Hong Kong is rainy this time of year. . . .

Well, I’m back from Hong Kong. After living there for nearly 3 years, you would think that I would be able to remember what the weather is like in summer. Luckily, I packed an umbrella, because we definitely needed it. It rained everyday. Actually, rained is a pleasant way of putting it for some of the days. At one point, we encountered a “black rain” day. Basically, this means run inside and stay there, and don’t come out until we tell you to. The rain was so bad that it made news headlines for days afterward, with dramatic pictures and roads completely washed away. It turns out that the Midwest is not the only place being drenched. (Though Hong Kong is mostly prepared for this in a way that the poor farmers simply cannot be.)

In the next few days, I’ll be retelling and reliving my trip in snippets on this site, with accompanying pictures.

In a stroke of luck, I managed to be in Hong Kong when an outbreak of bird flu was occurring. Thus, I got a firsthand experience and access to things that I wouldn’t have dreamed of back in Berkeley. This will help my dissertation project as well as my thinking through the issue of public health, prevention, and the cultural significance of disease surveillance. What fascinated me the most was that no one local seemed all that worried. People still purchased fresh chickens, people still went to the markets, and life went on as normal. Only with a lot of dead chickens in one market in Sham Shui Po.

Stay tuned for more. . . .

Returning to, and Blogging from, Hong Kong

In a few weeks, I’ll be heading off to Hong Kong.

For 3 years, I lived there, and going back will be a crazy experience. First, I never thought I would. Second, I’m finally with the person I wanted to be with back when I lived there. Third, I’m finally getting to do some on-the-ground scouting for field locations.

This is going to be great.

And expensive.

I’ll blog about my trip when I’m there, with pictures. A travel log of Hong Kong before the Olympics. As a ‘China watcher’, I’ll be curious to see how much people either care or do not care about the games in Hong Kong, and to see all the merchandising. Anyone want a Yingying stuffed animal? How about a Beibei.

Why XDR-TB is a problem that’s not going away

Last night, I was watching the news and saw a brief (and, of course, over-sensationalized) story about a woman who flew from India back to the U.S. with a deadly strain of TB. Since the initial portion of her flight was so long, authorities are guesstimating that she potentially infected about 45 people sitting near her. This will require them to be monitored themselves and tested to see if they develop the disease. Imagine waiting from 6-10 weeks for the results of an HIV test. Yikes. That is a lot of time to panic.

TB is a problem because of several factors – poverty, HIV and incarceration not being the least of them. The trouble is that people with already weakened immune systems (poor nutrition and/or having HIV) can contract TB repeatedly, increasing the chances that a particular, normal strain of TB will evolve into a drug-resistant strain. Also, like in prisons, hospitals, or homeless shelters, when people are clumped together, the likelihood of a resistant strain developing increases.

TB, or tuberculosis, has been with us for centuries. It is probably as old as our written records. Just a century or so ago, it was referred to as ‘consumption’, since people who have it tend to ‘waste away’. More interestingly, it was kind of a sexy disease. Poets, impossibly beautiful women, writers, aristocrats and famous people got ‘consumption’. The wealthy patients got to spend their last days at a big resort for consumptives called a sanitarium. The poor people got to go to a sanatorium, or a fancy term for a hospital. Funny how a few letters can make all the difference. (Personally, I would have preferred the former, particularly the ones in Switzerland.)

(For the ‘readers’ out there, check out Thomas Mann’s Magic Mountain, for a portrayal of TB and life in the sanitarium.)
Fast forward to the present.

XDR-TB is resistant to most drugs used to treat it. It got this way through a variety of ways, but at least one of which is that some people do not take the full course of antibiotics prescribed for them in the first round of having TB. Believe it or not, not finishing your course of antibiotics – or taking them without cause for something like a cold – is a huge part of the problem. Which is why, in large part, I am a medicine Nazi. I try to underline why people shouldn’t share their prescriptions with each other (this means you, Aunt Grace, unless you’ve gotten your MD since last summer), or stop taking their medication when they feel better (just because you feel better, doesn’t mean the infection is gone).

