I met Alexandra Liss on a rainy day last September, outside of one of my favorite Thai restaurants in San Francisco.

Alex had just returned from six months abroad, traveling through 21 countries for free while shooting her full-length documentary, One Couch at a Time. She was wrapping up the film and had requested an interview with me.

Our topic of discussion? The Sharing Economy.

Startups that are part of this “sharing economy” — like TaskRabbit, AirBNB, Uber, and Sidecar — have given us unprecedented access to incredible experiences and resources, allowing many people to completely upgrade their lifestyles. By capitalizing on underused resources and new technology, people can live many strata above their income. In Alex’s case, she was able to raise $8,000 through Kickstarter to crowdfund her travel and the making of her film. She also lived rent-free during those six months, staying with more than 80 different strangers she’d met through Couchsurfing.org.

In this post, Alex shares exactly how she’s managed to become a couchsurfing guru, and the steps you can take to travel the world on next to no budget…

Enter Alex

I love the look people get on their face the first time they hear about Couchsurfing.

I might mention how I’ll be hosting a revolutionary leader from Egypt, or that I’ll be crashing in the heart of the Amazon on a stranger’s couch. They inevitably tilt their heads like confused puppies.

Of course, once they’ve experienced Couchsurfing and understand how it works, their whole attitude changes. Nearly all of them end up loving it. Me? I can’t get enough of it.

After six months of sleeping in 80 different homes — staying with people I’d never met — I can definitively say that Couchsurfing has enriched my life more than anything else. In fact, I believe this site is changing our entire world for the better, one couch at a time.

What is Couchsurfing?

Couchsurfing.org is an online hospitality network that connects travelers to free places to stay all over the world. There are more than 4 million globetrotters and backpackers, in 80,000 cities, who want to share their homes and time with you… at no cost!

Couchsurfers are all over the world. This map shows the areas with the highest concentration of members.

A great host can offer a fellow surfer some of the richest experiences of their lives — and vice versa — all without a euro, rupee, dinar, peso, yen, shilling, or dollar being exchanged. Simply for the love of hanging out with a kindred soul.

Couchsurfing has brought more amazing people and incredible adventures into my life than I can count. Thanks to my hosts, I’ve met Peruvian Shamans, zipped through Ho-Chi Minh, taken boat rides in the delta of Maun, hiked to hidden spots in Victoria Falls, sat VIP during the Spanish Valladolid finals, ridden horses on an Afrikaans farm… The list goes on and on.

The bonds that form through Couchsurfing are on a completely different level from those that arise in hostels. Hosts will go out of their way to pick surfers up at the airport, open up their homes, cook exotic meals, and share their world. They can also readily show you the hidden gems in their city, unearthing attractions that you’d never find in a ‘Lonely Planet’ book. If you’ve ever wanted to get the Anthony Bourdain VIP treatment, Couchsurfing is for you.

But it’s not just the surfers who benefit; being a host can be tremendously rewarding, as well. For instance, my hosts in Morocco, Vietnam, and Brazil all use CouchSurfing as a means to improve their English. Others simply enjoy meeting new people and hearing interesting stories from the road. I get just as much enjoyment out of showing travelers around my city as I do being hosted. My appreciation for San Francisco is instantly revitalized whenever I see the wide-eyed look on a grateful CouchSurfer’s face, looking upon a site they’ve only seen in the movies.

Whether you’re hosting or surfing, it’s a win-win for both parties.

“Isn’t it dangerous?”

Everyone has a fair amount of skepticism when they first hear about Couchsurfing. The number one question I get from people is: “What if you stay with an axe murderer?”

My friend Eric, who hosted me in Paris, had this to say about the perceived “dangers” of Couchsurfing:

“When I first heard about CouchSurfing, I thought to myself, ‘There is no way am I going to stay with strangers and get raped, robbed, and murdered.’ But I was curious enough about the concept, so I did some research and made a profile. It turned out to be one of the best decisions I’ve ever made! It completely changed my life and has afforded me to see the world.”

As with anything in life, there are always potential dangers, but most risks can be easily avoided (more on this in the next section). As long as you adhere to community guidelines and use common sense, you are very likely to have great experiences.

Ready to give the Couchsurfer lifestyle a shot? Fantastic!

Here’s my advice for anyone who wants to travel rent-free…

8 Steps to Become a CouchSurfing Guru

1. Create a detailed profile.

Your profile is your key to the Couchsurfer’s kingdom. It allows hosts to learn about and trust you before meeting, and it will be a magnet for other fun surfers wanting to connect. It will behoove you to invest enough time and energy into building an awesome profile.

Here’s a screenshot of mine:

I cannot stress enough how important it is to accurately represent yourself. There’s no use in trying to be someone you’re not, or being bashful about your spiritual beliefs or diet preferences. If something is really important to you, then tell people! Show the community who you really are! The more information you can provide other members with, the better odds of everyone having positive exchanges.

Here’s what you’ll need to do in order to create a great profile:

1. Register on Couchsurfing.org. After signing up, you’ll be asked if you’d like to verify your profile with a contribution. You can skip this part for now (we’ll cover it in “Step 2: Verify Your Profile”) and begin creating your profile right away. Just click your name in the top left corner, then click ‘Profile.’
2. Post 5-10 pictures of yourself. We are visual animals, so don’t be afraid to upload a bunch of fun photos of yourself (ideally from any global excursions you’ve been on). Make sure the photos are interesting or remarkable, which gives fellow surfers material to start a conversation with you.
3. Fill out your profile. There are a lot of fields to complete, but don’t worry! You don’t have to complete everything all at once. Fill out as much as you can, then polish up the rest when you’re up to it. [Since I host a lot of surfers, I included a note in my profile to spell the word “couch” correctly when messaging me. You’d be surprised how many people request to stay on your “coach.”]

