Emails from our Oncologist

I was wrong about Jenny’s oncologist.  He replied my email. I was half expecting him to ignore it, and trashing it, after all I am no more a paying client. And battling cancer makes him a busy man.

But not for the first time since losing Jenny, my outlook on life and people in general, has taken a cynical and negative bent. Only that this time, I was wrong. I underestimated his professional pride.

He replied within a day of my writing to him. I was complaining why he had not shared the information about clinical trials on a new form of chemotherapy carried out at the National University Cancer Institute throughout the months he was treating Jenny. I felt that it could have made a life-and-death difference for my dear wife.

He started with some words of sympathy for my deep loss. Then he explained that “up to the time of Jenny’s diagnosis, there was no published data that intra-peritoneal chemotherapy produced any added survival benefit”. 

But he mentioned also that the study was “in reality… done on a very select group of patients and is not the magic bullet as it was made out to be”. He felt that the newspaper report of the study was “sensationalised”.

The email finished with an assurance that Jenny was given the best available treatment at the time of her diagnosis. And he offered me his deepest condolences.

I read his email reply a few times over - “Sensational way the study was described…”, “..not the magic bullet it was made out to be”. 

Who should I believe? The doctor was obviously protecting his professional pride. But have I also read too much in the newspaper report of the clinical trial?

The next morning I opened my email again. Apparently shortly after writing the first email he sent me a second one, asking to “indulge” him with the “time to share a few thoughts”.

He wrote that he was upset over the newspaper report for the “unnecessary emotional pain” it has caused me, “reopening a deep wound in the heart”. He further shared that “this was not the first time that sensational reporting in the media has affected cancer patients and their families causing confusion and sometimes, distress”.

He finished this second email with an offer to meet up with me “to talk over this if it will remove the guilt it may have unjustifiably caused in (my) heart.”

So should I take up his offer to meet?

Perhaps in the meeting he could run through a gastric cancer 101 to help me understand the complexities of chemotherapy treatment – intra-peritoneal, as tried out in the NCIS study versus the conventional infusion given to Jenny.  But would knowing more help assuage my pain? He was right about the report “reopening a deep wound” in my heart.  Sometimes, ignorance is bliss. I might be better off not knowing too much.

But he has proven me wrong by taking the trouble to write to me. And the tone of his reply was sincere enough, empathic of my situation. He has rightly sensed that I had first written to him largely out of frustration. And perhaps, guilt. Guilt that he had hoped that by talking to me he could help “remove”.

I knew that an apology was in order. It was unfair to pin the blame on him for Jenny’s predicament. No oncologist can guarantee recovery from a disease as deadly as cancer.  So I humbly replied him as such.

Oncologists, especially those in private practice, occupy the highest income brackets in the medical profession, arguably so. But perhaps it is fair compensation. Considering that their job requires them to stare into the face of death each day.  Whenever they look into the eyes of their patients. No other medical profession comes with the same cruel intensity.  Cancer is such a frightful killer and the path to finding a cure to date remains harder as ever. It is the holy grail of modern medicine.

But noble as it is, and for all the money they earn, I think it is really a very sad profession.  Seeing your patients die one by one, as many eventually would.  And having to deal with the broken hearts left behind.

A Day of Discoveries

Saturday, yesterday was a day of discoveries.

I read the night before of bloggers sharing a great place for running. The Pandan reservoir located at the south-western part of our island, not too far from where I live.  Why have I not thought of that before?

But Saturday morning started grey and drizzly. Come late morning, the rain subsided and with patience worn thin I put on my jogging gear and got into the car. The sky was heavy with clouds but not the kind that threatened rain. It was late already and I knew that by the time I got there I would be running under the mid-day sun. The reservoir is completely naked of trees unlike other water features elsewhere, but the thick blanket of clouds above me assured me that I could avoid heat-induced exhaustion.

I circled the roads running around the reservoir for the best parking spot, meaning one that might offer free parking. This is a rarity in our country where tight land constraints demand that any kind of space usage be fully chargeable. But golly be me, at a corner of the reservoir near the junction of West Coast and Penjuru, I found what I was looking for. A free car park for a canoeing club, opened also to the public and with ample lots still vacant. What a discovery.

