It started out as a joyful day.
I was attending the Ahlan Wa Sahlan Bellydance festival in Cairo: an exhilarating event attended by a thousand belly dance afficionados from all over the world. Some of the attendees were dancers, and some of them were students. It was all held at the gorgeous Mena House hotel, the nineteenth-century main building the former hunting lodge of the Khediv Ismail, with gorgeously landscaped grounds and the great Pyramids rising behind.
For several days I’d tried to find some other attendees who would accompany me for an early morning walk to the pyramids. So happily I joined my new friends Shelby from Texas and Teresa from Belgium (originally Spain) on the road that leads to the Pyramids.
Many cab drivers called to us. The “middle man” (we’d noticed before that he arranged all the camel and buggy drivers around the Pyramids) was sitting on a cement ledge in the shade of a store, sandalled feet in the dirt, wearing the same dirty brown galabeya Zora and I had seen him in the previous evening.
“My friend, good to see you would you like buggy ride camel ride today?” he called out. If we’d accepted, it might have been a more normal day for me!
But we declined, and kept on walking. We passed the little shops of curios, and past the rustic but utilitarian little stables and shaded area where the horses and camels and mules are kept and all of their tenders and drivers were hanging about.
We bought tickets at the little building in the hot sun, and walked up to the little crowd who were giving their tickets to the antiquities police. In their pressed white uniforms, black epaulets and black berets, they manned a little shaded stand in the pounded dust.
Then came the part that is hard to write about. Many large tour buses were pulling up and stopping. Suddenly there was the beep beep of a bus coming through, signalling to our little group to move sideways.
As the whole group moved, I lost my balance and crumpled to the ground, and my ankle collapsed like broken glass, at right angles sideways!
“Are you all right?” said Shelby.
“No, I said,” still in shock. “I am not all right. An ambulance must be called.”
There was a great commotion and everyone started shouting, as always happens in the Middle East whenever there’s a problem: the men who had been taking tickets, the bus driver, and even some of the bus occupants. With great difficulty two men lifted me up and helped me hop to an old, battered aluminum plastic chair under the nearby tiny shaded area.
They brought a statement for me to sign.
“Tell them I just fell,” I said to the tourist antiquities police. I still could not believe it. I’d always considered my feet so strong, so capable.
Actually I thought that someone must have inadvertently stepped on my instep at the same time that I lost my balance, but in any case, it was an accident and I certainly did not want anyone to get into trouble.
Finally the fact that I had only fallen settled in, and the brouhaha stopped.
The antiquities police asked “You have pass-a-port?” and I was alarmed, as it was under my clothes, and there were many men gathered around.
Somehow I managed to communicate this to a woman employee whom I called over, and she sat close to me so I could unobtrusively retrieve the document from under my skirt.
“No one push you?” the policeman wanted to make sure. They asked me to write “accident” on one line, and a statement saying what just happened and I wrote one and signed it.
I told Shelby and Teresa that an ambulance was coming, and they might as well go on and walk to the Pyramids. I gave Teresa the envelope with the money I owed Ahmed, our guide, and drew her a sketch of where to meet him, so she could still do the sight-seeing we had planned later in the day.
The ambulance, which I had to crawl into myself, had a small chair attached to the cab wall of the ambulance, and which had no seat belt. I had to pull myself up on this chair, my hurt foot dangling like a dead fish.
As we pulled away, I heard Teresa’s insistent, strongly-accented voice demanding through the window to the driver, “I must know where you are taking her.” At the time, this didn’t register to me as important.
Off we went, me holding on to the sides of the chair with my hand. After a while, the attendant, a sturdy, uneducated-looking man, said in barely comprehensible English, that I needed to remove my shoe. Of course, I thought, they’ll have to examine the foot without my shoe. Very carefully, I took off the shoe and sock.
The ambulance, which had been rumbling through the crowded streets of Giza, the small part of Cairo nearest the pyramids. We made a turn and went into an entrance that said “HOSPITAL” but looked more like a small free clinic, in a corner of a building of retail businesses. I was transferred to a wheelchair. The interior was not that clean, not even as clean as the restaurants which my friends and I had eaten in! The attendants, in blue smocks, were young girls who looked about twelve years old!
