Mask Squeeze and a Farewell to Zeppelin

Gonna Make You Burn, Gonna Make You Sting

Death isn’t something you expect to confront on vacation. But on my family’s recent trip to the Philippines, we did. We wanted the kids (ages 7 and 10) to experience the country and culture of the Filipino half of their roots. So we got a pet-sitter, packed for humid weather, and got on a plane with their Lola (Tagalog for grandma.)

We landed in the heat and chaos of Manila and spent five days meeting family, eating sisig, and visiting Taal. (Which features an island inside a lake inside a volcano inside another lake on an island in the ocean. Or, as the Garvins call it, Volcanoception.) With our urban adventures complete, we travelled to a resort on the island of Cebu, where the kids spent five days at the on-property waterpark while the adults (my wife, my sister-in-law, and I) went scuba diving. 

Then it was time to leave the glorious resort (which had aircon and, most importantly, American-style toilets) and head to the smaller, more rural island of Busuanga. There’s a town there called Coron which is famous for scuba-diving, thanks to a massive bombing run on a Japanese supply fleet during World War II. I couldn’t wait to strap on my BC, stick a regulator in my mouth, and get inside those ships.

Only I never did.

The morning of our scheduled first dive, we got a call from our pet sitter (and longtime neighbor and friend) that something was wrong with our twelve-year-old Black Lab, Zeppelin. She was having trouble breathing and wouldn’t come down the stairs.

Twelve is old for a dog her size, and we knew she didn’t have much more time. I was hoping she’d make it through one more Christmas. She loved being around people, you see, and I knew that one last trip to my parents’ house, packed with family, would be a joy to her. But, like me and those wreck dives in Coron, she would never see that Christmas.

My neighbor had to drag Zeppelin down the stairs and lift her into the back of their van. I spoke to the vet a few minutes later. She said Zep was in very bad shape. A chest x-ray had revealed a number of masses in her chest, and large portions of her lungs were not functioning. The doc said Zep would need to be moved to a larger emergency facility where they would have to give her oxygen. Surgery would be necessary to preserve her life. Ami and I had to make a call. Zeppelin was old. She was in pain. We made the hard choice to put her down.

Our neighbor put us on FaceTime so we could say goodbye. My heart broke as Zeppelin responded to the sounds of our voices. I wanted to be there with her, to hold her paw as she fell asleep.

The four of us held each other and cried.

The house is so empty without her. When I return home from dropping off the kids, running an errand, or writing at a cafe, she is no longer at the door, whining and yelping as if I’ve been gone for a week. When I open the door, she isn’t there, smiling and panting and whacking the walls and cabinets relentlessly with her tail.

I weep at her loss, but the deeper hurt comes from guilt. I used to walk Zeppelin every day and sometimes twice a day when I was writing and needed a break. Once the kids came, though, and I had to fight for keyboard time, walks with Zeppelin slowed to once every other day, then twice a week. When my son hit second grade and started getting real homework, those afternoon walks fell away. Recently, we treated Zeppelin more like a cat, feeding her and letting her roam the house. She got played with less and walked less. Our family priorities shifted.

But she never flagged in her duties. She was a loyal companion, insisting on being as close to us as possible. Usually that meant being practically under my chair at dinner, or between the coffee table and the couch when we were watching movies. At night, she had taken to lying at the top of the stairs between the kids’ room and ours as if standing vigil against any potential intruders.

During the day, she didn’t like being holed up with me in my office, so she would settle down in the kitchen to make sure I couldn’t leave the house without stepping over her. In the last year or so, she found a shady spot in the side yard and took long naps there, coming back into the house only when one of us got home, or when it was feeding time.

I should have walked her more. I should have played with her more. I should have made time for all of that, and now she’s gone and it’s too late. I hate regret. It feels heavy and permanent. I have a dark spirit, and my grief settles in that place like a hot iron musket ball in my gut. I think Zeppelin understood, in some dog way, that we still loved her. 

Zeppelin was a people dog. The more people in the house, the happier she was. She loved it when my parents came to stay, or when our neighbors stopped by. She’d stand in the entryway with her tail wagging like mad. When the kids came, she was so, so happy. Now there were five of us.

