Bangkok Old Hand

by Collin Piprell

  Fortunately or unfortunately, depending on your attitude towards drinking, most Caucasians and quite a few Asians can successfully metabolise acetaldehyde, so these symptoms don't usually appear. Because of the genetic difference mentioned earlier, however, many Asians don't produce enough of the aldehyde oxidizing enzymes. The result is practically an instant hangover; and this is an excellent prescription for moderation. Many people will not drink excessively if they not only know they won't have a good time, but will also get sick as a dog almost immediately. It's cheaper, if you're into this kind of gratification, simply to slam your head in the refrigerator door a few times. I never knew my Japanese girlfriend, in all the years I saw her after that jazz concert, to have another drink. (In fact, there is a drug, Antabuse, which is sometimes used in the treatment of alcoholism; it prevents the acetaldehyde from being metabolised properly, and one drink after taking this drug will make a person quite sick.)

  Most of us, however, are more favoured with the requisite enzyme and, hence, are less favoured in real terms of our vulnerability to hangovers. We should therefore take certain measures.

  The one foolproof way to avoid hangovers, no doubt, is to be a teetotaller. The next best approach is to drink only moderately. I, for one, sometimes find moderation too radical a notion by half. So what else can you do?

  One traditional bit of wisdom is that you should never "mix your drinks" the night before. The traditional riposte has been "Why not? Alcohol is alcohol; what difference does it make?" Although medical science has yet to give the theory a solid basis, it is possible that the various chemicals which lend alcoholic drinks their colour, smell, and taste may actually cause illness when taken in certain combinations. So alcohol is only alcohol, after all, but booze is not just booze; and mixing your liquor is probably to be avoided.

  Scientists have suggested there are chemicals in wine and most liquors that can cause headaches and other unpleasant symptoms, even if you don't mix your drinks. Heavy red wines and brandy (especially taken together) are perhaps the most lethal. On the other hand, it is generally agreed that vodka is least likely to give you problems, since this drink has the fewest impurities. Many people would argue that gin is almost as innocuous; given its reputation as an aphrodisiac, however, you might wake up with something even more annoying than a hangover.

  Beer has the advantage that it's hard to drink enough of it to suffer from alcohol poisoning. The carbohydrates in the beer also slow the body's absorption of alcohol, so your judgment shouldn't become impaired as quickly as it might while drinking spirits. If you drink spirits and beer together, however, or so I've read, the carbonation in the beer actually speeds the absorption of alcohol through the intestine walls, and this is an excellent way to get zapped in a big hurry and to wake up really wishing you hadn't.

  I've also heard it said that if you begin by drinking beer and then switch to whisky or rum, you are quite likely to keep drinking at the same rate that you were drinking beer, only now you've lost any real sense of how much actual alcohol is going down the hatch — a mistake from the standpoint of the morning after.

  Alcohol stimulates the secretion of both saliva and gastric juices, which is why it's such a good appetiser. That's also why it can cause gastritis, bleeding of the stomach lining and even ulcers, eventually. Drinking all evening without eating is a sure recipe for a surplus pool of acid in your gut, as well as a hangover which includes stomach problems.

  It's a good idea to eat while you're drinking. You should take it easy on the pickled peppers and Lek's cheese dip, of course, but some nice stodgy food at regular intervals is definitely in order. First of all, and it doesn't take a medical degree to figure this out, food leaves less room for booze. Besides that, carbohydrates will sop up the hootch and slow the absorption of alcohol, thereby giving better judgment longer to curb the born-to-boogie syndrome. They may also keep your blood-sugar levels up for the following morning's battle.

  Boozing depletes certain vital nutrients, and it's probably true that you can do yourself no harm by taking vitamin C and vitamin B1 supplements before retiring. Some authorities believe one should take the vitamins before you go out, half-way through the evening, and then again before hitting the sack. These well-wishers may work for the manufacturers of vitamin tablets, however.