The doctor appeared, a very young, very intelligent guy who spoke fluent English. Everything about him put me more at ease, but I admit what was going through my mind was, “They just have to set it. As long as they don’t have to cut into me I won’t catch an infection from this place.”
I heard two guys walking by, talking, and I heart one of them say “Amricaniya” and the other one, with a disgusted voice, said “George W. Bush!
“Thanks, George W. Bush!” I said sarcastically to myself.
The doctor came to speak to me, and examined my right ankle. Both bones were broken, and the ankle would require an operation after all! I begain to feel alarmed, but I wasn’t coherent in my mind enough to think clearly.
Luckily, someone else had been thinking clearly! Teresa, “my angel Teresa” hurried back to the hotel and would not rest until she found our tour leader, the famous dancer Morocco, and tell her what happened and where I had been taken.
So, while I was chatting with the young doctor, Morocco suddenly stormed in! She insisted vehemently that they must transfer me to “El Salaam International”, the best hospital in Cairo and the one that the foreign workers go to. She said, in an aside to me, that she bluffed and said that the American Embassy had an agreement with the tourist agency that any of their people would go to El Salaam International.
Vulnerable as I was in my position, you can imagine how grateful I was. Not only that, her entire manner was motherly and caring…and she even seemed enthusiastic, as if dealing with my problem was as much fun to her as any other part of the trip.
As she told me later, part of this manner was an act in order to give her more of an air of authority with the staff of the little hospital. It also was so helpful in assuaging my own growing sense of desperation. When a person is in that type of situation, one feels bad not just for oneself, but bad for the trouble one is causing others. Morocco could have been someone in my own family (my angel Morocco!)
Michel, the tour director from Peace Egypt Tours, the travel agency Morocco worked with in Egypt, was also wonderful. He made sure that what was needed to be done was done. A good man, you could see him going into strong sense of duty, and going into “getting things done mode” and all he evidenced to me was caring, with not a shred of a hint that he was feeling incommoded.
The same ambulance arrived again, only this time I was wheeled out to it on a stretcher. Three skinny Egyptian guys strained (holding the edges of a blanket) to lift me onto the ambulance.
I sure was pleased when Morocco climbed in the front seat of the ambulance!
“You’re coming with me?”
“Of course I’m coming with you!” She kept up a comforting conversation all the way to El Salaam International, which looked much more like the hospitals one is used to in the States.
The bright-eyed, head-scarfed nurse who checked me in spoke excellent English. It turned out that she was from the Phillipines and when she married an Egyptian, had been advised by her Catholic father, to convert to Islam so that the children “would not be pulled one way and then the other”.
I tipped the ambulance attendant and he immediately took the part of my protector: saying things to the nurse which sounded like they might be “she’s getting a very good room, of course,” and other things like that.
I was wheeled up to my room on an upper floor. A girl was in the other bed, behind a curtain and an older woman was with her. People came and went, taking blood pressure, etc. I was to fast until the operation.
A nurse who was dressed in a white tunic and pants, with a white headscarf, seemed to be in charge of me. However I don’t think she was really a nurse, because any time anyone came in to do something medical to me, it was someone else than she.
The room was painted mustard-yellow with striped curtains, and large blue tiles on the floor. The chairs for visitors had dingy covers.
Rocky and Michel stopped in after they checked me in. We both decided that it would be better if she took my purse, as it would be in the room, unprotected, while I was in the operation theatre. She got my mom’s phone number from me and promised to call her and tell her what had happened and that I was safely in the hospital.
At the last minute I decided to keep my little Arabic-English Rough Guide phrase book, which turned out later to be a very good decision!
If I’d known better, I would have kept a small pouch with money for tipping, but like many things about staying in a hospital in Egypt, I was pretty clueless.
I also didn’t know that the hospital also took my passport, and kept it while I was there.
After they left, I laid there for a while.