The jogging path around the reservoir

The running path ringing the perimeter of the reservoir dyke is paved with soft sand and gravel. The cushioning effect is welcoming news to my creaking ankles and knees. But as I had expected, the entire route as far as I could see is completely exposed and totally unshaded.  Unlike other reservoirs formed by natural lakes, Pandan reservoir is a service reservoir specially built to feed the neighbouring industries.  The absence of greenery with only stark looking industrial buildings surrounding the reservoir might make for a rather un-picturesque scene but for the sheer openness and immensity of the water feature, the panoramic view before me was actually quite stunning. Straining my eyes to the far-side of the reservoir, at least a 3-4 km distance away, I could barely make out the track that connects to where I was standing. It is an amazing sight to behold. And quite a rare one in our tiny and massively jam-packed island. 



The opposite side of the reservoir was really quite far to make out

But the sweeping view of the reservoir spoke also of the grinding toll ahead. For any would-be jogger like me, attempting to slog through its full perimeter. With a circumference of about 6km, this would be one path too long for my limited stamina. But I could always jog as far as I could and stroll through the remaining distance back to the start-point.

Aside from canoers, the reservoir was quite deserted.

Pandan reservoir was a really fine discovery despite its bareness and lack of shade.  There was a gentle breeze blowing across the reservoir but as I realized later that cooling feel was limited to only one side of the perimeter.  Across the opposite side, the air was still and stuffy. Despite the cloudy sky, the heat and humidity of the mid-day run bore down on my fast tiring body, sapping away my energy.  After half an hour of trotting at a steady speed, I slowed down to a brisk walk. I had covered slightly more than 4.5 km of the 6km path. Not a bad start for this first-time visit. I made a mental note to come by this reservoir again for my future exercise regimes. And better during the early morning or late evening hours. Admittedly, a very pleasant discovery of a new jogging destination by all means.

But through most of my exertion around the reservoir, my mind was as heavy as the clouds hanging in the sky above. I was mulling over a discovery of another sort. One that was made earlier, during breakfast

Earlier in the morning, a report in the newspaper's Top of the News section caught my attention. A clinical trial held at the National University Cancer Institute on a new form of chemotherapy treatment that can prolong the lives of patients with advanced gastric cancer, yielded very promising results.  The trial was started in 2013 and announced in a Consortium of experts of this terrible disease. 

Jenny died of advanced gastric cancer. She was diagnosed in late 2014.  We opted for a private oncologist to treat her on the recommendation of the hospital where she was first diagnosed, thinking that this option, though a more costly one, might offer her the best chances for survival. On hindsight it was a naïve one on our part and perilous for my dear wife.

But what troubled me was why were we not pointed to this clinical trial? We were led to believe that our oncologist was one of the best in gastric cancer.  Could he not have known about this new form of chemotherapy? True it was still under trial, largely unproven in its early stages. But we could have at least gone to check on it, if we had some information about its on-going. Or was our doctor at worse, withholding this information from us, putting his business interest ahead of his patients’ well-being?

Was I being fair to the doctor to think that way? I journeyed back to the many visits made to his clinic, the long hours of waiting in the cheerless silence of the reception area, the anxious meetings with the doctor trying to decipher the underlying messages behind his diagnosis. I could not help thinking also that the doctor might be using Jenny as a learning experiment for himself.

If only we had searched harder and sought advice from other doctors.  We had placed too much hope, no, in truth all our hope, rather foolishly in the hands of a single private practitioner. One who was well-poised to win us over by his confidence and apparent display of concern and suave demeanour. 

Asking a whole load of “what ifs” and "if only" at this time was totally pointless.  I was mindful of that. It does not make much sense to pursue this again, I kept telling myself.

But still I needed to get it off my chest.

So I went home and tapped out an email to the doctor.  I do not think I will get a reply but felt nevertheless the need to write.  This is the first time we would be communicating since Jenny died.  The last time I wrote to him was to update him that Jenny had passed on.  His reply of condolences was short and curt.  Again I have often wondered on hindsight, why I had even bothered to update him at all. 

And once again I find myself on familiar ground, wondering why I am sending this to him.

