Vanishing

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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.

 

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54 Comments
  1. While opening this its was zero comment. Now I have to go back to the house sit down and read. Then make a sensible comment

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  2. TB can be serious. Quite unusual to some people it never starts that serious. Happy that he recovered. Must have been a scary experience.
    Good read Biko

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  3. Not all Eddy’s are Eddy Ashioya, at least i know that fellow moved in at Ngong road not Kilifi or its a decoy bwana Biko? And now i can go to work. TB ina tiba!

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  4. TB ina Tiba. I so relate to this. My village mates were coming to basically bid me good bye, others openly suggessting meza ARVS. My parents were there for me the whole time with the little resources they had.

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  5. All Indian doctors I’ve met are distracted and avoid eye contact but they know what they are doing. Mine was a bird-like dentist that restored a badly done teeth job.

    Also, I cried alot reading this. I wrung out my clothes for two years from night sweats. Was in and out of hospitals taking malaria drugs and antibiotics until my friend Eva told me- go to Kenyatta- I did and got my diagnosis and treatment. That was in 2008, very scary times.

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  6. I lost a classmate yesterday. A finalist. She didn’t get to graduate with us. I’m grieving Biko and this story hasn’t helped with my grief in any way at all. But of course, this isn’t about me and I hope my friend’s soul finds eternal rest..I’m glad the mandem in the story got better. Godspeed.

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  7. The story we were waiting for. Thank you.
    Eddies’ seem like good chaps. Any kind hearted fellow who takes time to whip porridge and carry it in flask to visit a guy on his last breathe has a heart of gold.
    May he be rewarded abundantly, and may his good deeds come back to him a thousandfold.
    Amen.

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  8. I had TB in 2003. I had given CPR to a man on a street, as a St. John’s Brigade volunteer.
    A month later, I could hardly sleep – I slept while sitting up, feverish. And the cough, that hacking cough!
    My sis came in and she immediately recognized what was wrong, she’s a health worker. She immediately bundled me into a cab and we went to a government hospital – 8 months later, thousands of tablets swallowed, I was OK.
    I still hate yellow tablets.

    Other than COVID, I’ve never felt that sick.

    If you suspect TB, take it seriously. It could kill you – and even worse, spread to others.

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  9. This is just so well put! Brought tears to my eyes thinking of this guy, being alone and sick but then hope in the right diagnosis and a friend who stuck close…closer… TB ina Tiba!! Thanks for scripting this

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  10. Thanks Biko, very captivating read. Just some feedback.
    Since you need to create awareness on TB, this should have come earlier in the story.
    Talk more about the disease and where people can get help. Talk about what people can do to avoid infection.
    It would also be useful to inform us how to detect the symptoms for early treatment

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    1. That link provides all the relevant information about Tuberculosis. If such details were to fit in the story it would look like a medical report: very boring indeed.

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  11. I remember those night sweats. I had a cough and the first doctor I saw said it was an allergy cough. I was given meds but I didn’t improve. I was constantly out of breath an the fatigue was overpowering. Then came antibiotics, no improvement. The guy I was seeing left me, he said I must be HIV positive.Three doctors later, I was diagnosed with TB. The drugs made me sweat even more, my hairline receded, my nails broke, my memory became foggy. But I slowly got better.

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  12. Oh my, it felt like the story of an old friend.
    How I recall when he was down with TB when in Kampala and the visits to hospitals and us taking him to the Akamba bus station then Scadinavian, Regional, Buscar and Falcon.

    Eventually, he came back and recovered….all of a sudden, he flew out to South Africa and I have never heard of him.
    In life, it is not what you do to someone but what you do for them.
    I am glad to have lived then and to have served as a student leader at Makerere. We shouldered the burden of our brothers and loved to tell a story.

    @Biko, you need to scout for Nyiha- a Kenyan girl jailed at Luzira-Kampala for murder. She was a student then at KIU and she killed her boyfriend.

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  13. In 2010, my mother started to waste away before our eyes, her clothes hang loosely on her, she couldn’t do any chores due to breathlessness . She had been experiencing a persistent upper region backache so she too had seen many clinicians, and doctors getting different diagnosises raging from fatigue to arthritis. By the time she sort a good hospital she had lost a cumulative 25kgs. So the physician who saw her said he needed her to do an MRI spine. That was Aga Khan hosp and the scan alone would cost her 33k but it is what found the TB lounged in her spine. She started her long medication journey for 9 months and we gained our mum back in full health.

    That was the scariest time in our family because we thought we’d lose her. Years later she still tales about how she almost had an encounter with death, she would go to my dad’s grave to check which side she’d want to be buried.
    Working as a health professional now I know TB ina tiba because I have nursed TB patients to recovery, from mum’s illness I became extremely passionate about caring for them

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  14. I was treated of pneumonia severally before being diagnosed with TB. It was a horrible experience. I took four tablets for, I think two weeks, and then started taking three, since I’d gained some weight, for six months.
    The relieve one gets after the diagnosis, man! FaiTB ina tiba

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  15. TB can hide in the body and harass someo e before it’s discovered if one is lucky. I thank God it’s treatable though it takes long.

