Springtime meanderings

The blossoms of Istanbul are just making an appearance, and each sweet fragrance brightens my soul as the rest of me recuperates from back surgery. I’ve decided I’m hyperactive—recumbence has been more than a challenge. I try to recognize my body’s messages, and I mostly listen. We all do the best we can, don’t we?

spring daisies

My first major outing was a little over a week ago (two weeks after surgery) with my canine pal Libby. We trekked along our cobbled street, and before I knew it we were hiking up the next high hill above the Bosphorus. Go figure! I’d often gazed across at the beehives and winding road up to the electric tower, but never really headed up there. It was a slow, yet lovely walk. We watched a woman gather grasses (herbs?) near the beehives, then reveled in the stunning view over the Bosphorus.


our herb-gatherer


and her hillside beehives.

P3130022Our electrical tower


and the view over the Bosphorus

When we finally returned from our hike, I’m not sure which of us was more exhausted; we collapsed happily together onto the couch.

The next morning I walked down to the Bosphorus to meet my young friends Aşkin, Soner, and Ebru for breakfast at the Fincan Kahve. I’ve known Aşkin and Soner since my first year in Istanbul; they were engineering students seeking an opportunity to speak English, and my friend Terri and I were willing “tourists” eager for a Turkish connection. When these handsome young fellows first met us, they didn’t miss a beat. In spite of our age (no spring chickens, we) they were warm, gracious, and ever-attentive. We’ve been friends for five years, and now Soner’s girlfriend Ebru has joined the mix. A medical student, Ebru is always beaming—a delight as she struggles to improve her English.

We lingered over breakfast, then decided to check out Emirgan Park, famous for its spring tulips. It was a bit early (only a few tulips had opened), but we enjoyed a lovely walk through the grounds, as well as a steaming cup of sahlep to warm our bellies. YUM! Love that stuff.


Ebru and Soner

P3140063My handsome friend Aşkin


Libby and me

Monday was my first day back to school, and it totally exhausted me. Thank goodness they moved my office and some of my classes down to the main floor; I’d never have managed  my usual 300-500 stairs. I slogged through the day, dragged myself home, then collapsed on the couch. Whew! It was pretty much the same routine every day, teach—couch, teach—couch, teach—couch. I felt fine, but I tired so easily! Hmmm…

On Wednesday I took a nap after school, then joined a few friends for a classical concert at Bosphorus University (since it just involved sitting). Well, let me tell you, it was one of the most impressive concerts of my life. Seventeen-year-old Kim Armstrong, a phenomenal pianist (Can you still be a prodigy at 17?) played with the entire Istanbul Symphony Orchestra behind him. I have never experienced such a stirring piano performance in my life, and young Armstrong barely looked at the keyboard. My goodness! I’m honored to have seen him. I know he has videos on YouTube, so if you happen to be in a country where you can get it (not Turkey), check it out.


Kit Armstrong

A video link to Kit Armstrong at age 10

Kit Armstrong performs his own composition on Letterman

On Friday I came home at noon for a nap so I’d have the energy to go to the airport and meet my friends Shelley and Donna. I know, I’m pushing it, but heck—Shelly and I have been friends for over 50 years. Big hugs when they finally came through customs, then we hopped into a taxi for a VERY long ride home. Istanbul traffic never ceases to amaze me at its ability to remain endlessly stationary. Sigh…

P3200037Donna and Shelley a la mosque visit

They settled into my apartment, then we walked downtown for a leisurely dinner at the Abracadabra Restaurant. Delicious! I love that place.

Saturday we lollygagged in my sun-drenched apartment, then hiked up for a tour of the Robert College campus. Afterwards we hopped a bus to Ortaköy, a charming nearby community on the Bosphorus. We visited the Ortaköy Mosque (one of the brightest in Istanbul, glittering with chandeliers).


The beautiful Ortaköy Mosque


Its interior vertically…

P3200024…and horizontally…

Women's room, Ortaköy Mosque…and the women’s chandelier-free prayer room.


This lovely gem from the outside–Ortaköy’s pride.

Afterwards we wandered the streets, indulged in kumpir (baked potatoes with EVERYTHING on top), basked in the sun-drenched deck of a Bosphorus ferry, then finished the afternoon with a Starbuck’s coffee and a delectable fruit-filled waffle. YUM!


Shelley dives into a kumpir–baked potato with all the fixin’s


Neighborhood soccer pros playing on a street near my apartment

P3210090Yes! A perfect kick!