 Dear Dr ____

I read today’s news feature, (http://www.straitstimes.com/singapore/singapore-chemo-trial-gives-hope-to-gastric-cancer-patients) on the chemo trial carried out at the National Cancer Institute of Singapore that gives hope to gastric cancer patients, with a heavy heart of mixed feelings.

If you can recall, my wife Jenny was diagnosed with advanced gastric cancer in Oct 2014 by you on the recommendation of the hospital.  After 7 cycles of chemotherapy involving two different drug regiments, followed by 2 courses of immunotherapy, she died in April 2015. 

To read from the news that the above-mentioned clinical trial was announced in 2013 at the Singapore Gastric Cancer Consortium, my family is bitterly disappointed that over the 6-7 months of frequent consultation we received from you, there was never any information from you about the on-goings of this clinical trial taking place.  The information could have prompted us to explore as an option that might have offered my late wife a better chance of surviving or improving her quality of life.

Why was this information of the clinical trials at NCIS not made known to us?

In retrospect, recalling how Jenny’s condition had so swiftly deteriorated as the cancer spread into her peritoneum, we look back with painful regret that we might have misplaced our trust and hope with the wrong hospital and oncologist. Jenny’s life was cut short and she suffered an immensely poor quality of life during the months of treatment.

Sincerely,

Keith

 

 

Dwelling on death, on the way to work

By now I am quite used to waking up alone by myself. Dragged myself out of bed and got on with my morning routine after another night of much tossing and turning. It’s been more than a year without her. But I have spent ½ my lifetime with her by my side so forgive me if I am slow in adjusting to this so-called “new normal”, which pretty much sucks.

Lately I have been reading a blog site (“Life without T”) I had discovered quite by chance. It was put up by a middle-aged American who have lost his wife of more than 20 years. She died rather suddenly of a heart attack at home. It was a devastating shock to him and his two children, needless to say.

Another blog site (“Diary of a Widower”) that captivated me was started by a guy from Holland. His was also a tragic case of sudden loss.  His wife was killed in a road accident when her motor-bike was knocked down by, of all people, a careless police-officer.

I am not sure what triggered that turmoil in my mind this morning. But it led me to dwell for some time about the differences in circumstances of how our spouses had died – me and the other unfortunate widowers in those grief sites that I have been following. It happened shortly after I had driven out from the estate on the way to office.

Jenny’s last days were spent on a hospital bed. Her eye-lids could barely open and all her remaining energy was directed at drawing in air into her deflating lungs that were badly ravaged by the infection she caught 2 days before, tormenting her already cancer stricken body.  She was lying in that semi-conscious state for several hours since the early morning, all the while gasping and breathing heavily. We could not be sure if she was aware of our presence at her bedside. And when her final moment arrived, there was a short pause in her breathing and with that last exhalation sounding more like a reluctant sigh of resignation, she gave up the fight and yielded for eternal peace.

So which is the kinder end?  This inevitable departure from the physical world that no one can escape from. Sudden cardiac arrest or near instant death caused by some fatal road accident or a slower but eventual transition through illness? I would never know. Which is more traumatic or brutal, to the dearly departed and also the loved ones left behind. Death will surely visit us one day. We could only pray that when the time comes, the experience will be gentle and less punishing.

But dwelling on Jenny’s last moments this morning had me reduced to tears. I was babbling like a child even as I was steering the car out to merge with the relentless traffic flowing on the expressway. Not for the first time have I been so emotionally struck over Jenny’s tragic fate while commuting to and fro of work. Morning has never been the best time of day for me.  But it helped that the heavy peak hour morning traffic meant that I could not drive too fast.

On one of the grief sites I had visited, the writer had shared a quotation by Ernest Hemingway,

“There is no lonelier man in death, except the suicide, than that man who has lived many years with a good wife and then outlived her. If two people love each other there can be no happy end to it.”

I cannot agree more with this legendary novelist.

Romancing Mount Kinabalu

 

Was it sheer recklessness on my part? Attempting to scale up more than 1000m up a steep mountain when my body was still battling a bad chest infection. And in clear defiance of doctor’s orders.

The day before the flight out, I have already been certified unfit for flying and physical activities. With that simple note from the doctor I could apply for a full refund of the flight ticket and advance payment to the tour operator. So my expenses were recoverable.