  Drink lots of water, especially at bedtime. Your whole system will be dehydrated. Alcohol causes your cells to lose water, which helps explain the frequency with which you sometimes have to visit the toilet in the midst of the festivities. It also blocks a secretion of the pituitary gland, resulting in decreased reabsorption of water.

  Many people swear by aspirin before bed, as well. This is really only advisable, however, if you have a cast- iron stomach. Aspirin will exacerbate any gastric bleeding already brought on by the night's excesses.

  Judicious exercise in the course of the celebrations is also a good idea, at least according to the recently departed Sid Davis. He used to recommend dancing andor bar-room brawling, though he suggested an occasional run from the gendarmerie was also an effective way of burning off some of the booze while at the same time toning up the cardiovascular system.

  So far, we've looked only at caveats and precautions, but what about after the fact? What can you do after it becomes clear that you didn't avoid a hangover, and you are wondering if you want to live to see another one?

  Some people swear by a "hair of the dog". This expression, as you may know, refers back to an old superstition that the best cure for dog-bite is to swallow a hair from the same dog that bit you. By extension, many feel that if it's alcohol that has laid you low, a little more of the same the next morning is the antidote. Dangerous advice. Unless you're careful, this prescription will only defer the hangover till later; and if you then use the same method of coping again, you've entered into a vicious cycle that will finally have your friends shocked and perplexed should they ever see you sober. "What was wrong with him?"

  A little warm, flat beer the next day, mind you, probably does have a certain medicinal power. I once saw a film where, through the miracle of modern fibre optics, doctors introduced tiny lights and cameras into a bunch of hung-over stomachs. The stomach lining typically was an angry wrinkled red — something like the face of a new-born baby just after the kid's first rude introduction to existence via a resounding slap on the bottom. The scientists tried dumping various things like Bloody Marys into these wretched organs, which reacted immediately by scowling an even rawer shade of red. When a half-pint of warm flat beer was introduced, however, you could almost hear the sigh of relief as the stomach walls smoothed out and took on a nice healthy colour again.

  Still, I suspect a little pain the next day is good for the soul. It has a certain deterrent value, and inspires a healthy reflection upon one's aims and priorities in life. Anyway, treating alcohol poisoning with alcohol tends to cause the body to begin producing more of the enzymes involved in alcohol metabolism. After a time, your system has all these little enzymes running around saying "Feed me; feed me" and, if you don't have any alcohol to metabolise, you feel uncomfortable. Not the way to cure a hangover.

  Is there any real cure, then? I believe most doctors would say no, not beyond lots of water, rest, and time. Pilots sometimes swear by breathing pure oxygen from a tank; this is said to burn off some of the grunge in your system and clear the head in a hurry. Maybe so, but I've also heard that breathing too much oxygen is pretty unhealthy in itself.

  My own experience has shown that lots of hard exercise is the only recourse that produces anything like a full recovery. You must remember, though, to drink plenty of water before, during, and after the workout. I guess this prescription is also one way to find out if you've got a heart problem, though you might not have a lot of time to digest the news if you do have a weak heart. There is also a psychological hurdle to overcome: no matter how much experience has told me it works, the thought of crawling off my death-bed and into a pair of training shoes to make my way to
the track can seem a ludicrously misguided plan of action.

  Other than that, there's not much to say about hangovers. I could reveal the fact that I find a litre of ice- cold chocolate milk gulped in great draughts a salve for both body and soul, or that I chase the milk with a bottle of soda water, enjoying the scouring effect of all those icy little bubbles blasting down my throat. I'm sure the restorative properties of these things are mostly in the mind, but they work for me. A little soft music may help, as well, especially if you have some properly attentive and understanding company applying cold towels to your forehead, no doubt at the same time murmuring 'There, there, you moron" and similar endearments. In fact, if you can come to have faith in simple rituals like these, you can almost learn to enjoy a moderate hangover. Part of the pain of hangovers is simply the self-fulfilling expectation that they're going to be horrible.

  Or you can try the kill-or-cure exercise therapy. Just remember: you win either way.

