Today I’m back from the dead, no thanks to my friend E.coli, which apparently is in the water here. During monsoon, the water stagnates, and there’s not an effective drainage or sewage system. But I’m not entirely sure that’s the source of my suffering, nor will I ever really know; yet Aquaguard is running its ad campaign on Facebook reminding me ‘to stay healthy this monsoon’ with its various models of filters. The above photo is the one we now have hanging in our kitchen.
The English word dysentery is derived from two Greek words meaning “ill” or “bad” and “intestine.” Boy, have I got that. Some interesting tidbits:
Dysentery is one of the oldest known gastrointestinal disorders, having been described as early as the Peloponnesian War in the fifth century B.C. Epidemics of dysentery were frequent occurrences aboard sailing vessels as well as in army camps, walled cities, and other places in the ancient world where large groups of human beings lived together in close quarters with poor sanitation. As late as the eighteenth and nineteenth centuries, sailors and soldiers were more likely to die from the “bloody flux” than from injuries received in battle.
It is sadly ironic that, out of all my friends, I care most about my health and am meticulous about hygeine here. I have studied so much about nutrition, alternative medicine, exercise etc whereas most of them know very little; I even go so far as to wipe my wet dishes with a cloth if I am using them immediately after washing. They eat raw salads, don’t bother about their drinking water or where their food is coming from and whose hands have touched it. Perhaps it is because my health has been so fleeting while living here that it has become all the more a preoccupation; but even before moving here I was very interested in preventative medicine because of my family’s health history. That is, at least for the past five years, since graduating from college and ending the binge on various unhealthy practices.Most people, myself included, remark on the poor living standards and high prevalence of communicable diseases in India. To those who look down on India because of the former, I suggest perhaps instead they should be in awe of the miracle of Indian immunity. It is almost laughable that before coming here for the first time, my doctor made such a big deal about taking anti-malarial medication, and yet most people I know who’ve grown up here have had malaria at least once. I must say that I wouldn’t mind getting a transplant of an Indian GI tract, and I admit that I once had fantasies about drinking Indian breast milk to get some antibodies and build up my immunity, like cancer patients are now doing. Yes, being sick makes me desperate!
This bout has been going on since the 16th, a week and a half. At first I tried to be stoic, telling myself it would clear up, and actually it wasn’t so bad. It started getting worse on Monday, but I was faithfully sticking to my Ayurvedic medicine, courtesy of Dr. Rajesh at Maharishi Charak Clinic. But on Friday, my exhaustion was too much to handle and I caved to the antibiotics. Except they didn’t work, so yesterday was an adventure.
I woke around 6:30am, and by 9 it was clear that we had to try a new approach. I called my fellow Jaipurite friend who’s currently living in the US, to see if she could reach her doctor parents and figure out a way to send someone for a house call. We called everyone we could think of, but to no avail. So my partner went to the nearby hospital, armed with my lab results, thinking that the doctor could prescribe by that and send a ‘compounder’ to administer the injection. But, he returned sweaty and dejected, sans compounder nor Rx. The verdict: I had to go see the doctor myself.
But how?? How could I possibly leave my house, my haven of hope if not health? More importantly, how could I manage to leave my toilet, cleaner than any I would find in some government hospital? And yet, I did. We called a taxi to take us less than 1km, I inched my way down the four flights of stairs, clinging to the railing with one hand and my blessed mp3 player with the other. Corinne Bailey Rae, I thank you; I had ‘Put your records on’ on repeat and I’m convinced it was the only thing that got me through the ordeal.
Arriving at the hospital that, on a normal day, I can barely stand to look at just while passing by from the road, I kept my head down and intently focused on the ground. I felt a bit disrespectful to my fellow patients, but besides being unable to hold my head upright for weakness, I felt distinctly unable to raise my eyes and look around me–it would just be too painful of a sight. I made a beeline to the first free chair I could see, even though it was partially occupied by some woman’s bag. To my dismay, it was on the end of the row, and a line had formed to my side to the doctor’s office. This meant that people repeatedly bumped into me, each time feeling like more of an affront to my already internally bruised body. At first I didn’t realise that we were waiting for the doctor, since his office was just off the main hall, literally just inside the entrance; I thought maybe we had to take a number or pay some fee. I was staring intently at the red cement floor, and noticed that the woman standing just in front of me had two different sandals on. That’s when I felt I had reached a new low.
After a few minutes, I was granted the privilege of going to sit inside the doctor’s semi-air-conditioned office (it was quite open so the cool air could barely stay in). The mis-matched sandal woman was on the metal patient’s stool, struggling to breathe. She was an older woman with missing front teeth, accompanied by what I imagine was her son. I noticed the grime on the chairs, and little else. A brief eternity passed until I took her place, feeling wobbly on the uneven steel stooltop. The doctor asked some curt questions, which I answered in what seemed to him like whispers.
