“Yes, that’s right.”
“Good. That will be the closest large city during your research and they have a decent medical facility there. Remember, if they’re stumped while treating you, they can always call here. My phone number is inside the front cover. Now, for our discussion, let’s start with traumatic injuries, then we’ll go through bacterial infections, viral infections, fungal infections, parasites, lesions, and ulcers. We’ll give some special attention to Chagas’ disease, diarrhea, malaria, yellow fever, and dengue fever because they are so common. Snakebites, bee stings, curare, and various other poisons to the system are also included for obvious reasons. I think that’s a good order in which to approach the materials.”
Dr. Thomas referred to the diseases with professional objectivity while my insides roiled with anxiety. I looked him up and down again. The damn doctor looked like he had never had a tropical disease in his life. Maybe I should have gone to med school rather than anthro graduate school, so I could be the one giving disease books to scared graduate students.
“An important initial point is that there are many pathogens—bacteria, viruses, and the like—in the La Cuerda basin that we do not have in North America,” he continued. “Vice versa is also true, but that’s mainly a concern for the groups you will encounter that you may infect. Because you’ll be exposed to unfamiliar bacteria, you should be attentive to your symptoms and mindful that the experiences you’ve had here may mislead you. Comments made by your past physicians while treating you here are potentially misleading. As a result, when you experience symptoms of disease in the rain forest, you are at greater risk of misdiagnosing them than if you were here. In short, be skeptical of your acquired knowledge and cling to this book. It is your health Bible—or whatever other authoritative text you cling to—and you should study it more assiduously than any monk ever did his scriptures.”
He went through a few gruesome descriptions with notable preciseness. Convulsions, gangrenous limbs, paralysis, loss of sight, ulcers in a variety of colorful oozing forms, and subcutaneous parasites, such as worms and bot flies. I sensed queasiness in my stomach and wondered how doctors hardened themselves so they could wade through picture after picture of diseased and malfunctioning human bodies yet stay motivated to learn more about them rather than stalking off to listen to Haydn or read about medieval architecture. It made me reassess my previous speculation about going to med school. With that said, it was, of course, beneficial to me that the information had been collected and described for my benefit.
“I can tell this is uncomfortable for you,” Dr. Thomas said, observantly. “Let me get you some water.”
He went into the hall and returned in a moment with a paper cup filled with water.
“You don’t even have to boil it,” he said quietly as a small smile raised the ends of his lips.
“Your discomfort aside, you will need to learn this medical information because you’re going to have to do your own doctoring once you get up the La Cuerda. In short, this is likely the most important applied knowledge you will ever learn.”
His point could not have been clearer.
“Look at these pictures,” I mumbled to myself as I thumbed through the sturdily bound book. “Pretty gruesome.”
Dr. Thomas did not smile.
“I will doubtless forget much of this—especially the terminology—by the time I have to use it,” I mused.
“The material can be difficult, I know. Therefore, we tried to make it non-technical by replacing medical jargon with plain, simple English words wherever we could. We may even have succeeded part of the time,” he said wryly. “You will find that the text is fairly well organized. I did it myself,” he offered with some satisfaction. “The index pays special attention to symptoms because that is what you will have to work from. I also added diagnostic flow charts and matrixes based on the most common symptoms. They should help you rule out diseases as you work toward a diagnosis.”
Dr. Thomas opened his personal copy and turned to the Table of Contents. Being a conscientious student, I did likewise.
“As you see, the Contents begin with traumatic injuries. That’s because whenever there is a problem with breathing or the heart, or if significant bleeding is involved, or if there is a risk of going into shock, there is a threat to life, which must be addressed immediately. They come first.”
“I swear, all I could think about at a time like that would be ‘Get me to a hospital as soon as possible!’” I said, trying to lighten the discussion.
“Which is over two weeks of hard travel away,” Dr. Thomas replied calmly.
After traumas, he went through the other categories of maladies, being as thorough as our two-hour consultation permitted. At the end, he gave me four shots—one in each arm and one in each butt cheek. I asked him what diseases the shots would protect me from, but the scientific names were so difficult that I knew I would forget them before I left the building.
“In any regard, because you have just had the vaccines, you don’t have to worry much about them, so it’s not imperative to remember which ones they are,” said Dr. Thomas. “I’ll initial them in the Contents so you can start your diagnosis elsewhere…but be aware that, in rare cases, the vaccines may fail.”
That hadn’t occurred to me.
“You’re lucky that you could take all four of the vaccines at one time. There’s cutting edge research in two of them. Wouldn’t have been possible three years ago.”
I took Dr. Thomas at his word that I was fortunate. I had four fewer diseases to worry about. Before I left, Dr. Thomas gave me a bag with two dozen bottles of pills to take with me and a prescription for each to prove their legitimacy.
“Be careful to have the prescriptions handy when you go through customs in La Puerta. In the unlikely event that the drugs are confiscated or lost on the flight, you should get replacements for them before going into the rain forest. In that event, the med school will contact customs to make sure the replacement medicines get through to you in La Puerta. Let me reiterate, in no event should you go into the rain forest without the medicines and the book on diseases.”