If you’re already feeling overwhelmed with the task at hand, relax! Spend some time looking at other members’ profiles, take notes on what you like and dislike, then emulate your favorites when you’re ready to get started. And if you need a starting point, here’s my profile. Feel free to use it as a cheat sheet!

2. Verify your profile.

There are two primary methods for verifying your profile, which are designed to increase security and trust with members on the site. Both are technically optional, but I can assure you that you’ll have a much harder time getting started without having one or both of these:

1. Personal references. Ask a few of your friends to leave a positive reference for you, which shows the community that you are a worthwhile person to host or surf with. If none of your friends have profiles on Couchsurfing, check out some of the local activities and meet up with couchsurfers in your area. Let them know you just joined the site, and after you’ve made a few friends, kindly ask if they’d be willing to vouch for you.
2. Credit card verification. As mentioned in Step 1, you can pay a contribution to “lock in” your name and address. You’ll be mailed a postcard in 1-2 weeks with a code that you can enter into the site.

Members trust members who have been verified, so do not skip this step!

3. Seek compatible hosts/surfers.

Now that you have the two most important pieces in play, it’s time to get the ball rolling. Click ‘Surf’ or ‘Host’ in the site’s navigation bar, enter in your destination, and begin looking through the list of members in the area.

You can also set a number of filters to improve your search results, including:

- Age
- Gender
- Language
- Keywords (e.g. “vegetarian filmmaker”)
- Has photos
- Has been verified
- Most recent login
- Apartment is wheelchair accessible

Take some time to go through all the profiles in these results. It reallys pay off to thoroughly examine a potential host’s/surfer’s profile before you decide to contact them. That means reading their description, scanning their photos, and going through each of their references. Some hosts will want to hang out with surfers; others are short on free time. Some hosts own three cats, or they need to wake up at 5:30 AM… Whatever the case, you can easily avoid mishaps and unpleasant experiences by figuring out what their expectations are of you.

Couchsurfing’s official recommendations for finding compatible hosts and surfers.

Although the chances of an ax murderer hosting or surfing with you is slim-to-none, I always always ALWAYS read people’s profiles diligently. I do not share interests in “making hair dolls” or “watching you sleep,” so I do my best to steer clear of members who could pose a problem.

Once you’ve found a fellow Couchsurfer whose expectations and priorities appear to be aligned with yours, it’s time to reach out!

4. Write legendary requests

The purpose of your first message is to show the recipient how great it would be for you two to connect (it is NOT to immediately reserve a free couch). If you can successfully show that you’re someone they have to meet, a friendly dialogue will begin and you can make plans from there.

Here are a few ways you can create legendary requests:

1. Make it personal. This is absolutely essential. No matter how many requests you send out, every single one should be custom-tailored for its recipient (cut-and-paste CouchRequests are so obvious!)
2. Create a video request. If you really want to stand out, record a video with the camera on your computer and appeal to your host directly. Upload it to Youtube as an unlisted video, then send them the link. This might take longer than writing a message, but it gives them a much better idea of how well you’ll get along and improves your chances of being accepted.
3. Write a catchy headline. Include something about who you are and/or how you want to connect. For instance, one surfer sent me a request during a very busy week. She grabbed my attention in her title (“SOS Fellow Entrepreneur Coming to San Fran!”), then mentioned our similar interests in books and dancing. I made sure to meet up with her the following day!
4. Make it memorable. No one likes boring messages, so include at least one thing in your message that makes you stand out. Mention something you both have in common, suggest cooking them a homemade dinner, talk about your life path or your love for Mario Kart… anything that sets you apart from the crowd.

Be respectful when you reach out to other members. Remember: Surfing is a privilege, not a right. When someone writes a lame request, where they show no interest in their host but free accommodation, it destroys their chances.

Here is an example of what NOT to write in a request:

Hi, my name is Anna, im 20 years old student. I am in New York for summer and am looking for coach. Looking forward to hearing from you – email me on ***@gmail.com

And yes, that is an actual message I received.

The correspondence you have beforehand establishes your connection with this person, so be sure to do it right!

Send CouchRequests to five members, 1-2 weeks prior to your arrival, and you’ll have a couch lined up in no time.

5. Preparing for your surf.

Once your host agrees on having you stay with them, you’ll need to exchange contact and travel information. Here’s what both parties should know…

If you’re surfing:

1. Confirm your arrival and departure date. Although you might change these dates, it’s always polite to set reasonable parameters. This is CouchSurfing, not CouchLiving, so be clear when you’ll be in and out.
2. Write down your host’s address and phone number, and enter it in your cell phone. I can’t tell you how many times I forgot to charge my phone when entering a new country. When traveling, expect for some type of miscommunication or technology fail.
3. Have a backup plan! Whether it be your creeper meter or inevitable failings of plans – you need to have a back up. You’re in a foreign country and always need safeguards. Make sure you have established contact with a few other CSers who you might be able to call/message in an emergency, as well as the locations of some hostels before you arrive. Also, knowing where the nearest Internet cafes are can help you in a pinch to try to find a new place to stay if necessary.

If you’re hosting:

1. Send the surfer your address, phone number, and directions to your couch. Include any details about hidden keys or codes to get in (assuming you’re comfortable with this). And if you’re feeling generous, offer to pick them up.
2. Have their couch ready and room tidy.
3. Have a few local recommendations in mind. Your surfer will want to know the must-sees and tastiest dishes. This is your chance to show the best of your hometown!

One more thing… CouchSurfing is NOT a dating site. Don’t make your host or surfer uncomfortable by crossing into OKCupid territory. And yes, I’d be lying if I said I’d never been attracted to a host or surfer. I’m just saying… keep it classy.

Let the surfing begin!

6. Immerse yourself in their culture.

Congratulations, you’re not in Kansas anymore! It’s time to mute your hometown identity and embrace this new culture. This is harder than it sounds at first, but you will quickly get the hang of it.

Here are a few tips to make your time in this new world much more pleasant:

Avoid tourist tendencies. See the spots you want to see, but don’t follow what every tourist does. If your host is willing, let them take you off the beaten path to their favorite local spots. And whatever you do, leave your “I <3 NYC” t-shirt in your bag.

“When in Rome…” If you’re in a different country, curb your ethnocentrism and attempt to assimilate. Learn how to say “hello” and “thank you” in the native language. Respect their customs, try new foods, use the hole-in-the-ground toilet, be willing to go out when you are tired… In short: show your appreciation!

Facebook surgery. You’re traveling, nerd! Peel yourself away from the computer and go explore Your friends will withhold their ‘Likes’ of your photos until you return.

7. Express any concerns or issues.

If, at any time, you aren’t happy with your CouchSurfer’s behavior, be sure to tell them why. In most cases, the problem will be unintentional or a cultural difference. But if you don’t speak up, your CouchSurfer might never know they’ve bothered you (or vice versa). And if the awkward antlers keep cropping up and lines are repeatedly crossed, it’s your duty to warn the community of your experience in your reference.

In my over 150 CouchSurfing experiences, I have never had to leave a negative reference or had one left about me. However, I’ve had countless instances of cultural misunderstandings and uncomfortable learning experiences. For instance, when I was traveling through Cambodia with my Pakistani friend, Zohra, I thoughtlessly made an off-color comment about terrorism. Whoops. My “sense of humor” was extremely offensive to her, and when I learned about the atrocities she lives with everyday in Pakistan, I realized I’d been watching too many episodes of South Park. Best to leave your amateur hour material at home.

8. Leave the couch better than you found it.

When it’s time to hit the road, make sure that you tidy up and leave your room spick-and-span. If you borrowed anything, double-check that you’ve returned it. If your host isn’t at home when you leave, make sure that you know how to secure the door correctly. Leave a handwritten note or a gift from your home country to say “thanks.”

Last but not least, leave them a thorough reference. If your host treated you well, be sure to write positive things about them so other CouchSurfers will want to stay with them! And if you set the bar with a kick-ass reference, they will usually return the favor.

Final Thoughts

The age of sharing is just beginning. I’ve experienced first-hand the inspiration and transcendence that regularly takes place, and I plan to be a CouchSurfer for life. I want my future children to grow up around different cultures and instill sharing and exchange. And when I’m too old to travel myself, I’ll be hosting from my rocking chair.

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Do you have a story about how Couchsurfing or the sharing economy changed your life? Tell us in the comments!

Also, there are two public screenings of One Couch at a Time coming up soon…

- San Francisco - January 17th (tomorrow) @ 6:30PM at The Hub SOMA, 901 Mission St. (Buy tickets here)

- Los Angeles - January 26th @ 6:30PM at Just Cause Entertainment, 4130 Del Ray (Buy tickets here)

We’d love for you to come join us! (If you’d like to request a screening of the film in your city, click here.)

Last-minute packing is an art form, and most of my trips allow me to pack less than 10 pounds for a world tour.

This time, 10 pounds was just the starting point. My packing list was straight out of a James Bond movie:

“Shovel?”
“Helmet?!”
“Avalanche kit?!?”
“Tracking beacon?!?!”

I was seeing it for the first time around 4pm in the afternoon. The next morning, I’d be departing for Chile for “cat” (snowcat) skiing in Patagonia, after six years of no snow sports. What the hell had I signed up for?

Baptism by Ice – 15 Key Lessons

This post is based on my lessons and experimentation with the PowderQuest crew, with special thanks to Mo and David.

The first day was sheer terror. The second day was an improvement — just laughable. Then, around the third day…

Suddenly, I was skiing powder.

It wasn’t a gradual learning process. There were a few critical insights and lessons learned that immediately changed my ability to handle powder.

Here they are.

Positional tips and posture:

- Read a big newspaper. Keep your hands in front of you and downhill, as is reading a big open newspaper. Never read newspapers? Aim for about 6″ outside of shoulder width. Look at the picture sequence at the top of this post and notice the arm positioning throughout.

Keep your hands further ahead than you think makes sense.

- From this newspaper position, plant wide with your poles before your turn, and only move your wrists. Keep your arms from moving and flying backward, which throws you off balance — maintain newspaper position.

- Narrow your stance a bit, but not so close that your skis are touching. This will help with the “one ski, one turn” turning mantra discussed below.

- It’s fine to squat down a bit, but don’t let your knees end up behind your ankles. If your weight is this far back, you will suffer. “Sit back more!” is common powder-skiing advice, but all it did was burn out my legs and unweight the front of the skis, which led to the tips crossing more easily. Crossing = face plant. If your hands are forward, your weight is forward; if you hands are back, you’re weight is back. Once again: keep them more forward than you think makes sense.

- Scrunch your toes occasionally to test excess back-lean. If you can’t scrunch your toes, you’re leaning too far back.

Turning:

- Imagine your turns as rounded zig-zags down a hill. Squat at the mid-point of the straight lines, then — without a pause at the bottom — stand up to near-straight legs, which will unweight you. This is when you turn. Don’t time turns for when you are moving slowest; time turns with when you’re naturally unweighted.

- [This was big for me] Don’t avoid bump-like contours in the snow — aim for them! Rather than navigate around these bumps, run up them to unweight. It actually makes turning easier. Be sure to speak with a guide or snow patroller who can teach you the different between safe snow bumps (all snow) and dangerous bumps covering submerged rocks.

