march in the delta (clinic)

I absolutely thought it was malaria again – the fever, the aching muscles pulling on aching bones, my increasingly lack of ability to comprehend what was going on around me. Even as I sat on it, I felt like the couch got further and further away. The 104 degree thermometer in my armpit confirmed it. So I called a friend and she took me to the clinic. Malaria, I said, she said. A nurse called the doctor and the next thing I knew I had a handful of little bags – quinine for the malaria, paracetamol for pain and fever, some antibiotic for my guts that was not the loperamide the doctor wanted me to have (“we don’t seem to have any…”). After refusing to be admitted I went home to my friend’s guest room to sweat and hallucinate and shake with wrenching chills while ghostly paperwork flew around the room and my head…manila file folders, pink sheets of paper, envelopes, stacks of things I had done and not done over the previous week haunted me. I must be a nerd if the only things bubbling up when I don’t know if I’m awake or asleep are office supplies.

Anyway, the next day was worse. I threw up the water I was trying to drink, which meant the meds would not stay in my stomach. So back to the hospital we went, and I stayed – even though there was no IV quinine on which to put me, which was the whole point of going in. But then, it’s gastroenteritis, the doctor said, when for a second time they didn’t see malaria in my blood. I was infected with a raging unknown parasite, but he added: “It doesn’t really matter what it is as long as the fever’s coming down.” I was in no shape to argue. Having started the treatment for malaria, I had to finish it or risk developing resistance to it in the future. Quinine, by the way, makes your ears screech while the bitter yellow pills turn your stomach against you. It also wreaks more havoc with your liver than a month of nights at the Maun Sports Bar.

I SMS’d my brother and his wife. “So are you gonna die or what?” he yelled into his cell phone, standing in their kitchen in Italy. The nurses were lovely people but they did not really inspire confidence. Pushing burning antibiotics into my veins every four hours, they seemed to only enter the room when I was in just enough of a stupor to think I might be sleeping. Once I rolled over and my IV tube, hooked into a small bottle of liquid pharmaceutical fire, fell onto the floor. Medicine poured onto the floor. I grabbed for the bottle, twisting it upright while my other arm flailed at the nurse call button. After she stuck the tube back in, I pointed out that at least a third of the bottle was not coursing through me but pooled under the edge of the bed. “Oh, well, that’s too bad, because it’s the last one!” Next, a syringe full of one of the other kinds of antibiotics I was shot full of didn’t want to pour into the IV. So she leaned on the plunger. Hard. The back of my hand swelled with a germinating golf ball of penicillin, my distended vein making my eyes go wide with pain. “Let’s just take this out,” another nurse said softly, later, pulling out the IV needle. And shoving a new one into my inner wrist, so that I could not move my left hand without feeling the drag of the newly embedded needle against tendons and flesh.

I bled into the IV. My guts got me up every hour to go the bathroom. My bed and I slowly took on the smell of my gym bag. My head throbbed and my hips ached with the strain of trying to be absolutely still. I didn’t leave the little room with the indigo-swirled comforter (“It makes me think of water and bugs swimming in it,” said my friend) and pepto-pink door for three nights. I swung at mosquitoes with my dirty flipflop, figuring if I didn’t have malaria when I went in I might well have it by the time I got out.

The fever shrank, but the infection in my guts was unrelenting. Two days in, the doctor commented on my loperamide dosage while doing his morning rounds. “I’m not getting loperamide, you didn’t have any,” I said weakly. “How am I supposed to be taking it?”

“You take a double dose to start, then one more after every time you go to the bathroom,” he said. For the first time I felt despairing tears well up. “They gave me something once yesterday but that was it,” I said. I wasn’t taking the drugs I was supposed to have. No wonder. I have a friend in med school who thinks he wants to be a doctor in Africa. At some point, I remember thinking, maybe I should ask him if he really wants to work under these kinds of conditions. That is, what medication? You mean we should have quinine in stock during prime malaria season? And that there should be a close relationship between what gets written down on a chart and what happens to the patient?

The next day, after nine kinds of medications, half a dozen rotating nurses, three different doctors, the payment equivalent of about forty bucks, and my signature on 34 separate invoices, they let me go home from the Delta Clinic. Mostly I was tired – of more chemicals circulating inside me than blood, of the deafening ring in my ears, of not being able to sleep, of being poked at for what seemed like no reason. But I was also ok. Folks from work had come to visit, called, asked about me. Even the cleaning ladies gushed with relief to see me back in the office, eight days later. And I reminded myself, at least I wasn’t out in the bush. At least I didn’t have a major trip planned. At least my friends were around to look after me. At least I could afford to GO to the hospital. At least, at least. “What the hell were you doin’ in the hospital?” my boss cried over the phone from Gabs when he found out.

Maybe I should have said, I just needed a few days of air conditioning.