But getting a refund from my travel insurance was not in the game plan and certainly not what I had in mind. I have been romancing the mountain for a good part of this year and was not about to surrender this courtship. So throwing caution to the wind, I joined my friends at the airport for the early morning flight out to Kota Kinabalu, capital of Sabah in the island of Borneo. To get up close and personal with the mountain. Mount Kinabalu, to be exact and at a height of 4095m, the highest mountain in South East Asia. It sits high up in my bucket list of things to do, before I die.

We reached KK after a 2 hour flight. I felt queasy throughout the flight and doubts started creeping in my mind. Was I being reckless? I had been sick for a good two weeks, having caught a stubborn virus in Scotland and an extended rest at home might be what I need. But after a warm soupy noodle lunch at a local eatery I felt better. The road trip to Kinabalu Park took another 2 hour drive. We were to spend a night at the park resort. Our climbing group of 5 comprised of my very good friend J and his son and another couple. At a height of about 1800m, the air at the Park was crisp and chilly with the fresh feel of an alpine forest.

But again, I was racked by anxiety and uncertainty if my weakened body can withstand the punishment ahead. The night before even as we were relaxing after a satisfying buffet dinner at the resort restaurant, the frosty air aggravated my coughing. I felt wispy and breathless. My friend J who had initiated this trip, urged me to try out ½ a sleeping pill that he had brought along. On any other day I would not touch this stuff. But my sleep for each night over the last two weeks was punctuated by incessant coughing and I knew that I could not afford another sleepless night. Not before a day of such taxing exertion. So I obediently popped in the half pill without thinking too much. Soon after, the tranquilising effect of the drug began to kick in and I drifted into slumber-land.

After breakfast we got ready for the climb. I arranged for a porter to relieve me of carrying my own personal backpack. The 8 kg bag of stuff I needed to bring up might be too strenuous for my brittle frame to carry up. We had two porters in all, along with a guide. Our two porters turned out to be too pint-sized ladies who look like twin sisters. At less than 5 feet tall each carrying two backpacks, one of which was my own, I could not help feeling somewhat embarrassed. But it was just my biological male ego playing up on me. I had to get real and admit that I was not in the best physical state for this climb in the first place.  These two ladies at around 50 years of age as revealed to us, are as tough as the granite beneath their feet. They climb the mountain for a living, each capable of summiting with loads as much as 20kg on their back. Gender and state of health aside, there is no denying that we city slickers from our bubble world of affluent living are of less hardy stock. Our guide, Bil appears fit and trim with a quiet demeanour and sense of self-confidence that belies his youthful age of 24 years. He had climbed the mountain countless times since he started as a guide 7 years ago.

Our guide, Bil briefing us on the route before we started.

We started the climb from Timpohon Gate, about 5km from the Park office. I started the climb with some uncertainty, not being sure how my body would react to the physical strain. Clambering at a slow and measured pace, the first kilometre felt strenuous but not overly difficult.  I could go on. Much of the uphill path for the first 2-3km was made up of steps, uneven in height but nevertheless facilitated the ascent. Using both my trekking sticks I found that I could heave my body up with my arms allowing my upper body to bear

Our two lady porters, small in stature but tough as nails.

part of the upward exertion instead of relying only on my leg muscles. Still it took close to an hour to cover a single km of trekking. On flat ground at places like MacRitchie reservoir where we had trained often we could cover 6 km in slightly more than an hour. The huge difference is the gradient of the mountain and labouring against the gravity of our body weight.

With my tattered stamina and poor fitness, each step up the mountain was a leap of faith. Still, my months of dreaming of this endeavour was silently unfolding into reality. Scaling the mountain. Taking on the physical challenge, though that was actually secondary.  The all-powerful draw that beckoned me was the pilgrimage into the heart of Nature. 



