One night in March 2007 I was in a hospital in Liberia with my brother. He had been sick all day. Around midnight he started hallucinating and I decided that my medical knowledge—most of which came from skimming Lonely Planet Healthy Travel: Africa—was, shockingly, no longer sufficient. Outside help would be necessary.
Just over a year later I was in a hospital in Brooklyn with my parents. I had been put on steroids after being diagnosed with ulcerative colitis, a gastro-intestinal condition, but my doctor had told me to stop taking them after a series of unexplained bouts of crying. Now I was suffering from steroid withdrawal, and my blood pressure was dropping.
Jeff, my brother, was visiting me in Liberia for his spring break. I had been working in the country for several months with a human rights organization and wanted to share my new world with him. I took him to my favorite beach-side bar owned by a spunky Liberian woman not afraid to put you in your place. I took him to my office, where you flushed the toilet with a bucket of water and everyone left when the generator turned off at 5:00 PM. And, regrettably, I took him to Mongolian night at a popular Lebanese-owned restaurant. He got food poisoning.
His hallucinations—which we now know stemmed from dehydration as result of the food poisoning—were scary. “These numbers in my head, they keep coming, I just want to die to make them go away,” Jeff, previously unsuicidal, said at one point.
The first hospital we went to, the “best hospital in the country,” was almost as scary as the hallucinations. When a medical professional finally appeared, he squinted from the waiting room’s light; he had clearly just woken up. He offered to “check my brother out.” When asked what that would involve, he paused, and suggested taking his blood pressure. We left.
As doctors pushed a tube into my neck to get medicine that would raise my blood pressure to my heart quickly, hundreds of years of advancements in our understanding of how the body works were being put to use on me. I was connected to thousands of dollars worth of medical equipment. After I suffered a heart attack—caused partly by the low blood pressure, and partly by my own stress—another doctor performed a cardiac catheterization. I did some Google-ing; my insurance company probably paid more than $10,000 for this procedure.
I took Jeff to another hospital. A sign above a sleeping secretary said:
Liberians: 50 LD (about US$1)
Liberia is a country where people count in dollar increments. In the US we round to the nearest thousand.
We left the second hospital with some oral re-hydration salts. The physician’s assistant who spoke with us was professional, yet had limited substantive information to offer in answer to my many questions. A nurse had appeared not to know how to use a thermometer.
The next day I felt like someone had punched me in the stomach; I understood what sub-standard healthcare meant. If a Liberian had a stroke or a seizure or had cancer, quality healthcare was not available. He or she would die. This realization was traumatizing.
Back in New York, I got better. The bruise that had formed on my thigh where the cardiac catheter had been inserted—a bruise so dark and misshapen it looked like someone had spilled chocolate syrup on me—finally faded. My blood pressure stabilized. And eventually I didn’t feel the need to check it six times a day.
I understood that I owed my life to privilege. I was alive because I was in the US in the twenty-first century. This luck seemed unfair.
Now when I talk with Jeff about what happened in Liberia, he says it wasn’t a big deal. Perhaps it was more consequential to me because I didn’t experience it, and now even more so because of my first-hand comparative experience. Liberians have a saying: He who steps in first shows the depth of the current.