Sometimes, in the past, I would try to scare people into caring more about taking antibiotics sparingly and taking them correctly by telling them that their grandchildren would be faced with a world much like the old days before penicillin came along. Translation? A lot of child deaths. A lot more early and unnecessary deaths, period. I was sick a lot as a child, and I simply wouldn’t have made it to age 10 without effective antibiotics.

Now, however, it looks like I don’t have to make up boogey-men tales to scare people. We’ve got one ready-made in this new, scary strain of TB.

To scare yourself, go here: http://www.cdc.gov/tb/pubs/tbfactsheets/xdrtb.htm

And the next time you take a long flight, wear a mask. It looks a little Michael Jackson-ish, but it might save you from months of hellish treatment.

Houseguest Rules

Since it’s the summer season, when a lot of people travel and are trying to travel on the cheap, I decided to ruminate about houseguest etiquette. The same rules generally apply to everyone – whether or not they are family, friends or just acquaintances who took you up on that offer to “visit sometime”. I try to follow these rules whenever I’m visiting someone, and definitely put them in place when I’m hosting. Or, more honestly, I attempt to.

First off, it should be noted that living in a city that people actually want to visit is both a blessing and a curse. If you live in New York City or Paris, as just two examples, you are guaranteed to have all of your friends and family visit you. Really, this is code for “we want to go to Paris” or “I need a vacation”. You are the acting hotelier, make no mistake about it. Oh, sure, you are PART of the appeal, but not all of it, or sometimes even most of it. After all, people can see you at other events – holidays, parties, weddings, etc. And if you lived in East-of-Nowhere, South Dakota, no one would ever find the time, money or inclination to visit you at all. Trust me. So, if you happen to live in a cool city, or by a beach, or in the mountains during ski season, then you will have to grin-and-bear your loved ones.

1. Never assume that you can stay anywhere/anytime/for as long as you want. People have their own lives that will not stop just because you happen to be on vacation. People also have, especially as we all age, partners and husbands and dogs and kids that make hosting you more difficult. Ask before you assume.

2. Give the host at least three weeks to prepare for your arrival. Hell, tell them months in advance for safety. Do not, I repeat, DO NOT, give someone a day’s notice that you will be staying with them. Or, for that matter, even a week. Unless you like sleeping in dirty sheets and using stale towels.

3. Bring a gift/leave a gift. Please. Either one. Choose. You can even ship them something after you get home.

4. Buy a meal. This goes a long way to smoothing over the fact that you are mucking up their space and time. Good food and drinks can appease just about any host. You should at least get a good meal out of driving someone around sight-seeing for three days.

5. Never use the soap/loofah/razor that is in their shower. That’s just gross. And it’s rude. No one wants to find a mystery pube on their Dove. No one. (Side note: toothpaste, shampoo and liquid soap use are negotiable, but make sure to ask first.)

6. Turn your cell phone off during dinner/before bed. There’s nothing like being woken up at 3am by someone calling from London to ruin all the good will you’ve procured paying for dinner.

7. Be prepared to go off on your own. Don’t expect someone to babysit you. In other words, buy a guide, do some research, take public transport or rent a car (if applicable). Getting out of your host’s hair for awhile is always a good idea.

8. Say what you want to do; don’t wait to be entertained. There’s nothing worse than a guest that always answers, “I don’t know. You choose.” to the question, “What do you want to see/do today?”

9. If you have weird quirks or simple preferences – you’re allergic to down, you’re a vegetarian, you hate being in the sun – try to deal with them on your own. Bring allergy medicine, be prepared to order the salad at the steak restaurant, and bring sunblock and a parasol. Don’t make your agenda/needs into everyone else’s.

10. MOST IMPORTANT RULE OF ALL: Leave after 3 days. That old adage is true: houseguests, like fish, start to smell after three days.

