| Malaria Contracted |
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Writer Max Arbes contracts malaria in Senegal and lives to tell the tale There are some travel mementos, many would say the best mementos, that lodge themselves in the heart. I am thinking here of all those countless memories and uncounted pastries from that little café on the Left Bank of the Seine. Then there are those mementos that, by consequence of some small breach to the first rule of real estate, lodge in a location of far lesser esteem—the liver, to be exact. Unlike memories, these mementos of the second order are true artifacts of one’s experience. They are, in a word, authentic—though I think “endemic” is the term preferred by the Centers for Disease Control and Prevention. Malaria possesses a certain romantic appeal, a kind of “yes, I have been to those very nethermost ends of the world, and I have the blood work to prove it.” It should be noted that an unbounded ability to rationalize is not typically a side effect of malaria but rather a most useful precondition. Officially, the symptoms of malaria include fever, chills, headache, sweats, fatigue, nausea, and vomiting. Which is relatively easy to remember, since those are the selfsame side effects of Lariam, a common antimalarial prophylaxis, and my antimalarial prophylactic of choice. Additionally, Lariam is known to cause extremely vivid dreams, hallucinations, confusion, and forgetfulness. Malaria thus becomes a rather introspective disease—one in which the afflicted must decide whether his delusions are malarial or antimalarial in origin. At least, that has been my experience. I got malaria and have lived to tell the tale. Which is really the most important thing about malaria—to tell about it. It is easy to dismiss malaria stories as excuse-ridden permutations on the same simple theme: I forgot to take my medicine. My story is one of them. But if I can offer any insight on the matter to both skeptics and the afflicted alike, it would be that nothing is ever all that simple in remote corners of the world. The reason people opt for Lariam over competing antimalarial drugs is that it only has to be taken once a week rather than every day. I was traveling in Senegal and was on an excursion to the port city of Saint-Louis. I forgot to pack the pills with me. The instructions for the medication are very explicit that it should be taken regularly by routine on the same day each week. So when I got back to my host family's house a couple of days later, I decided to wait until the next scheduled day came around rather than mess with the routine. I arrived at the dusty doorstep of my Senegalese host family in a heap, still reeling from the bumpy road, which had brought me there by way of the Mauritanian desert. I entered sheepishly, interrupting what appeared to be a wedding celebration. Senegalese weddings are very inclusive affairs. So much so, in fact, that a disheveled and confused foreigner who haplessly wanders in is likely to be asked to take part. Not merely in the communal buffet, mind you, but in the ceremony itself—as a potential husband. After spending a good two hours shuffling between a knotty network of brothers, uncles, sisters, and cousins that even months later I wasn't fully able to count or comprehend, I decided that the odds of my avoiding becoming the day's second betrothed were stacked and, in one especially fervent case, pressed against me. So, reminding my eager hosts of the burdens of the journey, I asked politely to be taken to my room—alone. 
The place where I would stay consisted of four bare walls, a naked lightbulb, and a piece of yellow foam doubling as a mattress. I laid my sleeping bag on the relatively cool floor and tucked the ends of my mosquito net beneath the folds in such a way that ensured my legs would be completely ensnared by the morning. In a nod to the historically animist traditions of the region, my net functioned chiefly as a warding totem, operating on the principle that 95 percent of the effectiveness of a home security system is the sticker that says you have one. Two months and untold mosquito break-ins later, I had malaria.As I mentioned, delusions are a normal side effect of Lariam. But the most dangerous delusion caused by malaria medication may be self-delusion. As I became ill, my own train of thought degenerated as follows: Oh, look at that, I think I have a cold…Well, this is a tad worse than normal…Maybe it’s just an Africanized cold, like with those Africanized bees…Wait, aren’t those killer bees?...You know, if you take enough Tylenol, it’s not all that bad…I knew my body would eventually adapt to the heat here, but these chills…I’m sure I’ll reach equilibrium soon…. Then your body shuts down. Thankfully, my body happened to give out during the opening credits of an old Jean-Claude Van Damme movie I had been dragged to by some local friends. We arrived at the hospital just as I had regained enough sagacity to practice saying “I want a new needle” in French. My mutterings were lost on the three bemused teenagers at the reception desk who blithely passed me along to the buxom nurse napping in the back. The word for “yes” in Wolof (the local language) is “wow,” a nice jolt of excitement into an otherwise slow-paced rural existence. But when hearing the nurse reply “Wow” to my meek and fatalistic query of “Do I really have malaria?”, well, I think I can be forgiven for failing to account for the cross-cultural canyon separating us. My mind raced instantly to the furthest limits of the word’s foreboding. I could hear in her voice my demise: Wow, I’ve never heard of readings like this! Wow, I thought I’d seen pale white people before! Wow—how is this guy still alive? I began to really wonder myself, “Wow, am I still alive?” The question was answered when the nurse gently leaned over my body to whisper most seductively in my ear: “Are you married?” I had trouble choking back a cross-culturally inopportune “Wow” of incredulity. I had malaria; I wasn’t dead. Feeling better about the situation, I was taken by my guide to the night’s most surprising sight of all: a 24-hour pharmacy. After an impromptu rendition of Beethoven’s Fifth on the storefront’s shutters, my guide got the shop to open eventually. In 20 minutes, the roused clerk had delivered me my pills and, with that, delivered me from the night’s adventure—a true record for rural African service any hour of the day. I returned home, and when the dulling effects of the newly acquired medication finally kicked in, I collapsed in exhaustion onto my bed and fell asleep. In the morning, I marked my hasty retreat to a beach resort south of Dakar. Sitting on a shaded balcony at the ocean’s edge, I finally had time to reflect. It was surprisingly easy to find consolation in the experience. Besides a good story, malaria provided me with something infinitely more valuable: a gift for my mother’s birthday. A permanent, potentially fatal disease that could recur at any moment with vague, seemingly benign symptoms requiring constant care and attention? It was a Jewish mother’s dream. Not to mention, she could tell each of her friends all about it. |
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