Malarkey

A little before 4am, the muezzin begins sounding the call to prayer and all across Adabraka dutiful Muslims begin their focused worship. In my hotel room, I am on my knees, in a low bow. However, I am not a Muslim, and my head points West, away from Mecca. Instead, I am hunched over the toilet, vomiting.

'Allahu akbar' the muezzin sings.

'Oh god' I groan, as I double over again.

* * *

This was my second trip to Accra in a week. I had come the previous Friday to sort out a problem with my student visa for the UK. I left Keta around 3am so I could make the 3-hour trip, find some breakfast, and be at the British High Commission when it opened. Unfortunately, once I arrived I learned that what I wanted to do counted as an inquiry, and inquiries could not be made on a Friday. Inquiry days were Mondays and Thursdays (between 7:30 and 11:30), so I would have to come back on Monday. I went back to Keta that evening. I was feeling tired, as one would expect after so little sleep and so much pointless travel, and anyway I had a headache so I went to bed early.

Saturday morning I woke up to find that the headache had spread to the rest of my body, which was also drenched in sweat. I noticed that my room was extremely hot. I also noticed that my room was extremely cold.

Plan A was to stay in bed for the rest of my life, and it was a pretty appealing plan. I was still leaning heavily toward it even after the woman who brought in my breakfast advised me to go to the hospital; however, as kind of an afterthought I did pull out my Lonely Planet, open the travel health section, and flip to M. This is where I learned that 'Anyone who gets a fever in a malarial area should assume infection until a blood test proves negative, even if you have been taking antimalarial medication.' The next sentence included the charming phrase 'reduced consciousness and coma.' Also, 'death.' So that was pretty motivating, but on the other hand, going to the hospital meant that I was going to have to get out of bed and stand upright and put on pants, so the decision was not as clear-cut as it may seem. After deliberating for a while, I eventually convinced myself that of all the reasons not to go to the hospital, 'I'm too sick' is probably the dumbest. So off to the hospital I went, which was probably a good move because shortly after I got there everything started going dark and wobbly and hurrngh-I-think-I'm-gonna-no-wait-false-alarm-but-can-I-just-sit-here-for-a-minute, and then I was rolled off to the wards in a wheelchair.

I have been pretty fortunate, health-wise, my whole life, and this was actually the first time I have ever been admitted to a hospital. Well, except for being born. And I don't even know if that counts as being admitted, though I certainly was discharged.

(Rimshot.)

The nice thing about doing research on maternal health was that people at the hospital knew me. Just after I was admitted, word somehow made it to my contact at the Ministry of Health. He phoned up the head midwife, who came and made sure I had everything I needed. She moved me to a private room, which was very welcome, and she brought me a mosquito net, which seemed a little like closing the barn door after the horses had escaped on motorcycles to Switzerland but was nonetheless appreciated. Also, she bought me lunch. Kindness beyond what is reasonable.

After lunch a nurse came in.

'Do you like injections?' she asked?

I looked in her face for signs she was joking. She had to be joking, right? Yeah, she was joking. She was acknowledging that the treatment was going to be a little unpleasant, but hey, what can you do right? 'Not especially,' I said. 'But they're fine.'

The nurse looked worried. 'You don't? You don't like injections? Wait here.' She walked out of the room.

'Wait!' I called after her. 'Injections are fine!' She didn't stop. What answer had she been expecting? 'Injections? Yeah, I friggin' love 'em! Sometimes I get a few friends together and we all inject each other with grape juice just for yuks. No better way to spend a Saturday, am I right?'

Injection Nurse came in a few minutes later with another nurse.

'He doesn't like injections,' said Injection Nurse.

'Injections are fine,' I said.

They did give me an injection of -- well, something. And then they hooked me up to an IV drip of antibiotics followed by sugar, and I started to feel like a human being again and suddenly it occurred to me that I was in the hospital.

'So,' I asked, as politely as possible, 'do you know, are they going to do a blood test, or-- I mean, what am I waiting for, I guess?'

The nurse kind of raised her eyebrow and chuckled. 'Oh, so you want to go home, eh?'

Huh. This was unnerving. 'Well-- well, yes. If I can. Do you know when that might be?'

At this point she openly laughed. 'Oh, get comfortable. You will not go home today.'

She left.

By the evening, I was disconnected from the IV line and feeling better. Physically better at least. Because it was at about this point that boredom began to set in. Having thought I was coming into the hospital for a quick blood test and to maybe collect some pills, I hadn't brought anything with me to pass the hours. The hospital doesn't serve food, so Pearl had to bring me meals from the compound, and I managed to get her to bring me a few other things as well -- change of clothes, toothbrush, phone, and (oh thank God) a book.