  16. A long harrowing journey with TB. We a got a one strong soul over there. What doesn’t kill you makes you stronger. A good eye-opener piece on TB Biko! Btw is there always a reward for commenting first?

  17. So so glad he got better. We thank God for his grace and favor. My bro went through this for over six months .They had to isolate him at kikuyu hospital for two months.After that, he would visit the city council clinic for the jab and meds every week.

  18. MoH should assign Biko to rewrite all those FAQs into an interesting blog story that can go alongside it.

    Who knew we were reading about TB all along and enjoying it.

    Barely spent 2 minutes on that link.

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  19. Its always good to be kind to one onother..
    Sometimes the beginning might just mean death..I lost my dad in 2019 due to TB all i remember is the bones i could see from his body.
    May God grant you eternal rest and pardon you the sins you committed in this world.. every day i pray for your soul.

  20. Had a friend who had TB once he had to pop pills as big as half an index finger, he made full recovery but in the time in between, he was our designated driver and dry bar mixologist we kept him close and brought him milk like you would a cat this way he kept up with his regiment. God saw him through. I should reach out to the bugger.

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  21. Aaawww! Thank you Eddie!! You are a true friend, a gem and comfort amidst this troubled journey of life. Such a refreshing read. #HopeRestored #TrueFriend

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  22. Such an informative item. Kudos Biko for being there for us, just like Eddie was there for his friend. Truly, TiBi ina tIbA!

  23. I had TB back in 2012. The TB caused a pericardial effusion – fluid to fill around my heart. I had similar symptoms – fatigue, shortness of breath, weight loss.

    Luckily my diagnosis was made after one doctor’s visit. I had to stay in hospital for a week and had a fluid bag to drain the fluid. I have never been on as many drugs – and for so many months.

    Thank God I recovered. TB ina Tiba

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  24. I am telling you, TB is a sneaky fella. Mama had it, and no it was not in her lungs. It was this weird growth just above her collar bone. Back then we called them growths. We at first thought it was cancer coz the speed with which it grew, thing had a life of its own. Dr. Kioni saved her life like literally, he took it out and put her on TB meds. Thats when i learnt that any part of the body can get TB not just the lungs. She got it from sharing an office at work with someone who had it and the window was ever shut. Open your windows guys..

    1. Especially in matatus. More than 14 people in a matatu with all windows closed ati because its cold outside? How we dont all have TB is a mystery.

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  25. Being a clinician, this serves as a wake up call; to up my professional practice. Thanks Steve, sorry Jackson.

  26. From a person who had TB and got healed, I can proudly say TB ina tiba. Mine started as a cough. I was given antibiotics but the cough persisted. Weight loss, night sweats and lack of appetite were the signs & symptoms. Then one day I coughed blood and I knew this was no longer a joke. I was admitted, diagnosed with pulmonary TB, put on medication for six months and I got well. I saw a miracle, adding weight, becoming alive again. There is hope. TB Ina tiba.

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  27. You know it’s bad when other patients stare at you. Like they have forgotten that they were sick themselves and now the concern is on you, on whether you’ll make it to the next minute. Scary disease TB must be. Also mothers and their selflessness…aah..beautiful

  28. I can relate to this inhad tb in my last year of campus the passing out (fainting alot),fatigue,sweats I would be drenched when I woke up,the drugs and nausea that came with them I could keep anything down lost weight at one time I weighed a measly 39kgs.Never told anyone outside my family and the discrimination from doctors who immediately assume you have HiV/Aids is something many dont talk about.Thank God I recovered fully I read stories of people who die from tb and I think how lucky I was.Oh also never had a cough and my sputum test didnt reveal anything.

  29. I can relate to this i had tb in my last year of campus the passing out (fainting alot),fatigue,sweats I would be drenched when I woke up,the drugs and nausea that came with them I couldn’t keep anything down lost weight at one time I weighed a measly 39kgs.Never told anyone outside my family and the discrimination from doctors who immediately assume you have HiV/Aids is something many dont talk about.Thank God I recovered fully I read stories of people who die from tb and I think how lucky I was.Oh also never had a cough and my sputum test didnt reveal anything.

  30. I was there in 2012, at UON, same scenario save for many hospital visits. My diagnosis was quick at KNH. No coughs. But i had ignored the symptoms until it was late. Doctor said i was 168 hrs from organ failure.
    It was that silent TB.
    Tablets were swallowed. Religiously. With the kind of discipline and precision soldiers have. They were pink and innumerable.
    Eventually I conquered the demon.
    TB ina TiBa

  31. The doctor who initially saw he had pleural effusion and just treated him with IV antibiotics really did him bad,just a thorough history and you would know its classical TB.I remember sometime in 2014 during my internship the physician saying treat all pleural effusions as TB unless you identify another cause.But am glad he responded well to treatment and adhered to all treatment regimens and medications.Soo weird reading this article after completing some TB training program last week.

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  32. Googled the risk factors for TB and guess what was numbre one…….Poverty!….. Is google messed up or what?

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