Friends,

The above double rainbow is maybe the third I’ve seen in my life, but it’s the first time I’ve ever seen the rainbow come down in front of the landscape - see how the left end of the rainbow is in front of the trees? Very cool. Very auspicious.

Note: I’ve been continuing to translate my newsletters into Mandarin a month later (with my teacher’s very patient help), but currently don’t have a way for you to subscribe to the Mandarin emails. If you’d like to see May or June in Mandarin, visit the archives. 我翻譯了五月和六月的文章，想要閱讀的話，請點這裡。

Hello from the United States, where I am facing the fact that after multiple years of doing this big summer trip, I still don’t know how to manage my time. I feel obligated to spend time with other people as much as possible since my opportunities to do so are limited, but this prevents me from doing things I really need to do, like exercise, make progress on The Work, and writing this (late) newsletter. It’s also a little counterproductive because, as an introvert, my social battery dies quite fast, and I wear myself out, often resulting in “spending time” becoming “sitting nearby silently”. But there is value in that too, and we persevere! And we sleep more. I don’t think there’s a good solution to the perfect scheduling of this time. One amusing thing is that I probably spend more face-to-face time with my family and a lot of other people now, living across the ocean, than I did living in the US, because of the heavy weight of the rare visit. Two or three short visits per year versus one long one.

Back in May, I wrote about my upcoming first colonoscopy. This happened! It was An Experience. I’d read a good bit online, talked to a few friends, and even reached out to a former student who was a gastroenterologist in Taiwan for advice, but despite all this I still felt pretty uncertain about the whole thing. It turned out fine, but I’ll write my experience here, both for the person who might be undergoing their first procedure and so you can learn about what the process is like in Taiwan. Don’t worry, not too many poop details will be included.

First, I’m under the age where colonoscopies are routine. My annual exam found some “occult” blood (this is when I learned occult means invisible, not just secret magic or Cthulu research) which led to a gastro appointment who wanted to schedule me for the colonoscopy two weeks later. I asked if we could wait until the semester ended, 2.5 months later, and he said no problem. He asked if I wanted to sign up for anesthesia, that it’d raise the cost “significantly” (for Taiwan, significantly means from ~$20USD to ~$130USD), and that if I can handle a little pain it’s not really needed. So, of course being the big strong man I am, I said I didn’t need it. On my way out, I picked up the colonoscopy prep medicine which came with a disposable plastic, medicine-branded measuring cup. Since I did not want to hold onto that for 2+ months, I took a photo to share and laugh about, then threw it away.

When I got home, I read 100 articles and posts online about colonoscopies, wondered why in the hell I had thought I didn’t want anesthesia, and emailed my former gastro student. His authoritative response (basically, some doctors like awake patients because they can tell them if something is very wrong, but that’s vanishingly rare, so anesthesia unless you have some other reason not to) was calming and got me to flip the switch back towards anesthesia. Then I spent the remaining time until my appointment going between wishing I had scheduled it immediately to get it over with and wanting to postpone it as long as possible.

The diet sucked. I’d been eating more than usual due to exercise, so I went from 2500-3000 calories a day to the very limited prep diet to a full day of fasting. I’m glad I waited until after the semester was over primarily because if I’d had to deal with a significant amount of grading or lecturing while fasting I probably would’ve done something stupid. Prep diet guidelines vary a lot, but the one they gave me was basically they most restrictive I’ve found online, basically telling me only to eat white flour products, strained broth, and fish or eggs. During the full fast they only wanted you to drink water and sports drinks diluted by 50%! Compare that with Kaiser’s guidelines, which lets you eat basically anything that doesn’t have fiber.

Here’s a piece of advice I didn’t listen to but wish I had - get an afternoon appointment! If you instinctively want to get it over with in the morning, you take your first dose of the prep medicine the evening before, which means missing nearly an entire night of sleep. If you do it in the afternoon, instead, you wake up early to take the prep medicine and only miss a little sleep. The actual prep medicine was a powder I mixed into a certain amount of water, then I had to drink a certain amount of water after it, then repeat the process a couple of hours later (but stop drinking water at a point due to the anesthesia). It was less bad than I was expecting, but I would definitely recommend considering the effects of pooping many times and probably make sure you have a bidet (which I also recommend getting anyways, regardless of colonoscopies).

