14 August, 2008


I'm at Claremont Clinic.  I'm sitting on the bench outside the special TB office.  It's just off to the side of the general waiting area.  There are about twenty people in the general waiting area.  I'm sitting here because I've been here before. I had TB last year and did six months of treatment.  I know what I'm doing.  I'm here because I think I have TB, because I feel sick all the time, because I've had TB before.  So I'm sitting here, waiting.


How long will I wait?  I'm wondering that.  I'm wondering it more and more.  I'm starting to wonder it seriously, even though I haven't been here that long, I've been here for long before, I'm not a stranger to this. I can see the floor between my feet. I can see people sitting in the general waiting area out of the corner of my eye.  I'm wondering if I'm waiting at the wrong place. If I am it would be a mistake.  I'd have to start waiting somewhere else all over again.


A woman has just come in.  She's walked straight inside.  Straight down the passage.  I'm wondering if she's cutting in somehow.  I'm wondering if somehow she's making me wait longer.  I want to know who she is.  What she's doing here.  How come she can walk wherever?  How come I have to wait?


The woman has come out of the passage.  One of the sisters is walking with her.  They're talking.  I'm wondering if they know each other.  I'm wondering if they work together.  I think they do.  They're talking shop, they're acting like they know the same things.  They walk past me, into the office in front of me.  They close the door on me.  They're talking behind the closed door.  I wonder what they're saying.


I'm feeling cold.  My legs ache.  I don't want to be here.  I want to know why I have to be here.  The woman and the sister come out of the office in front of me, the door opens and they come out.  They're laughing.  The woman is walking behind. The sister looks at me.  
'I'll be with you in a minute' she says.  
I relax.  I've been seen.  I will be seen.  I look at the people waiting in the general waiting area.  There are about fifteen of them.


'How you feeling?' she asks.  
'Not good' I say, standing with her in the office on the scale with my jacket, bag and shoes on the chair so that I weigh about right. 'I've got pain in my lungs and breathing is difficult. I can't move faster than a walk because I get out of breath.  About every three days there's blood in my morning phlegm.  Not a lot, but some, either speckles and spots and little worms, or the phlegm is pink.'
She nods.  She fetches a file from the cabinet without looking at my card.  She doesn't know my name, my first name, but she knows my initial.  I've been here before.


I tell myself I have it.  I tell myself I've got it again. That I need the pills again.  I've got to take those pills, all the big fat thousands of them, so much medicine it makes me sick.  I tell myself I'm weak again.  That I'll lie in bed again.  I tell myself I've got to start again.  I start to smile.  I see myself not going to work, not working, lying in bed, too weak to move.  I see money slipping in through doors and windows, I see my bank balance rising.  I see concerned faces all around me, stroking me. I purr.  It hurts  to purr.


'You're clean' she says.
'What?' I say. 
'There's nothing' she says, 'you haven't got it. We'll grow a culture, but for now you're clean.  You haven't got it.  You're not contagious.'
I hop around a bit.  I work my mouth.  I chew the air.  
'So how come I feel sick?' I say, waving my arm.  'I feel sick, sick, sick!'
'I don't...' she says.  She looks at me.  She thinks a while. She looks at me some more.  She looks right into me.  She looks at all my insides.  'Here' she says, 'have an X-ray.' She starts to write on a sheet of paper.  'You can go and get it done at Woodstock Day Hospital.  You know where that is?'
'No' I say.
'It's on Mountain Road.'  
'Mountain Road' I say, suddenly seeing the place, 'I know it.'


I walk past the others waiting. There's about seventeen of them.  They haven't moved.  I hold the paper she wrote on in my hands.  Tomorrow I get an X-ray.  I go to Mountain Rd Day Hospital and get an X-Ray.  I must be there at seven.  Next Wednesday I come back here with the X-Ray and the doctor looks at it. In four weeks the culture result is back.  Then I'll know.  Tomorrow I must be there at seven.  I should be there just at seven.

