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Published: March 12th 2010
The chills enter my body minutes after I finish teaching a lesson at the BKC school near Chistye Prudi metro station. The temperature outside is 23 degrees Centigrade below zero so I assume someone has left a window open but there is none to be found. I put on my fleece and coat but still the chills get stronger. A horrific, unthinkable thought awakens in the back of my mind but I dismiss it instantly as an impossibility - 'maybe it's malaria recurring.' But it can't be. I was treated at one of the best hospitals in the world and they gave me medicine to ensure that it would never come back, that all the parasites that stay in your liver and cause recurrences were killed.
I begin to feel feverish and decide to head home as quickly as possible to lie down. What's happening to me can't be malaria but it is something. I really am feeling very ill now, my teeth chattering, limbs shaking and head spinning as I rush through the snow. The streams of pedestrians, the honking of car horns, the smell of exhaust fumes, they fade into the background and out of my sphere of
perception as my world shrinks to include nothing more than my own sick head and disjointed thought process. It does feel very much like a milder version of the malaria I had back in May...but of course it can't be, I was cured.
I collapse on a seat in a metro carriage. Mercifully it is midday on a week day so there are not too many people. I hug myself tightly to try to warm up and suddenly am engulfed by a burning heat that forces me to strip down to my T-shirt. After a few minutes the chills come back and I put my clothes back on. Over the thirty minutes it takes me to get to my stop in the outskirts, the last on the line, my condition degenerates terribly. A mother and her toddler watch me nervously from across the carriage. The slumped, shaking man opposite them is clearly a cause for concern and soon they get off the train and re-enter the next carriage. Other people follow suite until I am left alone. A terrible pain in the base of my spine makes any position maddeningly uncomfortable and I writhe in my seat, slumping lower
and lower until I am almost lying down then rising back upright when that too becomes unbearable.
I exit Rechnoy Vokzal station and, exhausted, climb into one of the awaiting "gypsy cabs", the ancient Soviet Ladas seemingly on the verge of collapse that crawl Moscow's streets 24/7 looking for passengers. "Ulitsa Duibenko dom tridsat dva," I gasp my address at the Central Asian driver. As we move at a snail's pace through the traffic of Festivalnaya Street his eyes flick back and forth between the road and my reflection in the mirror, possibly worried about me or perhaps just hoping I pass out and can be robbed.
After I get out I press towards my tower block, the icy air tickling my lungs and the moisture in my nostrils freezing solid. Any uncovered flesh is painful and my ears slightly iced over by the time I get there three minutes later. As I fumble for my keys with fingers made slow and clumsy by the extreme cold I cough and spit; I watch it steam furiously on the pavement for a few seconds before turning to ice.
Suddenly a little snippet of rationality and clever thinking manages to burst through the feverish clouds enveloping my mind: it is obvious now that somehow my malaria has returned. What helped me last time, at least during the first, less serious attacks, was hot tea. If I can make it to the Produkty shop fifty meters away and buy some it will be worth its weight in gold over the next few hours. I forget that last time I had someone to brew and administer the tea during my incapacitation whereas here I will be home alone.
I stumble down the pavement, the pain in my back almost making me decide to give up and turn back. I burst through the doors, impervious to the smile of the cashier who knows me as her only Western customer, probably the only Westerner she has ever met. I grab the tea and return to the counter to pay. Her expression has now changed to a look of concern as my shaking hand takes notes from my wallet and passes them to her. I delve into my pocket to bring out a handful of coins but a spasm in my arm makes me spill them all over the counter. I cannot stay here any longer. "Keep the change," I stammer through chattering teeth and stagger outside into the biting cold and back down the street. I do not realise that I have forgotten the tea.
In the lift up to my apartment on the tenth floor a sudden increase in the pain in my back forces me to double up to a right angle. I approach the door to my corridor like this, unlock it and make it the last few remaining paces to my apartment door. Good God I am so tempted to just lie down here on the dirty floor but somehow, still bent like the world's worst hunchback, I force myself to find the right key, open the door and lock it behind me before collapsing on my bed, pulling the duvet around myself and falling into the deepest delirium and most powerful hallucinations I have ever experienced. For three hours I lie there shivering, convinced I am interacting with a multitude of different people. Sometimes I realise that what I am experiencing is not real and I try to draw myself out; it is, however, inescapable and within seconds I have forgotten and am once again fully immersed in my feverish alternate reality.
Eventually I come to my senses. I still have the chills, although they are diminishing, coupled with a killer headache and a total lack of energy. For two whole hours I lie there drenched in sweat and unable to get up. When I finally muster a little bit of energy it is just enough to sit up, reach over to my desk and move my laptop onto the bed with me. I switch it on and find the number to call an ambulance in Moscow.
The ambulance takes two hours to make it's way across Moscow down streets and avenues clogged with the city's horrendous rush hour traffic. We arrive at the Second Hospital for Infectious Diseases well after dark. It is a state hospital. Almost every Russian I know has told me some horror story about these places: hordes of people waiting weeks to be seen, people dying unattended on stretchers in corridors, the need to bribe the underpaid doctors if you want to get any sort of treatment at all.