Now there are four of us.

I have nowhere to put my grief, so it leaks out my eyes and my nose and cracks my speech. She was only a dog, but she was my dog, and I was her human, and she was there through marriage and IVF and adoption and all the hell that came with all of that. And now I’m crying in a Starbucks in Manila.

Here is my pledge. When a dog once more enters our family, that dog will get walked every day, even if I have to do it in my pajamas at midnight. The dog will get to lick my face. The dog will learn to love the water. The dog will see our kids become teenagers and see Ami and I into our fifties. We weren’t a dog couple, and then we were, and then we were a dog family, and now there is a hole in our hearts and in our house. No dog can replace Zeppelin, but maybe we can open our hearts to one anyway. Someday.

Mask Squeeze

With the first wave of tears out of the way, we plugged the kids into the TV and left for our two afternoon dives, a welcome distraction from a painful event. Our entourage included our charismatic expat French divemaster, Matthew, several French divers, and a couple from Quebec who were getting their open water certification. The first dive was, as Matthew put it, “very chill.” We swam over a reef about 20 meters down. It was beautiful, diving usually is, but I found myself seeing all the bottle caps, all the dead coral, and it took effort to focus on the fish instead.

After an hour’s surface interval, we hopped off the boat, swam to a beach, and then, burdened with massive steel tanks of compressed air, we mounted a rickety wooden staircase up and over a rock outcropping. When we descended again, we were standing at the edge of an aquamarine lake in the bottom of a volcanic canyon. Jagged igneous formations jutted up on all sides like porous black teeth. It was spectacular. We jumped into the water.

I’d never done a dive like this. There was a halocline, or salinity gradient. The water was fresh at the surface, turning to saltwater as it got deeper. Salinity affects buoyancy, so I knew I’d have to compensate for that during the descent. But there was a thermocline, too, a temperature gradient from cold to warm which also affected buoyancy. In addition, I had shed my full 3mm wetsuit because the water temperature was in the 80s. To compensate, I took some weight off my belt. To put it succinctly: all the variables made the dive conditions a buoyancy nightmare. But I was with three more experienced divers, and I’d had seven dives already that week, so I was ready.

We dropped in, floated on the surface for a moment, then began to descend. When you dive in the ocean, you have all sorts of reference points to gauge the speed of your descent: the surface of the water, the bottom of the boat, the reef below, the other divers. But the water was thick here, and the bottom and edges were out of sight. All I had was the divers around me.

It got warmer as we sank, and I started to feel pressure on my mask. I blinked, tried to blow out air through my nose. But the pressure increased to the point of discomfort. Something was wrong, and I hated to be the joy kill, but I gave my divemaster the “not OK” signal, a hand held out palm down and then tipped left and right, comme si comme ça. He nodded and drew closer. I tried to pry the mask off my face, to let in some water and relieve the pressure, but I couldn’t break the seal. The pressure increased further. I was dropping faster than Matthew. The pressure became uncomfortable, then unbearable. My vision blacked out.

I felt Matthew’s hand on my vest, pulling me toward him. 

You can’t just ascend from fifteen meters like climbing a ladder; you have to take it slow. The ascent seemed to take forever. The water went from warm to cold. Minutes passed. My vision returned, dark and blurry. My face felt crushed. Still, I managed to control my breath through the regulator. I didn’t panic. Thank you, PADI training.

When we finally got to the top, I pried the mask off and lay on my back, floating. Ami surfaced a few moments later, then her sister, Jasmine. I talked them through what had happened. It was mask squeeze, Matthew explained. I remembered the term from my certification class ten years and twenty dives ago, but I hadn’t thought about it since.

Basically, as you get deeper, the water pressure on your mask increases, so you have to exhale through your nose to equalize the pressure (just like you do with your eardrums when the airplane takes off, only in reverse.) After a few dives, it becomes second nature. You just do it. But on this dive, for some reason, I didn’t do it enough. All those variables — no wetsuit, lighter weights, thermocline, halocline — had formed a perfect storm into which my good habits had disappeared.