15 August, 2008.

Mountain Road Day Hospital has the best medical posters I've ever seen.  Even the big hospitals don't compare.  Just from looking at the wall from where I'm stting I can read about what the symptoms of high blood pressure are.  I can learn some useful tips on healthy living with diabetes. I can think about ways to build healthy communities. I can take in basic information about Meningitis.  I can ponder the dangers of casual sex.  I can find out that there are home tik tests for concerned parents available.  If I want I can write down the number for the cancer buddy support network.  I can know about child safety tips such as preventing poisoning.  I can realise that breastfeeding is the best form of child nutrition.  I can be reminded of the dangers of contaminated sharps and dressings left lying around.  If I have the time I can memorise the possible complications of untreated diabetes.  These include: blindness, Beroerte, blood vessel and nerve damage, heart attack, liver verskading, painful ligaments, loss of sex drive, pins and needles in the extremeties and the amputation or loss of a limb.  Most usefully, I can jot down some TB medication tips.


A man to my right is telling the guy next to him what it was like when he broke his leg.  He's talking loudly so everyone can hear.  He's saying that he had to have five injections in his spine.  He's acting it out, going 'Oowwrhhh!' everytime he gets injected.  He's a small guy with tattoos all over, even on his neck.  He's got big forearms, incredibly well developed. A little lost guy.


'Whats wrong with you?'  
'I had TB last year' I reply 'and I feel like I have it again.  My spit test is negative.'
'When did you finish your treatment?'  
'Hmm...' I say, thinking up to the faded and watermarked roof, 'I think about November.'
'Okay.' She looks at my letter from the sister at Claremont.  
'Wait in the passage.'


Up here in the X-Ray department, on the second floor, down the passage, left, up the stairs, one, two, straight, follow the sign right then left into the X-Ray corridor, there are new things to consider.  For instance, basic daily hygiene tips, the Springbok rugby team, how to keep the silent killer (high blood pressure) in check, the pros and cons of using alcohol and drugs during pregnancy, how dangerous emotional abuse really is, good foot care practice (don't ever use scissors or razors on your feet, don't use hot water bottles on your legs, don't soak you feet in boiling hot water, don't wear shoes that are too high or narrow.  DO NOT walk barefoot.) Self breast examination techniques (with accompanying pictures of a young woman with excellent, beautifully rounded and firm breasts), the health of non-smokers as pertains to second hand smoke from smokers, and some more AIDs information.


    'Sex is a great desire, but without a condom, you play with fire!'

    'Don't be a monkey about AIDs and HIV!'


I've had my X-Ray.  I'm sitting in the X-Ray room, waiting for her to come back.  There are leaden coats on the wall.  One of them is marked 'Dr Mavis'.  They're flippin heavy.  A lead coat, literally, sleeves and everything.  A full-on leaden coat.


I've had to have another X-Ray.  This time I had to cross my arms above my head.  The woman taking them is very kind.  Standing with my shirt off is chilly.


I've got it! Got the sheets!  I'm finished at 8:24!  It took only an hour.  I walk quite quickly away from the X-Ray department.  Straight down the passage, passing the posters on my right, to the stairs where I go down two at a time two floors.  At the bottom I turn left, not needing to go back past the emergency waiting room, and follow the passage until I turn left once again, bringing me out into the parking lot.  This building is very much like a school, big with passages and rooms and rooms.  Courtyards.  Forgotten equipment.  I guess I'm saying it's a government place.  I get in my car and drive away. Till next week then.

19 August, 2008


I'm back at Claremont Clinic.  I have my X-rays from pre-TB treatment last year, and my current ones with me in a big yellow envelope.  Outside the clinic there is a sign that says 'Closed, TB Session, Afternoon'.  Great because the place looks pretty empty.  I'm here to see the Doctor.  I'm feeling sick.  Achey, tired.  I was told to come at 12:30, the doctor should be here at 13:00.


I'm sitting in the general waiting area.  To my right there is a black man giving me an evil stare. He's holding a baby wrapped in white clothes and a towel.  The baby is awake but totally calm, dark brown in the white clothes.  Two benches behind him there sits a couple with a baby too.  In front to my left two women are sitting, the one furthest from me is also holding a quiet baby.  Somewhere further inside the building another baby is crying.  I can hear the sister talking.  The baby is howling, screams getting louder and louder, the kind of sound you want to hit, do whatever it takes to get it to stop without thinking.


The baby has stopped crying.  It's become very peaceful here. Sun is shining though the big windows and reflecting off the linoleum floors.  I can see into a small rectangular court yard.  In the distance behind that I can see a peak of the mountain, covered in trees, a little hazy in a warm Spring sky.  There's a gentle breeze wafting through the place.


