The doctor had large leathery hands, the size of a frying pan. Warm, unhurried hands, searching hands. They had large veins running behind them, like a secret underground network. He had been touched by many healing hands before; small hands, brown hands, gloved hands, lithe hands and hands that touched him but never really felt like they were touching him. But these hands were different. With one large thump he lifted his eyelids and peered into his eyes with his milky eyes. He was an old doctor. The type that takes all their time with you. He prodded and poked, asked questions and scribbled on his file with a biro pen with half ink. How long have you felt this way? Are you eating? What do you like eating? Is there pain here? What about here? Open your mouth. Wider. Say aaaaah. When did it start? How did it start? Cough for me. Cough again. Breathe in. Deeper. Hold your breath. Breathe out.
Funnily enough that’s not the doctor who eventually found out what was wrong with him. The one who did was a thin Asian one who looked like a tall desert bird.
This was in Kampala, back in 2009. He was in university, in his first year, meaning he didn’t have any medical cover. At first, he had started seeing many clinical officers in small nondescript clinics save for loudly painted doors. They treated him for bacterial infections. So came the drugs and even more drugs. He saw more clinical officers but he wasn’t getting any better. In fact he seemed to be getting worse. He was constantly too fatigued to even sit up. His appetite for food vanished. He’d not go up one flight of stairs without feeling dizzy. He’d stop to rest while walking up inclined roads. He missed classes, and stayed in his hostel just lying down, listening to Sanyu FM. All day. Then the night sweats started, and he would sweat so much he would wring sweat off his clothes.
He spoke to his cousin who was studying medicine.
‘See a doctor”, he advised. “A proper doctor, maybe even a chest doctor”. So he went to see a doctor in a hospital at a place called Nsambya, which is on a hill, which isn’t saying anything because everything in Kampala is on a hill. The doctor did tests; HIV, TB, the works, and they all came out negative. He did an X-Ray and held it up. His chest was cloudy and it was filling up with fluid. That explains your fatigue, the doctor said. He had a large back, like a rugby player. You are drowning, he told him. He stuck an IV on his arm through which antibiotics crawled up. He did a sputum test again the following day, nothing came of it. Then after a week. Nothing. Just fatigue. He wouldn’t lie on his back without feeling like he was drowning. They treated him for malaria, at some point. Then he got better. Slowly, almost cautiously. When he was strong enough he came back home to Kenya on a bus. He stayed with his cousin in Nairobi. Two days later, a big wave of sickness overcame him. “You really need to see a doctor,” his cousin said. So he saw a doctor at a private hospital who ran tests and declared he couldn’t find anything wrong with him. Maybe some blood infection, he mumbled. He was given some drugs and sent on his way. A week later, he was back in Kampala because there was school to think about.
He never got better. If anything, he gradually got worse – and broke – from visiting clinics. By the time he was seeing the doctor with large hands, he was not any bigger than a carrot stick. He had lost so much weight in the last few months. He was willowy, swaying in the wind. He was down to 52kgs from 72kgs. He looked like a ghost. The doctor with the large hands advised him to go to the referral hospital called Mulago National Specialised Hospital. The Ugandan version of Kenyatta National Hospital.
At Mulago is where he met the Indian doctor who looked like a tall bird. He was one of those doctors who looked like they were constantly searching for something… in their pockets, in the drawers and in their heads. He looked distracted. He touched everything absentmindedly. He had no eye contact. His energy was nervous, jumpy, he couldn’t stay still. But that, perhaps, was his genius because genius can’t settle in one space.
At Mulago he was put in an outpatient holding area of sorts with other patients. They stared at him. “I knew how thin I had become. I had seen myself in mirrors and I looked like the angel of death. My eyes were sunken and white and my cheekbones looked so sharp.” Like a shard of rock in a rough sea. Cheekbones that could cut a carrot. The doctor told him that he had pleural effusion – excess fluid between the layers of the pleura outside the lungs. They also took a bit of his lung for a biopsy. [We won’t get into how they sliced that bit off]. Then they counted his ribs and plunged some long-ass needle through it to drain his lungs in a plastic bag. He sat there, looking like the poster child of death, fluid dripping into a bag. “If I looked down at my bony chest, I could see my heart beating.” Other patients stared at him.
At some point, someone in the next room died and they momentarily wheeled his body into the room he was in. He knew it was a dead body because it was covered all the way, shrouded under a white sheet. There was wailing. He wondered if this was the end of the line for him. If he would soon end up under a white sheet like that fellow. He knew nobody would be around to weep. He had friends but he mostly kept to himself, fended for himself, because of the kind of rough life he had led. “I wasn’t anybody’s child; my parents were long dead.” As fluid dripped out of him into a bag he remembered his mom’s last moments a decade earlier. He had gone to visit her in hospital. Took her mint chocolate. She was a bag of bones in bed. “She told me to eat the chocolate,” Even in her final moments she was selfless. A day later she died. And here he was now, in the shadow of death. Maybe he’d finally see his mom, maybe he’d not. Maybe there was nothing on the other end, just a white space with no language, with no time.
When the results finally came out from the labs, they said he’d had Tuberculosis all along. The little bugger had been hacking away at his lungs. At his body. At him. “I was relieved, because finally they’d be treating something they knew. And I also knew that I would be okay somehow because of those ads, TB ina Tiba.”
He was hospitalized and what he remembers of that one week he was in hospital was that only his friend Eddie would come along to visit him. “Each morning, without fail, he would bring me porridge. He wasn’t scared of me, he ignored how bony I had become. He didn’t treat me like I was vanishing right before him, like I was sickly or that there was danger of me passing. He was very casual around me, very charming, like I needed to get well fast so that we could go out for drinks.”
When he was discharged, his doctors advised him to come back home to Kenya to continue with his TB treatment. So he got on a bus and came back home (for good, it turned out). His cousin who picked him up at the bus station cried when he stepped off the bus. He was so emaciated. “I thought I was seeing your ghost.” His cousin said. “I thought you were a dead man walking.” He collapsed at the door when they got home. The next day he immediately embarked on TB treatment, in fact his road to recovery was paved with TB drugs. “I would swallow as many as 11 tablets a day without fail. Thankfully these drugs were free in government hospitals otherwise I wouldn’t have afforded it.”
Gradually he got better, a day at a time, a tablet at a time. It was a long recovery journey running into months. His appetite crept back, followed by his weight. “I was on steroids. My cheeks filled out again.” His lungs filled up with air again. He could walk up staircases without passing out. He could sleep on his back without drowning. Slowly, over time, he started jogging, just slow trots. Then he started playing basketball. “Funny thing, when I tell people about that moment I was dying and about TB, I tell them I never coughed. My TB started as a scratch in my throat, never a cough. That’s the irony. ”
He also thinks of Eddie, who never shunned him. Who never wrote him off. “Every year I go down to visit him in Kilifi where he lives now. We have a beer. Maybe play some ball. It’s good to have friends like him when you are down. I don’t mean this in a bad way but I’m waiting to be there for him like he was there for me.”
“Recovering from TB is like a long dedicated relationship with drugs. You have to take them at a specific time and not miss a tablet because if you do, you are ruined. You have to start all over again. From the beginning and sometimes the beginning might just mean death.”
Learn more about TB here.