But I could breathe okay, and I could see okay, so that was good.

I opted out of the rest of the dive, preferring instead to float on the surface and follow the bubbles of my wife and sister-in-law. I would meet them on the far end of the lake when they emerged from the water.

As they drew close to the other side, I put on my mask again and looked down into the water. There were my wife and sister-in-law, swimming around, looking where the dive master was pointing, apparently indicating some creature or interesting underwater volcanic rock.

Then, quite suddenly from my point of view, he grabbed Ami and they began to ascend to the surface. She came up coughing, and now my heart was pounding in my face. Matthew explained that she had gone into nitrogen narcosis. It’s a thing that happens to divers, a temporary alteration of consciousness that can be triggered by breathing compressed gas—but while the accompanying drunk-like symptoms would be funny on land, they can be dangerous underwater.

Basically, some water had seeped into Ami’s mask. But instead of clearing it like she had a hundred times before, she took her mask partially off her face and gulped water into her lungs instead. Her brain had misfired.

After a few minutes on the surface, she was okay. She just needed to cough up the water so she could breathe normally. Once she was back in control, however, she looked at me and her face changed. “Your eye,” she said. “It looks bad.”

Flight from the Island

We got back to the dive shop, and now I had half a dozen experienced divers looking at me. “Mask squeeze,” they muttered. “He looks bad.” The dive shop owner said 99% of the time, mask squeeze was benign, but that I ought to go see a doctor just in case.

Ami was concerned, but I felt fine, and I didn’t want to spend the night in the emergency room of a small hospital in a small village on a small island. I told Ami I would go to the doctor in the morning if I didn’t feel right.

Before bed, I sneaked a look at myself in the mirror. My eyes were very bloodshot, and dark purple crescents were forming beneath them. I put on dark sunglasses so as not to scare the children during dinner. We ate and went to bed. It had been a long, long day.

The next day, I was a horror show. My eyes no longer had any visible whites—the irises were surrounded by solid, shining red. Deep bruises ringed the sockets and my trademark overhanging brow. I looked like something from the second season of Buffy. Ami was visibly shaken. I agreed to see a doctor.

I got on a motorized tricycle with my eighty-three-year-old mother-in-law and headed for the local hospital. She spoke in Tagalog to the admitting nurse, who listened as she filled a syringe with gloveless hands. She explained that I needed an ophthalmologist, and that the closest one was two hours away. By boat. And that I would have to rent the boat, because there was no regular traffic between the islands.

It was starting to feel like a chapter from Alex Garland’s The Beach. I rode back to the hotel, connected to the infuriatingly spotty Wi-Fi, and started doing research. The nearest eye specialist was indeed two hours away by boat, but if I went there, he would be the only game in town. Mom would have to come with me to translate, and the kids would have to stay with Ami in the hotel. I really, really didn’t like that idea.

Thanks to the urging of my sister-in-law, I had purchased dive insurance before we left for the trip. It covered medical expenses and transportation in the case of a diving emergency. I wasn’t sure if this was an emergency, but it was close, so I called the hotline. I got to speak to a diving specialist who was also a medical professional, and he confirmed what the divemaster had said—that I was almost certainly okay, but that I ought to see someone just in case. It was my eyes, after all.

The thing that concerned the expert was that my vision that morning had been slightly blurry. I was almost certain it was just from the mucus—like the crusties in your eyes after a long sleep—but again, almost certain is not certain, and the almosts were piling up.

The closest high-tech hospital was in Manila, and that’s where I would have to go.

Another technical point here. When you scuba dive, your body absorbs nitrogen. When you come back to the surface, it takes a while for the nitrogen to dissipate. If you go from fifty feet underwater to thirty thousand feet above, the tiny bubbles in your body can expand, causing DCS (decompression sickness, AKA The Bends, and I’m not talking about Radiohead’s 1995 sophomore album.) That’s why it’s necessary to come to the surface for an hour or so between dives. It’s also why you have to wait 18-24 hours before hopping on a plane.