Everyone here has TB. There is a sign on the wall of the passage further on that says all windows should be kept open to help combat the spread of the disease.  It's airborne and catchy.  The sign is accompanied by a little cartoon of a man opening the windows.  He's got a huge big happy look on his face.  He fuckin loves it.  Opening those windows.  He flings them open.  He lets the TB out.


'All babies under 3 years old are to be wieghed naked.  A very sick child should be reported to     reception immediately.'


There are four posters and signs on the walls carrying the same message.  They all say that if your baby is sick you should report it to the sister immediately.  Even diarrhoea can be fatal.  I could see it happening, a baby dying because it has gone quiet, and the mother thought she should wait her turn.  Nobody talks.


Every sound here echoes.  It reminds me of when I spent some time at a fire station.  The sound quality was the same, echoey.  And the environment was the same. Stretches of linoleum, shiny in the light, quiet and still.  The only movement would be something wafting in a breeze, or one man, walking across and away.


The janitor asked me if I've got a brother in the security business.  I told him I didn't.  I don't have any brothers.


I went to the toilet.  I went to the last cubicle in the row to blow my nose.  I left the door open. I thought that if somebody came in they'd see that I was blowing my nose.  Someone came in. I heard the door open and footsteps.  I finished.  I walked back down the row of cubicles.  One of the doors was open.  I stopped and looked in.  A young girl was sitting on the toilet.  She was about four. She had her pants and panties around her ankles, her ankles dangling in the air.  She smiled at me.  I smiled back.


The little girl just came out of the toilet and went to go sit with her mommy.


Just sitting.  Light.  Colors.  Very quiet.  I have my eyes closed.  It feels like everyone else has gone away.  Someone starts talking.  I open my eyes.  It is a young woman talking on her cellphone.  Horrible.  She is yacking away, yammering, her disgusting mouth masticating words into her hand.


Silent again.  You never know how long it's going to be.  I could get up in the next thirty seconds.  I could get up in the next three hours.


Just had a fight with one of the nurses.  I was definitely reasonable and polite and she walked away from me.  All I wanted was to know what was going on.  Really pissed off now.  Have been here for an hour and forty-five minutes without even moving.


The Doctor is here! He's a little Indian man about sixty-five years old.  He walked in with a huge grin on his face clutching a briefcase the size of his chest and shoulders.  He went straight through.  There are very few people ahead of me in the line.  In fact only one.  I know that.  All of us are awake now.  We're all looking at each other from the corners of our eyes.  We're all measuring each other, wondering if somehow someone else is going to cheat somehow and get ahead somehow, somehow make the waiting longer.  I am, anyway.


The nurse is coming.  She's got a huge smile on her face. She's got two folders in her hand.  She looks at me and nods.  I can't believe it. I'm being called.  From two hours of terrible, silent, torturous waiting to standing up.  Finally standing up.  I pick up my things and walk down the corridor and around the bend.


The Doctor is a live-wire.  A smiling, joking live-wire.  He slaps me on my shoulder and tells me to sit down.


'Whats the problem?' he says.
'I've been coughing for months' I reply. 'I pretty much always cough, and I'm feeling tired and sick.  I pretty much always feel tired and sick.  I want to know what's wrong with me.  I had TB last year.'
'We'll need to give you a test' says the Doctor. 
'I've already had one' I say, 'it's negative, we're waiting for the culture result now.'
The doctor raises his eyebrows.  He smiles.  
'Lets just take a look at your folder' he says, pulling my file and the envelope of my X-Rays towards him, 'what have we got here?'
He reads. 
'Um... Um... Um... Yes...'.
I wait. 
'You had TB last year' he says. 
'Yes' I say. 
'These X-Rays' he says, 'where were they taken?'
'Those two were taken at Woodstock on the fifteenth' I say, pointing to two out of the eight, 'the others were taken in Malaysia last year.  I had TB and Pneumonia then.'
'Um...' he says, looking at all the different ones in the light.  Each is a metallic blue outline of a lung, the older ones are misted over with spider webs, covered with them, the new ones are much clearer, only a little web at the bottom of the right one.  
'Well' he says, looking at the new ones, 'these don't show anything. So, what to do?'
I shrug my shoulders.  We both look at the nurse.  She shrugs her shoulders.  
'A rapid action culture?' she suggests. 
'A rapid action culture' repeats the little doctor, 'why not?  What have we got to lose?'

