Many have probably heard it through the grapevine, by now, but I was terribly ill all day Sunday, while still in Kathmandu. I went to bed totally fine – and perhaps a little drunk – early Saturday night, but woke in the middle of evening in the most immense pain: my legs ached, my back ached, my head hurt, and I couldn’t relieve the pain all night long, no matter how I shifted or turned. I was drenched in sweat but too miserable to try to move anywhere or tell anyone, so when morning came and I wasn’t up at my usual super early 7am doing work (thank you, jet lag!), my friend Kanchan, with whom I’m staying, just thought her crazy American friend was finally chilling out and sleeping in.
I finally managed to clue her in at around noon, when we took my temperature and discovered it was at least a whopping 102 degrees. Now, a fever for me is usually around 99 (I can’t recall if I’ve ever had even a 100 degree fever – I don’t think so), so this was a pretty big deal. I was flabbergasted, but then again I was also flabbergasted that I’d easily just spent the last hour or so trying to divide 7 by 7 – I’m not kidding. As an indication of just how delirious I was, every time I tried to divide 7 by 7 the world ‘alphabet’ would pop into my head, in the same font as on the Alphabet cheerios box, and so I would get confused and try to divide the word alphabet by 7 (they’re not divisible, btw). I then tried to divide the number of letters in ‘alphabet’ by seven, and – yeah, I was riding the crazy train.
I spent a lot of the day trying to just look at and focus on the ceiling, to no avail, and couldn’t do anything to make myself feel better – I nursed a cracker for about an hour until giving up about an eighth of the way through; the only drink I finished was water; I couldn’t go to the bathroom because I got too dizzy, and showering or washing my hands were out of the question. The idea of how much effort it would take to even undress exhausted me. I knew I had a vial of Ciproflaxacin (prescribed by National Geographic in the days of yore – thanks dudes) kicking around my suitcase, but I was too dizzy and nauseous to find it, and my brain was too sluggish to remember where it was until late in the day. At one point I decided I must have Japanese encephalitis, one of the two ‘recommended’ vaccines I decided against getting, and became preoccupied that my brain was melting, and I would have permanent brain damage. I was OUT THERE.
Kanchan and her mom very kindly took on the role of nursemaid and applied cool washcloths all afternoon, which is the only thing for which I remember being glad, or from which I derived any relief. Together Kanchan and I managed to find the Ciproflaxacin, me by weakly calling confused directions across the room, she by good-naturedly searched through my baggage till she found the little vial labeled ‘for fever of unknown origin.” Well, yup, I’d say that about described it. I took one in the afternoon but my fever lingered, so late in the day Kanchan and her mom decided it was time for me to go to the clinic, and I shuffled perilously down four flights of steps to the car. The whole family jumped in (this made me grin with appreciation on the inside, although on the outside I was trying not to barf from all the potholes), and we went off to one of the local clinics.
At the clinic I was an anomaly, to be sure. Everyone stared at me but that was okay, because I was so sick I stared right back, with an “I’m looking at you but I’m not seeing anything at all” expression on my face, and wearing my brown sweatshirt with ‘YALE UNIVERSITY FORESTRY’ emblazoned across the front in the tropical heat, goosebumps periodically cruising up and down my forearms.
When the doctor eventually saw me he seemed to be taking his sweet time for someone I legitimately might puke on at any moment, but after a few minutes Kanchan shared that in Nepali he had said he was waiting for a face mask. To protect himself from me. This is about the moment where I looked at my hosts in horror and wondered if I’d just given them the cooties from hell.
The doctor and everyone else who had the information had realized, as I had, that a woman who has traveled internationally for two days, arriving within the last five days, having spent extended time in four airports and coming into casual contact with literally hundreds of people, would make a textbook case of Swine Flu, or H1N1, as they began to call it after the Egyptians began the world’s largest pig roast a few weeks ago.
