Emergency in a Foreign Land: The Horse and the Fall (Part 2)

I could have hit my head or my neck. I could have been kicked by the spooked horse, or stomped on. I’m lucky. I know that. But the pain of bumping along dirt roads and washes for dozens of kilometers exhausts me so much that as soon as we hit paved road I collapse into an uneasy sleep, 40 kilometers from Ulaanbaatar and major emergency infrastructure. Not a great sign.


No bathrooms for miles. In Mongolia you have to get good at finding little hidden spots (sometimes the far side of your vehicle) and copping a squat. Which is fine, until you lose the use of an arm.

Foolishly, I tell my guide we should go on with the plans for the rest of the day. In retrospect, I am glad to see the music show. I wouldn’t have wanted to skip it, but regretful that I was in such pain. There is nothing more stirring, evocative, or exciting to me than Mongolian chant and throat singing. Especially when they break into harmonies. But each time I sit, or have to leverage myself in and out of the SUV, every time I breathe in fact, I feel the burning pain in my shoulder. And I note that, strangely, my bra strap will not stay in place.

We probably should have gone straight to the hospital when we returned to Ulaanbaatar.

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One of the last few tourist stops, while injured.

That night, as I lay in my nightgown in my hotel room, carefully, ever so carefully, exploring along my shoulders with gentle fingers I find the issue and finally admit something I’ve known since this morning. Something is very, very wrong. Maybe not a broken bone, but very wrong.

My phone has since died. There’s been no place to charge it in the middle of the steppes and a local family’s ger, or the monastery or performance…. When I get a few bars of charge I find my Mongolian SIM card is also a bit on the fritz. Desperate, on the brink of tears and chanting to myself “it will be ok, it will be ok,” I go to the hotel reception and have them call my tour guide. It’s 9pm at night and he’s at home with his fiance and baby for the first time in five days.

“I need you to come get me, Ching. I have to go the hospital.” To his credit, he leaves immediately.

Somehow, by some miraculous twist of technology, my SIM card kicks back in. (I’ve tried the Thailand one already to no avail.) I raise International SOS for the second time that day. Rather than being sent to a local hospital, they have a clinic in Ulaanbaatar and send us there.

Ching has to fill in most of the forms as I’m barely able to lift my arm at this point, much less write. But it’s clean, quiet, I am the only patient (in fact they’ve opened the clinic for me) and everything looks top notch modern. The clinic sends an ambulance for the doctor and I’m both relieved to the point of tears and a bit ashamed of my reaction to see a Westerner arrive. My doctor has been in Ulaanbaatar for a week now and is on a rotation from Seville, Spain.

Under better circumstances I’d recognize his height, intelligence, and what must be a fascinating story to bring a Spanish doctor to Mongolia as exactly the seductive combination that attracts me like a moth to a light. As it is, I am simply painfully relieved he speaks English and, as he wakes up and regains a bit of his own personality, competently directs the staff to call in technicians and open up more of the clinic. I need x-rays, then painkillers, anti-coagulants so I can fly, and as I seem “a bit stressed” anti-anxiety meds. Plus a brace to hold my shoulders together.

I’ve dislocated my collar bone, but it’s not until I’m back in Bangkok two days later, after a grueling two flights through China, losing my patience with Beijing security, and finally accepting that no over-the-counter painkiller is sufficient that I head to the hospital here. And am told I have a grade 5 AC joint dislocation. There are 6 grades to this injury. One to three are the most common. Four, five and six all require surgery to repair. I have essentially sheared through every ligament and muscle attached to my collar bone. I’ve thoroughly mucked up my body.

I haven’t even been to the clinic in Bangkok for a cold. I’ve never had surgery in my life (except for my wisdom teeth.) All the doctors here are Thai and though they speak English, I feel very, very alone.

The first surgeon I see is very Thai. And so he is smiling and speaks lightly as a way to reassure me. But as soon as I hear “surgery” the bottom seems to fall out of the hospital, and the rooms keep growing while I am shrinking. The pain suddenly has a specific name and frightening resolution. I can’t understand why the doctor doesn’t have a graver attitude. Doesn’t he understand how serious this is? He doesn’t sound like he does. It’s the first, but not the last time I will feel intensely vulnerable and dislocated. Our cultural differences are too hard for me to see past right now.

My HR rep brings me lunch and offers to connect me to a friend of hers at another well-known private hospital. That night I call my family in the US and ask them to speak to doctors they know there. Everyone agrees that surgery is necessary and no one has a recommendation to a doctor in Thailand or Singapore. I don’t think I can manage the flight back to the US. So I see the doctor at the other hospital, who has at least spent 2.5 years in Britain and is used to Westerners, has a significant amount of experience and, as he doesn’t have to be the one to break the surprise of surgery to me, is much more comfortable to be around.

After some discussion with my family, my father flies to Bangkok to be with me and the surgery is scheduled for 7am on Tuesday. 8 days after the fall.

In the end, it all works out. The medical care in Bangkok is as good, and in some ways better, than the care I would have received in the US. For example, my surgeon (not the nurse and not his assistant) reviews and cleans my wounds personally every few days. But I have some very rough moments where fear and terror overwhelm me. What if I don’t wake up from anesthesia? Why doesn’t the hospital room look like what was described? And one night, although I had been enduring relatively well, I react with pain to the antibiotic IV and dissolve into sobs, as I have been riding at the edge of my endurance now for days and I’m incapable of handling anything else.

But after a few days in the hospital, and then a week of rest at home – which is not at all a straight line – I am without a doubt improving.

An injury abroad like this is terrifying. Had I not had the International SOS service (which my company provides to its expats) I would have been facing an Mongolian hospital with staff who likely spoke very little English. Pain like this is terrifying. But I also discover one night while lying in the dark, my mind running in desperate circles from the random memories of the hospital like being wheeled into the operating theatre or falling asleep against my will, that my identity has been soundly bruised by this experience too.

I am terrified I will be too frightened to travel again. And a huge portion of my identity now is my love of travel and my confidence to do so solo. Have I just damaged a critical part of my identity?

As I write this, it’s now two weeks post surgery and my shoulder and sense of self is healing. My planned trip to Nepal in August will have to be rescheduled for 2017, and my tentative September plans won’t materialize either. Which is practical from a physical standpoint, but seems to be practical from an emotional one as well. I will have to start small again in my travels to rebuild my confidence the same way I have to slowly rebuild my mobility and strength in my arm. I will take a short work trip in September as a baby step, see some familiar faces in Singapore and I’m starting to cling to my October and November plans with less and less of a white knuckled grip and instead increasing anticipation. It gives me hope that along with the months of physical healing I still have ahead of me, the emotional and identity healing will also continue to progress. And that I have not, after all, permanently broken something in my self.

But I’ll be darned if I’m going to get back on the horse that threw me any time soon.


2 weeks post surgery and out for a quick drink with my father before he leaves for the US

*side note – the cover image for this post, unlike most other photographs on this blog, is not mine. I was not exactly in the frame of mind to photograph anything right then. 


  1. Beth White

    August 13, 2016 at 10:58 am

    Oh my gosh, Kate! What a story. Your fear in the thick of it is so understandable. I’m glad you’re recovering in all the ways you need to to get back out there.

    Thanks for the Bangkok tips you gave to my friend. I feel bad because you must have still been in pain! I had no idea how seriously injured you were. Sorry!


    1. Kate

      August 13, 2016 at 11:03 am

      Happy to help! Don’t worry about the Bangkok request. I was in denial for a little while as to how injured I was anyways :). Hugs!

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