He starts to write in my folder, quickly, a scrawl that I would bet is impossible to read, that I would bet is more a hieroglyphic that the nurses have come to know than a word, like a flashcard shape they’ve come to call ‘Rapid Action Culture’.
‘What is it?’ I say.
‘They take your sample that we sent in and put it in a special tank’ says the nurse, taking over from the doctor. ‘Then they add special chemicals. It grows the culture much faster than the normal six weeks. It’s rapid.’
‘Action,’ completes the doctor, his eyes shining, ‘it’s fucking great.’
I blink. The old man grins at me.
‘Alright,’ I say, ‘sounds good.’
‘In the meantime I’m giving you bloody strong antibiotics,’ he says, ‘these should make you feel better.’


I'm standing in the passage.  I'm holding a blister pack of pills.  The packaging seems to be of beaten sheet metal.  There are nuclear looking symbols stamped across each pill's pocket.  
'You only need to take one a day,' the doctor had said, 'don't take more than one.'

The pills are massive, each torpedo shaped compartment about the size of the lid of a permanent marker cokey.
‘Do I swallow these?’ I had asked him.
‘Oh yes,’ he said, ‘swallow them down.’
‘But what about me being sick all the time?’
‘Lets see what the rapid action culture has to say,’ said the Doctor. ‘You come and see me again in two weeks. We’ll have the results.’
‘What if it’s negative?’
‘Then we send you to a guy,’ he said. ‘Maybe you’ve got hay-fever or something.’
‘Hay fever?’ I said.
‘Could be,’ said the Doctor, waving his hand around, ‘could be anything.’
I take my X-Rays and leave.

2 September, 2008

If your child has diarrhoea and or vomiting go directly to the ORT corner
and ask a health worker to assist you.’


I'm at Claremont Clinic.  I'm waiting for the doctor.  It's time for my follow-up.  It's raining today.  I can't see the mountain through the window.  The courtyard is wet and windy.  There's water on the windows. I'm thirsty.  Won't drink.  Germs everywhere. Have had a good two weeks.  Antibiotics worked very well.  After two days I was feeling much better.  After four I was totally back to normal.


Yesterday I got that runny nose and itchy throat again.  It's dropping.  Should rest.  Waiting.  It's a quarter to two.  The doctor should be here soon.  There are a few people here.  I don't think they're waiting for the doctor.  I think I could be the only one.  Except for a woman who came in after me.  She looks weak too.  I just saw that bitch sister from two weeks ago.  I said nothing.

Vitamen A saves lives.’


'Pamela Nadeema, Milton Schorr,' says the Nurse, calling us to the little office.  Now I have a good idea of what I'm up against.  It's just me and Pamela. 
'Go sit there at the back.  At the the back, ne?'  the nurse tells Pamela after she's done with her.  She calls me in.  I get weighed like the rest of the meat.  Ninety-four kilos.
'Go sit at the back,' says the nurse.  I go sit at the back.


At the back there's me, two young high school girls in uniform, probably fourteen, maybe less.  They're big, but plump.  A girl's age is harder to guess than a boy's age.  Apart from the two girls there are two other women sitting here too. And Nadeema.  I reckon she's Moslem.


One of the two women have just been called. Her name is Nosiswe.  She is wearing a black outfit, black blouse, black skirt, patched grey and black scarf, brown shoes.  I actualy think these girls are about eleven or twelve.  That makes them in primary school, not high school.  The doctor is late.  He was meant to be here at two.  Bad sign.


I fell asleep and dreamed.  Now I'm awake.  Everyone but one of the schoolgirls has left.  Another two people have just walked in.


Nothing's happened.  I slept again.  There are less people now.  I'm not going to sit here for two hours again. I can't.  I've got stuff to do.  I walk to the little office.


'Hi,' I say to the friendly nurse who is busy at her files.  
'Hi,' she says.  
'Um, do you know when the doctor is coming?' I say.  'I can't wait again today, I've got another appointment in twenty minutes.'
She looks at me a moment.  She nods.  'I'm going to give him a call,' she says.  She reaches for her desk phone and dials a number.  
'Hello this is Claremont,' she says after a moment, 'I'm looking for Doctor Moodley's cell number.  He hasn't arrived for consultation yet.'
The nurse listens.  She scowls suddenly. I wait.
'What?' she says. 
She listens some more. 
'But that's ridiculous!' she says, 'we were told every second week!'
She listens again.  She looks at me and shakes her head. 
'Alright thank you,' she says, and puts the phone down. 
'I'm sorry,' she says to me.  'The Doctor isn't coming today.  He's at Woodstock at the moment.  It's not every second week that he comes here, it's the second and last week of the month.'
'Oh,' I say.  
She shakes her head.  'I'm sorry'.  
'So what do I do?' I say. 
'Let's call and find out if they have a result for your Rapid Action Culture,' she says.  
'Cool,' I say.


