Beauty from Afar

I have mostly watched medical tourism from afar for several years, not participating in the so-called industry other than to continue to recommend my own dentists and to advise family, friends, acquaintances and strangers about how and when to access medical and dental care outside of the country.

I do know what I’m talking about — but I choose not to say much, very often. I have concerns about the Americanization of health care overseas, and also about general quality of care as more and more providers seek patients/clients/customers. A decade ago, when I first wrote about medical travel, I think it was actually easier for me to figure out an individualized approach if only because the doctors and dentists who were experienced were directly accessible. Now — that seems to be less prevalent.

I don’t know when or if I will update Beauty from Afar, the book, which is now eight years old, beyond the chapters on this site. It is available from online sellers for just a few dollars, at this point. I make nothing from it, which is fine. But I have moved on to other projects.

Back in the day — it was very exciting for me to be on NPR Talk of the Nation (Medical Tourism, and the Costs of Traveling for Care) and on ABC News (Money Matters, Special Report on Medical Tourism). If you’re interested in the topic — I think my book is still worth reading and those links are worth visiting. I’m leaving this site up — anywhere from 20-100 people a day still seem to want to take a look — but I’ll only be poking my head in episodically.

If you want to know what I’m up to, visit me at jeffschult.com … I am resolved to be there.

The whole notion of what a book IS, is changing. Everyone knows that, right? You don’t have to be a reader of books in digital form, as I have been for more than five years, to appreciate that what we read, how we read, is changing. Beauty from Afar kind of got caught in the early stages of all this change. My publisher did not release it as an e-book in 2006. I’m guessing that if BFA was released in 2009, there would have been an e-book. And I would further guess that if it were a book of its sort five years from now, it might be published only as an e-book.

Not that I think “real,” paper books are going away entirely, anytime soon. But there will be less of them, and more digital books. The fact is, Beauty from Afar is one of those works that would have been better as an e-book, in some future time of e-book ubiquity.

Why? There would have been pictures, lots of pictures. And the Internet addresses — URLs — would have been clickable and that would have changed how I wrote the book, too. I am of the opinion that URLs do not belong in paper books except maybe in foot- or end notes.

Nonetheless, I had no choice but to put them in, for people who might read the book and then want to go to their computers and type them in. I tried to put in as few as I could … I think they are wrong for printed books. They are impermanent.

There are quite a few of them in today’s page. Now, at least, they are clickable.

Chapter 5 Page 2 | Medical Travel and Cosmetic Surgery: Top Resources

Our little history lesson continues today with a segment about how a plastic surgeon in Costa Rica started marketing to the U.S. market in the early 1980s; and continues with a discussion of a somewhat prescient World Bank report on prospects for health tourism exports in the Caribbean.

Chapter 3 Page 3 | Build It, and They Will Come …

I thought I’d be sailing through Chapter 3 easily but have had a lot of reformatting to do from the version of Beauty from Afar from which I am working … which I have now realized is probably the penultimate digital copy. Aaaaiiieee! An alert reader, Debbie, caught a mistake the other day in which I had named someone other than Alexandre Dumas as author of The Three Musketeers. Fortunately, the error was fixed before the book was printed. I do remember how I felt when I found the mistake initially — after I’d “finished” writing the book and after it had been twice edited. I felt both as though I’d dodged a bullet and as though I was nearly too stupid to live.

There are a couple of minor errors in the paper version of Beauty from Afar. It is nice to have the opportunity to fix them.

I used to be appalled when I found typos or any kind of mistakes in books. How could it happen? Well — now I know the answer. It can happen in all sorts of ways. Human beings are involved. With Beauty from Afar, they mostly happened because I was allowed to fuss with and add things right up until the last second — as though we were producing a newspaper story instead of a book. Overall, I think the additions and last-minute changes made for a better book … but there is a tradeoff. Typos, however minor, are just disheartening.

There was a time when I thought that perhaps I ought to put myself forward as a reasonable candidate to be the caretaker and editor of Wikipedia’s entry for medical tourism.

Upon careful consideration, I realized that I would rather stick my hand in a bee’s nest. This is nothing against Wikipedia, which I think is a wonderful project; and I conclude Chapter 1 of Beauty from Afar with some direct quotes from Wikipedia. It was remarkable how the entry for “Medical Tourism” evolved in a short time:

Chapter 1 Page 9 | Medical Tourism: A Moving Target

… And the reasons which I am glad I did not become, or try to become, the Wikipedia editor of the page, are not yet apparent, in the above-linked passage from Beauty from Afar.

If you look at the current entry, you’ll see that it has evolved through a contentious few years. Many people have added and deleted and bitterly disputed sentences, paragraphs and sections of the entry, over time. It has been a bone over which dogs of the medical tourism industry fought. I make no apologies for the analogy. Medical tourism “experts” in every country with any claim to being a medical travel destination have vied to define the reality of medical travel. Bias was inevitable.

The entry is not so bad now as it was at a few stages in its evolution. For a partial discussion of the issue of bias, take a look at the Wikipedia “Talk” page on the Medical tourism definition/entry.

Bees sting.

Anyway — Chapter 1 of Beauty from Afar is now posted completely. It is in 9 online pages, rather than the 18 in the printed version of the book. I do have to add the end notes to the chapter but have decided to go back and insert them as footnotes to the appropriate pages in this online edition; so I’ll probably do that tomorrow, before commencing with Chapter 2.

Also, a technical note: I have made BeautyfromAfar.com a dofollow blog, which means that links on this blog have relevance to search engines. Many blogs use a “nofollow” default, meant to discourage comment spam. I don’t see the point, since I delete comment spam and blatant marketing attempts with extreme prejudice. If you have something to add to the discussion here, I want you to get credit for doing so, with a link from your name to your site, at least. (And if you don’t understand this paragraph, it probably doesn’t apply to you.)

