(Jama, Ecuador)—“Dengue or Chikunguya?” — In the evolution of getting well from this mosquito-inflicted illness, I’ve visited the local clinic four times in the past two weeks. Although I have used the ER room before, it has been a different experience this time. First, the clinic was filled with people tormented with physical pain, and second was the extreme empathy the sick ones received from their loved ones as they waited to see the doctor.
This past weekend after a three-day respite, I faced new symptoms. There was a low fever, and muscle pain replaced the bone and joint pain. Weakness returned, my blood pressure was low, and a painful rash dotted my chest. On Sunday night I found no relief from the discomfort, and as I awakened for surely the 100th time, I sat on the edge of the bed and peered out into the darkness. I thought of the people in the world who are fighting daily pain, and that my pain would soon be gone. I thought of Rob Thomas’s song, Her Diamonds, which describes his love and empathy for his wife and her battle with autoimmune pain. I planned to return to the clinic for another round of blood tests, but I did not realize I’d be witnessing many illustrations of “Her Diamonds.”
Today in the waiting room, one older heavy-set lady was leaning forward and groaning with pain. She sat beside a man about her age, who seemed to be suffering as well. The attendants took her to a cot, and though she was out of sight, she was not out of hearing distance. She shouted short gasps of pain and began weeping. A lean young girl of twelve walked by with the shuffling gait of a crippled old person. Unlike most, she managed to smile as she walked between rooms. From around a corner came more screams and groans that sounded as if I were in a crazy house.
Yesterday while I was waiting in line to request the blood work, my blood pressure fell. Every time I stood in line, I had to retreat to a chair to keep from fainting. When someone from the office walked by, I asked for help and explained my problem. Almost immediately a man appeared with a wheelchair and rolled me to the ER and helped me to a cot. A doctor looked in on me and said that she’d return.
I scanned the room; one beautiful 30-something year old lady curled in a fetal position; her sweater draped over her legs, and she shivered as her sister watched over her. Along the far wall, one mother sat with two children – the youngest was feeding at her breast while a toddler slept on the cot. One white gauze patch balanced on his head and another guarded the center of his stomach. Every so often the mother dipped the gauze in a bowl of water (?) and reapplied the patches. A young and beautiful paramedic checked my neighbor’s blood pressure and then mine. (Mine was 100/60).
Another woman in her 40s hobbled in and was pointed to the foot of my cot. In severe pain, she curled up on one end while I curled on the other. Her mother brought her a Gatorade, though she was unable to open it. She resumed the fetal position and resumed a low-pitch groan. Her husband walked in with a glass of water, which she drank. He then scooped her up in his arms and walked away with her.
This morning while waiting near the blood lab entrance, I watched a little boy of 5 climb into a little garden area and place his feet on the dry earth. He stared at the earth, at his feet and took a yoga-type pose. He seemed to have left the entire scene behind and was in his own little world. “Wow,” I thought, “that little boy looks quite evolved as he connects with the earth; I wonder what he’s thinking…”
When they called my number, I sat in the chair and watched the technician tighten a latex glove around my left arm to constrict the blood flow. Looking the other way, I did not see the young lad enter the room, but I heard his blood curdling screams which started about the time the lady began withdrawing blood from my arm. His screams grew louder, and I watched as his mother struggled to hold him in place. The lady finished with my blood, and I stood slowly then moved to the young lad. My attempts at distracting him were of little use, and the second attendant stopped her work and helped restrain the wailing child. Instead of chuckling, I wanted to weep for the little boy. He was exceptionally scared of being punctured.
The doctor today told me that most of the cases in Jama are confirmed dengue, and there are many unconfirmed cases of chikungunya; the symptoms suggest CHIKV, but I think that the lab is not able to check for CHIKV in Jama. The doctor suspects that my most-recent results suggest dengue, which showed negative a week ago. I will return for more tests on Thursday. She also told me not to walk (she knows me) and I chuckled and said that she didn’t have to worry about that! I take thirty steps and have to stop and sit down!
The people in the various departments of the clinic have been extremely kind and patient. These visits are free, including the “Tutti Fruiti rehidratacion” packets of sodium chloride, potassium, etc to help restore those imbalances. I know many of the people who work in the clinic and also know many of the patients – ‘Hi Roy! Are you sick?’ (“No, but my sister is.”) – (Roy is probably 15.) I see mototaxi drivers, the empanada salesman and the gal who works at the little supermarket. Mosquitoes don’t care if you’re old or young, frail or healthy, they just want a tidbit of blood! Whether we know each other or not, we (the sick ones) exchange nods as if to confirm, “You’re one of us. You’ve endured the pain and are now part of the club. You understand, and you have my respect…”
The newspaper El Comercio reported 6,000 cases of chikungunya in Ecuador as of May 8, 2015. (El Comercio.Com) I remain sobered by the numbers of people who are sick with fever and a pain that twists the victims into contorted postures.
There are several chikungunya songs on youtube, but this one from Jamaica fits this post best:
My Cevallos friends have insisted that I use their home as my home base when in town, so each day after the clinic, I retreat to their home for many hours before returning to Casa Loca. Sweet Xavier stops by most every evening and asks, “Do you need anything?”
Sometimes our rounds with illness make us realize how many people care, and for that, my cup runneth over. Thanks, everyone, and I’m getting stronger, just not as fast as I’d hoped.
The good thing is that I WILL be well, and for that I am grateful. Z