As always with traveling, the best laid plans to go to bed early and get on the flight refreshed failed dismally. We were up very late the night before attending to all the remaining details of things. Todd got here while we were still in way too little sleep zombie mode and was wonderful in helping us make it out the door and on toward the airport.
We made it to the airport Early in the morning, figuring that between my daily drugs in sorters and the CPAP machine and various other things in luggage we didn’t want to check since it might not make it to Thailand with us, that we might well have to spend a long time in security while they figured out what on Earth all of it was. We were pretty inefficient with the luggage once we got it out of the Beast, because we were awkward with new luggage and hadn’t traveled in a while. But we got it checked without problem. Then we proceeded through enough snaking dividing tape for a few hundred people to stand in line, right up to the front since the airport was still pretty sparsely populated that early in the morning. They made Deb and Joel take off their shoes and run them through the conveyor belt, but other than that and running one of my bags through the x-ray machine twice, we breezed right through.
We made it out to the terminal, had very overpriced McMuffins since we couldn’t eat until an hour after we’d taken our last dose of typhoid oral vaccine pills, which meant we couldn’t eat before we left the house. And then we went to the gate and sat with nervous anticipation and several bathroom trips between Deb and I.
Finally we were on a plane. It was a pretty full flight out to the bay area. Because Washington had imposed flight delays on everyone, we were worried that we might not make our connection to Japan, which is a problem when you are going someplace that only has one flight out per day and you’re on anything like a tight schedule. But it turned out the pilot warned us and the Washington scaled back their restrictions and eventually cancelled them, so, while we were late getting off the ground, we weren’t impossibly so. It was cutting things close at the other end but because it was all one flight number with the same airline, they held the plane to Japan for an extra ten minutes or so before take off. Everyone managed to make it onto the flight successfully, but we did sort of have to scramble through the airport.
The flight out to Japan was also impressively full with, among other things, a very large group of tourists who won trips to Japan for a week. We had one infant and a couple of small children with us on the flight in economy class. They were all remarkably good, all things considered. The infant was really pretty unhappy, but Dad walking it around seemed to mostly take care of it and the baby was not a particularly loud or shrill one.
The seats in front of Deb and I were filled with three of the prissiest self absorbed women I’d ever met. The one directly in front of me slammed her seat back into my knees and then said “sorry, but the woman in front of me put her seat back, so…” as though that somehow explained slamming it back as hard as she could without warning in some useful way that wasn’t already apparent. The three of them refused to put their seats up for the entire 9 hour flight at any point, even during meals or the several times that all three of them traipsed off together to the bathrooms as though they were 13 and afraid of the toilet python or something. The man on the other side of Deb was an exceptionally courteous Japanese man. If we had to have a stranger next to us on the flight, I couldn’t have made a better choice. He was a true compliment to a variety of things about their culture.
The flight seemed to go on forever. Watching movies without sound was very surreal overall. I kept overhearing the strange women in front of us discussing cosmetics. This seemed to be a primary topic of conversation off and on throughout the whole 9 hour flight. I just can’t imagine what on Earth anyone could find to say about makeup that would consume even half the time they appeared to spend on it.
I had asked for the Asian vegetarian fair because my experience with air plane food is that I have often been unable to eat it because it was so prone to things I was allergic to or was so very overcooked that it was impossible to consume and it is much harder to overcook veggies in a way that means they are too tough to eat. This turned out to be a great thing since the woman in front of me never put her seat up once and with it nearly touching my forehead, there was no way to get my tray table down far enough to put food on it usefully in that position. I ended up eating off Deb’s table since they brought the special meals first and then it took them long enough to get back around to the rest of the meals that I was done by the time Deb got her food. Mine was pretty good as airline food goes.
Coming in over Narita it was very clear that real estate in Japan is not much like real estate in the US. Any space that was prime agricultural space was used for that and all of the populations sort of clumped in awkward little corners and strange land configurations around that in the semi rural areas.
Just when we thought that our legs and backs and butts would never again forgive us, finally we landed in Narita Japan. All of the debarkation sights in the buildings were in use, so we disembarked onto the tarmac to a very misty and cool evening in Japan. They had managed to make up some time, despite leaving a bit late to accommodate our earlier connection. We were run back through security at the Narita airport, despite never having left any secured area or anything, which was an interesting statement about Japanese trust for American security screening.