Stepped pathway up the slope

Most of the path upwards was rocky and uneven

After about 3km up, the path turned rocky.  Carved against the precipitous slopes, the rocks and boulders are random in size and arrangement, artistically sculptured by no less a craftsman as Mother Nature herself. And on both sides of the path, a frenzy of flora and fauna made up the lush and luxuriant forest, beyond which lies more plants, darkness and hidden mysteries. At certain stretches of the ascent, a misty cloud hangs in the air, blurring our view of the landscape but enhancing its timeless beauty. The tranquillity and rustic freshness of the mountain was all consuming. Trekking at this slow pace, unfit as I was, my body had time to slowly acclimatise. I felt none of the altitude sickness that was reported by a number of bloggers who had experienced it. Instead, amid the exhaustion I found the climb exhilarating and even invigorating.  I knew I made the right decision to venture up to join my climbing group. It was worth the risks. Worthy of all the training I had previously put myself thru.

After about 6 hours of climbing, we reached the Laban Rata rest house, perched at 3200m on the mountain slope. All the climbers have to stay a night at this rest-house before taking on the last stretch of the mountain – a trek of about 2.5 km to ascend the final 850m to reach Low’s Peak, the summit of the mountain. With gradients of close to 70 degrees at some stretches, this second segment of the climb will be the ultimate test of the climber’s mental and physical stamina.

Laban Rata - the rest-house at 3200m up the mountain was a welcoming sight

I did a reality check. Assessing my own physical condition I felt that I should not push my luck any further. Not many people would attempt to scale this mountain unless they are in best state of health and fitness. I should not subject myself to further risk. The mountain deserved greater respect.

So along with the lady climber in our group and my friend J, who had suffered severe muscle cramps and had struggled the last two kilometres up to the rest-house, we decided to forego the summit. We had embraced the mountain and intimately savoured both its brutality and beauty. We can always return another day when we are better prepared for the summit challenge.

Sweeping view of the valley from Laban Rata

Once our two other team members descended from the summit and re-joined us, we began our slow descent down the mountain. I decided to carry my own backpack. It seems shameful to be trekking without a load strapped on like all other climbers. But carrying my own pack accorded me the convenience of going at my own pace instead of sticking close to the porter whenever I needed a drink or to retrieve items like my rain-coat should the weather change.

In any case, the climb down was not physically exhausting. But the downward path, along steep precipitous and rocky slopes could mean a treacherous fall or a broken ankle with a single misstep. This is where my trekking stick proved priceless, allowing the metal prod to bear a good part of my body weight to relieve the strain on my ankles and knees.

Our downward trek together was spent mostly in meditative silence and very soon our group separated from each other and I was walking by myself. For long stretches there was not another hiker in sight. Ahead or behind. Except for the constant background cacophony of insects from behind the trees, the soft shuffling of my shoes against the rugged terrain and plodding of the metal-tip of my trekking sticks into the dirt, there was an overwhelming sense of calm and quiet peacefulness.

Not that the downward journey was without dangers of its own. Once or twice I came close to slipping off a rock and twisting my ankle. But for my trekking stick digging in quick enough to bear my body weight, my ankle joint could have suffered more serious impairment. Jenny must have been watching me from above, keeping me out of harm’s way and my fragile health intact.

I like to think so.

If not for my rational mind getting in the way. The grand ideas of heaven and hell. Of pearly gates and eternal lakes of fire. Most religions worth their salt would have these ideas entrenched as major fixtures in their doctrine for faithful believers. I am not so sure about such ideas.

What I am sure of is that we are part of this huge reservoir of terrestrial carbon. When we die we return to be part of this earth and we give rise to new life as once it gave rise to our own birth. Perhaps this explains why, with Jenny’s passing my affinity and passion with nature could only grow stronger. I feel her presence as the wind brushes against my hair and skin. I see her amongst the trees and hear her whispering as the leaves rustle in the breeze. Jenny, my dearest Jenny, departed too soon from my life. My only hope of getting close to you is to commune with nature herself. Tears welling in my eyes were soon trickling down my face along with the perspiration as I trudged my way down the enchanted mountain.

For our group, the downward descent took longer than the journey up.  Our legs were soft like jelly by the time we limped back to Timpohon Gate.  Ravenous after the long trek, we helped ourselves to the buffet spread at the park resort restaurant. This was followed by a 2 hour drive back to the city and civilisation.  We checked into the Promenade Hotel at Kota Kinabalu to reward ourselves with 4-star comfort.

