Misery breeds great art, or so they say. It’s why artistes of any kind do their best work when they are unhappy. The relevance of this is that I have been unable to churn out the words that reveal my state of mind for quite a while. First, it was an unwillingness to indulge in writing, a somewhat shallow means of expressing this depth of emotion, then, eventually, it was a temporary freedom from that dark cloud of desperation that enveloped me. Now, though, that I am in between both spectrums I think it is time to write. This is going to be a very long post because I feel like I have a lot to explain that I have not previously.
During my last visit to LUTH it began like any other day except that because I had an appointment I was a bit more impatient with the staff’s unscrupulous ways of doing things. It didn’t help matters that despite the fact that our hospital cards were arranged in order arrival, they somehow managed to attend to people who came late much earlier than those who came early: of course there was no coincidence there. They were helping their friends. I saw the lady who was demanding money from me and promptly ignored her. She noticed and came over to ask how my mother was, in front of everyone, I just told her I did not want to talk about it and I believe she got the message because she stayed off for the rest of my time there. The consultation with the doctor proved what I had been suspecting for a while: my health was failing. My CD4 count had dropped by about 70.
When I attended clinic 3 months before, I was very surprised at my weight. Even though I had been involved in intensive physical exercise a few months before then, I had not been committed to it or my diet in weeks preceding my hospital appointment so there was no real reason why I was losing the weight. But in retrospect I remember I was under tremendous pressure at that time; I had been given a printing job which had so many hiccups I changed printers 4 times; I had just moved out of my own flat amid a lot of wahala into a room in my brother’s house with absolutely nothing on me. I had also been a bit ill for no reason, just feeling generally unwell, weak and indisposed. Obviously the stress had gotten to me.
But it was not the fact that I had failing health that aggravated me at this clinic visit, it was the way the doctor flippantly addressed it (and me). She was not rude or cold she just seemed disinterested, like I was just a statistic, which I probably was. She asked if I had been taking my immunity boosters, which I had, and then told me to stay off things that could cause me to be sick. I wanted to know if stress could be a factor but she just said ‘anything, anything’, like she was tired of the conversation. For me the emotions were many and varied. I had hoped to stay as long as forever without needing drugs. In truth by WHO standards I should be on drugs by now, but since Nigerian politicians insist on squandering our resources we have to rely on international funding for treatment and care of HIV. As a result, drugs are rationed in the country, and even healthcare is limited. For instance I do not know my viral load which is a huge determinant of how the virus is spreading in your bloodstream. I haven’t known in 4 years because the clinic I attend got burnt and with it all the reagents they needed to detect viral load. Driving blind is not the way to treat HIV, you must at regular intervals know what progress you are making, using every empirical measure available. There are people who have taken their medication so regularly that their viral load is undetectable- you can barely find the virus in their bloodstream. I know two of them and you probably knowone famous one: Magic Johnson. People like that can no longer easily transmit the HIV virus. This is necessary to know. In LUTH and I daresay Nigeria, it’s as though the hospital dangles your drugs in front of you and says ‘don’t worry about HIV we have the drug for you; just fall very sick first’. So this was one of my concerns, with the CD4 drop, when should I be worried?
Another major concern of mine was the obvious one: death. As a person I have no fear for the actual death itself; I just worry about the people I am leaving behind. My parents and my daughter. I would want to make life a lot easier on them before I live and while I am alive. Debilitating illness and death make that impossible. It might seem a tad dramatic for me to be linking my drop in CD4 straight to death but here are a few things to consider. A dropping or stagnant CD4 count even with proper treatment and care is a sign that HIV has progressed to AIDS. AIDS kills. Also, CD4 does not drop using and arithmetic or geometric progression: what that means is you cannot predict how it will drop. I could be well today and in a week look like those people who you see on TV when they say AIDS kills- it is that fast. My blood tests are done in 6 month intervals no thanks to all the factors I explained previously, and a lot can happen in 6 months. Heaven forbid that instead of being a source of strength for my parents in their old age, I become their burden and they are perpetual caregivers.
Underlying these fears was the nagging memory that I have no source of income and little hope in sight. (Before those who know me take up that matter as their personal matter, read on about what I know for sure about work.) This more than not contributed to my stress ad more frustrating was the notion that many of the things I was doing were not working and this was out of my control. Out of my control! More than 12 years excelling in a field and getting work is out of my control. Numerous months of rifling through books, clothes, in drawers searching for 70 naira to buy a drink for lunch. Or breakfast. Always begging for transport fare to attend one interview or the other, or even to attend clinic. And always seeing a lot of people who started out much later than me, going farther in the life race. The whole thing got to me.
I even went to my parents thinking I could stay there for a while and regain sanity, instead I became more depressed. I got a call for an interview in Lagos a short while after and I happily left with only enough money to get me to the park, stunning my mother who for whatever reason I refused to speak more than a few words to a day. I attended the interview but I did not think it went well, especially as my confidence was shaken by seeing quite a number of my former subordinates in relatively high positions there. It was not that we had bad relationships as a matter of fact we were happy to see each other, but it reminded me of how badly I was doing and created extra (unnecessary) pressure for me to get the position. I did not hear anything from the interviewers and that was how the depression finally set in.
This was the situation I was in before and after I wrote my last post. This is a rather long post so the next one explains where I am now.