- Make turns with your femur (thigh bone) instead off the edge of the ski. In other words, envision your thighs rotating in your pelvis, in the same direction, to turn the skis.

Don’t ski as you would on harder snow. If you catch your lower edge to turn (fine on groomed runs), the lower ski will just shoot under the snow, cross under your floating top ski, and you will then eat snow.

- “One ski, one turn” — a mantra for the preceding point. Make all of your turns as if you have one big ski, and rotate your thighs instead of catching edges. Try and maintain equal pressure on each ski for the entire run.

- Don’t rush it. Imagine taking nice, rounded turns — again, using your femur to slowly rotate the skis — as opposed to the hopping into ice-scaper-on-windshield zig-zag.

Notice the “S”-like curves after the straight-away traverses.

Gear:

- USE FAT SKIS. Once you go fat, you will never go back. Additionally, a little bit of rocker (reverse camber) goes a long way. This approach was originally tested by the renegade skiers who rigged waterskiing skis on snow.

- Drop some cash for boots if you can. I don’t ski often, so I wanted to rent skis, but damn: I was punished for renting boots. Particularly if you’ll be spending several days out-of-bounds or in the backcountry (“off piste” or fuera de pista in Spanish), particularly if you might be spending thousands on a trip, spend a few hundred on boots that will custom fit and last. Having foot pain while far away from ski lodges for 10-15 hours at a time sucks.

Find a good bootfitter at the resort, get a pair the first morning of a multi-day trip, and have the bootfitter adjust hot spots and customize to your foot that afternoon for pick up the following morning.

Falling and Yardsale Insurance:

It’s not a matter of if, but rather when, so learn how to get up the right way when you flip.

- X-factor: If you fall, don’t put your hands down to push yourself up, as you’ll simply fall through and get a snow sandwich. Cross your poles into an “X,” hold onto the intersection with one hand, place it uphill from you, and then push yourself up.

- The Sweeper: If you are a fall-prone novice, as I was, ask or hire someone to play “sweeper” and ski behind you, so that they can help you find skis if you eject out of them or “yard sale” (when you fall spectacularly and your gear shoots in all directions). Experienced skiers can still have fun while doing this for you, as they don’t need to ski slowly, but rather start their descent well after you.

- If you eat sh*t 10 times in a row, do two things. First, pause after each turn, or pause after getting up, and catch your breath for 20 seconds. No rush, brah. Second, when you’re ready to punch yourself in the face, or when your legs are totally shot, put your big girl pants on, head down to the ski lodge, and grab a hot chocolate or Hot Toddy by the fire. That will calm your inner animal, make you smile, and get you psyched to tackle it again in the morning.

Learning to ski powder can be immensely frustrating, but — like most things — it doesn’t have to be. If you’re looking for an incredible tour company for Argentina or Chile, take a peek at PowderQuest, who were simply awesome.

Enjoy the fresh tracks!

Have some additional tips? Please leave them in the comments!

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Odds and Ends:
Join me in Australia with Sir Richard Branson; Live Kindle Q&A

First, I’m finally making it to Melbourne, Australia!

Will you be near Australia Oct 21-22? If you can, join me, Sir Richard Branson, and others here. I’ve never been to Melbourne or this event, but I’m really looking forward to good company, good conversation, and good food.

Second, I will be doing a live Q&A soon for anyone who wants to submit questions via Kindle.

The questions can be about anything in The 4-Hour Workweek or The 4-Hour Body, but if you can tie your question — about tango, languages, Ewoks, etc. — to a passage, ask whatever you like.

Here’s how to send me a question, and early submissions get priority, so please submit sooner rather than later:

1. Using your Kindle (I suggest Kindle 3) or the Kindle App for iOS (iPhone & iPad), highlight a passage in either The 4-Hour Workweek or The 4-Hour Body. You will see options for: Note, Highlight, and Share. Choose Share. This won’t work in the desktop Kindle app.
2. You will see options to share via Twitter and Facebook. Choose Twitter.
3. Type the phrase “@author”, followed by your message to Tim Ferriss. Press the tweet button.
If you haven’t linked your Twitter account, you will see a dialogue that says “Set Up Account – You need to set up your Twitter account before Sharing.” If this pops up, press Okay.
4. Press the “Link Account” button on the screen to link your Twitter account.
5. Type your Twitter username and password, then press “Sign In”. You will be taken back to a screen where you will see your Twitter account linked. Press “Done.”
6. You will be taken back to the Kindle reading app and your message will be sent to the author.

[Warning: This post is one of my rare rants, perhaps my only rant, written last week when the reality-bending fury was fresh. Almost never seen, like a snow leopard, my angry self has come out to stretch his arms a bit, perhaps punch a few deserving people after warming up. The reasons -- primarily the safety of other people -- will become clear shortly.]

SEPTEMBER 25, 2011, CALCUTTA, INDIA
SAFE AT THE OBEROI HOTEL

Earlier today, a hospital superintendent snickered and offered me a feedback form if I had complaints. I declined, as I figured this blog would be a faster way of getting the message to the CEO in question, P. Tondon. Mr. Tondon, nice to meet you.

Forthwith, our promised programming…

The Power of the Checklist

Atul Gawande is an outstanding surgeon, Associate Professor of Surgery at Harvard Medical School, and author of “The Checklist Manifesto,” which details the power of checklists to prevent catastrophes or simply improve outcomes.

From the prevention of airplane crashes to decreases in hospital-based bacterial infections, having a clear, repeatable process is key. I read his book while flying to Amman, Jordan, and I ensured beforehand that I knew exactly where the best hospitals were close to our hotel, the fantastic Evason Ma’in Hot Springs. It’s as simple as calling the US embassy or consulate (if that’s your nationality) via Skype before you land. Here’s a list for your future use.