We had a couple of hours to kill at that point before our connection to Bangkok, so we left Joel with the luggage for what was by far the first time (Thank you, Joel, for your patience!) and we wandered around to see what we could see in the airport gift shops. I wanted to buy some things but was being sort of timid about figuring out getting Yen in a foreign country. Deb and I both went and found a money changing spot and got some change for some food and the pillow I wanted, which also meant that she had enough change to then use the internet kiosk to make a live-journal post.
My first impression of the airport terminal in Narita was how very quiet it was considering the number of people there. In the US, you would barely have been able to hear above the din and would have had no choice but to use the official paging system or walking the distance to contact someone at the far end of your line of sight. There, you could have gotten someone’s attention easily by simply projecting a little bit.
While we were there in the airport, Deb and I used the bathroom a couple of times. That was a fascinating experience. As far as I could tell everyone was trying to pee totally silently. The stalls were very narrow, the toilets and fixture, very low to the ground and I swear that there was soundproofing in the walls between stalls. The walls went all the way floor to ceiling and the stall doors did almost the same thing. It was clear that privacy was of an utmost cultural importance, as was technology. Everything that could be an electronic gadget was.
We bought some goodies in the gift shop and returned to wait at the gate for our flight out to Bangkok in a sore, cranky, very tired state. The plane to Bangkok was at least a little less crowded; enough so that the man who was supposed to be sitting next to me, having gotten fed up with the fact we were all crammed together, was able to find someplace better for his very long legs and we got three seats for the flight instead of two, which helped a great deal.
We were still ready to never again see the inside of an airplane by the time that we finally got to Bangkok. I swore that if we ever travel outside the country again, I want to wait till we can afford to do it at least in business class seats instead of having a perma-pain back by the end of the flight. What is it with airlines complete lack of understanding of the concept lumbar support, anyway?
We stumbled blearily into the Bangkok airport, stood in line for what felt like an eternity to me, because I was so tired, and finally showed our passports to the person checking them and went to pick up our luggage and head through customs. We had to stop and ask about what we should or shouldn’t declare since they said on the form that you should declare anything that was worth more than 10,000 baht, which would have meant our clothes could probably exceed the limit, alone, without even counting laptops and things like that. But apparently what they really meant was declare large sums of money or anything that isn’t a personal belonging, such as things you plan to sell or distribute while you’re here.
Once on the other side of customs, it took a little while to find our ride because there were drivers holding up signs at both ends of the very long hallway. Mercifully Wanee spoke very good English compared to most and she understood that McDonalds was probably a necessary peace offering to our digestive tracts after that much airline food.
She had to call a second car because most people do not own SUVs here and we had so much luggage that it wouldn’t all fit in the trunk of one. Joel rode with the other car and Deb and I went together with Wanee. She played an eclectic mix of music that traveled between Thai music to American music with some combined hodge-podges in various places in between. We talked about languages and Deb taught her things about English and various other languages on the way to the hotel in Chon Buri.
We had been warned about the driving patterns by previous Suporn patients, but I actually didn’t find it as terrifying as many people seem to, which is perhaps a strange statement about me. It was a lot like driving in Chicago in that everyone could be assumed to be doing their own thing and probably assumed to be doing the most aggressive things possible for the situation, except that most of them didn’t do it in a way that reflects the American use of the word “aggressive.” They were not angry or rageful or spiteful in the slightest. They just did things very smoothly, predictably and used their horns and lights and anything available to them to help to indicate whatever it was that they intended to do next. She used the horn in advance of an unpredictable maneuver instead of as a statement of disgust after the fact like many of us do. And there was never the assumption that anyone was expected to just stay behind slower traffic or not pass on either side or even on the shoulder, sidewalk, whatever as necessary.
