After leaving some newly formed friends on a Thai sleeper train, I was faced with the reality of a three hour wait before my bus connection to the ferry terminal.
While I initially stuck with a Czech couple who got off the same train, I ended up meeting a group of dive instructors who arrived later on. They were on a 'visa run', a trip where expats to run across the border to renew their visas in Malaysia.
It might seem strange, but seasoned travelers know this sort of shit is just par for the course.
The instructors had arrived via bus, soaked. The bus that was apparently so heavily air conditioned that is caused the passengers to simultaneously get soaked by the water runoff and freeze. Happy to be done, they clustered around the not-yet-open ferry ticket office.
It was here that I saw The Bite.
I had been sitting down, politely making small talk when I noticed this suspiciously zit-like wound next to me. I asked the owner what the story was. He promptly noticed the Wilderness Medicine Institute patch on my bag, asking for my opinion. I explained I wasn't a doctor, but that I'd be happy to take a look.
He did not know what the cause was, as it occurred in the night, but was 'fairly sure' it was a bite from a large bug. I wasn't entirely convinced. Regardless of cause, it sure looked infected. He reported a strong, brief fever on the day following the bite, but with the fever subsiding fairly quickly after that.
He also informed me that this was nearly a month after the bite. That didn't seem good. To further complicate things, he had been to some sort of island clinic on Ko Tao, where they gave him what was supposedly antibiotic cream. These clinics are notoriously dubious though and a cream is hardly what you'd want for a massive, seemingly infected lump. I doubt he used it properly either.
Another complicating factor was that he was a diving instructor, and the waters around Ko Tao are known to be chock full of microbes, causing infections rather frequently. Perhaps this was just all some sort of infected cut?
A remote Thai train station at 3AM is hardly the best place for rendering medical aid, but I advised him to seek a doctor. Realizing he wasn't going to do that, I followed up with suggestions that he keep the wound clean and consider finding some way to get oral antibiotics. It all seemed fairly futile though, he was set on heading back to his forlorn dive island. In the end I helped bandage it up a bit and tried to leave him with the impression that any increase in swelling or systemic symptoms should be his trigger for getting to proper help.