Never Again...

07-13-2007

…will I write in my blog “Hopefully, I’ll have some better stories for next week.” I guess I had it coming to me. I just got a letter from my mom that says she wants to know it all, good and bad. Well, here you go Mom – without the sugar coating.

But before I tell you all the bad stuff, I am going to spoil the ending and share a short passage from Thich Nhat Hanh. I can’t find the quote so I’ll have to paraphrase a little.

He talked about never forgetting the good things in your life. We tend to focus too often on things that we are suffering through and not the things that we are given. He asked you to remember the last time you were sick and could not breathe through your nose. Now remember the first time after being sick that you could take a big breath through both nostrils and how good that felt. If we can be that happy after one breath, how many other things are going right in our life that we are not acknowledging?

This is all to say that I’ve taken that breath after this experience and I won’t forget it. Now, stop here if you are a fan of the sugar coating…no, really.

Monday night, I was having a hard time getting my dinner down. It definitely wasn’t my favorite meal, but I’d eaten it before without a problem. That night as I was trying to swallow my last few bites (trying to show respect for the food and the cook), I was getting a gag reflex. I managed to not let my host mother know that I was gagging on her food and even to finish the last few bites. I didn’t think much of it until I was closing my window before going to bed. I could tell my muscles were a little fatigued and my brain put it together right away: “You’re getting sick.” I’d been sick twice in the last two weeks – maybe why my brain put it together so quickly. The first time was a fever with chills that woke me in the night and was gone within 24 hours. The second time was some kind of food poisoning that started in the night with vomiting and diarrhea and continued for two days with diarrhea and stomach cramps. Each one cleared itself up on its own, but I was not looking forward to what lied ahead of me that night

I woke up after one hour of sleep and the vomiting and diarrhea commenced. I woke up every hour thereafter with more vomiting and diarrhea. By the time morning came, I told my host mother I couldn’t eat breakfast and notified Peace Corps that I wouldn’t be coming to classes. They asked if I needed to go to the hospital. I told them no, I just needed to rest. By 11 a.m. my host mom, worried by my still frequent trips to the bathroom, had called Peace Corps and they had set up an appointment with the doctor at the hospital. I didn’t realize the shape I was in until I had to walk 50 yards to the PC vehicle. I had quite a fever, and because of all those trips to the bathroom, I’d become incredibly dehydrated.

A short but bumpy ride later, we made it to the hospital, which I would describe as a cross between a motel and an outlet mall. There were lots of different buildings all connected with covered walkways. There were lots of people standing and sitting around. I wouldn’t have known where to go on my own, but the Peace Corps driver walked me slowly over to a woman sitting at a desk outside of one of the buildings. While he convinced the woman that we were going to pay and needed to be seen right away, I puked in the bushes and then sat down on a bench to wait.

After a short visit with the doctor, they decided they needed to put me on intravenous fluids and do tests for malaria. I had only seen a handful of mosquitoes in Africa and had not been bitten to my knowledge. I’m also on prophylaxis, but they always rule Malaria out first because it is so common and dangerous if untreated. The Peace Corps driver took me through the walkways and we ended up in a hospital room where I immediately crashed on the bed. It was the only piece of furniture in the room, with terribly worn out springs and an old mattress without sheets. The room had windows on one wall with a decent view but one was broken as if someone had thrown a rock through it. The bathroom was very small. There was no room to move around as there was a toilet on your left (its seat and lid sitting on the floor next to it), a sink in front of you, and a barrel on your right, filled with water to flush the toilet in case the water was shut off. There was toilet paper but no soap.

After a few minutes of being alone, a nurse came in to take my blood. I don’t know why, but she took a little bit from three different places in my arm before hooking me up to an i/v drip. When she came back, to my surprise, they told me that I had malaria. Shortly after, our training officer came to talk with me and offer congratulations on being the first trainee to be admitted to the hospital. He was helping me to make light of the situation, but it wasn’t until then that I realized I’d be spending the night.