He was going to prescribe me some different tablets, but I had wanted injections because I had heard there were no side-effects with them and I had had terrible nausea from the tablets. Prescription in hand, I was free to leave that grubby place. The following is a passage from a superbly written piece about an experience similar to mine:
The worst thing about experiencing severe illness when thousands of miles from home and alone, is that it brings with it an acute awareness of personal isolation. No one cares. That’s probably not true, but at the time the belief is intense. I know this because I’ve experienced the feeling on the several occasions that I have been seriously ill in Asia. There is a terrible feeling of helplessness and humility, and it’s a humbling experience that I wouldn’t wish on anyone.
“How are you?†– It’s an innocent enough question, which demands a civil answer. But there is a problem. Most times the questioner doesn’t actually care how you are. It’s just a throw away phrase which really means “Hello†– a benign form of greeting. So if this is the case, then why don’t they just say “Hello”.
I have no problems with the “Hello†or “Hi†form of greeting. I can just return it with another “Hello†or “Hiâ€. But if someone enquires how I am, I usually say “OK†or “Very well†– even though I might be feeling depressed, seriously ill, homesick, at death’s door or whatever. It’s a more demanding and ambiguous greeting. If I told them how I really felt, they would switch off and become bored within seconds. Imagine the scenario: a stranger says, “How are you?†– “Well I’m feeling down, I’ve got diarrhea, the vomits and a terrible feverish headacheâ€. Most would probably not use “How are you?†as a greeting to anyone else ever again. In that case maybe I should tell them how I am actually feeling next time.
Indeed, as I was leaving the Satellite Hospital yesterday, so relieved to have made it out of there alive and without having had to use the loo which I was day-mares about, one cheeky young lad passed me on the street with a ‘How do you do?’ Unlike the above author I spewed a curt and somehow energetic ‘F&*! off!’ They are always so badly timed with their poor attempts at either misplaced friendliness or flirtatiousness. It is especially the guys travelling in packs (they always are), who dare to speak out of line. And before you say that it’s not out of line to say ‘hello’ or ‘how are you?’, the context in which it is said must be explained. If I were an Indian woman, they would never dare or bother to speak to me because they know better. They cross that line because I’m a Western woman, who they see as loose. Ok, perhaps I exaggerate; the author above is a guy and it happens to him too, of course. At any rate, this was my reaction at the innocuous greeting in my moment of vulnerability, after which I decided that if there’s a hell, I’m probably going there–soon, if the E.coli has its way with me!
Three hours later, after taking a long and much needed nap, my partner again returned to the hospital to fetch the compounder to administer my shot. He paid little notice to me, cowering on our floor mattress, instead taking more interest in my partner’s business affairs. He put on no gloves, nor cleaned my skin with alcohol; this was bare bones. He asked for some cotton, which he balled up with his unwashed hands, I lied down, the shot went in to my flesh, my hand instinctively squeezed the sheets. Then it was over, and I felt what I imagine might have been relief. He picked up the conversation where he’d left off (had he left off?) and my partner escorted him to the door, and then disappeared with him.
I felt a brief wave of panic–what if I have some reaction to the medicine, and now I’m alone? Where has he gone? He returned a short while later, having gone down the stairs with the compounder and back up again. He was trying to remain in the guy’s good favour, since he was going to be returning to administer follow-up injections. That was before I consulted with my mother, the doctor…
It turns out that the anti-biotic, Gentamicin, can have severe side-effects like hearing loss and kidney damage. Somehow, in the frantic delirium of the morning, I had missed that pesky section on the Wikipedia page.
Gentamicin is a vestibulotoxin, and can cause permanent loss of equilibrioception, caused by damage to the vestibular apparatus of the inner ear, usually if taken at high doses or for prolonged periods of time, but there are well documented cases in which gentamicin completely destroyed the vestibular apparatus after three to five days. Since the effects of vestibulotoxicity are physically and psychologically devastating, a Web site has been formed to advise people with gentamicin-induced destruction of the balance system: Wobblers Anonymous at http://www.wobblers.com/ Gentamicin can also impair or wholly destroy hearing. A small number of affected individuals have a normally harmless mutation in their mitochondrial RNA, that allows the gentamicin to affect their cells. The cells of the ear are particularly sensitive to this.
It also turns out that the dosage they wanted to give me was way over accepted limits according to my doctor sister’s infectious disease manual. It needs to be given according to body weight, and not just the standard 80mg/twice a day for two days that is the protocol here. Need I add that there’s no such thing as suing for malpractice?
I did feel better soon after, until speaking to my mother, that is. My intestinal ailment having taken a back seat, now I began to worry about my ears and kidneys. I tried reasoning with myself: appreciate your hearing now, who knows if it may go. Stay calm, worrying will only make things worse. And yet, the fears had taken hold. Despite her reassurances that I’d be fine, I spent a restless night.
Today, I feel quite well, and I have put a hold on any additional treatment until I see a specialist. And I still have faith in Ayurveda, perhaps even more so than in ‘allopathic’ medicine–which sometimes seems to create more problems than it solves.
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