I continue to be busy as I recuperate from my surgery, and every day I’m feeling a little better. I can’t wait to see what we explore next weekend. Shelley and Donna are staying in Sultanahmet, and I’ll hook up with them on their turf.

Until then, maybe I’ll just hit the couch…

Health care comments from Turkey and the U.S.

I was astounded at the many warm thoughts that came my way after my surgery, but even more intrigued by the astute comments about health care in both the U.S. and Turkey. I decided to post them in my blog so you can peruse them as well. Pretty interesting–and they run the gamut.

I’m recuperating well, and I go back to school on Monday, just two weeks after my surgery. Amazing.

Though I think I’ve spent some lazy weeks at home, I haven’t wasted all my time. I’ve finished knitting a sweater and most of a vest, read five books (a few on my Kindle), watched videos of House, The Wire, and Monk (thanks to kind friends), and solved innumerable Sudoku puzzles. I’ve also corrected three sets of papers for school, read and prepared for discussions on Animal Farm, and written an article on Istanbul for U.S. newspapers. Whew! Give a woman a few weeks to herself…


A photo of my tangible Recuperation Accomplishments

…and my sidekick Libby.

– – – – – – – –



Jacqueline Mallais, Istanbul teacher

So glad to hear you’re doing okay. Your stay at the hospital sounds like mine when I had a cyst removed there a few years ago – 5 stars all the way! I was told that flowers weren’t allowed in the rooms because of potential bombs being planted in the flower pots… or was that my strange understanding of their Turkish explanations?! Happy recovery, Ann Marie!

Terri Bakken, Mexico City (former Istanbul teacher)

I hope you are mending and feeling better every day.  Sounds like you went through a lot!  Am especially glad your hospital stay was so cheap.  I remember just having to pay for meals, which I think came to around $25, what with the extra meals for my nonexistent guests.  Our health care here (in Mexico) is not nearly as good.  Hence, we hardly ever see doctors.  Every illness has to be paid at around $250 before the insurance kicks in, so if you get a cold and then another in a couple months, it is a separate illness.  So, we often just ask a pharmacist to prescribe something if we are not dying!  And wellness is not covered at all, so if they run tests for something and don’t find it, you pay.  I think  I told you medicine is often expensive.  Sure wonder why meds aren’t high in Turkey, when everything else from foreign countries is?  But that’s a good thing.  Medicine should be cheap.  (One of our first grade classes closed today because of the flu, but we haven’t had any closures in months.)

While your hospital room was very nice, mine (at Johns Hopkins hospital in Istanbul) was swanky.  Totally deluxe.  Perhaps the Johns Hopkins hospital is newer.  Looks like yours was really comfortable, though.  And I am glad you had such good doctors and nurses.

Mike, English teacher in Izmir, Turkey
Blogsite: http://nomadicjoe.blogspot.com/

Happy to hear you made it through ok. Like you, I think I would be scared witless if I had to undergo surgery in Turkey. I had a minor heart glitch- stress and poor diet- and had to go to a hospital here. I was sent to the 5th floor and the elevators weren’t working. That in itself might have been the test. “You made it. You’re ok.”

But your stay doesn’t sound bad at all… if you don’t include the pain, of course. Geçmis olsun.

An anonymous friend, former Istanbul teacher

It’s good to hear from you, though I’m very sorry that the context is that you’re in trouble. I know exactly what you’re going through; it’s nightmarish, especially for such an active person as you and I don’t see how you could tolerate this level of pain and disability for much longer.

I’m always reluctant to advise anyone about anything! But my own personal experience with the American Hospital was outstandingly good. My surgery was very complex and the surgeon – Dr Mehdi Sasani, an Iranian – used techniques which aren’t yet available in the States. It didn’t cost me a cent, as the insurers covered it fully. I haven’t had as much as a twinge of discomfort since the operation – I feel rejuvenated by it,in fact – and I recovered a degree of flexibility which I hadn’t had in years. So I feel that you should go for it; lower back pain is a crucifixion that nobody should have to put up with.

Gilbert Evans, science teacher, Koç School, Istanbul:

Don’t ever put down Turkish hospital care. You’ll only confim in the minds of those readers who don’t live here that Turkey is backward in this regard.