… and I am quite sure I am the only one who noticed.

Here is what should have been yesterday’s update:

60 Minutes and Medical Tourism Part 2

And yesterday’s update, of course, should have come today:

Vignettes … Didi, Fabio … Part 3

I fixed the internal navigation of the site. And if I haven’t mentioned it before — I will be wildly grateful to anyone who points out any technical or factual errors I might make in the course of publishing the text of Beauty from Afar.

The 60 Minutes show in 2005 that featured Bumrungrad International hospital in Thailand did much to legitimize medical tourism in the United States.  It spurred more serious journalistic coverage of the subject and, thereafter, people who went abroad for medical care were treated with a little more respect.

It also got the attention of my publisher, which asked me if I could write Beauty from Afar faster than I had agreed. By contract, I owed them the book in January 2006. After some hemming and hawing and looking at the calendar, I said I could turn it in by October 2005.

It was April 2005 at this point. I was saying, “Sure, I can write this in six months.” And I did.

So the introduction to Beauty from Afar is now completely online. The concluding segment is Competition for the United States.

The intro seems short to me, maybe because I vaguely remember agonizing over writing it a few short years ago. There are only five segments; in the physical book, the introduction is only nine pages. Online, it is just five.

But it says what it needed to say. The difficulty in writing it, originally, was in deciding what to leave out; what to save for later. That was where having written a book proposal came in really handy. I trusted my outline.

I recall that one of my favorite moments in researching Beauty from Afar came not from the travel and not from the interesting people I met along the way. It was in finding out that Michael Crichton had written about medical tourism in — of all books! — Jurassic Park.

I’m not making this up; and the information made it into the introduction as a short section, which I added today.

I’m finding that I have to edit the text of Beauty from Afar, onscreen, with an actual copy of the book on my lap. The digital version I have to work with is missing words, occasionally, and is also entirely … mispunctuated. (Is that a word?) This is because I’m working from a Quark file turned into an Acrobat file, from which I copy and paste text into a text file, and then massage it.  Copy changes and even vanishes. Note to any other authors who try this: Yes, of course you could use the final version you submitted to your publisher in MS Word, or whatever. But … are you sure that’s the final version of the book?

P.S. The physical copy of Beauty from Afar has 215 pages. When I started this project, I thought that this online version would … mimic that. It made sense to me … the book has some 65,000 words and I thought that 300 or so at a time would be about right. And given that I’d like this project to at least pay for itself, I thought that having 215 pages with advertisements was not a bad idea.

Just a few days in, though, I’ve discovered what you would have, soon enough, if I had stuck to the plan. Page breaks are artifical and annoying unless you have pages you can turn immediately. (Well, it bothers me, anyway.)  So I’m repaginating as I go. This online version of Beauty from Afar, I’m thinking, will be more like 100 pages, in the end. I intend that each page will end as unjarringly as possible. There are no “widowed” words in the book; there will be no widowed paragraphs in the online version.

We have reached that part of the project where I am finally posting what most people would consider to be the actual book part of the book, by which they would mean: The Introduction. Chapters. Etc.

We’re done with the packaging, the excusing, the thanking, the congratulating, the greeting, the Buy-Me-Take-Me-Home part of the ordeal. We are back where I was in mid 2005. I had signed a contract in January of that year to write a book about traveling abroad for plastic surgery and dentistry and medical care; but I did not really start working on it for a few months, because it took that long for my publisher to actually write me a check for the first half of my advance and I was otherwise sort of broke, or at least broke enough that I couldn’t afford to do the travel I needed to do for research until I saw some money.

I finally sat down to start the actual writing of BFA in June of 2005. I wrote an introduction. Then I wrote another introduction.

I hated them both, and I started panicking. What had ever made me think I could write a book?

Finally, I retraced my steps. I reread the original proposal I had written for the book, which I had liked, and which my agent had liked enough to represent me, and which my publisher had liked enough to give me an advance.

And I found the right tone, and the third try at an introduction was … well, you know. It was fine.

Introduction: How I Got My Smile Back

I added Curtis J. Schroeder’s Afterword for Beauty from Afar today, along with fussing with links on the table of contents page and updating the “About” page to reflect the fact that I am available for work and that I am open to the partnership and advertising possibilities inherent in this site.

Curt, as far as I know, is still group CEO at Bumrungrad International in Bangkok, Thailand; and I am still grateful for his kind words, written in 2006.

Yes, putting up the Afterword now is out of order. I thought about putting it up last. But I decided that anything that was really about the book and gives people the reasons why they might want to read it, ought to go up before I started posting actual chapters.

Besides, I love the Afterword and it makes me feel good to read it again.

So … next, I’ll put the jacket copy up, somehow; and then the Introduction … and then, I’ll probably start letting people know about the site and, little by little, post the 12 chapters. I’ll make pretty ebooks, in various formats, once I have pulled all the text out of the Quark file and massaged it sufficiently.

There are all kinds of precedents for blogs becoming books, and all sorts of ways, even, to turn a blog into a sort of a book … software that will suck up all your posts and headers and produce, from a blog, something resembling a book.

It seems a little backwards, doesn’t it? The trend is away from books, and toward blogs.

I’m still trying to come up with something that lets me post Beauty from Afar a little bit at a time, and comment and update as I go, in a way that makes sense both for readers and myself. I have the book copy digitized, that’s not a problem. I can produce pretty little ebooks if I want … though there are so many formats for THAT, it’s ridiculous. I’m not a Kindle lover but will probably make a Kindle version at some point.

Anyway, bear with me for a bit. I’ve been very busy with content for Prisma Dental … which is all related, but not the same.