A nurse came and said, “clothes off”, and handed me a blue paper hospital gown, demonstrating how it went on. I was taken aback, though I really shouldn’t have been. In a foreign culture, the clothes you decide to wear there, and things such as the hidden inner pocket for your valuables and secret papers are part of your defense system, your “mask” against vulnerability. This was stripped away and one feels embarrassed and exposed.
I was taken in a wheelchair, which had a bent wheel, down to an ex-ray room, and brought back.
The surgeon came to talk to me. Tall, tan and bald, he had a clean-shaven face slightly reminiscent of Yul Brynner, a very intelligent manner, and the kind of confidence which doesn’t feel it has to prove anything. He said that they would have to put two steel pins in the left bone, but that the right wan they were going tl be conservative and let it grow back together on its own, and not operate on that one due the the condition of the skin. This did not alarm me because Morocco had seen the ex-rays before they had stopped in, and she had told me that they might not have to operate at all because it was such a clean break.
The “condition of the skin” refers to fever blisters. These were large circular patches on the ankle, which were called “fever blisters”. Because of these blisters, which are a common occurrence when a bone breaks, it is dangerous to wait too long before operating, leaving a short window of time between when the bone breaks and when the operation must be done. Once the blisters break, there is huge possibility of infection.
Another doctor came to talk to me briefly; he wore a trim beard and white coat. I can’t remember exactly what he talked about because he said he was late because of two bad things that happened. One was that the father of his colleague had died.
“I’m so sorry,” I said.
He then asked me what color cast I wanted, he said proudly that there was a choice of purple, blue, pink or off-white. He seemed rather disappointed when I said “off-white” without hesitation. He left before I could ask him what the second thing was.
Somewhat later, sometime in the mid-day, I was transferred to a wheeled operating table, wheeled to an elevator down the hall and around the corner to the operating room. It is a strange feeling being wheeled around a strange place seeing only the ceiling and occasional tops of people.
As they pushed me into place, a nurse in white, with white headscarf, bent low over me and said something in Arabic, and then translated into English, “Don’t fear”.
“Shukran ‘owee,” I murmured with intensity.( Thank you very much).
The surgeon had a little small talk to make me comfortable.
“You’re a tourist, what a thing to happen on your vacation,” he said. “What country are you from?”
“Amriika,” I said.
“American? I thought you were an Englishwoman,” he said.
“Well, I did not vote for George W. Bush,” I said.
It was weird being turned on my side while they injected several needles of anesthetic into the middle of my back. They felt like big fat needles, but they weren’t that painful so perhaps a topical anasthetic was used first. Soon the entire body from upper ribs on down felt like a huge mountain, and I could not wiggle my toes.
They put up a blue sheet so that I could not see what was happening. Though I was wide awake, I was pretty out of it and was not really aware of the passage of time. When they wheeled me back up and had me slide back on the bed, there was a cast from my toes to just below the knee.
The other occupant of the room, behind a curtain, was watching the MBC Egyptian channel, and the Oprah show came on with subtitles.
“Oprah? Hena?” I called out. (In Arabic, “hena” means here).
“Yes,” said the young woman’s voice in fluent English, “If you watch this channel you will eventually see every American program.” I never did see what she looked like.
And what was Oprah’s topic that day? Pole dancing. Yes, that kind of pole dancing. I felt like merging into the bed. The two women behind the curtain were commenting absent-mindedly about the program. (Except for PBS, I basically dislike most American TV, so to have to listen to it in that hospital room was like adding insult to injury!”)
An advertisement came on which was a message about the power of prayer. It showed a young man running through shadowy situations and worrying people, fearful and looking one way and another. Then he kneels to pray, the back ground music became calm, the expression on his face becomes tranquil, and as he finishes his prayer with the look to the left and to the right, the young woman in the other bed said, “Gamil ‘owee” (very beautiful).
I fell asleep, and woke a little later to find Ahmed, the guide whom my friend Leyla has hired for so many years that he has become a close friend, standing over me. He was holding flowers, and Leyla standing close by. It was wonderful to see them. Ahmed was quite emotional and kissed me on both cheeks. Teresa had found them at the arranged meeting place in the Khan El Khalili souk, but had decided not to go sightseeing, and only done a little shopping.