As our friend [above] told you, his operation was a great success, and a cutting edge (excuse the pun!) technique. Have you forgotten about Leonard [Gilbert’s son]?! Open heart surgery on a two-day old baby! – in Bakırköy. My carpal tunnel release operations, done at Acıbadem hospital. There is no reason, other than personal prejudice, why anyone should need to travel ‘back home’ for an operation. In fact, many of the private hospitals in İstanbul have patients coming in from other countries because of the good value for money they represent.

As for the cheap medication, that’s done by government subsidy. Something that President Obama is trying to do for the US, finally.

Melissa Altintaş, teacher, Istanbul

I have to share my recent experience last summer with my father after he suffered a major stroke in a hospital in Ohio — and in which he fell out of bed because “they were understaffed and couldn’t didn’t have anyone to sit next to him” even though he was labeled a fall risk. That and my experience three years ago when Orhan [Melissa’s Turkish husband] had a double hernia repair at the American Hospital and Pelin’s experience of having a baby at the American hospital (they even sent a hairdresser to cut and blow dry her hair after the birth!) have all left me feeling less worried about the possibility of ever having a major health problem here in Istanbul instead of the States.  I actually think I might prefer to be here in so many ways.


Ani Pierpont, writer, California
You are [not] missing out on all the fighting here on who justly deserves medical services.  I think the far right would feel that your pain was from some evil thought, thus no help for you.  The far left would pay for all care because no one should profit from someone’s medical misfortune.  We will get some “mashed potato” in the middle that I believe will not help much.  Americans don’t travel to foreign countries enough to know how we are getting screwed on pharmacy costs, not to mention all medical costs; $1.60 there $150 here—ouch.  Single payer is out of the picture, and I think that’s the only way to go.  When I hear how great our medical facilities are [best in the world] I laugh because, as you found out, they’re doing just fine elsewhere, and even better than here in many instances.

A place for the friend to sleep!?!?!  Where!?!? Two years ago my father had heart surgery in San Francisco, and it was an hour and a half to get there each day to help out.  I got him out of bed and moving, then walking around the hospital to build up strength.  Got him extra fruit and food from the cafeteria to make sure his diet was balanced, made sure he sat up in a chair for awhile and then did the breathing exercises so pneumonia wouldn’t set in.  He was out of there in record time to the surprise of all [at 89 only 9 days.]  I was a wreck from the stress, being there all day and the 3 hour commute.

I’m so happy for you to be out of pain.  By the way, what did all this cost a foreigner? Americans need to know.  And you didn’t pay $100 for the toiletries!?!?!!! wow.

[Note: My entire surgery, doctor fees, lab fees, and 4 days (5 including the surgery day) in the hospital cost a total of $13,000. I paid $2000 on a co-pay. A.M.]

P.S. from Ani on Health Tourism: In today’s on-line Zaman site there is an article on Turkey as a medical destination with 33 hospitals accredited, more than any other nation!  Turkey has a “superior health care infrastructure” it goes on to say, and 200,000 medical tourists come each year!!!!  WOW!!!  They pay 30-80% less than in the U.S.  You found this out the hard way but now your recovery is almost in the ‘rear view mirror.’

Anonymous friend, Grand Marais, Minnesota:
So glad you are mostly out of pain.  Amazing story of their health care system.  Why can’t we get some of that kindness (people able to stay in your room) and the low drug costs.  We think we are so above other cultures in so many ways, it drives me nuts how naive we are.

Anonymous friend, rural Minnesota

Actually, I just read in the paper the other day that Minnesota, under Governor Pawlenty’s leadership, is currently ranked 43rd among the states in our nation for overall medical care for our citizens.  That is very alarming, and of course, the poorest among us are also receiving the inferior care.  I’m sure you’re aware of the GAMC debate that continues to go on here.

Mary Bebie, Grand Marais, Minnesota

We, Roger, Badger and I, are so sorry to hear about your back.  So glad you were able to find a doctor that was able to help you so quickly.  We do hope you are back on you feet soon.  We were so impressed with the hospital and drug prices.  This is an American dream.  Do rest and heal quickly.

Christy Buetow, Grand Marais, Minnesota:

(recent heart transplant recipient at Mayo Clinic in Minnesota)

It was so good to get your e-mail and read your story.  Annie had let me know about your back and need for surgery.  I’m so glad that things went well and that you’re recovering well.  It’s so interesting to me that we ego-centric Americans think we’re the best at everything without giving credit to the skill, training and innovation of other countries.  It seems like you’ve just experienced that first hand.