We walk together down the corridor, round the bend, past the wet courtyard, to the heart of the place.  She collects my folder from there.  I see that it had been laid there neatly, obviously in anticipation of the doctors visit.  I soften towards her.  
She opens it and draws the phone in there nearer to her.  She dials.  
'Hello this is Claremont,' she says, 'I'm calling to find out the results of a Rapid Action Culture. A Mr Schorr.  Thank you.'  She nods and waits.  
'Hi,' she says.  'Oh.  Why not?'
'Oh alright.  Thank you.  Bye.'
She shakes her head. She puts the phone down.  She looks up at me.  She smiles apologetically.  She shakes her head again.  
'I'm sorry,' she says, 'they couldn't do the test.  It seems they can't do the test if your first test isn't positive.'
'But I thought the point of the test is to find out if I am positive?' I say.  'How can they found out  if I'm positive only if I'm positive?'
She shrugs her shoulders.  'I also thought so,' she says, 'it seems I'm wrong.  The test isn't to find out if you're positive, it's to test what strain you've got.  I'm sorry. It's a new test.'
I give her a dirty look.  I immediately regret it. 
'Well thanks,' I say.  'What should I do?'
'I'd say come back this time next week.  The doctor will be able to see you then.'
'Okay,' I say, 'thanks.'


I drive off in a huff.

25 December, 2008


My lungs are bleeding. This morning I coughed the most blood I can ever remember coughing.  Two out of the first five globs were full of blood.  More blood than snot.  Blood the consistency of snot, straight from inside me.  Looking at the blood slopping in the bowl I was scared.  I thought, 'I'd best go to the hospital.'


The day is cloudless as I drive.  Everything looks clean, washed.    The shadows are long and gentle, the streets still empty as the city wakes.


Arriving at Somerset Hospital I see that the entire layout had been changed. The main entrance is now located on Port Rd, not on Beach Rd as it was in the past.  I ask the two men standing at the boom holding a sign-in register, 'which way to emergency?'
'Straight' says one, pointing to the road in front beyond the boom, 'then right, between the trees.'
'Thanks' I says. He opens the boom. I drive through.  I round the corner and see that it is just as he said.  Two big trees that if I drive through the middle of take me straight into a parking lot.  From the parking lot there is only one entrance into the building.  Although it isn't signed it seems obvious enough.  I am off to a good start.  Guards that can give directions that I can understand.  I climb from the car, groaning at the ache in my legs and the pain in my right lung, and walk inside.


At reception there is a woman standing with two small children.  One looks to be about nine and the other three.  The woman iss waiting.  I stand behind her and wait too.  I see a small cooler box marked 'Human Blood' wedged into the gap between a pipe and wall, on the other side of the passage from where I am standing, about shin height.  There is also a  letter stuck to the same wall with prestik, outlining the schedule of changes happening at the hospital in terms of construction, information on where new entrances would be, dates they would be used by, where staff were to park, etc.  There is a fair crowd of very sickly looking specimens waiting in the general waiting area.


The receptionist arrives, a man wearing a leather jacket with the beaurocratic cow look on his face. I dislike him instantly.  He slowly navigates his computer as the woman explains to him where she lives and what is what. He nods, then asks her to repeat herself.  I discipline him in my mind.  The woman moves off.  From eavesdropping I learn that it is her youngest daughter than needs help, the one that was hiding between her legs.


