The Good Knight Nurse’s Health Report

May 28, 2023 Posted in The Honey Badger Diaries / Musings

A health report from a Knight nurse who's no Nightingale. The patient, though uncomplaining, shows signs of fatigue and exasperation. His night sweats are uncontrolled, forcing the Good Knight Nurse to seek alternative sleeping arrangements. In a 7.2 m x 2.5 m (18 sqm) truck, that's a problem. She resorts to writing her reports.

I remind myself of these sage words: “If you think adventure is dangerous, try routine; it’s lethal.” ~ Paulo Coelho.

As he twists and turns in the sodden bedclothes coiled around his arms and legs, the Good Nurse pads around in the dark, searching for a scrap of space to fashion a dry nest for the night. Picnic baskets, crates, camera bags and discarded shoes are shuffled and moved. She juggles cushions onto the floor and uses any available length of cloth to cover herself for a smidgen of warmth. The summer heat has also eased in the subtropics.

Sleep will eventually come, she knows. A twinkling star draws her gaze skywards. A cool shower of air sifts down from the open hatch above her. The silky coolness touches her arms and neck. Her attention briefly shifts from their calamities. Now focused on the night sky, she hears the Verreaux Eagle owl’s soft, frog-like prrrups. There are always positives, even when the skies are bleak. She wishes he'd snore, like the good old days; now she has to feel his pulse or poke him in the ribs when she doesn't hear his breathing. He's so quiet.

It only takes one domino to fall to set off a chain of events. In Butch’s case, a Blister Beetle hiding in his underpants set it off as long ago as February. After two courses of antibiotics, tubes of ointment, and TLC, it took weeks to heal, and the purple scars still haven't faded.

We had just packed and stowed the medicines when he complained of a bladder infection. We pulled out the meagre first-aid box; fortunately, there was no cure lurking in the dark corners, so he went to the GP, who checked all his vital signs. His heart and lungs were fine. He returned with a second course of antibiotics and a prescription for more after his molar tooth extraction.

We agreed he’d brave the extraction site’s healing, gargle with salt water, and take only the dentist-prescribed probiotic.

I’m a food person, not a doctor, and I rarely take medicine. This might stem from my early childhood and boarding school education, where one had to be on death’s doorstep before receiving medical attention. Just as well. Today I’m an unsympathetic nurse who believes, as a former matron drummed into our heads, that “God only helps him who helps himself.” A bitter pill to swallow when you’re eight and feeling poorly.

---oOo---

In pretty Pomene, we went arse over kettle when a massive wave struck us, whipping our feet from under us and smashing Butch, unsteady on his feet, into jagged coral and a razor-sharp rock face. The gash on his leg seemed minor and was healing. We cleaned the wound meticulously and applied ointments daily.

Although Butch had no discomfort a fortnight later, we noticed that his ankle was swollen and his calf muscle discoloured. After a good night’s sleep, the swelling would subside but recur, especially after a long day behind the steering wheel. The small gash showed signs of infection and weeping, so he immediately started another course of antibiotics the dentist had prescribed.

---oOo---

And then the unthinkable happened. Butch, returning from the ablutions one evening, decided to cross a Macadamia drying floor by picking his way over these green, slippery, nutty marbles—a lethal mistake. Anton, our host, and I were startled by a god-almighty crash. Butch went down like a ton of bricks. His feet set the nuts in motion, rolling like ball bearings. With no grip, his feet were swept from under him, knocking the breath out of him as his head, back, bottom, and legs hit the hard clay floor. He saw stars, and what followed was a cry of anguish, despair, and near concussion. He’d set off a chain reaction, and the dominoes started tumbling.

Reminding me of William Congreve's comedy of manners, The Old Bachelor (1693): "Thus grief still treads upon the heels of pleasure: Married in haste, we may repent at leisure."

---oOo---

Easter weekend was approaching, and we thought a visit to Gorongosa National Park would be a good bet. But then he developed a high fever, night chills and hallucinations. We both realised his condition was deteriorating.

Fortunately, we were the only campers on a farm, and the owners were very clued up about tropical illnesses and suggested Butch start a course of antimalarial medication. This was despite a negative malaria test I’d taken the previous day. Some days were better than others, and he kept his spirits up. The soothing ear-candling session was a hit and a welcome distraction.

Performing the malaria test for the first time was quite daunting. First, the instructions were printed in such a small font that I had to photograph and magnify the template. The packet contents and the instructions didn’t match, so I had to wing it and hope for the best. By then, Butch was beyond caring anyway.

Butch’s leg wasn't doing well at all. It was purplish-red, hot, rock-hard and inflamed, but not sensitive to the touch. We consulted our GP in South Africa, who gave us further instructions and kindly checked in every day to see how he was doing. She diagnosed a coral infection, one that takes ages to heal. The gash was clearing up and no longer painful.