If the corner was congested, people drove through the gas station parking lot to circumvent it in front of the police officer directing traffic, which makes me believe it must have been legally acceptable. People just took any available space and often made one when there wasn’t, but without any apparent malice toward one another in doing so. Lane markings, street signs and stoplights were optional. They existed to indicate that at least three people should be able to pass on a three lane highway and that if someone came up flashing their lights, you should make it possible for them to get by if there were only two of you drifting down the road next to each other but taking up too much space to make it easy for a third person to pass. Places with no-U-turn signs had cops directing people making U-turns at them. A red light meant that someone else technically had the right of way, so pay attention while continuing on through and make sure they see you if you plan to cut them off from using their right of way. It really is a fascinating system that seems to work primarily because it is a cultural assumption away from rage and resentment of each other and toward courtesy and awareness of one another.
Motorcycles are extremely popular because they are so much more maneuverable, but they are also not really motorcycles as we think of them in the US. You just don’t see something that brags it can do zero to sixty in under some particular number. They are more like mini-bikes and scooters and dirt bikes. I doubt very much that more than maybe one or two of the several hundred I’ve seen at this point could even do 70 miles per hour. They are also a form of common public transit that runs at all hours of the day or night. You can find people wearing government or company issued vests with numbers on them at all hours to take you anywhere you want to go, but it is good to know what they expect you to pay before you hop on because all such things are entirely negotiable.
Another form of common transportation during daylight hours are the Tuk Tuks which are basically three wheelers with box carts as the back seat. They seat two easily, smell like hell and if you’re over 5’4” tall the chances are only about 20% that you will be able to see anything at all out the sides because you head is likely to be so far up in the canopy that even slumping won’t allow you to see much out the sides. Early on in our stay, one of the girls from Suporn’s clinic gave us a phone number that was supposed to make it possible to schedule them for transportation, but we are yet to get that to work in any fashion, and generally find it much easier to find one of them sleeping in their cart somewhere nearby the hotel and proceed from there.
There are also very small pickup trucks that have been turned in to public transit vehicles with bench seating and a canopy over the back, and occasionally busses, but usually for foreign tours, as far as I can tell. By far the most common thing is transportation by motorcycle. So much so that it is extremely common to see women in nylons and heels and small tight skirts headed for work driving one or services carrying women and children leisurely sitting sideways on the back of them with their various bags, etc. They manage to pack an amazing amount of stuff on these tiny bikes (about half the size of a US motorcycle). At one point I saw a wrinkled older woman with a couple thousand limes wedged between her and the faring and steering mechanism at 5am, presumably headed to market to sell them.
They hotel is very nice and the people here are exceptionally friendly if often struggling to understand us or be understood. But most of them know someone who speaks better English than they do to help, or they have enough passive understanding to at least use body language to answer questions. The Tuk Tuk drivers, for example, seem to not understand how to speak English other than to say “yes” and “no” and “hospital” and “hotel” and such. If you ask them how much something will cost, they hold up their fingers for the number in the tens place for the amount they would like, such as five fingers for fifty baht.
The natives are clearly extremely pleased by attempts to comply with their culture or language. If you bow the way they do or learn a few words of their language like their perpetual greeting, they absolutely love that you’re trying. They are such a friendly people that it seems to please them intensely to find that they can communicate with you in some way and be helpful or kind.
Everywhere that you go, no matter what the architectural style of the facility you are in, there are little nooks built for their religious shrines. The lobby of the Mercure hotel is done in very modern American stylized lines and asymmetrical fixtures and much open grandeur and in the midst of it all are small accents original to their country, and always the nook no matter how seemingly incongruous for their altars.
Once we got to the hotel upon arriving, we managed to communicate with Wanee’s help, enough to get us a non-smoking room. They didn’t understand that we needed a third bed initially, presumably because two much smaller Thai people would happily sleep in what is only ever so slightly wider than a twin bed in America. The very young (15?) bell boy who lugged all of our luggage upstairs and set up the bed apologized for himself and stumbled over himself through-out the process making me wonder what he imagined we expected from him. We gave him what was, to him, an extraordinary tip since it was the middle of the night and he was clearly trying so very hard to please us and our luggage probably weighed as much as he did. He has now become our new nighttime friend any time we need something in the middle of the night.