After the diagnosis, the nurse added quinine to the i/v bag turning it yellow. I didn’t know it then, but I would come to hate that yellow bag. With the quinine comes a diminution of hearing, ringing in the ears, and a terrible metallic taste in your mouth. I think it might have also been responsible for some mild hallucinations I had later on when I closed my eyes. While the vomiting had stopped I still had very frequent diarrhea, a dull pain in my entire belly and a fever in addition to these new side effects. Throughout all of this, my host mom and Peace Corps staff came to bring me things – all of my meals prepared by my mom, sheets and a pillow for my bed, toilet paper (I ran out quickly and the hospital didn’t have extra), soap to wash my hands, bottled water and Gatorade to drink to stay hydrated, all the prescriptions written by the doctors, tape for the window to keep the mosquitoes out, a mosquito net, insecticide to prevent mosquitoes getting into the room because there was no place to hang the mosquito net, and stuff from my room like a change of clothes, toothbrush and a book to read.

By early afternoon on the second day, and already into my third yellow bag, it became known that because the frequency of my diarrhea hadn’t diminished, I’d be staying another night. From the time I finished dinner and my host mom and brother left, until 2 a.m. when yellow bag number 4 was scheduled to arrive, I went from incredibly low to rock bottom. The absolute unceasing and miserable nature of so many things had built up for too long: In the last 48 hours, I had gone to the bathroom at least 48 times. My stomach ache was intense and hadn’t let up at all from the beginning. It was the least when I would stand up but I didn’t have the energy to stay standing. Sitting added to the pain and lying down, which was the only thing I wanted to do, made it the worst. When I did finally give in and lay down it was on a terribly uncomfortable bed that had already give me a back ache. The spray for the mosquitoes was toxic and breathing it could not have done a thing to help my condition. Almost all of my interactions were in French. While I speak at a decent level now, it takes a lot of concentration, especially because my ears were ringing and it felt like I had earplugs in on top of that. I hadn’t gotten more than 1.5 hours of continuous sleep the last two nights and I didn’t expect much more for the night to come. Those yellow drips – I really despised them. With every bag the side effects got worse and I knew number 4 was coming soon. We had learned in one of our health sessions that malaria is often over-diagnosed to be extra precautious and I didn’t know if my treatment was even necessary. My stool sample was negative for amoebas yet I was taking a medicine to kill them which made the stomach ache worse. I was having to force down food with absolutely no appetite in order to attempt to lessen the pain caused by the medicine. Whenever I would try to think about my stay here in Africa, all that would come up would be negative. I became fixated on one thing – a plane trip back to the states.

When the nurse came with the i/v bag at 2 a.m., I had her wake up the doctor. When he came, I vented. I even called and woke up the Peace Corps Medical Officer (PCMO) so that she could talk to the doctor. In the end, I had to take the 4th bag. The PCMO said she would call the other doctor in the morning and talk about changing my treatment. The doctor kept telling me that the stomach ache and diarrhea were going to be going away by the next day. I smiled and said OK. When they started the drip, I had another hour of imagining that plane ride home and then fell asleep.

The good thing about rock bottom is that things only get better from there. I woke up after getting 3.5 hours of continuous sleep…and I was ecstatic! It felt so good to get that rest. I followed up with the PCMO and we got my malaria treatment changed from the drips to pills and we added an antibiotic because bacteria wouldn’t have shown up in the stool sample. Physically I was still in agony, but I felt in control. Because of the sleep, I had more energy. I could stand longer and I was able to force myself to eat more to lessen the stomach pain. And I found a way to put up the mosquito net so I didn’t have to breathe insecticide for another night – Yes, another night. Despite my 3.5 hour record, my bathroom trips the following morning weren’t any better than the previous days and they still needed to monitor me. As the doctor said it would, though, my symptoms did start resolving themselves early that evening.

After diner, I got a surge of visitors – 8 or 9 people, 3 of whom were fellow trainees. Things were looking up, but that visit really raised my spirits. All the good things about my time in Africa started pouring back. Someone even gave me some treats and their iPod so I could listen to music that night. The visit didn’t last that long, but it was enough. After forcing some food down and taking my meds, I turned on the iPod and found the Beatles’ “Rubber Soul.” It was the album I was listening to when I was packing up my room in Baltimore in preparation for coming to Africa. The second the first song started, the last of my desires to hop on a plane melted away.

I got 6.5 hours of sleep that night and was released in the morning. Things are looking fine. Right now it’s midnight. I’ve been writing for a while and am ready to get a good night’s sleep in my own bed.

Next week we go on site visit. Maybe I’ll have a good story, and maybe I won’t.

Tim