By Easter Monday, there was no marked improvement. Butch was becoming increasingly anxious, and we decided to head for Beira. By then, I’d run out of diagnoses, Butch had run out of patience, and we were both running out of good vibrations and medication.

---oOo---

Butch and I agreed he needed to see a physician immediately. Given the dire opinions about local medical care, we decided, to Butch’s relief, that he should fly to Johannesburg. His nephew agreed to do the legwork and enquired about a suitable doctor and hospital.

Within two minutes, we received a call. Under no circumstances was it advisable for Butch to fly without first having a double Doppler Sonar to see whether he had developed a hematoma or blood clot. He could die from the pressure and altitude associated with flying. We had no option but to consult a doctor in Beira.

By now, Google was an excellent, intimate friend. We were told about two hospitals. We’d travelled from afar and had 10 hours of driving behind us. We were stressed, hungry and in a foul mood. I had driven the Honey Badger, which, at its best, is stressful, as I battled the roads, traffic, sudden speed limits, and my driving instructor, who, despite his ill health, still had plenty of advice.

Praise be. We made it to Beira. We gratefully accepted the offer to “camp” in a construction company’s yard. Once again, a stranger, without a second thought, was ready to help us, ferry Butch and me to Beira's private hospital, and assure us we could stay as long as needed. He’d stay with us and act as our go-between and interpreter. Nothing was too much for this generous good Samaritan.

---oOo---

The pretty young Mozambican doctor attending could’ve been our granddaughter. She ushered Butch into an examination room, held his heel in her palm, swivelled his foot this way and that, examined the two-centimetre wound and his swollen, discoloured leg, and made her diagnosis. A barrage of Portuguese erupted as she explained his condition to two student doctors, who nodded, leaned over his leg, and offered their opinions. We couldn’t understand a word.

Every so often, I’d try to chirp in and update her on my ministrations, but she swatted my words aside, uninterested. After her preliminary examination, Butch was whisked off for an X-ray to check whether he’d broken a bone in the macadamia fall. The X-ray was as clear as daylight: no broken bones.

Then to the pharmacy, where a pharmacist dispensed the required medication. Another double round of new, better and stronger antibiotics was prescribed, with instructions to report back the following day at nine o’clock for the sonar. We were swiftly dismissed. Later, we realised the pharmacist had also prescribed an injection that had not been administered.

With the formalities quickly attended to and our bill, equivalent to thirty Myprodol in South Africa, settled, we could return to our truck. Although all thoughts of flying to Johannesburg seemed to have fizzled out in the night air, we felt more optimistic. I was relieved to know that an actual doctor had seen my patient, and she thought we were daft or ill-informed for preferring a South African medical opinion. She tutted and tsst-tsstt’ed a lot whenever we brought it up.

---oOo---

Bombshell! The Good Knight Nurse could picture the headline “Stepmother Misdiagnoses Our Beloved Father in Mozambique.” How would I ever live it down? I set out to document Butch’s medication, symptoms and diagnosis. Meanwhile, our nephew had investigated flights from Beira to Johannesburg—astronomical at R21k.

If Butch had a blood clot in his leg, he'd need an Emergency Medical Evacuation, which our travel insurance would cover, but we would have to pay upfront in cash before take-off. I shudder to think what that would cost. A sixty-minute scenic round trip from the Waterfront in Cape Town costs R6000 per person without the emergency medical crew and their expensive equipment.

We were up bright and early the following day to report to the hospital for the sonar. Butch was readmitted and wheeled into an examination room, where he was once more prodded and probed by a menagerie of pretty young nurses who smiled, nodded and offered their opinions in rapid-fire Portuguese, which sounded like a round of bullets from an old AK47.

A general surgeon had been alerted and would attend to Butch once he’d completed his ward rounds and seen his patients at the General Hospital. A very charming doctor arrived who seemed to understand a smattering of Portuguese. Our hospital interpreter informed us that he was a Cuban doctor in Mozambique and that, if we understood and spoke Spanish, we were welcome to do so.

“Agua con gas, por favor, Signor” is all the Spanish I picked up in Mexico while floating on a giant pink flamingo lilo with my daughter’s in-law five years ago. “No, we do not speak Spanish. Can you translate for us, please?” Thankfully, he replied, “No problem, you’re welcome!”

---oOo--

My mother drummed it into our heads that "cleanliness comes before Godliness". We were never, ever to leave the house without clean underwear, in case a bus drove over us, because the whole town would gossip about the dead Knight in shabby underwear. She couldn’t live down the disgrace, she said.

Butch assured me he had presentable underwear on before our mission to the hospital. His mother had also been terrified of shoddy underpants and of the injured child.

After Butch gave a lengthy, detailed account of his injury, his treatment so far, and his wish to fly to Johannesburg to see a doctor, the Doctor nodded sagely, wrung his hands in exasperation, and agreed to perform the sonar, confirming cellulitis of the leg. The medication prescribed the previous evening was appropriate and would do the job.