I step forward and bend down to the talking hole in the glass, looking at the man full in the face for the first time. I feel my contempt rising.  The sicker I am the more easily I am irritated.  
'I came here about ten years ago,' I say to him, 'I'm not sure if you still have my details.'
'What do you want?' he replies. 
'What?' I say.  
'What do you want?' he says. 
'I'm coughing blood,' I say.  
He points to a locked steel gate across the waiting room.  
'Go in there' he says, 'be examined.'
I looked to where he points.  
'Where?' I say.
'Through the double doors'.  
I look again.  There are two possible double doors, a door and a gate.  I walk over to the door next to the gate.  I look inside.   The little woman and her two children are in there.  She looks terrible under the bright flourescants.  Very thin.  There is no nurse.  I walk back to the receptionist.  
'Um...' I say. 
He gives me a sigh.  'Go through the gate,' he says, 'second door on your left.  Be examined.'
I walk over to the locked gate.  I rattle it.  I look around and see an electronic bell.  A nurse appears from inside.  She opens the gate and walks out.  I slip in.


I walk to the second room on my left, labelled 'examination room'.  I enter and see the usual sight of men and women lying on hard, plastic covered folding beds, lying in positions that hide their genitals because the gowns they wear don't.  To my left there is a huddle of three women around a machine, talking.  
'Excuse me,' I say. 
'Yes?' says the closest, turning to look at me.  She is a plump, motherly looking nurse.  Perm, dyed hair and spectacles.  I sigh.   
'I've been coughing blood,' I say. 
The nurse immediately points to another of the woman.  'You'll have to speak to the doctor,' she says.  
The doctor is young, about my age, and black.  I don't trust her.    
'I've been coughing blood,' I say, this time making very big hand gestures.  
She steps back.  She puts her one hand on her hip and looks up at me.  She is a little tired.  She has a mask on her face.  She pulls it away from her mouth and takes the sterile cap off of her head.  She gives me a stare.  
'I had TB last year,' I say, 'I've been for tests this year again.  I'll get the results on Monday.  I've had lung problems all my life.  In the last two days I've been coughing more blood than ever.  I'm worried about the blood.'
'Where do you live?' she asks. 
'In Woodstock, but during the festive season I'm staying in town.  I'm unemployed.'
'We can't test you for TB here now,' she says, 'there's no point.'  
'Yes but I probably have pneumonia or at least bronchitis, my right lung is very sore at the bottom.'
'We can examine you,' she says, 'but you'll have to wait.  I have to see more urgent cases first, and because you're not in your area it will take even longer. Some patients have waited up to 18 hours.  That's all I can do.'
I look at her.  She looks at me.  She is being sympathetic but firm.  I look at the dirty flesh in the beds and remember the dirty flesh waiting in the waiting room, one of them rocking too and fro with red eyes and spittle at the corners of his mouth.  I can hear the germs breeding.  
'Alright, thank you,' I say, 'I'll go.'
She nods and goes back to her work.  
I walk away out of the building, passing everything I'd passed on the way in.  I am glad that I at least made the effort to come.  I'm was also feelng much better.  I'm happy that I didn't have to sit there all day when I wasn't feeling well anyway.


As I was walk out the door a man comes up behind me.  He sings, 'Ye mama, Ye Mama,' twice, in a soft, sweet voice, then skips into a run and speeds off across the parking lot to a pre-fab building on the far side.  It reminds me of when I'm working somewhere and getting into it, filling myself with my own rythyms, living in my own private world of making time work for me.  I wonder if he ran away because he realised I heard him.  It's what I would have done.


When I arrive home I clean up.  Take the cat shit from the litter box and put it in the bin.  Then put sweaty blankets, cups, plates and tissues away.  Then I hear a heart-wrenching scream from outside.  I hurry over to the window from the third floor flat I am staying in and peer out, carefully, not wanting to be seen gaping at the tragedy.  I hear the scream again.  A horrible, torn throat scream, real grief and pain, and after that see a homeless woman staggering down the road.  She is literally staggering from grief, walking upright and out of it, each step jerking her entire body, so deep is she in her own trauma.  I can't make out what she was saying but I think she says, 'he was living for seven years.'  I look up to see Table Mountain towering above the City, the whole front view.  I'm tired.  This morning has worn me out.  Going to Christmas lunch with family soon.  I'm a lucky chap.

26 December, 2008


    I'm worse.  It started with a few good chunks, nothing out of the ordinary, the normal blood speckles, but then on the fourth cough I brought up my first full-blood mucous gob.  Strictly still phlegm, still the consistency of phlegm, but the entire shiny thing was red and rich, about the size of a five rand coin.  I got a real shock when I saw the thing slopping in the already bleeding toilet bowl.  
'Shit' I thought to myself.
I manage to make myself coffee before the certainty that something has to be done about this overtakes me completely.  Things are complicated by the fact that I was feeling much better.  The night before I'd woken fully soaked only twice, otherwise I'd slept blissfully and felt refreshed by sunrise.  I sms the GP I see from time to time.  It reads:

    'Hi.  Tried to phone two days ago and left a message.  Had blood in phlegm for three        days now, this morning the worst ever.  Suggestions?  No answer at practice.  Milton.'

