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The Death Grin [Surgical Tourism]

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Promotional image for an overseas "dental holidays" site. Company motto: "Your smile will never be the same again."

The dentist grinned at me.

He was missing teeth. Several teeth.

He stood in front of a small, sturdy building in a dusty town in southwestern China, sharpening some kind of crude metal tools on a stone wheel. Like his office, he was short and sturdy, stolid in the way that’s required for pinning a man down and pulling out his teeth.

I rubbed my jaw and wondered how many teethed he’d yanked over the years. Did he pull his own teeth? I stared at the black holes in his grin, and thought I was too young to go toothless.

Yet my body was falling apart.

My fiance Monica and I had been traveling around Asia for six weeks, to Hong Kong to visit family, to Thailand for rock climbing and scuba diving, then on to backpacking around southwest China. We’d saved for two years to fund the trip and it was supposed to be our blowout farewell tour of Asia, after nearly 5 years of living in Japan. If only we knew what we were in for.

Medically speaking, things had not gone as planned. Soon after arriving in Thailand, my foot started aching and my pinkie toe became inflamed and swollen. Within a couple of days, puss-filled blisters emerged all over the toe, making it look like some exotic plant had fruited from my foot.

A friendly doctor at a Bangkok clinic asked where I’d traveled, took a look appraisingly at my erupting toe.

“You have bad case of Hong Kong Foot,” he concluded. He gave me a tube of balm for the toe and told me to keep the foot dry. In short, he told me to escape Bangkok.

We had arrived in Thailand’s capital city during Songkran, the yearly festival in which Thais roam the streets pouring water on anyone and everyone. The entire, smiling populace of the city seems armed with squirt guns, hoses and buckets. Fire trucks are commandeered for blasting innocent pedestrians. Swimming pools are emptied.

Once, fed up with the festivities and fearing for my toe, we fled to our room to get dry and escape the chaos of the streets. Hours later, clean and dry, we tried to sneak through back alleys to get some dinner, only to have a guy on a balcony dump a bucket of water on our heads.

Eventually, we escaped Bangkok and made it to Krabi, a province in the south of Thailand that’s home to the karst cliffs of Railay peninsula, an iconic limestone climbing area. My foot simmered down enough to squeeze it into a climbing shoe, but the infection lingered. After a overnight boat ride to Phi Phi, an island in the bay of Thailand know for its excellent scuba diving, the blisters came back.

While Monica explored the coral reefs of Thailand, I laid sweating in a hammock, foot up, nursing bottles of Singha and hoping the toe healed before we went trekking in China. It was also around then that I discovered the hazards posed by squat toilets and dehydration.

But the details are unpleasant.

To my chagrin, when we left for southwest China after a month in Thailand, the foot infection held. The blisters came and went as we wound our way north from the city of Kunming, shoehorned into a variety of ramshackle buses and trains. Hiking Tiger Leaping Gorge, a stunning river valley, I kept thinking of stories I’d heard about soldiers with trench foot. I worried they’d have to amputate.

Also, my head had started to hurt and I was nauseous in waves. I wondered if the infection wasn’t spreading to the rest of my body. On the steep sides of the gorge, we passed stone grave mounds decorated with white ribbons. I wondered if any of the deceased were felled by this Hong Kong Foot. Did they bury foreigners in stone mounds?

How would they get my body home?

After the hike, we made our way to a city, and visited a hospital. The doctor spoke enough English to take a medical history and ask where I’d traveled recently. He looked at me earnestly.

“You case of Bangkok foot,” he said, handing me a tube of balm. “Apply twice day. Foot keep dry.”

Things went even further downhill from there. The pain in my head got stronger and the waves of nausea were foreshadowed by a metallic smell, one that warned me to stop whatever I was doing and find a place to curl up into a ball and hold my head. I soon realized I had an infected tooth. When a bus dropped us in a dusty little town, I asked around for a dentist and was directed to the stocky fellow with the missing teeth.

It was a moment of clarity. My infected foot wouldn’t fully heal for another six months, long after I’d returned to the United States, where doctors would essentially tell me I had some mysterious infection contracted in Asia. Of course, they called it “Asia Foot.”

To ease the intolerable pain in my mouth, I would self medicate with antibiotics to quell the tooth infection for the remainder of our trip. An American endodontist would later charge me more than $4,000 for two root canals and crowns.

As I stood there on the narrow street watching the Chinese dentist sharpen his dental tools on a stone wheel, I contemplated having him pull my tooth. The pain from the infection was intense, some of the worst I’d felt. People all over the world had teeth pulled everyday. Was I too good to have my tooth pulled?

Not too good, I decided. Too young. Too alive. My illnesses on the trip had awakened me to fragility of my physical being, to my own mortality. Giving up a tooth somehow meant admitting defeat. It meant accepting the inevitability of my own death.

With that realization, I left the dentist to his sharpening and went in search of drug store.

I needed antibiotics.

—Chris Emery is the editor of STRAY, an online magazine and guide for people with a passion for adventure, travel and the outdoors, despite—or thanks to?—the risks.

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