I hope this helps. And Beck, I still owe you some wine for hosting us in May. Sorry, my bad.

How to Survive a Road Trip

Having just completed the long journey from New York City to Berkeley, California, in a car, I can tell you that road trips are difficult. You see a lot, you do a lot, you are stuck in a space that is four feet by four feet for hours at a time. Some of it is mind-blowingly beautiful, some of it isn’t. Some of it is interesting and quirky, some of it isn’t. Sometimes you love the person you are with, sometimes you don’t. The truth is, road trips test the mettle of relationships. Any relationship – family, best friends, lovers, coworkers. You cannot be in a car with someone for that long and not get to know things about them that you never would have otherwise. Like the fact that refried beans give them gas. Or that they really, really like taking pictures, which requires you to pull over the car. In light of this, I’ve decided to try to compile a list of do’s and don’ts to help others who might be considering a summer road trip of their own.

1. DO decide ahead of time what the stereo rules are. For example, you might decide that the person driving is in charge of the radio selection or that you share time 50/50. Do not leave this until you are sitting in the car listening to banjo music for a six-hour stretch.

2. DO decide ahead of time how much you will drive. Are you sharing it equally? Is it a rental car, so everyone can get a go? Or is it someone’s baby, which means that you are far less likely to have a turn at the wheel? And when (and if) you do, you will be nervous the entire time that you will somehow be responsible for a scratch (or worse). I drove less on this trip, but it wasn’t my car. This made both of us happier.

3. DO negotiate pit stops. Maybe the person/s you are with do not want to see the famous Corn Palace. Do not assume that everyone else is as interested in checking out the “largest ball of yarn on earth”. However, be aware that if you make someone stop at the ‘1800s town’, you might have to go on the ‘old mine’ tour. It’s a give and take.

4. DO NOT eat five times a day at scary fast-food restaurants and highway dives. Also DO NOT eat everything that you think you want. I promise you that the rules of basic caloric intake still apply on a road trip. If you do not follow this rule, you will end up approximately 5 pounds heavier per/1000 miles.

5. DO NOT play “Do you know what is wrong with you?” in the car. Ever. I guarantee that for every bad thing you discover about your driving partner/s, he/she/they have discovered at least one about you.

6. DO NOT have outrageous expectations. Plan on being disappointed at least some of the time. The truth is, Mount Rushmore is neat, but kind of boring. The Midwest is flat and the desert is only exciting for about 20 minutes, give or take. DO leave room to get excited about the things you discover along the way that you didn’t count on. It turns out that the 1800s town was actually pretty cool.

7. DO spend more money on a good hotel room. A good, clean bed is worth the extra $20. Trust me on this one and look up bed bugs on wikipedia.

8. DO plan on spending more money than you thought. You never calculate the beef jerky you buy at the rest stop, the $25 entrance fee to Yellowstone, or the $20 mug you buy to commemorate your experience.

9. DO NOT go anywhere without having GPS, two maps and a book of Holiday Inn locations. You never know where you’ll end up.

10. DO maintain a zen approach to everything. It helps to mumble “I’m zen” to yourself as you bring your hands together in Angeli Mudra. As a suggestion, do this at least once after every comment that starts with, “Well, I’d rather . . . .”

11. DO bring sunscreen, a hat, and have a bottle of water in the car. Also, it helps to have a cup you can pee into in an emergency. When you see the sign that says, “Next rest stop 118 miles”, you can rest easy.

12. DON’T pack too much. You’ll be happier when lugging your shit into and out of the car every night. You probably don’t need those ‘dress shoes’ anyway.

13. DO try to remember you’re not perfect. Neither are any of the people in the car with you. On a long car trip, you’d probably want to shove Jesus, Ghandi and your grandmother out of the moving vehicle anyway.

These simple tips should help you to muster through any road trip. However, please note that these rules do not apply to traveling with children and/or teenagers. For that, you’re on your own and I wish you Godspeed.