By the time I was three-quarters through my coffee a reply came. It read:

    'On leave.  Go to casualty without delay.  Don't procrastinate.' 

I sigh.  The man is right.  My health should be my top priority.  I heave on jeans and shirt and everything and go down to the car, this time much more easily than the day before as I am feeling better.  A cunning plan begins to form in my mind.  
'What if...' I say to myself, 'I go to Cape Town Medi-Clinic first and just see how much a consultation there will cost?  Maybe it's comparable as I don't have ID, proof of income or address on me and am liable to be charged the full rate at Groote Schuur.'
Smiling broadly I drive right instead of left and thread my way through the suburbs to the entrance of the private clinic.


'Hello' I say, smiling brightly. 
'Morning,' replies the lovely young receptionist.   
'I've been coughing blood,' I say, 'and wondered what your rate would be to see the doctor this morning?  I don't have medical aid.'
'Well, sir,' she replies, a beautiful smile on her face, 'that would be four-hundred to start, then, depending on what doctor says, the consultation could go up to six hundred and ten, any procedures would then be on top of that.'
'I don't understand,' I say. 
'Just for doctor to see you,' she says, leaning forward and really looking into my eyes, wonderfully professional and friendly and articulate and smooth, 'it will cost you four hundred Rand.  But it might be that it could cost six-hundred and ten Rand.  I think that's if it takes a little bit longer or if he has to do something extra.  After that whatever procedure Doctor will have to do will be on top of that.'  
'Right,' I say, resting both elbows on the counter.  'Do you happen to know how those rates would compare to Groote Schuur?  I was on my way there but don't have personal details so they might charge me the full fee.  I've been coughing blood.'
'I don't know,' she says, and shrugs her shoulders.  
Neither of us speak.  Just from the way she is and the room is it's obvious to both of us that I really should just spend the money and get some decent health care, but, one thing is gnawing on my mind, what if I have Pneumonia?  They would want to know, and to know properly they'd need to take X-Rays, the best diagnosis for Pneumonia is spotting the tell-tale mist or spiders web spun in the lung.  I know this and can imagine that an X-ray at this place would cost an arm and a leg.  
'I'm going to go and see how much it will cost at Groote Schuur,' I say to her.  She looks at me as if I I'm a bit out of my mind.  She seems a little worried even. 
'It's okay,' I say, giving her my smile again. She put hers on also. 'I'm just going to find out.'
I left that place and drove to Groote Schuur.


At Groote Schuur I do what I always do, try my luck.  As the guard at the boom approaches my window I put on my best smile.  He stops at my window, stoops, and peers in.  
'Whats wrong?' he says.  
'I've been coughing blood,' I say brightly.  I make a coughing and passing stuff out of my mouth motion.  He looks me up and down, his eyes narrow.  
'Can you walk?' he asks. 
'I can walk,' I say confidently.
'What you want?' he says. 
'I want to drive in and park close to the door.'
He looks me up and down again, then looks around at the very quiet hospital.    
'Wait,' he says.  He gets onto his walkie.  
'There space to park upstairs?' he says, 'the guys got a cough.'
'He's got a what?' comes the reply. 
'A cough.'
'Oh', says the voice again.  'Yes.  There's space.  Send him up.'
'Okay,' says my security, 'go up.'
I go up.


There is a male nurse in the emergency waiting room.  He is a very well maintained person.  He has lovely smooth, soft, light chocolate colored skin.  His hands are well manicured and his pate is shaven.  He wears a simple, dark, two piece uniform that is both well fitting and loose, perfect for the summer heat.  He seems cool, temperate.  He handles his instruments with pleasure.  For instance, when he holds his big, thick requisition pad his fingers are tactile.  Each one hugs the printed paper.  He has created an oasis of cleanliness and orderliness for himself.