Finally, the procedure itself. First there was a delay because I didn’t (and still don’t) know where I was supposed to pay the extra fee for anesthesia. Then I was called into a large room where other patients were coming in and out - privacy, outside of data, is much less a concern in Taiwanese hospitals than in the US - and went through a questionnaire with the staff’s poor English and my poor Mandarin meeting in the middle (did I follow the diet, have any allergies, have someone to escort me home). The nurse set me up with an IV port while I was sitting in the same chair at the same desk I’d answered the questionnaire at, then I was led to a locker to put my stuff in after I went in the changing room and changed into a gown. After changing into a gown, the nurse asked if I had remembered to remove my underwear. I had not. Once that was sorted, I was led into the room with a hospital bed where four people in scrubs were standing around looking like they’d been waiting for me. I couldn’t figure out where to put my shoes, then realized I shouldn’t have had them on. I apologized in Mandarin, the doctors laughed, and I laid down on the bed. They asked how long I’d lived in Taiwan as they hooked up the Propofol drip to my IV port.

And that’s the last thing I remember until literally getting out of the taxi at our apartment and the taxi driver telling me to stay healthy. Apparently I put my pants on backwards. I went inside and immediately took a four hour nap.

I found out a week later they had cut out seven polyps, no cancer, but three that were “pre-cancerous”. There was almost no discomfort in the days after - I avoided high fiber foods because supposedly it would make me bloated, but everything I ate made me bloated, so I don’t know it helped. Sometimes when I bent over my abdomen felt… weird, uncomfortable, but no pain. I would’ve been fine with going back to work the next day.

I get to go back and do it all again in two years!

The main personal takeaway I have here is that the test that originally prompted the colonoscopy is not one I’d ever had before moving to Taiwan. How many years would it have been before I had it in the US? Would I have gotten a colonoscopy before the normally suggested age? Would that have led to problems?

It’s not just this - I’ve learned other things about my health through these checkups that I can imagine easily being missed had I kept living in the US. On the one hand, I’m grateful for Taiwan’s socialized healthcare system. On the other hand, it’s also added a lot of stress! Of course I want to know early, but I also don’t want to know at all. Maybe I can just Propofol out every appointment and have someone manage it all for me.

Actually, no, scratch that. If I’m going to Propofol coma anything it’s going to be these 11 hour flights. Call me when they’re available.

Further reading:

• Happy birthday, America.

• Visiting Kentucky, we were a little paranoid about the reported rise in ticks, especially because I now know three people with Alpha-gal Syndrome. I learned a lot from Kate Wong’s reporting on what to do if you find a tick on your body.

• A local continuing education organization did a really cool profile of my neighborhood! Usually all the focus is on the nearby historical cemetery, but this takes a look at the temples, businesses, and people too. Many of the pictures are a stone’s throw from my door!

• In other Taiwanese news, we have the first case of a student getting caught using “AI Glasses” to try to cheat on an entrance exam. In this case, the student’s odd behavior gave them away, which makes me think others might have gotten by.

• Formosa Plastics is Taiwan’s worst ambassador. Read about the activists trying to hold them accountable for their many, many horrible, environmentally destructive deeds, from Dylan Baddour and Inside Climate News + The Xylom. h/t to Ben Young Landis for the link. (Honorable mention to other poor ambassadorship in the news lately is Taiwan clinging on to relations with Eswatini despite that nation being ruled by a regressive, absolute monarchy, just because Eswatini recognizes Taiwan’s legitimacy.)

• If I had to go back to teaching high school, I’m pretty sure I would disallow all technology in my classroom, but I’m also kind of a pushover. It’s nice to see accounts like this where the end result seems so positive (though thinking of all the time and money wasted on Chromebooks and iPads undercuts you a bit).

• Steve Martin on Diane Arbus photographing Disneyland. Really, the title is all you need to be hooked.

• I’m sorry to everyone who is facing a nearby data center. The stories are really horrible. The New Republic JJ Anselmi’s profile of the myriad ways they wriggle their way into communities is worth reading, to see what it looks like up close and personal.

• I retaught one of the great pieces of short fiction, Ursula K. Le Guin’s “The Ones Who Walk Away from Omelas”, recently, and in the process I found a riff of a follow-up story from Isabel J. Kim, “Why Don’t We Just Kill the Kid in the Omelas Hole”. You should read both, even if you have in the past.

• My latest favorite non-caffeinated beverage is buchu tea. A student brought it back from South Africa for me and it’s really lovely - a mild, pepperminty flavor that is delicious unsweetened, hot or cold. Definitely check it out if you have the chance.

One of my first duties in Texas (besides to eat an absurd number of tortillas) was to take my godson and two other teens to Free Slurpee Day at 7-Eleven on 7-11. Whoever is in charge of the marketing for that should get a big raise. Tons of kids on bikes, tons of parents with their kids, everyone smiling. The kids I was with saw one of their friends, and they’d been planning the trip for a while.

After seeing so much about how limited the lives of young people are these days (reduction of spaces to freely spend time in + more restricted movement thanks to technology and fear mongering) it was so nice to see one counterexample, however much capitalism and high fructose corn syrup it involved.

Hope you stumble across a positive counterexample, too.

-g