(Later she wrote me that she had become quite upset due to my injury, and had not even gone to her second technique class which she had been so looking forward to the day before, but rather had sat despondently on the little patio of her hotel room most of the afternoon.)
I was quite touched that she’d gone to the trouble to go across town and meet him, and give him the envelope of money which I’d set aside for him.
I started shaking uncontrollably, and Ahmed noticed that the little bottle of drip fluid was empty. He ran to make sure that someone changed it, and during the time we visited it had emptied again, I must have been quite dehydrated.
It was great to talk to both of them; I felt incredibly touched and comforted. He went and found out that I could have water but no food yet, bought two tall, cold bottles of water, tipped the attendants, laid two 20-Egyptian-pound notes on the bedside table for me to use for tips, and left me improved both mentally and physically from what I’d been when they arrived.
I became aware that I needed to use the bathroom, but no crutches had been supplied! I looked up in my tiny, beat-up, rough Guide phrase book and found the word crutches translated into Arabic. When I pointed out the word to the attendant, he said, “Akhas!” and brought me a walker, so that with quite a bit of pain and effort I could make it to the bathroom.
It wasn’t long before the doctor came in and said that I was now off of fasting; however, no food came. Finally, quite late in the evening, I pleaded for some food, and a nice young teenage boy in a vest and pants and white shirt of a waiter came and brought me what was the usual Egyptian breakfast, “fuul” (mashed fava beans) and pita bread. It looked like the best dinner in the world to me.
“Shukran,” I said effusively. And after he left, I said aloud, “Shukran owwee owwee.”
An attendant asked if there was anything else I wanted and I pointed to the TV and said, “muziqa?”
She changed to a channel that had Arabic music videos. I always enjoy watching these, and it helped to pass the time, both for the music and the cues they give to the culture, so it helped to pass the time. However, as the hospital grew darker and quieter, the music seemed louder and louder, but of course there was no way I could get over there and reach up to turn it lower, or turn it off, which was what I now wanted.
I was glad the other occupant of the room was gone, so I didn’t have to worry about keeping them awake.
Finally another nurse/attendant came in, and said rather sternly to me that it was too loud for the other patients, and thankfully turned it off. It was quite upsetting to be reprimanded for something which I had had no fault in. I was rather glad the other occupant of the room had gone home, and there was no one in the room that night. I slept deeply.
Breakfast was brought the following morning, without asking for it, which was a relief.
The next day Morocco and Michel were there again, and told me they thought I might get “sprung” that day. Michel was worried about the blood seeping through the cast at the place I’d been operated on, but they found out that there was nothing dangerous about this, and that I would be getting another cast put on before I left the hospital. Their visit reassured me. I was still so tired that it was a chore to sit up and eat.
Another patient moved into the other bed, an older woman. Two younger women accompanied her. Thankfully they did not have the TV on a channel which showed American shows, though they kept the volume so low that I could not hear it, and kept the curtain pulled so far out that I couldn’t see the TV. I guess they thought that the TV was for that side of the room only.
The young women, tall with lovely faces, good bone structure and posture, were wearing the most hip-looking “hijab” I’d ever seen. These outfits had tops that were tunic-length but quite form-fitting, with matching head covers of knit material which fitted rather closely to the head and neck. One of the outfits was red with tan trim, the other was white with the tunic part of it made of denim, and matching pants. I could hear that they were having quite a thoughtful conversation, occasionally breaking into English phrases without seeming to realize that they were doing so. Various international locations were mentioned in the conversation.
Later a man came in and joined them; I assume that he was the girls’ father and the patient’s son. He was tall, wearing an elegant camel-colored suit, cafe-au-lait skin with slightly African features, his black hair straightened and styled. He joined in the conversation and they all talked as equals, in the same thoughtful voices as before.
In spite of my tired condition and the traumatic experience, the “anthropologist” in me was interested to observe this rather academic type of Egyptian.