So Mount Kinabalu proved to me a summit too high to scale, not being in the best state of health and fitness. But respectfully, I have to be happy and contented of reaching the 3200m point at Laban Rata, scaling a vertical ascent of about 1300m. How high is that? Perhaps 5.5 times the Westin Stamford, the highest hotel in our country which scrapes the sky at 77 floors. I have tasted the mountain, savoured its charm and left enough of my foot-prints behind.  I will leave the summit as another challenge for another day.

Doctor blues and the lure of the mountain

“You are too late. Registration is closed. We cannot accept any more patients”.

I looked at her with befuddled astonishment. “But it is only 10.30am and your clinic closes after 12 noon does it not? How could I be too late for registration?” The youngish lady seated behind the clinic counter, who could be no more than 20 years of age, held her ground and with a straight-faced icy look explained without a hint of apology that registration time is never fixed and depended on the number of patients they receive each day. So too bad, I came too late and they could not accept me.

I looked around the tiny clinic reception. True, the clinic was packed. There were at least a dozen patients, mostly foreign workers, probably Bangladeshis or Indian, some still in work attire with their high plastic boots, all seated shoulder to shoulder against each other. I had naively expected the clinic to be relatively empty even as the clinic would be opened for half a day. After all it is Saturday. Not many locals are working and would be in need of an MC. But I forgot about the legions of foreign workers who have swarmed our island and in no small numbers and whose gruelling and sometimes dehumanising work regimes would mean they have to grind out their weekends like any weekday.  Which explains the profile of clientele now competing with me for the doctor’s limited attention. And Saturday mornings like this one, would attract many of these workers in search of doctor’s certification to accord them the rare luxury of a restful break over the weekend to repair their battered bodies and recuperate from afflictions real, imagined or feigned.

But I was not about to give up.  After all it was another two hours to closing time.

“Please be flexible on this. I have been sick for some time. Your records would show that I came twice to your clinic over the last two weeks. I need the doctor to certify that I am unfit for travel so going to another clinic will not help as they would not have my records”. I put on my most pitiful look and pleaded to be accepted. In truth, I did not need to try too hard to look pathetic. My face is pale and gaunt and my voice was barely audible, hoarse and frail from weeks of ferocious coughing.  But she shook her head, without making much eye contact as if to assuage her guilt of shooing me away. I wondered quietly if it would destroy the clinic’s good standing if she had said ok and accepted me as the last patient for the day. I went on to explain that seeing another doctor will not do as they would not have my past medical records.  And I needed the certification before tomorrow morning which was the travel date.

My date with a mountain to climb.

It was one of the things I had longed place in my bucket list of thing to do before I die. A date to scale up the 4095m of rock that makes up Mount Kinabalu, the highest mountain in our part of the world and located in the neighbouring island of Borneo. A mountain which preteen school kids to geriatric grand-mothers alike have conquered with enough regularity to make me feel ashamed that in my lifetime, whilst I am still alive, able-bodied and fit as to why I am still not registered amongst the mountain’s roll of honour.

 So for some months, with a few close friends, we conspired to accomplish this physical endeavour and Sunday 8^th of May was marked for departure to fly off for the expedition.

But blame it on fate or my own rotten luck, as it turned out, two weeks ago I caught a virus that near ripped out my chest and respiratory system.  Fighting back with antibiotics and countless bottles of cough syrup and other flu medicine had left me weak and wasted. All the months of physical conditioning put in to prepare for the mountain was cruelly undone as my body sought for the respite and rest it needed for repair. I could hardly climb up two flights of stairs without my pulse rate racing away and raspy breath breaking into another coughing bout.

But if there are any merits of being bugged by a persistent virus, it is to be equally persistent. I was not about to give up myself.  I could not see myself being defeated by some wide-eyed under-aged “counter aunty” who thinks that it is a noble work ethic to be rigidly sticking to the rules even if it means turning down a customer in need.

“Surely you can be flexible. I am only one more patient and I would not take long. I do not have a choice as all my medical records are here”. I leaned even closer against the counter, my thin frame looming close above her. She turned to look at her other two colleagues, both equally youthful looking as her.  One of them gave a slight nod and perhaps that was the signal needed to bring her down from her high and mighty perch.