The ambulance drivers walk me up to the door to reception and past an old man vomiting on the pavement. I lie on an uncomfortable wooden bench for an hour before a nurse arrives. Despite my protests that I know exactly what is wrong with me she insists on taking blood and says that, in true Soviet fashion, it must be from the finger tip.
"You can't take it from my arm?" I ask hopefully.
"Why not?" she replies.
"No," I say, a bit confused, "I mean... FUCK!" She jabs a needle into the end of my finger as I speak, her clever distraction having gone exactly according to plan. I am now bleeding profusely so she takes four grimey-looking slides and presses my finger tip to them to collect samples.
I wait perhaps another hour in the same place. "Is there a toilet?" I ask. I am pointed to an open toilet in the corridor, in full view of everyone in reception and anyone entering the corridor.
Eventually I am taken to my own room. It seems clean apart from a few stains on the walls and some peeling wallpaper. Amazingly it has an ensuite bathroom where I am told I can smoke. On inspection I find that the toilet has not been cleaned since the room's previous inhabitant left.
Throughout the night I am fed pills and have blood taken. Around ten different nurses and doctors come and ask me the same questions over and over again in brusk, humourless voices that attempt to exude efficiency. Over the coming week one of my few sources of amusement will be flashing smiles at these people as we speak and watching them attempt to keep a straight face.
For a week I lie in that bed staring at the ceiling with no books, no TV, nothing. Friends try to visit but are turned away for missing visiting hours. They bring cigarettes and fruit but have to leave them with the security guards at the entrance who steal them. The boredom is maddening. Fortunately I have no more malaria attacks due to the immediate high dosage of medecine they gave me on arrival. Nevertheless the weight loss already caused by the illness is compounded by the fact that I am starving. The food is inedible. Every day I am served three meals of foul gruel, porridge, buckwheat, rice, eggs, all simple stuff that it should be impossible to make taste bad but which is enough to make me wretch. Each meal goes in the bin in my bathroom then I am expected to clean the plates and bowls in my sink with my hands and without soap. If I do not, and very often even if I do, the fat serving babushka screams at me when she next comes round. Likewise the cleaning babushkas scream at me when they come in to mop the floor of my room, as does whoever is on duty if I bang on my door when I need something. I usually cannot make out what they are screaming about but react by glowering at them from my bed, looking them directly in the eyes for a second then turning away haughtily without saying anything. I imagine this saves me some dignity and does not give away the fact that I do not understand; it certainly seems to have the effect of stopping the outburst although it does nothing to prevent the next one.
The doctors themselves are kind, if a little abrupt and emotionless. They seem to sympathise with my situation but do not have much time to spend with me, just a couple of minutes per day. They never ask for bribes though, treat me with all the correct medicine and, when I am finally discharged, do not ask me for a penny. I do not even need to contact my insurance. Russians I tell this to can almost not believe it; it runs contrary to everything they have previously experienced in their country's hospitals. The only explanation I can offer is that I was one of the only malaria patients they had ever treated and they were glad of the opportunity I gave them to observe how the illness works. This would seem to correspond with the amount of people they sent in on my first night to repeat the same questions over and over again.
I am allowed out after a week. Due to a severely swollen liver and spleen I am put on a horrifically strict diet: no fatty food, salty food, spicey food, fried food, restaurant meals, cheese, milk, tomatoes, sauces, canned drinks, coffee or alcohol for a whole month.
I go back to work the day after being discharged. I receive my first complaint from students after 18 months of teaching. They tell the administration that I look drawn, jaundiced, tired and unfit to teach, that my lesson bordered on the boring.
I keep taking my pills, this time the correct combination of medicines to kill off my malaria for good. But, according to the World Health Organisation guidelines, the dosage is too low for malaria contracted in South East Asia. I desperately scour Moscow's pharmacies for more but neither they nor the hospital can provide any. I resign myself to the fact that I may have to deal with malaria again but at the same time am pleased that the symptons were so mild this time in comparison to the last. Perhaps I am developing a resistance to it. I gradually recover and life goes on much the same as it did before.
Anyone with a morbid interest in the first time I had malaria can read the following two blogs:
My battle with malaria, part 1: the beginnings of an illness that nearly killed me and
My battle with malaria, part 2: shamanist reindeer-herding nomads, a near-death experience and "the best hospital in Mongolia". Although the malaria was contracted in the Philippines I came down with it in a remote part of Mongolia and it was infinitely stronger than what I had in Russia. It took me ten days, during which time I had numerous attacks and nearly died, to get any medical attention at all. In the above blogs I describe these attacks in detail with all the symptons, physical and emotional.
Click this link for advice on
independent travel in Russia, with individual sections on many beautiful, interesting, hard-to-reach and off the beaten track destinations within the country.
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I'm seriously considering getting re-tested after my hospital experience in China last year, despite that I was given a hell of a lot of antibiotics..The parasites can remain dormant in your liver for years. You should come back to the UK and get tested and treated properly at the Hospital for Tropical Diseases..