  Finally, if all else fails, you should try sitting on the edge of your bed and rocking back and forth with your face in your hands, repeating "Oh, woe; oh, woe" in a soft monotone. Eventually, this will have a soothing effect, and you may even go to sleep. Be careful not to fall off the bed.

  I never did get to sweat off the hangover that inspired this story. I got caught up in making these notes, and the distraction of writing plus, I suppose, the simple passage of time restored me to the realm of reasonably happy, reasonably sentient creatures.

  I guess I'll start my fitness campaign next week. Right after my birthday party.

  22 AND DON'T SAIL OFF THE EDGE OF THE WORLD

  There are worse things than hangovers lurking out there (aren't there?). And it sometimes seems that these modern plagues proliferate in direct proportion to the amount of disposable income and leisure time the modern middle classes have at hand.

  Travel has always been fraught with peril. From the time of Ulysses, every traveller's mother has warned him: "Look out for the Sirens; for goodness sake don't sail off the end of the Earth; and whatever you do," she's always said, "don't drink the water."

  The Sirens still exist, of course, and may be found in places like Shaky Jake's Go-go Bar. ("I thought Harold was only going to stay in Bangkok for a week, dear. It's been six months, already. I'm worried.") Seasickness is still with us, as well; and Montezuma's Revenge continues to take its toll, whether it masquerades as Bangkok Belly or the Rangoon Runs. Other travellers' terrors have virtually disappeared, however. Nobody sails off the edge of the world any more. And when was the last time you heard anyone complain of scurvy?

  That's progress, right? Sure; these days progress is everywhere you look. Every time you open the newspaper or consult the Reader's Digest, you discover six new ways to get cancer and seven new sources of killer stress. And neither has Progress spared the realm of threats to the traveller's well-being. Scurvy is a dawdle, compared to some of the new disorders of the body and soul you're about to have described to you.

  Technological innovation generally carries with it mixed blessings. Everybody knows about jetlag, but worse shoals lurk out there for the unwary. For example, you no longer need worry about a four-month voyage in steerage against the monsoon from Canton to Ceylon, complete with the attendant seasickness and, quite possibly, scurvy. No, now there's something new and improved to worry about for us modern equivalents of the steerage passenger. ECS stands for Economy-Class Syndrome (The Economist, 3 September 1988), and it's no joke, if you can believe the three reputable doctors who recently published an account of the problem in The Lancet This syndrome involves the formation of blood clots that interfere with the function of various internal organs, most notably the lungs. (There was a study conducted in 1986 of sudden deaths among long-distance air travellers out of Heathrow, and it was determined that 18 percent of 61 deaths over a three-year period were caused by blood clots in the lungs.) ECS, it seems, may cause death as long as several weeks after a long flight in economy class.

  For scurvy, you suck on lemons. What do you do for ECS? The best preventive is to fly first class. Although the cause of this disorder is not yet clear, restricted leg-room appears to be the most significant factor. Of course, first- class fares can be more distasteful than death, at least for some of us. So the next best thing to do is avoid alcoholic beverages (also worse than dying, in some opinion). Booze causes dehydration, which interferes with circulation and can exacerbate the danger of clotting. You are also advised to take lots of soft drinks, to get up and walk around from time to time, and to exercise particular care if you are predisposed towards coronary heart disease.

  If you're a proper yuppie, mind you, you have no business in economy class with riff-raff like myself, and so there's no need to sweat the ECS. At the same time, however, modern affluence has its flipside. Your need to get away from it all in the first place may be greater than mine. Another feature of progress has recently appeared — the dreaded Yuppie Disease (Time, 20 June 1987). This has been described as a "stealthy epidemic" draining the mental and physical vigour of our overachievers. (Of the thousands of cases diagnosed in the States, a disproportionate number have been young white professionals.) Extreme exhaustion combined with depression is its worst symptom, with everything from blinding headaches to swollen glands and fever attending. Medical research seems to indicate that some unidentified virus is the culprit, though it isn't clear why this virus favours the sleekly tanned and well-nourished bodies of the yuppie set, rather than clapped-out carcasses such as that inhabited by this writer.