This week, I violated my own process: I didn’t check on hospitals before traveling.

“Ah… but where to?” you ask.

To Sweden? No, sir. To Japan? No, ma’am. I landed in Calcutta (Kolkata), India. Home of Mother Theresa and pathogens galore.

Ultimately, I ended up spending 3.5 days in two ERs and hospitals.

Before I explain the comedy of errors that led to this post, a few caveats to flavor the haterade for the anonymous ankle biters we affectionately call “trolls”:

- After 30+ countries visited, I don’t believe I’m a spoiled American. Puking on the floor of Chinese hospitals? Check. Getting probes and pokes (not that kind) in Argentina? Done. I’ve roughed it plenty of times and know the world isn’t covered with linoleum.

- I’ve been in dozens of hospitals and ERs around the world, had multiple surgeries, had food poisoning 4 or 5 times, and spent hundreds of hours with MDs for The 4-Hour Body.

- There were a few heroes in the following story, so this isn’t “us versus them” nonsense. Among the heroes: Pawan, our guide; Dr. Gunjanrai from Belle Vue, who saved our asses; and all of the friends I traveled with, especially Dr. Kareem Samhouri.

The Avoidable Pain of Poor Checklists

Preamble complete, here’s an abbreviated version of what happened:

- I ate a usually delicious local Bengali fish, Bekti, at the Tollygunge Club’s Belvedere restaurant, which my girlfriend Natasha later dubbed The “Tollygrunge” Club.

- Diarrhea and vomiting ensued through the following morning, as did fevers. I hit 101 and Natasha passed 102. I made the executive decision to go to the hospital for, at the very least, intravenous (IV) fluids.

- To stabilize my girl, who was incoherent, and avoid 1-2 hours of traffic, we first visited the closest hospital, the name of which I can’t recall. Now things get interesting.

- Enter war zone — Dr. Sumon and Dr. Chatterjee admit us to the ER. Natasha is wheelchaired in and put on a cot. No vitals are taken besides blood pressure. One of the doctors then alcohol swabs the arm, to prepare for IV insertion, following by slapping her forearm with the bare hand he’s just coughed on. I stopped him to correct course, as I had to do so with both doctors multiple times. Eventually, once her IV was delivering saline solution and lost electrolytes, I had to lay down, as I’d declined an IV and could barely stand. My only choice for rest was a cot with dried urine all over it, which Kareem covered with a towel. Who says chivalry is dead?

- The good news: when we leave, the grand total cost is 150 rupees for both of us, or about $3 USD.

Round Two at Belle Vue Clinic

- We leave for a reputedly much-better hospital, Belle Vue Clinic, where we’d be meeting an expat specialist named Dr. Ghosh. Sigh of relief. Natasha is still delirious and nonsensical, so I’ll be the only one coherent for our first day there. The pamphlet for Belle Vue Clinic is seductive:

Equipped with the finest resources of medical science, the clinic’s emphasis is on relief, reassurance, recovery and rehabilitation.

At Belle Vue Clinic, a patient is not a bed number. He or she is consider as a member of the Belle Vue family. A scrupulously clean and homely ambience is provided. There is always service with a smile.

- Without further ado, here are a few highlights from our slapstick treatment. Keep in mind, Belle Vue has good materials and drugs on hand. Their “Rules and Information” brochure reads “44 years of proven and trusted medical care of international quality.” In retrospect, I realize that “international quality” could mean “From St. Lucia to Somalia, we combine the most preventable mistakes possible.”

The following are process fuck-ups:

* Upon being properly admitted, a “sister” — or nurse attendant — takes my armpit temperature without paying attention. It’s half in contact with my shirt, resulting in a 98-degree output. “Fever, ne,” (“No fever”) she says and starts to walk away. I yell for her to wait, pull an electronic oral thermometer out of my pocket and repeat the drill: almost 102. “Fever, yes.” She later insists twice that I have no fever, until the doctor puts a hand on my forehead and settles the matter in my favor.

* Natasha had a terrible reaction to pain medication they administered, Drotin® (drotaverine), and collapsed on the floor that night after going to the bathroom. No one was watching her properly, so I had to leap out of bed with my IV and help her get up. They administered it the following day and Natasha’s temperature skyrocketed and she began to shiver uncontrollably. I called Dr. Ghosh, got no answer, and did what I could: tell all staff to absolutely NOT administer any more Drotin. When Dr. Ghosh arrived around 7pm that evening, I told him the same, which he said he’d note and convey to all staff.

That evening, as Natasha was falling asleep and I was going to bed, a nurse comes in with — guess what? — a syringe of Drotin to give Natasha. Fortunately, I wasn’t in the bathroom and intercepted it.

* Natasha ran out of toilet paper — as we did several times, which diarrhea will do — and rang the call button. The sister who came in asked her to use water instead to wash off. My girl, as I would hope, refused. The sister then took a dirty towel she’d used to wipe Natasha’s feet and offered that. Again, no dice. Eventually, we got the toilet paper with a chuckle of “fussy” in English. Bonus anti-hygiene points: The bathroom featured a used bar of soap from the prior occupants and nothing to dry your hands with.

* The second or third afternoon, Natasha’s feverish temperature was put in my chart, resulting in them attempting to switch our medicines. I had to make the correction.