The short version of what came next went something like this: doctor lists off my symptoms, including two I did not have, and I tell him so. He insists I have a sore throat because my voice is scratchy. Kanchan wonders to herself when he last heard my voice? No point though, because I’m being referred to the Center for Contagious Disease and Prevention, where I will be tested for H1N1. Everyone in the hallway of the clinic suddenly seems to know where I’m going and what for (remember the cootie bug? And Typhoid Mary? Well yeah, it’s me), and the girl on the phone of the hospital we’re headed towards (which is like a mini CDC, for the Americans out there) sounds excited. I may be about to become Nepal’s first confirmed case of swine flu.
I myself am not excited, although somewhere in the back of my deadened brain it occurs to me with amusement that between Swine Flu and Typhoid I’ll have pretty much the fiercest bragsheet of anyone I know, if I make it through okay. I’ll also probably win every game of two truths and a lie for the rest of history, but that’s not terribly reassuring, at the moment. It also occurs to me that I’ve read Nepal’s most up-to-date regulations regarding swine flu, thanks to an overzealous Google Alert, and I know it requires about a two week in-country quarantine period. As in, if I’m sick, I can’t just go home.
I don’t feel afraid for my own well-being, though. I do feel afraid of giving innocent Nepali folks without health insurance or access to health services the cootie bug, and possibly killing them for my negligence if I don’t get it checked out. I think a bit about how incredibly irresponsible it would be to even go back to Kanchan’s house, if I think I have Swine Flu, and how easy it would be for an American to make a lot of people sick very quickly in a less-developed country, and then survive it themselves because we have better access to healthcare. And I think a lot – a lot – about healthcare, and Obama, and how much it matters and how good of a precedent it is to set, in the world, to make healthcare universal. And so off to the CCDP we go.
When we get to the Contagious Disease hospital, called Teku, it is pretty freaking gross. I try very, very hard not to make unfair comparisons between countries with different resources, but holy god is it gross. The floors are dark and dirty pseudo-stone, the light bulbs are bare and in some places, cobwebbed, and I am led into a room (with finality – as in a, you’re-sleeping-over-because-you-have-swine-flu-whether-you-like-it-or-not type hospital room with hospital bed), and told to sit down on a bed that has obvious, obvious rat excrement encrusted on the blankets. On the blankets. On the bed. Rat excrement. Did I mention there was rat excrement? Did I mention excrement means shit in French? I proceed to become fixated on the poop, obsessed by it, concerned in the insanity of my fever that I both not touch it and also not pass out and fall into it, and in my crazy state check on it periodically to make sure it is really there, and also that it hasn’t moved. It is, and it hasn’t.
The doctor comes in and he is young, maybe even younger than me, and cute and very serious, wearing a face mask (everyone at the hospital had a face mask ready when I got there) and barking questions like he knows he might be about to be famous for “finding” the first swine flu case in Nepal and he doesn’t want to screw it up. I notoriously balk in the face of health care (why do they have to be so brusque? jerks), in part since I am inexperienced in it – I have been very lucky, and never gone to a hospital for anything other than volunteering and my siblings being born.
The doctor threatens me with quarantine as if to keep me in line, and I decide that sleeping on the rat poop would in fact be more than I could handle, at this point, and cut out the sass in my answers. I am also wearing a mask, which makes it hard to answer and is distracting – mine smelled like something unexpected and institutional – not flowers, though. Although I have committed to being serious and answering the questions to avoid a fate of old rat excrement, I still chuckle when he asks if I’m married. I think the question is bizarre (I’m so young!) and Doctor Serious thinks it is, in fact, very serious. Instead he takes my parents’ names and phone numbers, because someone must be responsible for me, right? In the middle of Dr. Serious’s monologue about how he’s going to ruin my Nepal trip his pants begin to ring, to the tune of “Jump on It.” I kid you not. Dr. Serious maintains his composure while I struggle not to laugh behind the mask, but when he turns his back I eye Kanchan and do the Cabbage Patch and then the Sprinkler to the rhythm of his cell phone tone, making his assistant’s eyebrows shoot up and into his hairline. How’s that for serious, eh?