I'm actually not much of a reader in normal life, as I tend to get distracted by the internet and TV and talking to people and beer. This is why it's taken me over a year to read Tristram Shandy, and before that I spent almost as long reading Swann's Way. However, in the weeks since my arrival, I hadn't had regular access to any of my distractions, and so I had finished Tristram, started it over at the beginning, and finished it again. What Pearl brought me was a copy of Eats, Shoots, & Leaves I had found in a bookstore in Accra. Unfortunately, it was pretty light reading, and within a few hours I had finished it, started it over at the beginning, and finished it again.

Before I went to sleep, the doctor stopped in with Injection Nurse to check on me. 'How are we feeling?' he asked.

'He doesn't like injections,' said Injection Nurse.

'Injections are fine,' I said.

I told him I was feeling much better and I asked him if I would be able to leave the next day, which was Sunday.

'It's that I have to be in Accra early Monday morning,' I explained. 'It's a visa thing.' This was of course true, but I was also being strategic. It was a way of saying 'Now normally I wouldn't be a troublemaker. It's certainly not that I'm a big baby who just wants to go home to his own bed because hospitals are scary, evil places that smell like chemicals and sick people. No, far from it; in fact, I am relaxed and ready to accept whatever your medical judgment deems best for me. It's just -- well, you know how bureaucracy is. I'm afraid it's out of my hands. SO GET ME THE HELL OUT OF HERE.' Without actually saying any of that.

'I see,' the doctor said calmly. 'I'll have a word with the staff. We'll see what we can do.'

Feeling pretty good about these words of hope, I flipped off the light, tucked the edges of my mosquito net under the mattress, and went to sleep.

* * *

The next day, with nothing to read, I discovered a new hobby: pacing around my room like a tiger in the zoo. Quite a lot like that, actually, because two walls of the room had windows onto the outside corridors, and people passing by would look in to see the strange, pale, agitated creature that had somehow become trapped in the hospital. I started imagining a little placard for myself outside.

YAVU (Homo sapiens albus). Young male, North American variety. Native to urban environments. Omnivorous when pressed, but in the wild subsists largely on grilled cheese sandwiches when available. While quite good-tempered in its native habitat, it becomes threatened and confused without reliable internet access. Highly vulnerable to malaria; reacts poorly to captivity in confined spaces.

Two men came in to check my vitals and seemed startled to find me out of bed and prowling. After they took my blood pressure, one of them told me I was in the normal range.

'And the temperature? Is there any fever left?' I asked. I really was feeling better, but also I was covertly gathering information I would use to argue for my release.

'No fever. For sure they will discharge you tomorrow.'

Not good. 'I was hoping today,' I said. 'I really need to be in Accra early tomorrow morning for a visa thing...'

'Oh, ok,' he said. 'I will tell them.'

After a few more minutes of tigerpace, a new doctor came in with a few of the nurses I had already met. ('He doesn't like injections, Doctor.' 'Injections are fine'). He spoke to me for a few minutes, did a quick examination, and announced that I seemed to be healthy and would be able to leave the following day as planned.

'Doctor,' I said calmly, trying extra hard not to be **that patient. 'If it's medically necessary for me to stay, I understand. However, if it's at all possible to discharge me today, I really need to be in Accra early tomorrow morning.'

It wasn't possible. And I get that. They needed to finish out the full course of IV antibiotics. Fine. Frustrating, but legitimate and not anybody's fault. And anyway the doctor assured me that they would finish first thing in the morning and discharge me with enough time -- barely -- to make it to the embassy.

I settled in for a pacing party. I had mixed feelings about being on display the way I was. On the one hand, privacy is important to me. On the other, so is having attention paid to me by young women in nurses' uniforms. There are benefits to being a curiosity.

Not that it did me a hell of a lot of good. Honestly, I don't really understand how anybody manages to flirt across cultural boundaries. How do you hold eye contact just half a moment too long when you don't know how long you're supposed to hold it in the first place? Because flirting, at least the way I do it, is the art of just barely hinting at a suggestion. It's showing affection that's maybe just the least perceptible shade past the edge of friendly, and then you escalate in tiny gradations if and while your behavior is reciprocated. The other party, of course, is welcome to jump over any of the intervening levels if she likes; otherwise, the process takes somewhere between a few months and the rest of your life. Settle in; I'll get there eventually. It is also extremely possible that I flirt this way because I am a coward.

'I like whites with blue eyes.'

I was startled out of my musings on the impossibility of flirting by a strikingly gorgeous woman giving me a ludicrously direct compliment. An awkward and racialized compliment, but unmistakably a compliment.

'You cannot tell your wife that you are here. She will worry.'

Well well well! Now we're getting somewhere, I thought. She's checking to see if I'm taken! None too subtle, hon, but no worries. I can work with this.

'I don't have a wife.'

'Oh, well your fiancee then.'

'No, I'm not engaged.'

'Really? Why? At your age?'

Well this seemed to be going south incredibly quickly. 'How old do you think I am?'

'Oh, I would say you are between thirty and...' she trailed off. SHE TRAILED OFF.

