A Nightmare

April 10, 2010

The next 2 days Atish and I spent with Niharika at the new library in the slum community and at the Swechha office teaching a group of children dance and songs. I plan to write about those experiences and my observations of Atish’s interactions with the children when I write an entry about our work with Swechha/Pagdandi.

It was important to Atish to visit the state of Gujarat during his first trip to India, the state where his family is originally from. And so, despite warnings from everyone about the heat, we booked one-way tickets to fly to Ahmedabad from Delhi. The plan was to travel throughout the state of Gujarat then up through Rajasthan to return to Delhi by train, during the month of April. Atish and I were both not feeling well when we boarded the plane in Delhi, it had been something we had eaten/drunk. But we weren’t at all prepared for how quickly and violently “Delhi Belly” could strike.

During the 1.5 hour flight Atish and I alternatively complained of stomach pains and light-headedness. When we landed Atish looked pale and weak and I summoned the strength/adrenaline to show some enthusiasm and energy to get us through the airport. At the baggage claim Atish left to use the toilet. I got the bags and waited nervously for him. When he returned he looked like he could faint, it was clear he was losing fluids fast. We got on an autorickshaw to our hotel, the driver ripped us off majorly having noticed we were in no position to hang around and haggle. As we checked into the room I ran around to fill out the paper work downstairs and buy water. When I returned to the room I found Atish throwing up into a bucket. I was scared and panicked but I tried to calm him and ease his discomfort. He was shivering, said he was cold, his stomach was cramping. All I could think to do was get antibiotics in him as quickly as possible, but his stomach was empty and he also had to drink water. I prepared a bottle of water with ORS (electrolytes) and gave him an antibiotic to take. He took it and drank a little and lay down. I waited and watched.

When I’ve had traveller’s diarrhea (a topic of discussion which can’t be neglected when honestly writing of one’s travels in India) taking antibiotics have stopped it immediately. I hoped the same would happen for Atish, but was worried because I had never been so sick and thrown up before. Within 5 minutes he was sick again, losing the water he had drunken and more. My heart was racing as I leaned over to look in the bucket… red. “That’s bad, right baby?” he asked me weakly. “Ok, we’re going to a hospital right now,” I announced. I quickly gathered our money belts, water, biscuits, sweaters, and helped Atish downstairs to the reception desk, less than half-an-hour after we arrived. Blood in stool or vomit was very bad.

The hotel manager still wanted me to fill out the details of Atish’s visa, and he still had to sign he told us. “We need to go to a hospital right now,” I said, “Please, do you know a good private hospital in the city?” The men consulted in Hindi for several minutes while I watched Atish from the corner of my eye and tried to understand what was going on. “Please, it’s urgent, we need to go now. Do you know a private hospital; otherwise we will leave now for the government hospital.” Finally they seemed to come to some agreement and one of the men took us down to the street. He hailed a rickshaw and got in with us, directing the driver to a nearby clinic. He led us upstairs the old building to a tiny office where a single nurse was asleep. “Can we see a doctor? Is there a doctor here? Do you speak English?” I asked her, pleading with her to make eye-contact with me and acknowledge the urgency of Atish’s condition. She casually motioned for us to sit down and went to take his blood pressure.

Atish had lost so much fluid and he looked so weak. I’ve never been so scared in my life. I spoke to the nurse in a constant flow of words I hoped she would understand, sick, vomited, blood, do you understand blood? Dehydrated, weak, cold, water, he needs water, maybe an IV, there was blood, is there a doctor here? She walked around the desk and place a call. The doctor will be here in 10 minutes she announced. “Does the doctor speak English?” I asked. Without answering she left the room. I was so frustrated. I didn’t know anything about this clinic. The sign outside had said something about maternity care. If we couldn’t communicate here maybe we should leave right away and find a different hospital, the government hospital mentioned in the lonely planet? Would it be so much worse or better? I knew nothing of health care in India except for a horror story my mother had told me about her experience having her stomach pumped in a public hospital in Bangalore, it didn’t comfort me.