The next morning, or rather, later that morning as we didn’t get to bed until past midnight, Wanee met us to take Deb to the clinic to pick out her boobs and then to the hospital to check in. We met some of the other TS patients while we were there in the clinic and several of Suporn’s staff which was made up of a lot of very cute young women, primarily. We joked with them about Deb’s nipple rings and how big her boobs should be. And we turned over the load of traveler’s checks that we had had so much trouble getting taken care of for the trip. They were all in my name and they told me probably 15 times to try really hard to sign them as close to the same as the original signature as possible because the bank had apparently just refused to take some from someone else whose signature looked too dissimilar to the original which had turned into a royal pain for them.
We went from there to the hospital and Deb was poked and prodded and then admitted. She was hyper and nervous but mostly happy that she was finally getting to do what she’s known for some time she really needed to do. We all met Dr. Suporn who was a very nice man who is probably genetically advantaged in his chosen profession because he has very small hands. He was clearly a kind man who was very concerned with the people he cares for and wants very much for them to understand their risks. He is very careful to attempt to make sure that they are realistic about the expectations, the pain they will face, the results he will get, etc. He is so conservative on the subject that he almost shoots himself in the foot in a sense because he really is extremely talented at what he is doing and it comes across as not giving himself enough credit to some degree.
He examined Deb and talked about the fact that he never does the colon surgery variety of SRS, even in the case of those unfortunate enough to have been unthinkingly circumcised as children, because he feels that a compromise of a smaller vaginal cavity and dramatically less physical trauma and biological risk is better for everyone involved. Many surgeon’s won’t work on someone like Deb without doing the surgery wherein they take out a section of your colon to use as the vaginal walls because they were circumcised as children. But Suporn guarantees at least 5 inches of depth in his patients, even if they are circumcised and prefers that with some dilation to the risks and dramatically higher risks involved in the other sort of surgery.
He showed Deb pictures of his results as well as genetic women and made sure she understood that it is not like picking a nose out of a book. The results will vary because the structures are not built of bone and cartilage and the patient doesn’t exactly get to pick what it all will look like in the end.
Normally he uses the penile hood to build various structures, including inner labia, but that is impossible in someone who has been circumcised. Deb is fortunate to have had enough other skin available that he did not have to omit inner labia, but the trade off was that there was some chance that some hair follicles might survive on them. He wanted to be very sure that she was okay with that risk and understood all of what was going on and why.
He gives everyone literature about expectations and frequently asked questions and in it he has to warn his patients that his technique continues to evolve and is increasingly complex and that recent patients have reported that they have experienced extreme pain during stages of recovery because the nerves are so well preserved that you feel EVERYTHING rather than going through stages of numbness as is generally expected with some SRS surgery.
One of the adaptations he has started doing is that he includes some of the nerves around the head of the penis as tissue around the urethra, as well as building a clit and what is functionally a G spot out of them. He smiles while explaining that this ends up leaving you actually more sensitive than a genetic female in many cases.
It is very clear that he is both proud of his work and cares deeply that his patients still have functional sex lives and positive results as often as humanely possible, which doesn’t seem to be the impression you get from patients of many of the North American surgeons who many of their clients feel are only in it for the money at this point. I wondered coming over here if his advances were merely a result of understanding that he had to be more technically advanced in what he was doing in order to attract people to Thailand to deal with language barriers and additional fears, or if he really cared.
It was clear upon listening to him talk to Deb, that he really does care a great deal about his patients and takes great pride in what he does. Don’t get me wrong. I’m sure he is an extremely wealthy man by Thai standards at this point, but I also think his concern is genuine. I personally suspect that some of this is cultural. There does not seem to be as much of the stigma about cross dressers and transsexuals and drag queens, etc, that there is in the US. They seem to focus so much on what there is to enjoy in their every day lives, as a cultural thing, that they do not spend the energy on condemnation of others that many of us in the US seem to.
Once her meeting with the doctor was over, Deb had a lot of pent up nervous energy. I don’t think he really told her anything she didn’t already know from having done lots of research about him and his technique, but I think it became much more real to her, having him point to her genitals as he explained and hearing it from him directly. Watching her afterward was making me tired on as little sleep as I’d had and how much energy she was expending, grinning all the while.
Most of the staff seemed baffled by the idea that Deb wanted us to try to be back at the hospital in the morning before she went into surgery, and didn’t seem real hopeful that it was possible, but we managed to get back up at about 4 am and get our friendly nighttime bell boy to help us get motorcycle rides to the hospital. We walked past the nurses’ station full of cute little Asian women completely asleep under blankets with their heads on pillows. Deb was awake and glad to see us. We talked and played with her hair and mostly distracted her from her nervousness for as long as we could until they needed to put in an IV and start surgery prep.