'I'm twenty-six.'

Her eyes widened. 'No.' She said. 'You look much, much older.'

'Oh.'

'Just-- your face. And your body build, everything.'

'Okay.'

Naturally, after this exchange I was feeling like a champ. This was to get worse when Pearl brought me my dinner. In chatting with her, I learned that Pearl also had malaria. Apparently she had spent the last few days untreated, because, well, the medicine knocks her out, and she had to bring me food in the hospital. She would start treatment after I was released.

She went home and I sat in my bed feeling like a big turd.

I was cheered up a little later by a visitor. A nice thing about being sick is that sometimes you can be pleasantly surprised by who turns out to care. Gilbert, who works at the internet cafe and with whom I had spoken only a few times, stopped into the room to say hello and ask how I was doing, and we chatted a while. He said he got malaria about twice a year.

When speaking to Ghanaians, I usually try to avoid overly-colloquial language because I'm never sure it'll be understood. But I decided in this case to risk it.

'Gilbert, malaria sucks,' I said.

'Big time,' he replied instantly.

* * *

I woke up Monday at around 6. As long as I was discharged by 8, I could still make it. I waited and waited. Nurses came in to check my vitals, which were still fine just like they were fine yesterday and can I go home now. I mentioned to them that I did need to be discharged quickly because I needed to be in Accra in a few hours. I was no longer all that concerned about being a bothersome patient. Finally somebody came and hooked up the last IV of cipro and I watched it drip, drip, drip into the chamber. It finished. It was just a minute or two after 8. And I would be able to leave as soon as they came to do my blood test.

Wait, what? Oh right. So it turned out that the lab isn't open on Sundays, and it is barely open on Saturdays. So they couldn't actually test before to see if I had malaria. They had treated it as malaria, and I had gotten better, and those two things were either connected or they weren't. But they still needed to the blood test to confirm. They would come by to draw my specimen shortly.

I waited and waited, and the hours passed and hope was lost and my Monday plan became definitely a Thursday plan. By lunchtime I was serene. I would be discharged eventually and I would make it to Accra at some point within the next few days and I would make my inquiry on Thursday instead of Monday and if that meant that there was no longer time to sort out my visa before my flight, well-- let's worry about that later. Anyway, surely they wouldn't give me any trouble at the border once I explained that any failure to have my documents in order was due to malaria.

'Ah, the old Nigerian shivers! Well that's quite all right, old bean,' I imagined the border guard chuckling through his mustache. 'I had a bout of the stuff myself whilst serving his majesty in Rhodesia.' Oh, and also, in my mind the guard is like a hundred and fifty years old apparently.

'Dreadful business,' he would mutter, placing his pipe back in his mouth and polishing his monocle. 'Anyway, welcome back to Merry Olde. Pip pip!'

Just as I was getting comfortable with this image, a crowd of orderlies and nurses burst through my door. 'They say you need to leave right away because you have to go to Accra today today!'

I blinked. It seemed as though the dozen or so people who I had told about the visa issue over the past few days had all been walking to the administrator's office incredibly slowly, and had all arrived there at the same moment early Monday afternoon to bang on the door and demand my release. Suddenly, everyone felt that it was very urgent for me to leave -- except me, because of course it was several hours too late. But I did want to go home, so why not? I played along, checked myself out, and tasted sweet freedom.

* * *

Being able to actually make the trip to Accra the next day felt like an incredible luxury. I had talked up this trip for days. I had begged for it. And now I was actually there! A friend was passing through town after her own fieldwork in Liberia, so I got to spend time with her. It's amazing how much one can miss the ability to use sarcasm trusting one won't be taken at face value. These little vitally important cultural understandings. On top of that, I felt completely healthy, I didn't have a single tube connected to me, and I was taking enough antibiotics that I was sure I would never get sick again.

'Go ahead,' I said, chatting with someone back home from an internet cafe. 'Name any item in Accra and I'll lick it and be fine.'

Later that day, I got food poisoning.

* * *

By the time I made it to the British High Commission I'm sure I was visibly green. I checked in and waited with a huge visa-seeking crowd for an hour, straining to hear my name. When I was called, I approached the counter, where a tired-looking, middle-aged English woman took my forms and looked them over.

'And when is your flight?' she asks.

'The 27th.'

She stopped for a moment. 'You know,' she said, obviously annoyed, 'there's only just barely enough time to process this before you leave. Why on earth did you wait until the very last minute?'

Sadly, it was a rhetorical question, and in any case she had neither a pipe nor a monocle -- just a stamp and a long line of too many people asking her for help. Now wasn't the time. I muttered an apology, she stamped my forms, and she sent me on to the next desk. I am sorry to have irritated her. I can only hope she reads my blog.

UPDATE: Blood tests found no evidence of malaria. What actually happened will be an exciting mystery forever.

'Hey, can you take my picture with the sick white person? Thaaaaanks!'