My Blockeo: Health Care in Bolivia and Why I Heart El Anti-spasmodico

Bad Night in ViIla Rivera

On my ninth or tenth night in Bolivia, sleeping back in our cozy Villa Rivera  hotel after a weekend of partying in big-city Cochabamba, I awoke with bad stomach pain. Not really my stomach, I realized with a gasp, as another  surge of scary intense pain cut through my guts. Deep in my guts pain, from below the belt line, and quickly radiating into my lower back panels, like the worst slipped-disc pain I ever had. I had been dreaming about being attacked by tigers, and now was covered in sweat. Slipping down the hall to the bathroom, my brain reeled: what the hell? Some medical condition? Burst Appendix? Kidney Stone? Sciatic nerve? I tried to imagine the long complicated road to a medical evacuation, as I hunched over the toilet.

My trip to Bolivia so far had caused me only a few minor digestive bumps and grinds, a day of travelers diarrhea, quickly passing (so to speak). I had settled down, and the solid diet of potatoes, potatoes, rice, a little chicken, rare guinea pig,  and plenty beer suited me just fine. Of course, I had eaten the largest steak in Bolivia the day before,  with a pitcher of Sangria, at a  fancy "meat palace" restaurant in Cochabamba, to start our roving party night. Now I was scared. Another wave of pain hit me and sent me to the tile floor. This was different and something bad.

What is that Barfing Noise you are Making, Roomie?

No poop, and I could not barf,  though the nausea from pain made me want to and try to, let it out. My roomie, Tim, a solid cowboy from Big Sky country, heard the horrid retching noises (all tile bathrooms echo so) and found me rolling in pain on the floor with my head in wastebasket trying to barf.

"This should be a recruiting poster for Water For People Volunteers", he said dryly, before going straight to wake up a driver and take me to the local hospital. He stayed with me from then on.

Lucky for me, ViIla Rivera had a small hospital, a Puesto de Salud, and we were at the gate at dawn. I was led right into the trauma room by a nurse, who went for the doctor. I paged through my Spanish Dictionary, preparing for the language challenge of describing my symptoms accurately. Another important situation not covered in my language classes, and I was feeling less than prime. The pain was coming in serious waves, and in between I just felt very weak and scared. There were posters for Rabies treatment and Dysentery on the walls, and big old stains on the floor, and I look around the room and wondered how many people had died in there. Not if they had, but how many.

The Doctor, nurse, and desk attendant all came in. I had the full attention of the entire medical staff of the Villa Rivera hospital. The doctor was a slim, intense, pretty woman of 30 with simple gold earrings. Not from around there, I'm guessing.  She got right to the diagnosis, asking me direct questions about urinating and Diarrhea (that is not my problem, but the opposite is), about what I had eaten and drank in the last 24 hours. The nurse helped her explain or extend some questions I did not understand, (how do you conjugate the verb for urinate?) all in clear Spanish, and I could feel their group medical intelligence focused on my situation like a calm relentless beam of light. It felt good, reassuring,  healing in fact.

I told them in the last 24 hours, in the course of a big party night in Cochabamba, I ate a really big steak, Sangria (with fruit? they quickly asked, and yes, damn, I ate all the fruit in the pitcher, I said), couple of empanadas with meat, rolls, couple glasses of red wine, sweet pie for dessert, and 5 or 6 beers later on that night once we were rolling. And meat-on-a-stick from a street vendor after midnight at the music concert, and a bowl of cheap soup and roll at a market stall before, and, uh, I had been chewing coca leaves, lots of coca leaves, with that black tar stuff they give you with the leaves. They looked at each other and then back at me.

What a pig, their faces said. The Doctor said to me gently, "Hombre, no wonder. In Bolivia, You can not do this.. I cannot eat and drink like this without problems in Bolivia."

Que es Blockeo?

"Did you spit or swallow the coca juice" asked the nurse. Some of both, I said. They looked at each other again.

"Blockeo" said the doctor significantly. The Nurse and assistant nodded. I nodded. "Si, si, un blockeo, sin duda". The doctor left the room. "Uh, what is Blockeo?" I asked the nurse timidly.

The doctor came right back in with a giant Dr. Frankenstein needle in hand, like a 1950's needle, the kind with a round metal thumb hole at the top and a permanent long steel spike like you would use for a very sick horse.  She looked at me, serious and grave. "You have intestinal blockage and colon spasm, very serious, and we will give you injection of anti-spasmodico. If the pain stops, and you eat very calm diet for two days, you will be fine. If pain continues, come back fast. And never swallow the coca juice."  Strangely, the needle (and the confident answer from this competent young woman) gave me a feeling of  relief, a sense of hearing a sound diagnosis and a clear treatment. Give me the needle, Doc. This is big pain, it needs a big needle.

She injected the anti-spasmodico into the meat of  my thigh, plunking the needle in as calmly as a frat guy tapping a keg, and leaning forward to plunge down the shaft with her thumb. My brain screamed, but I only twitched a little.  I swear, I could feel the pain reducing immediately, just melting away. It was great. I wanted to cheer then, to hug them for them for getting it so right the first try. It was like a giant fist was unclenching from my guts. I suddenly felt weak and sleepy, and so grateful. They charged me 27 Bolivianos, something less than 5 bucks. May God Bless and Keep them Safe Always.  I ventured a joke in Spanish as I left, wobbly, "Me amo el anti-spasmotico", (I love the Anti-spasmotico) and my medical team smiled and walked us to the door.

That day I slept, then rose at noon and then entered data into the laptop while the other mapping teams were still out. I felt mostly recovered by dinner, but  Dona Maria of our hotel made me special bland meals of rice and white chicken breast for days. She made me promise to never eat street vendor food again, shaking a finger at me when she learned I had eaten a bowl of soup in the Cochabamba market that cost 12 cents.  We all stopped swallowing the Coca juice, and some stopped chewing altogether for a while. I returned the iron-clad food rule of "boil it, cook it, peel it or avoid it" , removing lettuce and raw fruit slices from my diet. For the rest of the trip, I used the phrase "Me amo el anti-spasmotico" whenever someone asked how I was feeling. And it was the truth.