stood on the passenger pegs and
held onto the driver who leaned forward for counterbalance. My son bravely held on to the drivers orange jacket with only one hand because his other hand was wrapped in a makeshift splint made of ten chopsticks and two shirts.

We were headed to the hospital. There was no other reasonable way to get there.

Typical Bangkok shortcut to a hospital
My epiphany could have been about "the things we do for our children," but that is never a topic for debate with me. You do whatever you can. Period. This 
epiphany was more about what we do TO our children. I grew up in typical
American Suburbia. I was ten minutes from a hospital and five minutes from a 
pharmacy. Since my father was a doctor, there was an endless array of medicines and medical tools available in the house when my siblings and I got busted up. You could die of boredom in New Jersey but not from a routine medical problem or exotic animal attack. This has not been the childhood my children have known.

My son has spent his first four years in central Bangkok and his last three years in an Indonesian jungle. My youngest will not live in civilization until he is at least two and, depending on my next gig, maybe longer. We currently have no idea where that will be. They won't know the difference, but I will. I'll continue to torture myself daily with concerns that they are being deprived some secret, critical lessons that can only be obtained in the First World. What am I missing? What have I not considered? Its probably just part of being a parent, but if not they will 
have ammunition for their first psychotherapy session. The educational lessons and learnings of the First World are not my real concern. We have schools here. And if lessons are perceived as lacking, we have the technologies that level the playing field 
of learning for all kids.

The real source of parental anxiety is the question of danger.

Just regular morning snake removal from the yard.
I've worked in plenty of other remote locations where I wouldn't consider bringing the wife and kids. Usually this was due to prevalent violence. To be honest, if there is a Beverly Hills of remote living, we've found it here in Sumbawa, Indonesia. We live in the middle of nowhere central, but its a comfortable nowhere. We are surrounded by 
a group of people in the same boat. We make efforts to be supportive of each other 
and most of us are on the same remote-living page. Its not for everyone and there are those who don't last long. All of us, however, (including myself) rely on me to make some hard and quick decisions when emergencies happen and the need for life and limb saving care goes beyond the capacity of our beautiful little jungle clinic. This happens regularly. When it happens to adults, we justify it. It was a choice to be here for rough work and money while living an adventure. When it happens to the kids its not the same because we dragged them here.

When I lived in Bangkok my job was the arrangement of emergency evacuations of the sick and injured all over the world-- places quite similar to the one in which I live. I remember a case requiring extreme measures to helicopter a pregnant woman out of rural Camaroon. She had contracted severe malaria and was going into early labor. I remember wondering: What is she thinking? What the fuck was she doing THERE in that condition? What could justify that risk? We got her to a Western standard hospital in Europe and she was fine, but what could have 
happened was unthinkable. Cut to one year ago today and you'd find my wife seven months pregnant on a remote Indonesian island, in the thick of the Asian Malaria and Dengue Fever belt in a place where evacuation to higher medical care between five PM and seven AM is categorically impossible. Not by boat, not by plane, not by helicopter. Calculated risk we call it. Especially when it turns out well.

Another day at the office.
In the sphere of calculated risk this little paradise in Indonesia was the best choice. I 
turned down jobs in Ukraine, Iraq, Irian Jaya, Papua New Guinea and Congo to 
come here. Each and everyone of them I would have taken in a heartbeat without 
a family in tow. In some of them I would have even carried a firearm. I'll admit that I've always had that secret macho dream of being a pistol packing doctor. Before children I never turned down a job with extreme potential biologic, violence or weapon risks. Those aspects sweetened the pot. I'm not stupid, but I meticulously and soberly understand the concepts of calculated risk. And there's a psychology involved. I come from the comfortable, generic, middle class, low risk environment of suburban southern New Jersey. I have an obvious subconscious need to affirm that beneath this privileged, cultured shell,a badass can indeed emerge. My infantile need to feel this way led me to leave a comfy, lucrative medical practice in Beverly Hills (not the metaphorical, but the REAL Beverly Hills) to live in shit, learn to take a punch and be fired upon randomly. Ultimately I reached my goal.  I attained a confident, self-perceived level of badassness. Right up to the day I became a father. All of a sudden actions had consequences and responsibilities. Being a father makes you a flawed badass.