I tried to tell Atish everything was going to be fine, just breathe deeply, hold on, the doctor was on his way. He kept his head in his hands. Incredibly, the doctor did arrive in 10 minutes, telling me they took us seriously. And more incredibly he spoke perfect English. He examined Atish and said he was to be admitted for the night. They would put him on an IV and run a blood test. They had a single private room in the clinic with two beds, I could stay the night with him and watch him. The room had AC and a bathroom attached with a western toilet. They would run out and get us toilet paper, soap, snacks, bottled water. Atish was to drink as much ORS as possible. They injected antibiotics through the IV tube in his wrist.

Before Atish left Seattle my father had made him promise to take me to a doctor to ask about my persistent cough I had since Sarnath. There in the private hospital, looking paler than I knew possible, lying with an IV in his arm, Atish asked for the doctor. “Doctor, will you please look at her? She has a cough.” We both laughed. The doctor was confused. Then I knew Atish was going to be ok.

The care was amazing and I was so grateful to the doctor and his staff for their help. I knew Atish would recover, but I still felt stressed that night after I made sure Atish was comfortable. I’ve never seen him look so miserable and so weak. I wondered how we would fair in Ahmedabad in the heat. And after the whole ordeal I didn’t feel so well myself, the adrenalin was wearing off, I felt dizzy. We had so much to see and do in Gujarat, now we had lost a whole day and surely would need several more to recover. I drifted into a restless sleep. Waking up every half-hour or so I would check on Atish, when I was asleep I dreamed of my mother’s illness.

By morning Atish looked a bit better but I now had diarrhea as well. I hadn’t eaten a proper lunch or dinner the day before, and hadn’t had breakfast, I felt extremely weak. The doctor examined me and concluded that Atish had dysentery, I had traveller’s diarrhea, we were both weak from the infection and had to eat a lot of fruit, biscuits, yoghurt, and drink water for several days before we would feel well again. I nursed Atish and he nursed me. There aren’t many things that can bring people closer than 24 hours in a hospital together in a foreign country. We told each other we were going to be fine, that this was just one of those experiences when travelling, and soon we would continue our trip. When we left the hospital we were a little stronger physically but a lot stronger emotionally.

By the end of our hospital stay at 7pm that evening Atish had been given 6 IV bags of saline and sucrose solutions. His blood test came back, everything was normal except he had been extremely dehydrated when admitted, close to renal failure. It was terrifying to think that it had all happened over the course of about 3 hours after leaving Delhi. If we had taken a train instead of flying we would have been isolated and lost without access to medical facilities.

Atish and I never asked the doctor how much the private room cost to stay in, or what the doctor fees were. We wondered if the price would be ridiculously high, if the doctor would take advantage of our situation. He knew we were American and that Atish was a professional. So when it was time to see the bill we were ready for anything and resigned to pay it, after all, it would be worth it considering it was all very necessary. We were shocked by the total… 4,100 rupees. The total came to less than $100US. This included staying in the private room, all nurse costs, medicine fees, doctor fees, snacks and water. No wonder people leave the USA for medical procedures. We gave the doctor $100US, he would have quite a tip when he got it changed to rupees. We left 500rupees for the wonderful nurses. In all, it was an extremely positive experience all things considered.

Over the next 3 days we drifted between subdued bouts of energy and periods of weakness. It was frustrating and sometimes scary when we would lose our appetite or need to return to the hotel to rest. How were we going to travel like this? Where should we go? Should we head back north to the mountains where it was cooler? Should we go south to the Portuguese island, Diu? The heat was unbearable and it made recovering and regaining our appetite difficult. And Ahmedabad is not a great place to be sick. But little by little each day we got stronger and regained the enthusiasm to leave Ahmedabad.

It was an ominous beginning to our trip and it definitely set the pace for the rest of our travels. For the next month we never felt completely healthy and the heat held us back from exploring during the day. We managed to go to many places and enjoyed ourselves, but we learned our lesson to avoid India during the hottest months of the year.