“Alright, next time when you come on a Saturday make sure you come early enough. We are always very crowded on Saturdays as you can see”. With that she took the identity card from my hand and registered me for an appointment.  “You may have to wait up to 1 or 2 hours”.

I was relieved. I needed to consult the doctor for him to certify me unfit for the trip and for physical activities. That will allow me a chance to recover the flight and travel expenses spent on the trip from the travel insurance.  Foregoing the opportunity to climb this mountain is painful enough. Not being able to recover the expenses paid for in advance would be salt in the wound. It is the least I could do to salvage this trip.

In truth, on the eve of the trip I am still toying the idea of embarking on the hike regardless of the doctor certifying me unfit and my actual withering physical condition. But I would be subjecting myself to tremendous risks. What would I do if after two hours of physical toiling, my weakened body could labour no more? I would be stuck in the wilderness, in the middle of nowhere.  Nature and flora all around, with a beaten track stretching upwards before. The sounds and smells of the forest, freshest of air that one can breathe in and perhaps even with butterflies fluttering around.  Nature that embodies harmony and balance in no better way.  But I do not plan to die under such perfect circumstances. Not yet when my kids still need me.

Anyway the doctor, an elderly man with a portly pleasant disposition heard my case and promptly scribbled a note for me that I can use to recover my travel expenses should I need to make a claim.

So should I stay at home and put up the claim?

Unfortunately the lure of the mountain has proven too strong. All that hassle of seeing the doctor and securing the medical note to help me recover my travel expenses. It is a strange day of shifting decisions. My head tells me not to go but my heart said otherwise. I packed up my knap sack to prepare for the flight early tomorrow morning. Jenny would be most displeased. I could almost see her frowning. But truthfully she is not here to stop me.  

Wishing me safe travels, Honey. And a pleasant climb. I will pace myself and be mindful of my age and waning health. You know how much I love being close to nature. I will be thinking of you on the way up the mountain.

Falling sick with a mountain to climb

My official trip to the UK finished up rather badly.  For me at least. I suffered one of my deepest fear when on the road – falling sick.

I supposed I could count myself fortunate that I was fit and fine for the first 5 days of the trip, when most of the major meetings and visits were scheduled.  I could have been careless, letting my guard down, either by not hydrating well enough or missing my vitamin supplement for that day. It was towards the Saturday weekend evening when the symptoms started telling their warning signs - aching in my joints and a drastic reduction in appetite. All is not well.

Although most of the trip itinerary was done with, there was still a remaining stint that require my two other travelling colleagues and I to journey up north, cutting diagonally across almost the entire Scotland from Glasgow into the Scottish Highlands and towards a small town called Forres, located close to the North Sea coast and about 320km or a 3-4 hour drive from Glasgow. Weather-wise, we could expect strong winds and chillier temperatures. My weakening body, fresh host to the invading virus now playing havoc in my system, trembled with this unwelcoming news from the weather forecast.

The Saturday night before the long drive up north was an endless series of tosses and turning. My mind was stuck on fight mode, in a perpetual state of delirium, too active to sink into restive dream-state and the sleep my body was craving for, and any success to actually enter into sleep would be quickly frustrated by my lungs exploding in successive staccatos of violent coughing.  My appetite for food was also completely taken down by the intruding aliens. I managed only to nibble part of a banana for my breakfast and drink some hot tea to sooth my throat, bruised by the incessant coughing.

It was fortunate that we had another driver amongst our traveling entourage of 3 persons and she was confident and adept at driving in foreign soil. This was one tender mercy I should not discount. Not many Singaporeans are experienced at overseas driving. That relieved me of the responsibility and allowed me to rest over a larger part of the trip in the back seat of our rented car. A 4 hour journey that require focussed concentration in my current woozy mental state would be precarious.

Once out of Glasgow sub-urban, the Scottish Highlands unfolded itself with picturesque beauty typical of the British countryside but instead of the gentler rolling fields and knolls of the English landscape, towering hills and mountains sweep majestically into the distance. In the foreground, clumps of quaint stone cottages with the occasional small castle or cathedral, surrounded by countless sheep and sometimes cows that dotted the broad expanse of open fields all around told us that traditional farming is still very much alive in this supposedly modern country.  My two travelling companions seated in the front were oozing “oohs” and “ahs” to the pristine beauty of the Scottish glens and countryside.