Baddass enough dad?
Following that eventful motorcycle ride of dodging cars, dogs, tuk tuks, street food carts, businessmen coming from work and Bangkok transvestites going to work, I did some thinking. Maybe it was time to stop the madness and make a pros and cons list of these extreme living choices for the sake of the kids. I know I can get my boy to a hospital on the back of a shitty Honda 50 cc through a living madhouse if I have to. But should I really have to? When my second son was seven weeks old I brought him 
back to the island from his Bangkok birthplace. We had to change planes in Bali and the only aircraft available to get to Sumbawa was a helicopter--the horrifically loud, ear drum piercing, no noise suppression Bell 212 chopper. The standard issue noise reduction earphones were as big as his little head. I spent an hour crouched over him squeezing the huge earphones over his ears to make a reasonable seal. I worried the entire time that I'd be the cause of damage to his tiny little eardrums long before he had the chance to do it to himself with crappy music.

I've been dancing around the idea of returning to Americana suburban civilization for the last eight years. Each time the opportunity arose I balked. I constantly talk to my friends back in America to get a barometer of how things are for children 
these days. I live in the illusion that it is the same as when I was young: days spent outside on our bikes or over friends houses. Or running around the neighborhood from house to house until someone's mother kicked us out and sent us home for being 
a knucklehead. My friends tell me otherwise. They tell me of the constant fear of sexual predators.  They say  they don't know their neighbors and their kids only get together if a "playdate" has been scheduled weeks in advance.

Anti-venom:  we keep it next to the coffee mate
Here in our village we have predators, but none of them are human (and thus predictable). The kids have to learn not to approach the monkeys and to call an adult when they see a snake or a monitor lizard or spider bigger than them.  Poisonous snakes are always a concern.  We have the big three in our village:  King Cobras, Green Vipers and Brown Mambas (although I'm yet to see a Mamba on the beaten path).  The occasional giant Huntsman Spider makes its way through the bathroom vents. The largest we've had is about seven inches long.  They are not very dangerous, but seem daunting when you are naked. Fortunately, our predators fear the kids more than the kids fear the predators. On the weekends, the parents convene around the local beach bars while the kids play on the beach. In plain sight, at all times. The kids run freely from house to house. We lock our doors only because the Macaque monkeys have figured out how to work the door latches. If we don't see our son for a few hours we know he's annoying one of the neighbors and will be kicked out shortly 
for being a knucklehead. I've instructed him to thank the members of his friends’ households by saying:

"Thank you for putting up with my nonsense." Pretty normal stuff, right?

Uninvited clinic visitor
It is those kind of internal discussions that quell the fatherhood fears and bring a little perspective to current realities. The truth is that there's few places in the world likethis where a doctor gets to test his skills and ability to improvise without a safety
net. I dig that part of the equation, but admittedly it has put my family at risk. I'm proud of what I do here and I want my kids to one day be proud of me. I care greatly for my patients here. Most of my patients are also my friends and a part of our small social circle. This raises the stakes. When they get sick, it gets personal. I've watched their kids grow up and they routinely spend time at my house........until my wife throws them out for waking the baby or being knuckleheads. I could make a lot more money as an American doctor, but this would come with the frustrations, insurance problems and restrictions intrinsic to the American medical system. In my parts of the world I get to do the right thing for my patients when its the right thing to do at the right time to do it. Pure and simple medicine. For now I choose adventure over cash.

Personally I could use a few more restaurant choices. A 7-11 or proper one-stop pharmacy chain or Starbucks would make life easier also. The lack of shopping and city access has my wife twitchy by now. Within a year my contract will end here and we will move on to a job and a place as yet undetermined. The thought is exciting and daunting at the same time, but I'm not worried. 

I figure that between a remote Indonesian island and the New Jersey suburbs there is a world of opportunity. For me. And for my kids.
We ARE Jungle Family

1 comment:

  1. no black mambas?? ...oh wait.... kobi lives here in LA.... great perspective though!