The next day, I felt a little under the weather from the inoculations, but the spots where I’d been stuck didn’t ache too much. A few days after that, I walked to downtown New Haven and bought some items I would need in the rain forest: a good survival knife, a hatchet, a zippered hammock, a couple of compasses, and costume jewelry for gifts to natives. At the Paper Clips store, I bought eight bound journals for taking research notes and ink in plastic bottles. I would buy food in La Puerta because it was obviously too heavy to carry on the plane.
It was time to stop making notes for the day, so Rick pushed back from the table. He was hungry and looked forward to dinner, whatever it might be, and to the night’s sleep.
Your true pilot cares nothing about anything on earth but the river….
Mark Twain
CHAPTER 8
La Puerta and Up River
The next morning, Rick returned to the table to make more notes, covering his flight to Imaginación, his brief stay in La Puerta, and the first part of his trip into the interior.
On the flight to La Puerta, my mind, in spite of my best efforts, was fixed on the dangers I would face in the rain forest. Clearly, I was putting my life at risk by plunging into the wildest of natural environments…and for what? An academic degree? What was I thinking about? For comfort, I told myself—at least a dozen times—that generations of anthropologists had done fieldwork in remote places and had survived to lecture at cushy campuses. If they could do it, I could too. But how sure was I? I could do academic work on a campus, but that was no guarantee that I could do fieldwork in the rain forest. This was going to be tough…life-threatening tough. Nevertheless, I was willing to risk all to complete my dissertation.
The ride from the La Puerta airport was unremarkable, except I noted that the cab driver spoke serviceable English while I struggled with Spanish. Given
my difficulties with foreign languages, how was I going to do research in a totally unfamiliar language? He drove me to the hotel I had picked. It was part of an American chain because I wanted one last stay in familiar surroundings before plunging into the unknown. I ate an American meal in the restaurant off the lobby, and then settled in for a deep sleep.
The next morning, first thing, I went to the wharves to charter a boat to take me up river. Most of the harbor area was plain and worn except for Wharves A and B at the eastern end where two large cruise ships were moored. I had researched boat charters before I left so I knew what I was looking for was at the other end of the harbor, Wharf J. When I got there, I asked a workman where I could find Raul Menendez, whose name I had found in my research.
“Oh, Raul. Si. He’s on this wharf, the sixth boat down if I count right. Left side. I guess you want to go up the La Cuerda. Raul gets a lot of that business,” he said, with a faint grin.
Then his expression darkened.
“Nobody else wants to do it. It’s a tough river to be sure, that La Cuerda. I trust that you don’t want to go too far up. If you just run up a little, look around, take some photos and get back here, you should be OK. Farther up, it’s difficult.”
“Muchas gracias, señor,” I said, not wanting to dwell on the risks I was facing.
At the sixth slip, I saw a boatman, hose in hand, washing the deck of his vessel. He wore only khaki shorts with no belt and some old sandals. His bronzed skin smoothly wrapped his rangy muscles and glistened in the sun from his sweat. Straight hair stuck out from beneath his wide-brimmed straw hat. All in all, he looked very much like a Latin American boatman should look, I thought. I scanned the boat and didn’t see any serious maintenance problems, although I knew precious little about what to look for. It was obviously not a new boat.
“Hi, Mr. Menendez?” I called out.
“Señor, call me Raul. What can I do for you this beautiful day?” he said in accented English.
“I need someone to take me up the La Cuerda. I hear you take charters there.”
“Yes, day trips mostly. The La Cuerda is a wild place, even for a day trip.”
“So I’ve heard,” I said, “but I need more than a day trip. I need to travel the river deep into the interior to do research.”
“Way up? Are you sure? You know much about the river? It gets wilder the farther you go. Challenges all around.”
“I only know what I’ve read in books,” I responded. “I need to hire you and your boat to get me there safely.”
“Nothing is safe on this river,” he corrected. “How far up do you need to go?”
“Farther than you have ever gone. Take me to a group that no one in La Puerta knows about. Drop me off then. In about a year, I’ll be finished with my work so I’ll need for you to pick me up.”
Rick had decided to allow a year for research with two extra months built into the schedule in case he fell behind.
“So it’s two trips you want. Tricky. We’ll have to figure out the details carefully. If I get comfortable with our arrangements, then OK. It’s my business, after all. While we’re up river, we’ll find a place where I can pick you up…a place we can identify for sure.”
“If I had to, couldn’t I ride the river current back to La Puerta?” I asked.
“Riding down river is easier than going up river, but it would still be risky. If you don’t know the river, you could go over a waterfall or wreck in rapids.”
Raul’s description of the dangers gave me pause, but at least he wasn’t glossing over them. As we were talking, I glanced at some spots of rust on the side of Raul’s boat that I had missed seeing before.
“Can this boat make it up river, Raul?”
“Yes, indeed. I’ve taken it up and back many times, and it had gone many more times before I bought it.”
So Raul had bought it as a second hand boat but, then, a lot of boats went through several owners…several owners before they were junked. How close to junk was this one? This question rattled around in my brain while we discussed arrangements, such as how many days it would take and what it would cost.