Tom Mathews, retired journalist, NY

Your report on the American Hospital and the followup from your friends was fascinating. The NY Times Travel section should run your story. Everyone in this screwed up country of ours that still believes we have the absolute Number One Best health care system in spite of all the evidence to the contrary and who insists on seeing hospitals abroad as hell holes should read your story.

An Insider’s View

I’ve had a rare insider’s view of Turkey this week, although certainly not by choice. In fact, if I could have avoided it, I would have done so wholeheartedly. It’s been a rough week.

Last Sunday I woke with an ache in my lower back. Had I slept wrong? My Grand Marais guests Dominique and Sophie were heading across the Marmara Sea with me to visit the hot springs at Termal, so I shook them awake and hiked down the hill with Libby to find a taxi. I felt fine on the ferry crossing, although Sophie was a little nauseous from the wild seas. Our friend Gizem met us with warm hugs on the other side, announcing that the ferries were cancelled for the rest of the day. Sigh… That meant a bus ride home to Istanbul—AGAIN!


Sophie and Domique outside the Grand Bazaar

By the time we got to Termal, my back was pretty sore and pains were shooting down my thigh. Oh, for a massage! After soothing myself in the hot waters of the hamam for an hour, I hit the massage table. It was a pummeling treatment, but I thought it helped. That is, until I stood up.


I found temporary relief in Termal’s warm outdoor mineral pool.

The long and short of it is that the pain was becoming so intense that I could barely walk. Gizem’s mother gave me a pain-reliever she uses for back problems, which seemed to help. The three-hour bus ride around the Marmara was barely tolerable. I hobbled off the bus at Harem and hailed a taxi for home, worried about Libby’s 12-hour cross-legged wait. Poor baby. Needless to say, she was thrilled to see me.

My friend Amy agreed to take Libby for a few days, and she also accompanied me to the emergency room of the American Hospital, a private hospital in Istanbul where most of the staff speak English. Bless her heart.

American Hospital

Amerikan Hastanesi–the American Hospital, from their web site

The doctor there gave me a shot of pain-killer. Nothing. They stepped up to the opiate level, which mildly eased the excruciating pain in my thigh. Was it sciatica? He didn’t think so, as it was the front of my leg. He sent me home for a few days of bed rest with a some pain pills and four prescriptions. I thrashed through the night, each relief-seeking movement bringing throes of agony. Oh, my. I went back to the hospital for an appointment with my orthopedist, Dr. Onur, on Wednesday morning (doctors here are called by their first name, like Dr. Mike). He brought me to Dr. Nazan, the physical therapist, and after an excruciating exam, she ordered a series of MRI tests on my back and neck. By 3:00 I was back in her office with results—time for surgery. I was shocked. Surgery? In Turkey? I couldn’t imagine.

MRI-herniated disc

My MRI, showing at the V where the disc had hernaited into the nerve cavity, cutting off the nerve. ARAUGHHH!!!!

Be assertive, I told myself. Insist on a flight back to the Mayo Clinic in Minnesota. I had always promised myself that any major surgery would be done there, as my parents were firm believers in the Magic of Mayo.

Then reality set in. It wouldn’t be easy to set up, and there was no way I could manage an overseas trip with the pain I was in. It just wasn’t an option. I e-mailed a friend who’d had a complicated back surgery in Istanbul, and he responded promptly with laudatory praise. He said his American Hospital surgeon “used techniques which aren’t yet available in the States. I haven’t had as much as a twinge of discomfort since the operation – I feel rejuvenated by it, in fact.” My school director at Robert had also had back surgery similar to mine, and he assured me that his procedure went smoothly and well. He had every confidence in the system.

I was convinced.

Dr. Tunç, my neurological surgeon, explained that they could repair my problem with microdiscectomy, a fairly non-invasive procedure that would remove the herniated tissue compressing my nerve. The recuperation time would be only a few weeks, and the pain would be alleviated immediately. Whew!

Thursday I madly prepared lesson plans, and Friday morning I called a cab to the hospital in time to check in at 7:30. There was a possible surgery slot at 10:00 AM, and a certain one at 3:00. They immediately settled me into a room, where I adopted the fetal position, curling my spine to lessen the pressure on my nerve.

The room was nice. It was a private room with a high-tech hospital bed, a brown corduroy couch, and a cherry upholstered straight-backed chair with a matching side table.

room view

Nice digs–$300 a night, double occupancy, including meals (and wireless).

