Tuesday, July 16, 2013

Peru-Brazil 2013 – Day 29 – The “fevers” of the Amazon

Do you remember that all daring explorers of the Amazon were sooner or later laid down for a day or two by the miasmatic fevers of the Amazon? From Francisco de Orellana to Alexander Von Humboldt everyone has had to pay with a little discomfort for the privilege of following the equator. Today was my time to do so. It all started three days ago, when in the boat I had some of the suco de maracuyá (some cool water mixed with the juice of the maracuyá fruit), which in turn gave me a mild case of the runs. Nothing too severe, mind you, so I tried to ignore it in the best way I could, only mildly increasing my consumption of water.

Today in the morning I had a couple of cups of coffee, and gladly ventured with my Honey unto the discovery of Belém. First we did some walking trying to find a place where we could get some laundry done. Once we left the dirty clothes in the charge of a nice old fellow we headed for the old city, intent of visiting a couple of museums and the original fort that was the seed from which the whole city grew. Unfortunately it was Monday and all museums were closed, so by the time we stopped for a rest in the gardens around the fort it was approaching noon and was getting very hot. Belém is the first big city we have visited in Brazil, and we did quite a bit of walking, so I didn’t quite noticed that I was getting tired and thirsty. After going around the fort we stopped at a kiosk and I had a coke sitting on the friendly chairs provided by the vendor. After another half hour of walking I was again deadly tired and thirsty, and I bought a cold beer at a supermarket and drank it on the spot. Finally we were standing kitty corner to the hostel, and I had a second cold beer in a little café. Because we were both hot Annie had suggested that we find a cool shopping mall and spend a couple of hours there, a suggestion that I enthusiastically applauded. We were a few steps from the hostel, however, so we decided to stop there for a quick rest before going farther afield. I made it to the little garden in front, where a shady bench provided all the allure I needed to lay down and take a nap.

Ten minutes later my Honey came back, and suggested I stepped inside where we could both lounge in the shade and the breeze of the fan. I thought it was a grand idea, and made as to follow her inside. All of a sudden I see her panicked face hovering over me, asking if all was right (a rethorical question since I was sprawled on the floor). I mumbled something about being clumsy, got up, and went down again barely missing hitting myself on the head with a concrete cornice. Next I remember my Honey is asking for somebody to call an ambulance (I wonder why she wanted an ambulance), and a nice big fellow assisting me to my feet, along the narrow corridor, and then plopping me on the couch. Poor Annie was very scared, not really knowing if her request for an ambulance had been heeded (it had). Thank God for her iPhone, which at considerable expense can be used internationally, so she was able to reach Jake and Katie, who stayed in text contact with her for the following few hours, providing us with medical and spiritual support.

Half an our later two nice paramedic ladies came in, took my vitals, and expressed great concern about the fact that my blood pressure was very low (90 over 70), and that I was all cold and clammy. They questioned Annie about what had happened, and she explained I had my eyes fixed and rolled back so only the white of the eyes could be seen, as if I were dead or possessed by the devil. It was a great description, and from it I can see the fear that must have gripped her soul at the fear of loosing me on the spot. But alas, they didn’t speak any English, so all the poetry was lost on them as I made a feeble attempt to translate into Portugese the flowing narrative. Finally they decided the case merited hospital attention, and around 1 pm took us in the ambulance to the Hospital de Pronto Socorro, the first-aid municipal hospital. The hospital was doing brisk business that day, with people in gurneys and wheel chairs everywhere, waiting in corridors hooked to IV lines. I was wheeled straight into the reception area, where a young doctor looked at the report of the paramedics (they had taken my name and other info from my passport), wrote a few lines of conclusion (they must have bought a million sheets of Xerox paper with copy marks all over them, because all case histories were written on this paper that was barely legible), and then filled a bunch of half pages with the orders for what needed to be done: chest x-rays, electro-cardiogram, blood tests, IV fluids, and final medical evaluation. So off we go into the hospital maze, with my poor Babe pushing me from the x-rays, to the IV ward (where my place was going to be, on a plastic chair, right under my name neatly posted on a piece of paper stuck to the wall), the ECG/EKG lab, and back to the IV ward.

The IV ward had about 8 to 10 gurneys, and me sitting, with people in all sorts of degrees of pain. Almost everyone had a companion (I had my fabulous Babe with me), who was in charge of providing the basic comforts. Half of the gurneys were bare steel, and the other half had thin pads, and almost everyone had some sort of blanket (the nice paramedics had told my Honey to take the blanket I had used with me, no doubt knowing that it was a fend-for-yourself world inside the hospital). In the middle of the ward was the nurse station, managed by a half dozen very capable and very busy nurses. One of the male nurses took it upon himself to be our protector, and it was him who chaperoned us to the x-rays and EKG labs. In between I sat on my chair, fearing that I would be forgotten there, among so many cases who were clearly in worst shape than I. Not for a moment did I see a drop in the level of activity. Gurneys came and went, people got their IV going (mine was dripping at such a slow rate that I though it would take days to finish), the packets with the illegible Xerox cover went flying, and from time to time a doctor would come in, make a final evaluation, and the patient mysteriously disappeared to either be discharged or to be sent to another long-term care hospital. It seemed chaotic to the untrained eye, but the nurses and doctors knew what they were doing, and they did it efficiently without dropping a beat.

My time came at last. With Jake on the other side of the phone to provide a second opinion, Annie in the middle to ask questions, and a very nice lady doctor doing the explaining, she concluded that the ECG/EKG was normal, the X-rays were normal, the blood work normal in everything except elevated levels of leucocytes (which she interpreted as my body fighting the intestinal infection). She concluded that I had dehydrated due to the runs, and that trying to do its job the body had started shutting down peripheral functions and that had caused the drop in blood pressure (me, I would think that efficient blood pumping would not fall in the category of a “peripheral function”), and this in turn had caused the loss of conscience. So she wrote me a prescription for an antibiotic to take care of the intestinal infection, an electrolyte to bring me back to normal, and millions of metachlorians to replenish my intestinal fauna and flora. With that, and an enthusiastic shake of the hand, I finished my tour of Brazil’s socialized medicine system. It is not pretty, but they were kind, efficient and (I hope) effective. I certainly thank them for the care and concern they gave to two lowly tourists.

A taxi brought us back to the hostel, and Annie (with the invaluable help of Katie and Jake back home) took charge. She moved us out of the hostel into the Crown Plaza Hotel, picked up the laundry, had the prescription filled, and decreed that for the next 24 hours I have to do nothing but recover. I am in fine fighting trim by now, but will gladly heed her directive, and muster my strength luxuriating in this fine hotel until it is time to go to the airport for our flight to Rio.

No comments: