When Red, Itchy Things Happen To Sad People

Well, it has finally happened: faced with just two more weeks in Ife, and just one week after my soul itself made its own grand exit from this infernal village, my body has begun to physically reject my surroundings. Perhaps some of you were deceived into thinking that I was no longer writing because I was suddenly having more fun. Maybe you thought I had too much work to do. It is even possible you thought that I had lost the will or the drive to jot a few of my thoughts down. None of that could be further from the truth, because your dearest kulutempa has been shuttling back and forth between home, school and the “state of the art” clinic off-campus, namely Apex Medical Center. I want to be sure and identify that particular institution. Apex Medical Center—never forget that name. If you fall off your luck train, i.e. you are abducted by armed robbers in Kano who are trying to flee to Niger but lose their way, then suddenly decide that you are their only unwanted burden and choose not to kill you but instead, to your dismay, drop you off in Ife, you will want to remember Apex Medical Center as a facility to avoid.

On Monday, I woke up with a disgustingly painful headache. This, after a rigorous weekend filled with a near-beating experience by city thugs (which is indeed a story worth telling, but must be saved for another time), and then my return home to discover that my directors were trying to make sure that I would never be free of tension in this host home again. It was a headache, quite all right, but I knew that it was going to develop into something more. You see, I’m prone to migraines (relatively mild, but migraines nonetheless). Actually, I’m prone to headaches of many sorts, and it doesn’t help that my eyes are photo-sensitive, but I digress. I had a headache, and my body was incredibly weak. The directors of the program asked me to come to school, where they would pick me up and take me to “state of the art” Apex, where the senior doctor and owner of the clinic was German-trained and still gets most of his drugs either from Germany or directly from the manufacturer. I’m not one to take drugs for almost any ailment; I choose to rest, or to take herbs. But I must admit that I was relieved—the Nigerian in me was impressed by the fact that the word “Germany” appeared several times in the discussion about my treatment, because anything foreign in Nigeria is better than its native counterpart. In fact, I already felt cured, despite that, thirty minutes later, I could not even open my eyes because the pain in my head was so intense.

Nigeria is not a place to be if you suffer from headaches, migraines, or any such ailment. Even in my state, I was learning that lesson. At first, I was lying down in our “seminar room”, which is just a large classroom, bare of any furniture except some chairs that had been welded together in immovable rows. I had been helped there by my host mom, who had briefly forgotten that she wasn’t talking to me because I’m not eating her “food”, and the six cleaning women who were loudly sympathizing with the fact that I was immobilized by my headache. Each one of them was trying to make sure that I would hear her “Ah! Omo mi, se ara e ko ya? Pele o!” ringing in my head for the rest of the day, lest I forget they had shown me empathy when I got better. After they dispersed, I was trying to lose consciousness so as to avoid the pain, but then other visitors wanted to let me know how sorry they were that I had this crippling headache. When I fell asleep, they woke me up to tell me sorry. When I asked them to please lower their voices, they interpreted that to mean that they should talk in a low scream, right over me, as they hypothesized about what might be causing my headache. It didn’t even stop when I got to the hospital, where the nurses were cracking loud jokes as they took my blood pressure and temperature. I could have sworn that I told them I was in there because I had a migraine, but I couldn’t hear myself over the blood rushing through my head, so maybe I didn’t.

At any rate, one of the junior “doctors” was available. The first thing he did was ask me if I wanted a shot of something. I said no, I don’t take medication for anything. What I wanted was a dark room and silence. They all bustled about noisily looking for a quiet room, then returned to tell me that the only room they had available was a closet-sized space beside the toilet. I almost tasted the toilets in Ibadan (refer to Letter #2), so I declined the offer. Then the doctor offered me the shot again, telling me that it would give me immediate relief and why don’t I just take it? I caved.

That was Mistake #1.

I did feel better. Within ten minutes, I was able to open my eyes fully—it was a miracle! But they told me that I still needed to rest for about an hour or two. They moved me into a private room, and I tried to catch some Z’s. Not too long after, I heard the door of the room open and heard some steps walking towards the bed. I looked up and saw the grotesque face of an ancient man staring down at me. Half his face was comprised of his huge, red eyeballs. They looked like they were about to roll out of his head and I was briefly tempted to reach out and grab them; I wondered if they would feel as wet as they looked. He reeked of layers of cigarette smoke and last night’s beer—I remember thinking to myself, why is the town drunk in here looking at me? Turns out he was the senior doctor, the owner of the clinic, the German-trained wonder. He told me that I would be all right now that I had taken his medicine. I believed him.

That was Mistake #2.

Since you are not all doctors and don’t need to know the full history of this case file, let’s fast forward through the next couple of days. Tuesday: I wake up with rash on my chest. I think it’s eczema or something; I curse Ife. By afternoon, the rash has spread to my arms and back. By nightfall, it’s all over my thighs. Wednesday: the rash is now a bright red color and itches terribly. I am appalled and panicking; I’ve never seen anything like this before. I return to the clinic to ask them what they have done to me. They deny having any part in this; they blame the water, my bathing soap, the Ife air. I go and see the doctor in his dungeon of an office, where a second set of his giant eyeballs stare at me from a life-sized portrait of his slightly younger self hanging behind his chair. The picture was probably taken in a Nazi training hospital in Germany; it had all the life of a brick wall. From across his desk, he prescribes a new set of medications for me, telling me I’ll be all right. Thursday: rash is worse. A whole lot worse. It now looks splotchy and covers more surface area, from my scalp to my toes and I even notice some splotchiness on my palms. I feel like death. Friday: I can’t take the anguish anymore; I go back to the hospital to ask them once again why they are trying to kill me.

The Godfather rasps from across his desk: “Well, it is obvious that you are reacting to something.” Thank you, Columbo—are you also ready to admit that I am reacting to the drug you gave me for my migraine? “It cannot be the Piroxicam; it doesn’t cause a rash. The book says so.” This book he’s referring to is a handbook detailing various medications and their purpose; I saw one of the junior doctors flipping through it earlier and almost choked on my anxiety and dismay. I was prescribed even more drugs. Let’s note at this point that I have never been examined by any of the doctors at Apex; the doctor isn’t concerned with what the rash looks like; he just wants to make sure that I’m drugged senseless. I decided then and there that I wanted a second opinion. Finally, my brain was working again. He referred me to a dermatologist, whose very first pronouncement was that I was in need of an examination, which he gave me immediately. His next pronouncement was that my situation was grave, which made me extremely nervous and jittery. After interrogating me about everything I had been through this week, he told me to discard all the medications I had been given by the other “doctor” but one, which he would re-prescribe for me. Now, this medicine causes ulcers and shouldn’t be taken without food and an antacid; the Godfather had told me the opposite. Long story short, I felt more comfortable when I left the dermatologist’s office, and after my first dose of his prescription, I saw a marked improvement in my appearance. Praise be to God.

Later on that evening, I decided to go to the NIH website and see what they have to say about Piroxicam. What I saw nearly stopped my heart. In black and white, on the internet for the world to see, I read the following:

Piroxicam is used to relieve the pain, tenderness, inflammation (swelling), and stiffness caused by arthritis.

I swallowed spit. Piroxicam is used to treat arthritis? Could I really have been in so much pain that I said I had arthritis when I meant migraine? I mean, what kind of game were these people playing?

On April 7, 2005, the Food and Drug Administration (FDA) announced that they are asking manufacturers of all prescription nonsteroidal anti-inflammatory drugs (NSAIDs) to revise the drug labeling (package insert) to include a ''boxed'' or serious warning about the potential for increased risk of cardiovascular events (including heart attack and stroke) and serious and potentially life-threatening gastrointestinal (GI) bleeding associated with their use. Piroxicam may cause an upset stomach. Take piroxicam with food or milk.

But the Godfather said that I could take Piroxicam at any time, with or without food. Gastrointestinal bleeding?? Nobody said anything to me about GI bleeding; that’s a serious warning—shouldn’t I have been informed about that?

Although side effects from piroxicam are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:
headache
dizziness
nervousness
upset stomach
stomach pain or cramps
vomiting
diarrhea
constipation
gas

Indeed, I had suffered from a dull headache for two days after I took the shot, and my tummy hurt a little bit, but it was the following that made my blood run cold:

If you experience any of the following symptoms, call your doctor immediately:
bloody vomit
bloody diarrhea or black, tarry stools
ringing in the ears
swelling of the hands, feet, ankles, or lower legs
skin rash
itching

SKIN RASH AND ITCHING??? The very things the Godfather said to me could never have been caused by his Piroxicam?? It was in The Book, for Christ’s sake!! I was weak. I mean, they said the man was trained in Germany; I should have asked whether he was trained there during WWII. The Holocaust didn’t start in Germany for nothing. All I can think about right now is that he is going about, giving people shots and dispensing all kinds of prescriptions from on high all willy-nilly. Right now, someone out there is suffering from a mysterious rash, wondering how many of their clothes and bedsheets to burn, and considering bathing with bottled water for a few days because they don’t know that the Godfather is a quack doctor and is responsible for their ailment. There but for the grace of God go I.

I have said my piece, and the program directors have been made aware (in the kulutempa way) that they really could have done better with our choice for healthcare. In Africa, there is only one rule to remember in this sort of matter: follow the white people. If you want to get better, go where they go. And if you really want to help yourself, just don’t fall sick. And don’t come to Ife. Beg the thieves to kill you instead.

Update: My skin is fresh and brown again; I'm so happy and grateful to God. I'm leaving Ife on Saturday, and I spent all of yesterday packing my load. If I had to leave right this instant, I'd be good to go!