When the good doctor finally fills me in, it is apparent that I do.not.have.swine.flu. The abject absence of a runny nose or sore throat (Beware! Beware!) seems to clear me of the plague, and it’s Influenza A Meredith he is now concerned about. And a much more docile creature, she is. At this point I become a little bit of the pissy, delirious foreigner, and tell him I’ve been vaccinated for it (I later check and it turns out I absolutely have not), and also belligerent because I already had the flu this year, and how many times do I really have to do this?
My claims fall on deaf ears, however, as the snot test and two throat cultures are on tap for me. I’m not going into the snot test – let’s just say they fish out snot with a long Q-tip and leave it at that, shall we? The throat culture is funny because Kanchan and her mother were plotting mutiny in the doctor’s absence, assuring me they will smuggle me out if Doctor Serious tries to quarantine me, which concerns me because I’ve given the doc my mother and father’s names, and I’m worried in my absence he’ll send the World Health Organization to my parents’ house, because he said he was contacting them. I have no doubt that, should the doctor have tried to quarantine me, a kidnap attempt would be staged successfully. For that, I love Nepal. And Kanchan. And her mother.
But back to the story: I’m feeling a little overly confident and smug that I’ll be smuggled out, now, so when Joe Throat Culture tries to do the tongue depressor thing I tell him in strident, incomprehensible American tones (and English language) that I have “a strong gag reflex.” And hoooooo, boy does he find out how true THAT is. At least I warned him.
Tests done and temperature taken (now a remarkable 102.4), we are left alone for fifteen minutes while the flu A test is processed. If my result is negative we are told, in no uncertain terms, that I will be staying the night. Or several nights, while Doctor Serious waits for the World Health Organization to call him back and trigger the ‘Jump on it’ song all over again. I can hardly wait, and Kanchan, her mother and I spend the time in the hospital room critiquing the dirtyness (soooo dirty. Preventably dirty, even with very little resources). I am eyeing the squat hole in the bathroom, and thinking about the fact that I am 99% certain that if I have to use that hole to go to the bathroom tonight when I’m so dizzy, I will fall in it and drown in my own excrement, never mind the rat’s, when all of a sudden I feel a wash of heat come over me. My shirt begins to actually drip with sweat (gross, I know), and my eyes focus in on the toilet hole as the first thing I’ve really looked at all day. Right there in Doctor Serious’ ward of no-fun, my fever breaks.
Five minutes later, Doctor Serious returns to tell us that my test has come back negative. I fist pump in victory (because I’ve won, right?) making Doctor Actually-Kind-of-Cute Without a Face Mask smile, whip my own face mask into the trash, and give one long, last look to the rat poop before heading out with Kanchan and her mom, making us a very relieved trio.
The rest is ridiculous. I went home and showered without a problem, and my fever (with the help of two prescriptions) began dropping that night. All of my symptoms were gone the next morning (24 hours later) except for the headache and the stomachache, and lack of appetite. That took another day.
In hindsight, more than anything, I’m glad I got it checked out, and thankful it happened when it did. Were I to have been in Pokhara when it happened I would just by the nature of things have had far less support, and in the field – I don’t really want to think about it. It would have been horrendous, or what might politely be called an “incredibly unique and unusual cultural experience.” I was lucky it struck when I was staying with Kanchan and her marvelous parents, and that they were willing and able to take care of me (and also to drive me to the clinic – there wasn’t a chance in hell that I was going to make it walking).
And there were benefits. I spent most of Monday not on a plane to Pokhara, as planned, but continuing to take it easy at Kanchan’s, periodically bursting out into “thank god!” or “I win!” or “I feel so good it’s amazing!” Being so sick, even if for a short time, really made me appreciate being well, and I have had several incredibly productive days since, as right now I thrive in just feeling okay. And in being very happy with that.
-M-