The tall, Yul Brynner-looking surgeon came in and told me that I would need to walk on the foot. I was absolutely surprised by this, and hardly believed him, but he made me get up and do it, using the walker, right then and there. He also gave me a card, and told me to tell the tour guide to call him. The card was in Arabic, but I knew enough to read the name of the surgeon, and I did know my Arabic numbers.
Still, the request caused me to feel a little panicked and upset. After the surgeon left. I did find Michel’s telephone number on it, and tried to dial it on the telephone by the bed. It didn’t seem to work, and the nurse/attendant said that the hotel’s phone lines were down.
Feeling quite desperate, I hobbled over to the curtain, and said “Afandim?” toward the closed curtain. This word means, according to my little Rough Guide phrase book, “excuse me” (even though one often hears the phrase used as a kind of title, perhaps one always says “excuse me” when addressing any titled person).
One of the daughters immediately offered her help in fluent English, and the man whipped out his cell phone and handed it to me. I called Michel, but he called back and said that the number didn’t work. I ended up giving both the numbers to the girl and they took the surgeon’s card and got on the phone with Michel.
The problem had been that I hadn’t known that although Arabic is read from right to left, Arabic numbers are read from left to right.
Sometime after that the younger, amusing doctor walked in.
“You know that I told you I had two bad news,” he said, “that my colleague’s father had died. Well the other is that my wife is pregnant!”
“That’s wonderful,” I said with real enthusiasm, “How many children do you have?”
“Its my first one,” he said.
He held up a package, off-white gauze wrapped in plastic. “I got your color, though it took me two hours.”
He called into the phone but couldn’t get a nurse to help him. “Oh well, I guess I’ll have to do it myself.”
He started to saw the temporary cast off, my foot resting on a dingy upholstered chair. I was surprised that the blood dripped on the chair and it didn’t seem to concern him. While he was putting on the cast, he mentioned that I needed to keep all weight off it completely.
“But the surgeon said to walk on it,” I said.
“No, you must keep weight off of it.”
“Yes, he made me get up and walk around this room with the walker, putting weight on it.”
“Well,” he said, rather annoyed, “Ask the American doctors what to do then!”
“They’ll probably tell me two different things also,” I said.
The afternoon wore on. I woke from a nap, and the older woman in the next bed and her family were gone. Daylight had faded to dark, and no dinner had arrived. Finally, with the use of the little guidebook, I said to one of the young attendants, “Ana ga-awana” (I am hungry). He disappeared, and somewhat later a waiter brought a covered plate with a roasted chicken quarter on it and some rice and vegetables.
It seemed that, for “one of the two best hospitals in Cairo”, a lot of miscommunication was going on. Thinking about this issue later, I decided that because patients’ family members always stay all day with them in the hospital, the family members will make sure they get what they need. So it’s not as important for the nurses and the attendants (who don’t seem to have any medical training at all) to be as careful about making sure of the non-medical needs of all patients have what they need. Their family members can run and make sure it’s done.
Because Egyptian women never would travel alone, they probably thought I was some sort of social pariah who had no friends and family! Egyptian women traveling together, if one had to go to the hospital, the others would be there with her. Whereas I, as an independent American, wouldn’t dream of asking friends to give up there sightseeing and dance classes, and come and stay all day in the hospital with me!
(It was later explained to me that the kitchen had been under the impression that I had only stayed one night, so they’d not sent up food on the second night.)
Alone in the room the second night also, I was glad that I didn’t have to worry about my snoring bothering anyone. It felt kind of sad, though, to be in that room by myself. It was getting to feel like quite an ordeal, though my overwhelming sentiment was still of gratitude, that I was in a good hospital and that the break was taken care of.
Feeling that gratitude reminded me of my father during that hospital stay due to an operation, ten years before his death. He was undergoing so many physical difficulties in that hospital bed (wires, what seemed to me condescending nurses, constant little discomforts) his main sentiment was gratitude to all of those who were taking care of him. Tears came to my eyes, tears for how much I had loved my father. I slept deeply in that dark room, in fact I’d been sleeping quite a bit on and off throughout the day.