Joel and I went back to the hotel and mostly killed time. We had breakfast and went and wandered around the market. Imagine if the flea market were made a permanent fixture in the lower level of every hovel nearby. Something like shopping in China town in New York city, interspersed with all sorts of tiny general stores and car parts dealers. Most didn’t take up more than maybe 100 square feet. Many were dirty and a completely bizarre mixture of goods that made little if any sense to the casual American observer.
There were beggars on corners with stacks of toilet paper someone had donated to them, hundreds of little food vendor carts with raw food sitting out in the sun, waiting for a customer, growing salmonella, etc. There were young people of all ages, running about. Most school children were in uniforms, as were most of the well dressed women. Professional women working for large companies seem to almost always be found in uniforms of one sort or another, many of them making them look terminally 13 years old because of the very school girl style to them. Some men wear uniforms as well, but less commonly as far as I can tell.
Eventually we managed to get back to the hospital after some interesting times trying to call a Tuk Tuk, and Deb was awake by that point and our of surgery, back in her room. She was very groggy in her morphine haze, but she was doing pretty well, sore, but not in too much intense pain, and very glad to see us. We helped navigate some of the early communication struggles with nurses when it mattered the most because she was still in too much pain to turn on her side without help she couldn’t explain well to the nurse and those sorts of things.
One of the employees of Suporn’s clinic had an unemployed friend who could use some money come to the hospital to get us and take us back to the hotel that night, after much petting a very groggy Deborah, since we’d managed to stay longer than the Tuk Tuk’s were still available. It clearly made her week that we paid her something like 100 baht which was all of a couple of US dollars.
Wanee stayed with her the first night because she is both a nurse and speaks better English than most of the nurses. We went back to the hotel and had dinner with several of Suporn’s patients who are also staying there and are further along in their recovery. One of them was a delightful woman named Joan who had the misfortune of being born with genetics that made her something like 6’6” tall. She didn’t transition until she finally pulled herself out of a thirty year alcoholic haze. She had wanted a whole series of surgeries along with SRS but because of her age and the alcoholism, the doctor talked to her for a long time about the fact that she was exposing herself to a very high risk by doing everything she wanted to do to help herself pass more effectively. She decided somewhere along the way that she was better off accepting herself than risking her life for cosmetics, and she was therefore a very self confident and interesting person to talk to with a very good sense of humor.
Two of the other TS women appear to be from England and at least one of them if French. There is one more who is some indeterminate variety of Middle Eastern or Asian originally, all at varying ages and stages of recovery and more or less obviously TS to the rest of the world. But all have carried themselves with dignity and pride in the short time that I have known them, running in to them at most meal times or whenever we’ve stopped in to Suporn’s clinic. It has been sort of neat to see them all care for each other emotionally because they all have spoken more English than most of the staff and have treated each other like sisters despite having known each other for so short a time. The ones most recovered have helped those just out of the hospital adjust and given them tricks they’ve figured our or learned from those who have already moved on to Pattaya or gone home. All of them seem to think it is cool that both of us came over here with Deb and most seem to wish that had been a possibility in their own lives. The nurses also seem to think that is part of the reason she is healing so fast.
She is already only taking the opiates maybe every 8 hours instead of every 4, and her range of motion is extremely good at this point. She says it’s wild to be able to feel what she remembers being distinct sensation points from her previous genitals in distinctly new locations and she continues to complain about how intense the sensations are down there and how that is both a very good and a very painful sign right now. But the doctors are ecstatic at how fast she appears to be healing overall.
Communication with the natives has been interesting, and while probably remarkably easy compared to many places in the world, frustrating at times, but as much because Joel has been so very uncomfortable functioning in another country, as for any other reason. I’m letting myself feel too much pressure to solve it for him because he is so unhappy with dealing with any of it, grouchy about it, etc., combined with being a little timid at being effectively otherwise alone in a foreign country if I don’t take him with me places. I am looking forward to my adventuresome Deborah being available again, if even only for short periods for a while.