* Critical requests for water (we’d been instructed to drink a certain number of liters per day), IV bag changes, IV blocks, etc. often took 10+ call button rings over 30 minutes. Calling Dr. Ghosh, as he encouraged us to do “anytime” did little or nothing, as he didn’t pick up 90%+ of the time. If he did, he said he’d speak with staff and then nothing changed. This meant we had no reliable English or supervising physician at the hospital until Dr. Gunjanrai rescued us by sheer good luck. Achtung: there appear to be quite a few people who speak English at Belle Vue. I’m not being an uppity entitled American; they had the capacity to triage this, even if it meant making the dietician, who was outstanding and spoke excellent English, our point person at additional out-of-pocket cost.

* Dr. Samrat Chatterjee (I ALWAYS write every doctor’s name down when being treated) enters our room to tend to us: a blood draw for me and a new IV for Natasha. He points to Dr. Kareem Samhouri, my friend who was visiting during proper hours, and says brusquely without looking at him, “You can leave,” while pointing at the door. I make it clear that Dr. K is my physician on the trip and listed as next of kin: he’s staying. Dr. Chatterjee then starts taking my blood sample and refuses to answer any of my questions, which focused on an odd yellow liquid in one of the collection tubes that mixed with my blood. Then to Natasha: Dr. Chatterjee rushes into the new IV insertion as Natasha screams in pain. He laughs and tells her she’s overreacting, repeating “fussy” with shake of the head. Later, when Natasha’s forearm skin swells up like lemon holding liquid, Dr. Gunjanrai will try and aspirate (draw out) blood from the IV — nothing. If you can’t get blood out of an IV, guess what? It ain’t in a vein. It’d been pushed into the tissue and several liters of fluid had been forced into Natasha’s worthless sham IV.

Dr. Chatterjee, you’re a motherf*cker and should have your medical license revoked. Hopefully this post gets you part way there. You’re welcome.

* The next day, my IV clogged at least a dozen times. Somewhere between 6-12 times, I was therefore given “Hep-Lock,” named after it’s principle ingredient, heparin. Heparin can be quite dangerous, fatal if you overdose, and neither the nurses or Dr. Ghosh were remotely concerned. The blocks were blamed on me getting up to go to the bathroom or on me bending my arm. My left arm was so swollen and red from heparin that I had tingling in my fingers and couldn’t straighten my arm.

Dr. Gunjanrai, our repeated savior, replaced my IV when she removed Natasha’s sham IV. Problem fixed and perfect flow. No blocks. The only issues that cropped up were, again, process-related. On two occasions later, there was no drip; the nurses wanted to use more Hep-Lock (not a chance), so I used sign language to show they’d forgotten to put an additional needle in the IV bottle to create necessary vacuum and flow.

* On our last morning, we were to have fasting blood draws for follow-up testing. Natasha’s blood was drawn but mine was not. Since Dr. Ghosh had told us the night before we’d both be tested, I asked the sister, who replied with “Not you.” But yes! About 30 minutes after I’d finished breakfast, I was told that I’d have a sample drawn (we also had our temperatures taken right after we’d downed water). “Doesn’t it need to be fasting? Typically 8-12 hours?” No problem, I was assured.

Now, I’m no MD, but I’ve had compared hundreds of my own blood values. Blood readings taken 30 minutes after eating are not the same as from fasting. Not even close.

The End Result

We survived.

Even though I was more coherent than Natasha, I was a mess of delirium. My diarrhea was about three-times worse that hers (by frequency), I vomited more, and there were some episodes I won’t describe here, as they’ll make you nauseous. To maintain hawklike spider-sense while incapacitated, quality-controlling everything to avert disaster, is taxing beyond belief.

No one should have to do it when such simple measures can fix it. All of the above issues can be fixed with proper protocols and checklists. This is not the first time Belle Vue has had serious process screw-ups. Read this appalling news flash of a newborn baby declared dead, only to be later found alive.

But perhaps Belle Vue is too poor to make things work? Not likely, at least not based on my bill.

Cost: about $1,350 USD per person.

Dr. Ghosh’s fee? Almost 50% of each bill. Extortionary. He’s an outstanding ER physician, and he’s saved many people with horrifying injuries and infections. That said, if he’s almost never available to his patients (us in this case) and can’t manage staff to follow his life-saving directions outside of his 7-8pm visits, his expertise does next to nothing. I suspect he’s amazing when on the case 24/7. In our case, it was as if he weren’t there. 50% of the bill is an insult.

Dr. Gunjanrai’s fee? Less than $20. Give that woman a raise. She’s a superstar. I know she doesn’t have Dr. Ghosh’s credentials, but she fixed every problem she encountered, undid the messes created by others, and did it all with a Zen-like calm that made us calm. That’s a good doctor.

P. Tandon, fix your hospital. If you didn’t know already, now you do.

If you choose inaction at this point, you should be charged with premeditated homicide.

Here’s your feedback form:

The Bright Side

Experiencing pain allows you to appreciate pleasure.

Looking at the creature comforts of San Francisco, the world-class medicine I perhaps took for granted, my experience in Calcutta was a useful recalibration.

Getting the Belle Vue treatment is not necessary to increase your appreciation of what you have. This should be a principal goal in life, of course, as gratitude will determine your happiness more than achievement. In fact, Stoic philosopher and master statesman Lucius Seneca encouraged his students to practice poverty for precisely this purpose. From Martin Frost’s excellent introduction:

The second type of apathetic training proposed in the Moral Epistles is practical training, which is essentially a Stoic modification of a common Epicurean practice. In Epistle 18, Seneca informs Lucilius that Epicurus frequently set aside a number of days in which he satisfied his hunger with cheap food. The goal of this exercise apparently was to develop enough self-sufficiency that he would be able to remain happy, regardless of what his circumstances might be. Using this example, Seneca similarly advises Lucilius to practice extreme poverty for limited periods in order to test the ability of his mind to withstand the loss of his wealth in the future.