The next morning Rocky and Michel were there, Rocky saying cheerfully, we’ve come to get you sprung out of here, ducky.” They went to take care of the bill, which Rocky paid, showing me the amazing total: the operation, plus two hospital days, was under $2000 US. She had paid the bill, and I would reimburse her when the travel insurance reimbursed me. She urged me to be careful not to lose any of the documents which the hospital gave me.
I had not realized before that most travel insurance policies will not pay up front. The patient must pay the medical bills, and then the company will reimburse when sent correct documentation. Rocky knew this, and, as a long-time tour leader, always brought enough funds with her to take care of these emergencies. She told me that on one trip, one of the members of her group had a brain aneurysm on the trans-Atlantic flight!
While they were handling the bill, I had another need to use my skimpy Arabic. I had been left alone, sitting in a wheelchair in the middle of the room. A very sick-looking woman arrived, wheeled by a friend or family member. The other bed had been taken out, and the two women were obviously upset that there was no bed for her. I would have wheeled myself out, but the attendants had left the huge cleaning cart right in front of the door!
I pointed to myself, made walking motions with two fingers. At first the woman looked blank, but the second time she understood and said “Imta?” (when) which was also one of the words I knew. I held up five fingers and said, “Khamsa da-ay-eq” (five minutes), and both women looked visibly relieved.
Boy, did it feel good to be wheeled down to the elevator, down to the first floor, and to the Peace Tours Van! The buildings of Cairo passed by my window, the garbage-strewn canals luxuriant with lush green vegetation, some with tiny cornfields planted here and there by little shacks, right along a road between tall apartment buildings…it all had never looked so interesting, so poignant, and beautiful. When we got down to the Mena House, one of the bellboys had to wheel me down the hill to the other wing, sweat on his kindly middle-aged face.
It was great to get back to my hotel room and take the first bath….a sponge bath…that I’d had for two days. As I lay there, I thought of my two-day ordeal. In spite of all of the discomforts, it had been an opportunity, in a way…an opportunity to find out more about Egyptian life.
There are probably few Western tourists who knew that if you has an accident near the pyramids, the ambulance takes you to a tiny clinic with dirt smudges around the light switches. (My accident happened in 2004, so things may have changed by now.)
But the average tourist also wouldn’t know this: that when a female hotel guest returns to the lobby of the hotel with a cast on their leg and crutches, the usually reserved, designer-head-scarfed hotel tour agent who had always sat behind her elegant desk, super correct and barely polite, turns into a highly-emotional, worried mommy, making high wails, screaming “Hena, bil Arabii!” (here, in Arabic!) and running around her desk making little concerned sounds over said guest. I nodded and shrugged as if it were no big deal, but it was rather gratifying.
On returning home to Arizona, I made the recommended follow-up appointment with my own doctor, who said that he couldn’t understand why anyone would go to a country such as Egypt,and in turn referred me to a joint specialist. That specialist, who happened to have some personal friends who were Egyptian, told me that the Egyptian doctors had done a very good job, although they had left a milimeter more “play space” (between the bones?) than would have been done in the States.
He said that it was important to keep the muscles around that joint strong, to give it better support, and referred me to a physical therapist. The physical therapist gave me a set of ankle strengthening exercises to do on my own after the series of physical therapy visits were done, exercises which I still try to do a couple times a week. (I also always try to put my shoes and socks on while standing up, because I can feel how much it uses those muscles in the ankle.)
The main lesson I had learned from my ordeal was that a health emergency in a third-world country is totally different from a health emergency in a developed country. At home, once the ambulance is called, you no longer have survival worries. But how different my experience would have been had I not had Teresa run to find Rocky, and not had Rocky, our group leader, to make sure I was transferred to a quality hospital and to front the bill for me!
Ever since then I have strongly felt that, no matter how much one enjoys traveling alone in Europe or other Western countries, it’s much wiser to have traveling companions with you, when traveling in an undeveloped country. And also I say, “Never go on any outing, even a short one, without your phrasebook!”