Butch was ordered to lie on the examination bed, and when ready, the Doctor would perform the sonar, he said, handing Butch a cotton sheet. Butch stripped down to his boxer shorts. As luck would have it, the Christmas boxers were missing a few stitches from the crotch seam. Whether it was nerves or relief, we laughed, giggled and cried hysterically. With a sheet pulled up to his chin, he waited in state for the Doctor, who couldn’t suppress a giggle at the sight of his near-naked patient. Whether he noticed the missing stitches, we'll never know. He kept a straight face.

---oOo---

The Doctor thoroughly examined all his arteries and veins, showed us pictures, and explained each heartbeat and pulse in detail until Butch was satisfied. His final diagnosis confirmed cellulitis, which, if left unchecked, could be very serious.

A nurse cleaned and dressed the wound, and I was given instructions on the procedure going forward. It was crucial that Butch complete his course of medication, keep the injury clean as required, and keep his leg elevated and rested. He prescribed three days of bed rest.

We made reservations to stay in a hotel in Beira with a sea view. We'd be without our Honey Badger for three nights. A first in six months.

---oOo---

A fortnight later, Butch finished his course of medication; the wound had healed, and we were thrilled to announce that his leg had improved. His ankles were back to normal, there was no discomfort, and the searing pains in his legs associated with coral fever had gone. He reported that he was 98% better.

Relieved, I packed the bandages and Betadine ointment, discarded the empty boxes, and sighed. I had no problem being the chief, cook, and bottle washer, but nursing didn’t suit my impatient personality. One morning he said, “Marich, we’ve been on the road for seven months, and not one day has been boring. In all this time, I’ve never considered giving it up.”

98% is not 100%. Ask any wannabe Einstein. We were out of the woods but still in the jungle. On two occasions, after a prawn dinner and copious amounts of yummy, salty roasted peanuts bought from street vendors, he suffered an upset tummy, cramps and a general feeling of malaise. He opened the first-aid crate and treated his symptoms. He accepted his lot and, for a while, refrained from those favourite foods, fearing an allergy.

---oOo---

From time to time, Butch dislodges the hidden scales from behind the loo and ceremoniously weighs himself. His intermittent fasting has certainly paid off, and he’d remark triumphantly that he was nearing his “Goal Weight”.

Trying not to sound too bitchy or envious, I held back for a while, but on Monday I spoke my mind. I thought he was too thin and that his immune system wouldn't have recovered. He had lost too much weight; at 93 kg, he was losing muscle, not fat. I had enough and reminded him that anorexia was an eating disorder. He agreed. But he had to force himself to eat, as he had no appetite and had become apprehensive about what he ate. My beloved was half the man he used to be, which worried me greatly; he didn't think it was a train smash.

On Saturday, just 18 days later, after a long journey marked by many delays, bad roads, roadblocks and a border crossing, we arrived at our current campsite. An exhausted Butch alighted from the Honey Badger and later complained of light-headedness and fatigue.

Alas, we constantly neglect ourselves when we're in a rush, and the clock keeps ticking. We would pay dearly for it. Butch was very weak, dehydrated and worried.

That night, he developed severe hot-and-cold fevers and diarrhoea, which persisted the following day. He had a telephone consultation with a local doctor, who prescribed an antibiotic and advised him to hydrate.

The fevers continued, and the Good Knight Nurse decided to add a course of malaria medication to the regimen. That set everyone in motion, and in no time, Butch, much to his annoyance, reluctantly let us bundle him into a waiting car to take him to the clinic. I slipped his iPad, spectacles, phone charger, and phone into a Woolies shopping bag, promising he’d be home shortly and that he’d have his book while he waited. With these words echoing, “I just want you to know, I’m not at all happy about this!” he was off.

The hospital took blood tests, and the malaria test was positive. He was admitted and spent 24 hours in the clinic receiving drips and injections. His sister immediately realised he hadn’t eaten and insisted on giving him eight golden bananas.

He received excellent healthcare; the staff were kind, helpful and friendly. They certainly knew the drill. Although conditions were a far cry from what we’re accustomed to in our private healthcare system in South Africa, his fears were allayed by their expertise in malaria and its treatment, which is top-notch.

---oOo---

Butch was discharged the next day. He still had to complete a course of antibiotics. He has had only one bout of fever since then and reports a general improvement in his well-being. He is still weak and needs to rest, but his appetite for food and life has returned.

We’ve stocked up on malaria and bilharzia medication. We do not want to tempt fate, but forewarned is forearmed. Today, he’s feeling chipper and will slip on his flippers and strap on his goggles to snorkel in Lake Malawi. I’ll hold my thumbs; nothing unforeseen will attack us.

We will continue our journey north into East Africa. We have pink skies at night, a traveller’s delight. The Good Knight Nurse will hang up her medical bag and resume her duties as cook, cleaner and clairvoyant (it rhymes). “If life were predictable, it would cease to be life and be without flavour.” – Anonymous.

---oOo---