Although Seneca does not expect this type of practice to go on indefinitely or to be too severe, he makes it clear to Lucilius in Epistle 13 that it should be more than just a “mere hobby” that rich young men might play to “beguile the tedium of their lives.” Even though it is meant to last for only a few days at a time, the method should be harsh enough that it can prepare the subject for the most extreme reversal of fortune—the possibility of utter destitution.

Rehearse worst-case scenarios and they lose their power over you. Practice what you fear and ask all the while: “Is this the condition I so feared?”

You’re more resilient than you think.

34. I’m turning a glorious 34 this year, right about now.

It’s going to be a great natal year–-I can already feel it. Perhaps it will be good luck for you, too: in this post, I’m giving away a round-trip ticket anywhere in the world.

But back to that strange birthday gift…

Much to the chagrin of my momma-san, I’ve become quite difficult to buy presents for. Some friends even think I’m impossible to find presents for.

It’s not entirely true. I love handwritten letters, home-made brownies (like Fred Wilson), girlfriends dressed in next to nothing, and–-most of all-–when people do something nice for others.

In lieu of gifts this year, my birthday wish is to help the poorest kids in the world learn to read. I believe literacy, and the self-determinism it allows, is fundamental to solving the problems of this world. Want an alternative to extremist terrorist schools, to have fewer welfare states, or to prosper with better economies? Teach people to read and help themselves…

On a personal level: can you imagine never having read a book? Never being able to satisfy your intellectual curiosity? That’s unacceptable.

Since I am turning 34 this year, if you feel so inclined, please help me build a library for children through Room to Read by donating $34 (or whatever you can) to my donation page (give it a minute to load). Readers on this blog have already changed the world in real, significant ways, like this school in Vietnam that you all built!

A stand-alone library costs just $20,000 and can provide the educational foundation for multiple generations of kids. Here are two additional kickers:

- If you all help raise $20,000, I will personally foot the bill for another $20,000 library.
- I will put the names of the top 20 donors (and one person below) on dedication plaques placed on each library, 10 people per library. These are real libraries that will be finished in 2013, which you can see with your own eyes. It’s an incredible feeling you’ll never forget.

If we don’t reach $20,000, the funds will still go to Room to Read directly for building schools. If we raise more than $20,000, all extra funds will go to building more schools.

Beyond the good karma, I’ll add another incentive to act now: a free round-trip ticket anywhere in the world that Star Alliance flies, which is just about everywhere. There is no expiration date on the trip, so no rush on deciding where or when to go. Here’s how it works:

No later than 11:59pm PST this Sunday, July 31st:
- Spread the word however you can. Send people to this post or to my library page.
- Leave a comment below telling me what you did (Facebook, Twitter, e-mail blast, add to your e-mail signature, encourage employees/friends to do the same, etc.). Measurement of any type gets huge bonus points.
- Lastly, answer the following question at the top of your comment: “What does education mean to you?”

I’ll pick the top five promoters, and you’ll all vote on the winner of the round-trip. Easy peazy. This winner will also get his or her name on one of the school plaques as a top donor. Pretty sweet, right? Perhaps that’s where you’ll globetrot with your free round-trip ticket?

But the best reason of all…

Beyond the bribes, you’ll feel awesome about yourself for doing real good for little ‘uns who have so little, perhaps no future without education. Trust me.

Superman is not coming to help these kids, nor is the government–will you pause for a moment and step up for even two minutes? It would mean the world to me. I’ll share pictures and updates from first construction to opening day.

Again, here is where to go to donate $34, $1, $1,000, or whatever you can.

Thank you for reading this post. You are all rock stars, and I continue to write on this blog purely because of you.

This is a guest post by Tim Leffel, a travel destinations expert who has dispatched articles from five continents over a period close to two decades.

Think world travel needs to be expensive? Think again…

Enter Tim Leffel

Like an annoying house guest who keeps packing but doesn’t leave, this recession keeps dragging on. That downsized international vacation can still be exotic though—if you pick the right destination. Or if you really want to alter your finances for the better, move to one of these places as an expat.

The dollar is in healthier shape than it has been many times in the past in relation to the euro and pound sterling, but a trip to one of Western Europe’s capitals still feels like a shopping trip to Tiffany’s. Australia is not much better, and a trip to Japan could drain your whole life savings in a week.

Here’s a better idea: go someplace where your travel dollars are still worth a bundle.

Below are some of the best deals on the planet right now, destinations that are relatively easy for travelers and also easy on the wallet.

1. Egypt

Photo: Jungle_Boy

Despite having some of the world’s best-known monuments, Egypt struggles to fill its abundant hotels. With less-than-wealthy locals far outnumbering the tourists, it’s easy to find a bargain meal or a guide or taxi driver. (They’ll find you whether you need them or not.) Admission prices for the ancient pyramids and temples are reasonable, generally ranging from $3 to $14.

Sample deals: a first-class train ticket from Cairo to Luxor for $17; a Nile-view deluxe double room in Luxor for $60 with breakfast; a private room by the sea in Dahab for under $20; entrance to the Nubia Museum in Aswan for $4; a falafel sandwich at a Cairo street stall for 40 cents. There’s no great independent travel site for the whole country but Egypt’s official tourism site is better than most.

2. Indonesia

Photo: Erik K Veland

This Southeast Asian nation is one of the most diverse and attractive destinations in the world, with a long string of volcanic islands and a range of topography and culture. It could also be the best value on the planet, with cheap hotels going for $5 a night, often right beside great snorkeling spots. Bali is the most developed island, but even there you can find plenty of deals. On Java, Sumatra, and Sulawesi, however, it’s easy to branch out like an intrepid explorer or get pampered on the cheap in the most popular spots.