I had a small refrigerator, built-ins for my clothing, a wide-screen TV, and a massive bathroom supplied with hotel-type toiletries. My sixth-floor picture window overlooked the rooftops of Nişantişi, on the European side of Istanbul. It was gorgeous. (I later saw that my room was a very basic one. Many of the rooms were suites, with a separate living room area for guests as well as the main hospital room. Pretty posh. I think the American Hospital has only private rooms.)


Room fee also includes toiletries…

window view

…and a great view.

But then, there was the waiting. No food, only tiny sips of water, and too much pain. As with childbirth, I promised myself it would soon be over. My nurse Tuba did her best to interview me about my medical history. Her English was limited, but we managed.

Most of the staff spoke English, and my minimal Turkish was enough to “chat” with orderlies who wheeled me to various pre-surgery tests. I was too miserable to read, but occupied myself with an audio book. My greatest fear was that they’d make me lie flat for the surgery, but I was “feeling no pain” long before that happened.


“Ann Marie! Ann Marie! Ann Marie!” Through a haze I saw smiling faces welcoming me back to reality. A nurse removed my oxygen mask. “I’m so cold!” I said, shivering uncontrollably. Suddenly warm air enveloped my body, soothing me  as it was blown beneath my blankets. I drifted back off for a few moments, then realized they were wheeling me back to my room. NO PAIN!!!!

I was groggy, but elated. My legs were stretched straight out for the first time in a week. Without pain. I grinned as my new nurse, Nurgül, gave me a sip of water and took my stats. “When can I eat?” I asked her.

“Only small sips of water, and no food until 10:00,” she said, “because of the drugs. They will make you sick.” It was 6:00. I hadn’t eaten in 24 hours, and I was famished.

Nurgül brought me a tray around 9:00, dear heart. Two ceramic bowls—one with bland chicken soup and the other with chilled pear juice. Manna from heaven. At 11:00 an orderly brought in kahvaltı, a Turkish breakfast of cucumbers, white cheese, and bread. Solids. Yum.


My last meal in the hospital–a bit more substantial!

I slept through the night, except for the usual nursely interruptions for stats, and woke at 7:00, energized and ready to go home. Well, not really, but I was thrilled to be pain-free.

I was surprised when the caterer (dressed in vest and bow tie) brought me two meals. “Arkadaşım yok,” I infomed him. (I don’t have a friend.) The Turkish hospitals assume that you will have a refakatçi, a friend or family member who stays in the hospital with you. The fees at Amerian Hospital include a bed and meals for that person. In fact, each evening an orderly came in and offered to make up the couch into a bed for my imaginary friend. I declined. My friend Amy told me that the Turks had the highest survival rate of all injured European soldiers during wartime, and it’s thought to be because of this refakatçi system. Makes sense.

On Saturday my energy continued, fortunately, because I had visitors. First was Berk, a student from my core English class, with his mother and sister. They brought me a certificate for flowers that waited for me in the flower shop on the main floor. Apparently the hospital doesn’t allow flowers in the room. HUMPHH! Dangerous microbe-laden carnations? Strep dahlias? Oh, well. Another difference that I didn’t much care for.


Get well (Geçmiş olsun) notes from my LP1 Students

I was also visited by two couples from campus, each bringing me a soy latte from Starbuck’s HOORAY! Three girls from my core class (Bala, Esin, and Ekin) brought another flower certificate and a huge box of scrumptious chocolates, which I happily shared with visitors, nurses, and any staff who came into my room.

Well, I got better, although after that first day I had little energy. The doctor said it was because my liver was working overtime to clear my system of the many drugs I’d been taking in the past week. Then there was some minor leg pain—rejuvenating nerves, he said. OK. That I can manage!

Tuesday afternoon my friend Sandra offered to accompany me home after her eye appointment. I picked up my pain medication, which cost all of $1.90. Needless to say, I didn’t bother with my credit card or even a receipt. Drugs are SO much cheaper here than in the U.S. One of my prescriptions cost me $6.50 last week, and when I looked up information about it online (the accompanying flyer is in Turkish), I saw that it sells for $150 in the States. What gives?

I’m glad Sandra helped me home. It was an uncomfortable, jostling ride, and she hauled my bag and wilting flowers up into my apartment.


Me back home with my consolidated bouquet–smells WONDERFUL!!!

So here I am, pretty much out of pain, recuperating nicely, and duly impressed with the Turkish medical system. I’m even more impressed with the kindness of all my students and friends who have visited, called, run errands, and brought groceries for me.

Lucky me, huh?