So I needed to get to a hospital ASAP, and that hospital was in Manila, but I couldn’t fly until 18 hours after my last dive. I found a flight and left that afternoon. Oh, and it was only $99. Is it wrong that I was so pleased with myself for finding a cheap flight in all that chaos? Because I was.

So it was that, three days before we were to return, I drove to the single-terminal Busuanga airport and got on a plane. It only took an hour to get to Manila, then an hour and a half of stop-and-go traffic to get to St. Luke’s Medical Center.

I Left My Wallet in Manila

I’ll be honest, I didn’t have high hopes for the hospital experience. Manila is very different from any city in the US. The streets and sidewalks are crumbling. There’s more slump stone than stucco, more aluminum siding than shingles. It’s a beautiful city, and it has its own chaotic rhythm—but to my suburban, western sensibilities, and under the circumstances of a possibly serious medical problem, my prejudice was in full swing.

I don’t know what I expected. A single large room with rusty bed frames and doctors in blood-soaked scrubs? A World War II-era triage camp? Instead, I saw the cleanest, best-organized ER I’d ever been to. The moment I walked in, a security guard handed me an intake form. I filled it out, and he took me to the counter. No more than five minutes after stepping into the building, they had taken my blood pressure, given me a wristband, and assigned me a bed—to which they insisted on pushing me in a wheelchair. I was dumbfounded. It occurred to me later that some of this probably had to do with the fact that I looked like I’d been hit in the face with a baseball bat by a professional wrestler.

I waited maybe ten minutes for the doctor to examine me, then ten more for the ophthalmologist (yes, it’s really spelled like that.) He poked and prodded my eyes, shined lights into every corner, then used a fancy laser device to take pictures of my optical nerve. After ten minutes of examination, he said there was no serious damage, just hemorrhaging in the conjunctivas. To put it bluntly, so many blood vessels had burst in my eyes that they were completely red. Combine that with the heinous bruising, and I could’ve been cast on The Walking Dead with no makeup necessary.

After another short wait, the attending physician wrote me a prescription for eye drops, and I was at the billing desk. The process had taken an hour and fifteen minutes, and then I got the bill.

IT WAS LESS THAN $50 US.

That’s right. Efficient emergency medical care including two nurses, two doctors, AND a specialist, for FIFTY DOLLARS. If there is any takeaway here, it’s that the medical system in our country is broken.

That, and equalize your fucking mask as you descend.

But the comedy (tragedy?) of errors wasn’t over. I got in a Grab (the Filipino version of Uber) and headed to a local business hotel. I wanted a shower, a beer, and dinner. But when I got to the check-in desk, my wallet was missing. NOOOOOO.

Luckily, I had kept my currency and my passport hidden in a belt pouch. I paid in cash, then went up to the room and started calling. I called the hospital. No wallet. I called the pharmacy. No wallet. I tried to call the Grab driver through the app, but since I had a “ghost” international number, I couldn’t get through. I submitted a lost-and-found form through the app (give us 48 hours to reply) and then googled every number for Grab I could find. None of them worked. I went outside and searched the street for my wallet. It wasn’t there. No one had turned it in at the registration desk.

I gave up and headed to the restaurant.

All’s Well That Ends Well

Halfway through a dejected, silent dinner, a security guard approached my table and held up a driver’s license. It had a picture on it that looked like me, minus the demon eyes. IT WAS MINE! He said the Grab driver was waiting for me outside. I followed him down some stairs and into a back alley.

I have never hugged a stranger that hard. He gave me my wallet and I gave him a handful of cash. He said his passenger had found the wallet, and he’d driven back to the hotel of his own accord. It had nothing to do with my calls to Grab.

Feeling triumphant, I went back upstairs and drank to his health (and my own.)

There it is. The ordeal had a happy ending. I’ve heard people say, “All’s Well that Ends Well,” but I never really understood it until that Saturday night.

My eyes are healing from the mask squeeze, and my heart is healing from the loss of my beloved dog. I can’t say with conviction that I enjoyed my vacation, but I will certainly never forget it. As my wife says, we were making memories.