Sample deals: a double room with pool and breakfast in Yogyakarta, Java for under $20; a five-day small ship cruise between Lombok and Flores islands via Komodo for $200 per person including meals; a first-class train seat from Jakarta to Yogyakarta for $25; an hour-long massage for $8-$15; a day’s motorbike rental on Bali for $10. Indo.com has a good listing of mid-range hotels in Bali and some other areas while the official Indonesia tourism site has travel info and enticing photos of the diverse islands.

3. Mexico

Photo: Tim Leffel

In mid-2008, the peso was at 10 to the dollar. Now it’s close to 13. That’s a discount of more than 25 percent in a country that was already a deal. Plus Swine Flu followed by drug gang violence on the U.S. border has meant that travelers have tremendous bargaining power on hotels and tours. To find the best values, visit the historic colonial cities or beach areas where Americans don’t outnumber the locals. (As in places where there’s no Señor Frog’s in sight.)

Sample deals: a three-course lunch at a market stand for $4; nice hotels in centuries-old colonial buildings for under $75 double with breakfast and Wi-Fi; a round of Negra Modelos for five at nearly any bar, including gratis snacks, for $10; and some of the nicest deluxe buses in the hemisphere for $6 to $8 per hour of travel. It’s a big, diverse country, but here’s an extensive set of links and the best books on one page: Mexico travel resources from Travelers-tool-kit.com.

4. Honduras

Photo: Tim Leffel

Few people knew anything about this country until it was all over the news last year when the president got forced out of office. You can find fabulous deals on scuba diving packages on Roatan Island. This Caribbean island sits next to the second-longest coral reef in the world, and every hotel seems to offer attractive package plans no matter the season. On the mainland you’ve got tropical national parks, the rugged Moskito Coast, and Copán, one of the key Mayan sites in the Americas and a great little colonial town.

Sample deals: $35 white-water rafting trips; weeklong learn-to-dive packages with room, breakfast, and transfers for under $600; a cold coconut with a straw for 40 cents; and admission to the Copán archeological park for $10. For more info, see the Honduras Tips site or Roatan Online, or see more travel prices in Honduras here.

5. Guatemala

Photo: Tim Leffel

This is only a shade farther to fly than Mexico, but it is a truly exotic destination. The descendants of the Mayans still dress in traditional clothing in the villages surrounding stunning Lake Atitlán. The Spanish colonial buildings in the city of Antigua are older than anything left standing in our historic city districts. The sprawling archeological park of Tikal is the granddaddy of Mayan ruins, and still surrounded by jungle.

Sample deals: taxis in Antigua for $4; great hotels with a view on Lake Atitlán for $60 a night; a week of private Spanish lessons including homestay starting at $180; a zipline canopy tour near Tikal for $30; three pounds of bananas or avocados for a dollar. La Ruta Maya Online is the best resource for hotels, tours, and Spanish language schools.

6. Peru

Photo: Tim Leffel

Machu Picchu alone is worth the journey, but it’s just the start in this value-packed country. Inca ruins are scattered all around the Sacred Valley, and Cuzco is one of the most attractive cities in South America. There is also hiking in the Andes, admiring colonial architecture on the streets of Arequipa, trips through the Amazon, boating across the highest lake in the world, and flying over the strange Nazca lines.

Sample deals: Bus from Arequipa to Colca Canyon – $6; a big traditional lunch and a beer for $7; simple restaurant meal in the countryside $6 for two; entrance to the Inca Museum in Cuzco for $1.50; cheap single room or hostel bed $4-$10; airport taxi in Cusco $4. Andean Travel Web is an exhaustive resource site for trekking info, hotels that are a good value, and general travel info.

7. Thailand

Photo: ccdoh1

As with Honduras and Mexico, visitor numbers plunged when Bangkok was all over the news recently, so there are plenty of deals on airfare, tours, and hotels. This is a popular destination for travelers of all budget levels. Thailand continues to be one of the best bargains in the world in terms of hotel prices, and with a well-developed infrastructure, it’s easy to get around and see what you want to see, be it historic ruins, Buddhist temples, or tropical beaches.

Sample deals: a standard double at a true 5-star hotel in Bangkok for $250 or less per night—or a cheap place to flop down and sleep for 1/20th of that price; admission to the main ruins in Sukothai for under $2; a first-class round-trip sleeper train from Bangkok to Chiang Mai for about $40; a Skytrain ticket across Bangkok for about $1.30. The hands-down best travel resource for Thailand is Travelfish.org. They also put out some great iPhone/iPad apps on specific regions and islands.

8. Czech Republic

Photo: Tim Leffel

In much of Europe, prices in the big cities are often double what you find in the countryside. This is especially true in Eastern European countries like the Czech Republic, where vacationers on quick weekend breaks have driven up hotel and restaurant prices in Prague. In the smaller towns and cities, however, the country is one of Europe’s remaining great values. Castles on hill crests, some of the world’s best beer for a dollar or so in a pub, and winding cobblestone streets without crowds—Ye Olde Europe without the new Europe prices.

Sample deals: a room at the best hotel in town across Moravia for under $100 with breakfast; fully equipped hybrid bike rental for $25 a day; sommelier guided 12-bottle tasting at the Wine Salon of the Czech Republic in Valtice for $19; a train ticket from Prague to anywhere in the country for $12 or less. The official Czech Tourism site is excellent while MyCzechRepublic has good general info on different regions plus a message board. See more Czech prices outside Prague here.

To dive in deeper on any of these cheap destinations and see the current situation on the ground, check the message boards at LonelyPlanet.com and BootsnAll.com.

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Travel writer and website publisher Tim Leffel is author of “The World’s Cheapest Destinations” and runs the Cheapest Destinations blog.

[This post is an updated version of an earlier article that appeared in the Boston Globe travel section.]