“When can we leave? I’d like to get underway as soon as possible,” I told him bravely.
“Day after tomorrow,” answered Raul. “I need to prepare the boat for the trip. Have you bought food for the trip?”
“Not yet. I was planning to pick some up here in La Puerta,” I answered.
“Good. You’ll need some for the trip up river, about three weeks’ worth.”
“Do have any suggestions?”
“There are not many grocery stores in La Puerta, and those few are pequeño. Most people buy their food fresh in public markets that set up only a few days a week, but fresh food on the boat would go bad right away in this sun,” he said, removing his hat to wipe his brow. “However, there’s a grocery store on Calle Velasquez that has packaged food. Try that.”
“Is there anything else I need to get?”
“You plan to stay in the rain forest for a year, so I tell you now there will be things you wish you had once you get there. As you packed, you thought carefully about your basic needs…medical supplies, tools, clothing?
“Yes, I tried to be careful…”
“You should walk around La Puerta to see if anything catches your eye.”
The next morning, before going to the grocery store, I went to a nearby bank to deposit the cash I had brought with me. I couldn’t risk taking that into the interior. Then I found the grocery store where I bought three weeks’ worth of provisions, including some bottles of multivitamins, enough for two hundred days. I hated to add the weight but I worried about becoming malnourished. The amount of food in the grocery cart comforted me, but then I remembered that, except for the vitamins, it would last only as long as the trip, about three weeks, after which I would be on my own getting food from the rain forest. Before Raul left me in the rain forest, I’d have to learn enough to feed myself. As I checked out, I spotted a can opener hanging nearby and tossed it in the cart. What a mistake it would have been to overlook that! Outside, I hailed a cab to take my food and my large backpack to the wharf to load it on Raul’s boat. Raul had told me that I could leave my stuff on his boat because he would sleep there. Altogether, my stuff took up about one-sixth of the storage space on the boat. The rest of the space was taken up by Raul’s supplies and his gasoline. Rather than join Raul on the boat, I returned to the hotel for one last night in a bed before I began a year in a hammock.
The day of the departure, I awoke early and got to the wharf at 7:00 am. Raul was already there preparing the vessel for the trip up river. I brought cash as payment, just as Raul had asked. He counted it and handed it to a young boy, about thirteen or fourteen, I guessed.
“Take good care of this, mi joven amigo. Keep it in your pocket and take it directly home as soon as we leave. You will do that?”
The youth nodded yes.
“…as soon as you cast us off,” Raul added.
The youth nodded again.
Then Raul turned to me.
“He’s a good boy. I can’t carry the money up river because it might not make it back,” he said with a wan smile.
Raul stepped into the boat with a smooth practiced step, and then turned to help me make it aboard, which I did awkwardly. Although I had no reason to distrust Raul, I glanced at my backpack and food that I had loaded the day before to make sure that they were as I had left them. All was in order. Raul took his position at the wheel, cranked the engine, called to the youth to cast off the fore and aft ropes, and moved the boat slowly away from the wharf. At last, I was on my way up river. I hoped that the motor would have a steady sound that would comfort me. Instead, as soon as we got on the water, I noticed that the motor sputtered. Not all the time, but frequently enough to get my attention. I told myself, that it was a normal sputter. Nothing special. I went to my backpack, removed my survival knife and put it on my belt for the first time. I fondled the black com
posite handle that was molded to fit the hand. Once outside the harbor, Raul turned eastward, and announced that we were headed toward the mouth of the La Cuerda. As the boat droned onward over the next two hours, we passed the mouths of two small rivers, prompting me to ask Raul what their names were.
“They’re the La Cuerda,” said Raul pleasantly.
“Both of them?” I responded.
“Yes, and even more ahead. Many mouths to this river.”
“Hmmm. So many. How do you know which one to take? Shouldn’t you take the closest?” I asked.
“You could take the closest, of course, but no good boatman would go up it because it has silt bars and mangrove plants. Changing tides could easily trap you there,” he said, clenching his fist to emphasize his point.
My instinct would have been to take the first opening, but that would have been a mistake. Of course, I expected to make some mistakes as I learned about the rain forest, but I had to take care that my mistakes were not big ones. In twenty minutes, we reached the mouth of the La Cuerda that we would use to enter the interior. Raul steered the boat along the far side of the waterway, that is, the eastern side. Immediately, the ride became smoother.
“You can settle in for now,” said Raul.
For the rest of the day, Raul’s boat sputtered up the La Cuerda. I was struck by the lushness of the vegetation along the river. It grew right down to the water like it does on a Louisiana bayou, although the La Cuerda was much larger. Its volume reminded me of the Mississippi, moving inexorably toward the Gulf. The only question was where it would cut its channel. If it had to make a new one, it would do so. Although this river’s power was unstoppable, its current moved slowly so I could scarcely tell it was flowing against us, yet I could hear the motor working hard. The propeller beat against the current for hours, laboring upstream. I could judge our true progress only by looking at the trees on the bank. I reflected on my situation. I needed to bolster my confidence.
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