  The nature of this illness is still a mystery, and treatment has been largely unsuccessful, limited mostly to stress reduction measures and sleeping pills. Still, on the theory that a change is as good as a rest, travel might well be prescribed.

  And travel is supposed to broaden the horizons. Sure it does, but beware: lurking out there in the realm of

  expanding consciousness are new dangers, even once you're past the ECS.

  So you thought you'd just hop over to Florence and browse away in a bunch of museums? Unwind a bit? I'll bet you haven't heard of Stendhal Syndrome (Newsweek, 14 December 1987). In a recent 10-year period, more than 100 cases of this psychosis among visitors have been treated in one Florence hospital. These unfortunates have quite simply OD-ed on culture, perhaps bringing to their appreciation of the finer things the same manic intensity they brought to earning the wherewithal to travel first-class. Some of the victims have had to be hospitalised for days. Apparently the emotional crisis — a mild nervous breakdown — is brought on by too avid a drinking in of all the artistic wonders at hand. Disorientation, palpitations, a sense of dread, and even collapse can strike in mid-tour. Some travellers go back to their hotel rooms and refuse to come out again. Cowering away under the blankets, one fellow told his doctors he felt "imprisoned by the succession of Florence campaniles, bridges, piazzas, loggias, statues and imposing palazzos". (The ailment is named after the French writer Stendhal, who himself suffered the syndrome in Florence in 1817. Psychiatrists have reported similar disorders from cities such as Venice and Jerusalem.)

  So be careful. Go some place boring, one is tempted to suggest. If you're afraid that won't generate enough good stories for the folks back home, then at least take care, when in one of these hotbeds of cultural diversion. Go to a gallery or museum, if you have to, and then devote the rest of your time to an appreciation of all the little trattorie you can find. This is proof against Stendhal Syndrome, and the cumulative hangover that ensues can have the additional advantage of masking the symptoms of jetlag after you return home (though it does increase the risk of ECS if you're flying economy class).

  And pray that your Stendhal Syndrome isn't complicated by retrophobia, or you won't know whether you should be coming or going. Retrophobia? Sure. A psychologist has recently discovered and classified this "irrational fear of going back to work after a long break" (The Economist, 25 August 1990). But, in the same way it doesn't mean no one is out to get you ju
st because you're paranoid, the fear of going back may not be so irrational after all.

  Of course, you aren't safe just because you've made it home. Forget the jetlag. Leave aside the possibility you might succumb to ECS weeks later. There is still the threat of Post-Vacation Dysphoria (International Herald Tribune, 8 September 1988). Even if you've enjoyed the respite your holiday has given you from the stress of maintaining a life-style that includes foreign vacations, even if you've successfully circumnavigated all the horrors of modern travel, from Stendhal Syndrome to Jerusalem Hysteria (a passing psychosis that afflicts a surprising number of visitors to the Holy Land), you may still fall prey to the post-vacation blues (or "dysphoria", as Dr. Alan Stoudemaire, Associate Professor of Psychiatry at Emory University, Atlanta, Georgia, would have it).

  This malaise of re-entry into the real world is channelled quite differently by one person or another. Some suffer a failure of spirit, stricken with the universal maladies of Angst and Weltschmertz, especially when it dawns on them that nobody really wants to look at their slides, and everybody's already been to Florence anyway; don't you know Lhasa is the place to go this season? In fact, Post-Vacation Dysphoria can be transmitted to your friends and colleagues back home. The usual vector is the Slide Show Without End, though the simple recital of all the exotic experiences you've just suffered may be enough in itself to spread the symptoms.

  Other sufferers lose themselves in work. There is a measurable surge in productivity in the autumn, in America, and this could be due to the mass of returning vacationers, people who choose to take their minds off the fact they don't want to be back at work courting the dreaded Yuppie Disease by in fact courting that very syndrome with a new passion. But that's what it's all about, back in the real world.