“No Beerlao.” The advice to abstain from the popular local libation came with the over-the-counter antibiotics sold to us at a pharmacy in Luang Prabang, Laos. If only that were the extent of our problems.
Two days earlier, our stay in this tranquil riverside oasis took a worrying turn when Brian developed an alarming-looking patch on the back of his neck—what we assumed to be some kind of insect bite, a light brown spot surrounded by enflamed red skin and sprinkled with pustules. We set out for a pharmacy to try and get some help figuring out what it might be, only to find the place shuttered in the late afternoon. A printout tacked to the door noted a 45-minute break for lunch, which had passed hours before.
Foiled from our mission, we returned to our hotel and rounded up the manager, Evelyn, a Canadian expat well-traveled in Southeast Asia. She suggested that Brian take the Benadryl we brought with us from the States and hold off seeking medical treatment for the time being. After all, wicked bug bites aren’t uncommon in this part of the world.
Brian’s souvenir held steady for a day and then worsened, getting hotter, redder, sprouting more pustules, and covering almost the entire area on the back of his neck. With an infection clearly brewing, we returned to the now-opened pharmacy and left with a broad-spectrum antibiotic, a topical cream, and the cautionary recommendation to avoid mixing booze and the meds.
Disinclined to pop random pills dispensed over the counter without a diagnosis of the underlying condition, we returned to our room and fired up our computers hoping to get a better understanding of what we were given. It didn’t inspire confidence.
The cream, we learned, was most commonly used to treat vaginal yeast infections. We were both pretty sure that wasn’t Brian’s problem. Of course that didn’t mean the cream wouldn’t help, we just didn’t know because we still had no clue what was wrong.
The antibiotics, still in their branded bubble pack, were a pretty straightforward variation on penicillin. That was good. The instructions we received on how to take the pills, however, were less good. Instead of downing 1,000 milligrams with food, the normal dosage for this antibiotic was a quarter or half that amount taken on an empty stomach. Oh, and it’s perfectly fine to consume modest amounts of alcohol with these pills—so, yay, Beerlao!
But the celebration didn’t last long. Our original confidence that things would pretty much take care of themselves was giving away to genuine concern. Brian’s condition was worsening to the point where he was beginning to feel feverish, a decidedly bad turn of events. We still had no idea what was wrong or whether the medication we had would even help. And worst of all we were in a place where we didn’t speak the language, had no idea where to go in an emergency, and were pretty much trying to play the role of doctor all by ourselves. We’ve had better nights.
With no improvement by the next morning we decided it was time to seek some professional help. Staffers at our hotel’s front desk conferred with each other in Laotian before suggesting we visit a clinic a few miles away. Out on the street we bartered with a young songthaew driver, Idin, who sped us through the streets of Luang Prabang in his colorful truck.
Turns out the “clinic” was actually the office of a single physician. And if the doc’s away, the clinic is closed. He wasn’t expected to return until 5 p.m. the next day, which was longer than we wanted to wait even assuming he’d actually be open for business then. Given our experience thus far, we weren’t convinced.
Fortunately Idin had waited for us without being asked and offered to take us to another clinic that “Lao people use.” We climbed back in the truck and set off again, only to find this clinic gated shut, too. Idin stopped and spoke with someone on the side of the road, asking directions to yet another facility.
Whatever confidence we had dissolved completely in the back of that songthaew. Everywhere we turned we were greeted with shuttered doors. As we drove further and further away from Luang Prabang with no one, not even our taxi driver, knowing where we were going we decided it was time to head to the hospital.
If you’ve ever visited an emergency room in the U.S., you’ll understand why we hesitated to go there in the first place. The wait can last an entire day, and the bill can add up to a small fortune. But in Luang Prabang, it was the exact opposite.
After entering sliding glass doors at the Luang Prabang Provincial Hospital’s main entrance, we saw a sign marked “International Emergency Room.” Wandering around amid the hustle and bustle, we looked for an information desk. We couldn’t find one and finally stopped an official-looking person with a badge to ask for help. Luckily for us this particular ailment didn’t require any language skills. All Brian had to do was pull down his shirt collar and flash the reason for our visit. Seeing our bug’s handiwork prompted a less-than-comforting gasp but also some blessedly quick action.
From there things progressed with astounding efficiency. We were whisked into a back room where a doctor identified the nefarious creature that had sent us to the hospital: a Paederus beetle. Brian likely never even saw the tiny, flying, villainous insect, which if crushed against the skin emits a toxin. Our advice: don’t do that!
We showed our new doctor the medications we received from the pharmacy, and that prompted a snigger about the cream. She said we didn’t need that, but we required more antibiotics as we hadn’t been given enough. She also prescribed two other medications to combat the allergic reaction.
We were then assigned a nurse who worked with us during our hospital visit. She cheerfully shepherded us through the process of first paying for the M.D. consult and medications before directing us to a separate window to fill the prescriptions. The grand total: less than $20. We were at the hospital for about half an hour before hopping into our waiting songthaew for the trip back to the town center.
That evening, we watched the sun set at a café along the Mekong River. With Brian now on three different medications we heeded the original advice and foreswore our favored drink. We had mango smoothies instead, mockingly served in Beerlao mugs.