Chikungunya: That Which Bends
“So, where are you from?” said the doctor, as he tried to keep my left arm in a horizontal position; each time he lifted my arm, it dropped.
Almost everyone here in Lucknow, northern India, asks me that question. It’s because of my textbook Hindi from school and college days, interspersed with the kind of English some of us try to use to impress in a non-English environment.
From Bangalore, southern India, I said.
“Hmm…” the doctor said, and summoned my friend who was watching from the doorway. He was the one who’d brought me here on his scooter despite being very ill himself.
“Hold his arm,” the doctor said.
My friend did so and the doctor wrapped the lengthy cloth on my upper arm. Then he placed the stethoscope on the inside of my elbow and started squeezing the pump. Pssk Pssk. Pssk, it went. His gaze rose and fell, rose and fell, obviously following the mercury column which I couldn’t see. After some more pssks, he murmured, “110”.
His wife, also a doctor, who sat on the other side of the table, gave a grim nod. She examined mostly females; this region is one of the most conservative milieus in India.
“Headache?” the doctor asked.
Yes, I said. Also I can’t sleep, can’t get up if I sit, particularly in the toilet, and there’s this pain at the back of my eyeballs.
“Your balls?” Obviously he missed hearing a critical portion of the word.
I pointed two bent fingers to my eyes.
And my knees, ankles, fingers, toes, wrists, shoulders, they all seem locked by Godrej, I said, attempting some humor. Godrej is to India what Chubb Locks is to the West.
“Hmm...” No smile. No surprise. Just another glance at his wife who gave another grim nod. It seemed like this doctor-couple had come across many patients like me, belying the government health-department’s claim that there were only a few cases of chikungunya in this city.
Strangely, the doctor never once uttered the word ‘chikungunya’ on that first visit. I was to learn later that many doctors around here don’t reveal the names of the ailments to patients. It could be the belief that truth would cause unnecessary alarm. But I think the more probable reason is that most patients don’t ask; education and literacy levels are low.
Chikungunya is the Makonde word for that which bends and describes the bent posture that the severely afflicted exhibit. Makonde is in Africa, bordering Tanzania, where the disease was first observed in the early Fifties. And thanks to the Aedes mosquito, the carrier of the virus which is mostly resident in monkeys there, the disease traveled to other tropical parts and some western countries.
I knew I was a victim of chikungunya because my neighbors, my friend and his wife,\ were suffering from it. They had moved downstairs to be close to the rest of the family for more immediate succor should the need arise. I was left alone on the top floor. I joked that the mosquitoes wouldn’t make the effort to fly down; they would just sneak into my room. Who knew that the joke would turn truly sick?
“Drink plenty of fluids, especially coffee,” the doctor was saying. “That way the virus will eventually drain out. Take paracetemol for pain, not aspirin.” Aspirin doesn’t help in chikungunya cases.
He let go of my arm and my friend followed suit. My arm dropped like a relieved anchor after a long voyage.
The doctor scattered a handful of pills of varied colors and sizes on a sheet of white paper and segregated them into three heaps. Each heap comprised three or four pills. My head buzzed some more, my eyes started to smart.
“Afternoon, night, morning,” he said, pointing to the different heaps one after the other.
Then he brought out another pill. “This, if your fever goes up.” It was already 1040 F.
I wanted to ask: doc, could you please explain slowly: which pills when?
“Come tomorrow,” he said, and packed up the pills.
My neighbor patted my shoulder and whispered, “Don’t worry, I’ll tell you later.”
That was the thing about him, great memory power that did not slacken during his sickness. Also, he was slim and fifteen years younger. He had resumed work after only a week’s rest, although from the way he drove his scooter I could sense he was making a superhuman effort to keep it steady. He rarely demonstrates or talks about any pain or trouble he may be experiencing. “His nature is like that,” his wife said. That’s what his mother too told me.
He held my arm and I winched myself up. Then I started the jerky motion of placing one leg forward and bringing up the rest of my body. But the doctor couple wasn’t interested in this oriental version of the robot, they were already attending to another patient.
Entire families in our neighborhood fell prey to the disease. Every now and then one could see a man or woman limping, grimacing, on the streets. Eager for some extra sympathy, I thought someone would stop me and ask, “Chikungunya?” No such luck. I would have fared better in Bangalore; I am not known here. The only person who did ask me in a roundabout fashion and after several encounters was my regular grocer. Mystified at my purchasing one bottle of pain-balm after another over the last several weeks, he finally enquired, “Bhaiyya, what’s this problem that’s not going even after so many bottles of Zandu Balm?” When I told him, he shook his head in sympathy and said: “That pain will take some time to leave you. In fact…” He went on to talk about a chikungunya case in his extended family. Ailments are substantial meat for conversations.
I have given up jogging in the mornings, a routine for the last fourteen years. I walk longer distances to make up for that but am thinking of giving this up too because rashes erupt on the inside of my legs, thighs. Maybe physical exertion awakens some sleeping toxin which irritates the skin. I have put on weight because of less physical activity. Eating less is something I have always abhorred, thanks to my late father who maintained that food and books are one’s only true friends: they ask nothing of you except to devour them both.
What has compounded my problem is that it’s winter in Lucknow. With temperatures hovering around 450F, the chill has intensified the pain. And I am struggling to forget a media report that said: in some cases, especially the middle-aged and above, chikungunya symptoms last for years. How much ever I want to believe otherwise, the mathematical fact is I am middle-aged.
As I type this two months later, my fingers are still stiff; they bend only after some effort, some pain. My feet can collapse if I don’t walk carefully. I am extremely wary of the chaotic Lucknow traffic, especially the fast two-wheelers; I have to prepare myself well in advance to step out of their way. Climbing or descending stairs continues to be slow: one leg, one step, stop; same leg, next step, stop. If I sit for long periods, getting up is painful. Getting out of bed in the mornings is achingly tricky; my feet take time to understand that their god given job is to support my body.
This morning when I met the doctor for checking my blood pressure, he assured me that I have built up immunity for life. “Against chikungunya, that is. Not other diseases caused by mosquitoes.”