But I spent most the trip huddled in the back seat, coughing away pathetically and depriving me of restful moments. It was dreadful. But at least I did not have to drive.

The next two days was a struggle. Cold weather with glorious sunshine alternating with flurries of hailstone rain whenever a dark cloud glided overhead.  It was weather I had never seen before. When the long meetings with our partners were finally over and done with I was thankful. I had eaten very little, mostly soup and some bread for each meal and real restful sleep was still escaping me.

The long-haul flight back home promised of better things to come. Back home to warmer weathers and where I could immediately seek medical attention. I hardly ate anything on the flight for fear of throwing up. It was amazing that the business class food menu could boast of an amazing range of dinner options but not a simple bowl of warm vegetable soup. I glanced under the menu section of “Delectables” where passengers could choose a range of snacks in-between meals. Tom Yam noodles. That sounded palatable enough. Instant noodles it may be but I would stomach a few mouthfuls and ingest some of the mildly spicy and hot soup served with it.  The stewardess who took my order was puzzled about my choice but did not query or not try to change my mind.

Out of the airport gates, my boy, W picked me at the arrival pick-up and quickly we were on our way back home. After a quick clean-up I made my way to our neighbourhood clinic. The locum physician on duty prescribed a 5 day course of Augmentin anti-biotics.  It was four days since I caught the virus.  I now wonder if the medical treatment has come a little late. I was virtually fighting the virus on my own for the first 4 days without medication. Now nestled in the comfort of home, with medical leave followed by a long weekend on account of 1^st May being Labour Day, a public holiday I have had plenty of rest and should be recovering well. But not so this time.  My head felt heavy, sleep was still a rarity and always the violent spasms of coughing tearing up my lungs despite four days of medication. Perhaps the viral strain from a foreign country is proving itself to be a harder adversary for my body to deal with.

It may sound ridiculous and out of place. The compelling reason why I was so racked by anxiety of not recovering quickly enough to restore my health was mainly because of a mountain. Yes literally speaking, a mountain more than 4000 m in height which I have planned to climb. And the crucial date that is looming closer with each day I spent languishing in bed – 8^th of May, is less than a week away.  It would be expected to be the most physically arduous venture I had undertaken all my life.

Mount Kinabalu is a mountain located somewhere in Borneo Islands that is beckoning and for which a small group of friends and I have made a date to climb. We have booked the trip early in the year and have been meeting regularly every few weeks to trek around our nature reserves and build our fitness to prepare for the climb.  Like the majority of leisure climbers we will be taking the easy route that requires no mountaineering skills but the climber is still expected to be in very good physical condition.

I had in the past floated the idea of climbing this mountain to Jenny.  But she was not an outdoor person so the mountain had little appeal to her.  In later years I had suggested teaming up with friends for the climb. Without her of course.

 “And leave me alone at home worrying for you?  At your age it is too risky! You never realise you are not as young anymore”.  Cold water quickly dousing whatever flames of enthusiasm that might still be simmering within me.  The idea was quickly canned. How could I make her worry for me just so I could pursue my own selfish ambitions?

But lately my good friend J was keen on climbing the mountain and had plans to organise a trip for a small group of 5.  Do it before we get too old. This is true. And it gives us a reason to push ourselves further in our physical workouts. Like doing vertical climbs of 40 storey blocks not once but twice over. Or trekking around our central reservoir, a 12 km route at around 2 hours.

So Mount Kinabalu was a much anticipated project, a date I had clearly marked on my calendar and for which I was very much looking forward to. Back to nature, and the possibility of standing on the peak of the highest point in the region, with my head above clouds or if the weather is clear, to see as far as the eye can see.

But I did not see this flu bug coming and how it appears now to be playing havoc to my next holiday plan. I could see Jenny from a distance looking satisfied of this unexpected turn in events that would now be scuttling my plans. But she would also share my disappointment if I have to cancel the trip as getting even a partial refund will be highly unlikely.

I will  need to work harder over the next few days to rid myself of this virus and get myself back in shape.  Even if it is a mountain to climb.