'My pulse was one-ninety-one, then they gave me tablets.  Then it was two-hundred, so they said I must come back.  I'm very dizzy,' says the old man in the wheel-chair with the big takkies on his feet, a soft spoken chap.  
The male nurse nods and writes on his pad.  'Wait there,' he says, pointing to a row of chairs set against the wall on the other side of the room.  The old man nods.  A young man walks over and takes hold of the wheelchair.  I would imagine his son.


It is an old ward room, square, all beds except for the one in the top corner next to the entrance have been taken out and chairs put in instead, making it a waiting room.  The curtain railings in the ceiling are still there, Christmas tinsel  twisted round, pieces of green, purple and red.  The walls are painted peach on top and green on the bottom.


A Christmas paramedic wanders past.  She has a Santa hat and big bug shades on.  She nods to us.


A security guard wanders past.  Vacant stare from big eyes.  Can'tt read him at all.  No personality.  A waste of space.


The only signs that I can make out are:  'Chairs for patients only. Thank you' and,  'No cellphones allowed.'


The chairs are comfortable.


The father is scared.  He shows it as angry, but I know the meaning of the eyes shifting inside that mask.  I'm the same when I say 'I'm frustrated'. Sometimes I'm just bloody scared.


A man just walked past carrying his own IV and holding his gown closed with the other hand at the same time. It's the public hospital shuffle.  A particular gait seen nowhere else.


The doctor has come in.  'Great!' I think.  She's young and sexy.  A Doctoress.   She has an athletic body.  She's wearing an attending doctor's uniform, a kind of tailored overall with little pockets everywhere.  Her name is sown into the lapel.  'Dr S Kraus'.  I begin to imagine.  I'm glad I didn't stay at the Medi-Clinic.


When she speaks she croaks.  The kind of talk that I think some think sounds good, kind of lazy and laid back.  I don't like it.  It sounds pretentious.


Jesus she struts around!  Now her voice is high and piercing.  Condesending.  No one likes her.  But I think she might be a good doctor, right questions, wrong manner.


'Didn't they teach you how to do it at home?' she asks a small man stuck in a wheelchair attended by a brother and his daughter.  He's looking weak.  
'No, it's an operation Doctor.  They said I should come to hospital to have it changed.'
She's telling the man off for coming into the hospital to have his operation wound changed.


'I haven't eaten in three days,' says the old, thin man dressed in his gown.  'I keep getting messed around!  I'm hungry!'
'I've told yo...'
'I was told that I'd have the exam two days ago!' The man rants.  'I'm hungry!  Why am I being treated like this?'
'I've explained it to you already!' shouts Dr Kraus, 'Somerset said they'd give you the exam on Wednesday, then you came here and we can only give it to you today.  Somerset has got nothing to do with me!'
'I'm hungry!' yells the man.  
'I'm busy!' yells Dr Kraus.


I've stood up to her. Someone had to.  As she went through us, doing a quick check on who's what she asked me if I've been hospitalised for lung problems in the past.  I said possibly, I can't remember exactly.  She said 'Ha? You can't remember?'  Before walking away rattling off how she'll get me a TB test.  I said, 'I've already had a TB test!  I'm waiting for the culture to come back, sputum was negative!  I should have the results next week! Ha!'
She stopped in her tracks.


She sent me to get an X-Ray.  Good.  Now she's thinking right.


I've had two X-Rays.  They were fine.  I had to take my shirt off in front of two young women.  I liked it.  I put my clothes back on and the gown back in the plastic bag.  A young radiologist appears at the service window with my sheets.  I thank her and leave.


Back at the Emergency ward I stride in confidently, my X-Rays large in my hand.  I sit in my chair again, holding them so that Dr Kraus can see them as she works.  She is just finishing an old lady off.  In a moment she looks at me and holds out her hand for the rays, just shoots her arm straight out like a little miracle in this drab place.   I get up and walk over to her, feeling a little weak and shaky.  She takes the sheets from the envelope and holds them up to the sun.  
'There's nothing obvious here,' she says, 'some scarring, here, there.'
I nod.  
'Do you smoke?' she asks. 
'I used to.'
'How long for?' she asks, still looking at the different sheets, comparing them in the light.  
'Probably for about ten years in total,' I say, 'I used to smoke drugs too.'
She looks at me sharply.  'What kind of drugs?'
'Weed, Buttons, Heroin' I reply.  She smiles wickedly. 
'And now?' she says. 
'I'm clean.' I sit down on the examination bed, 'for about two and a half years now.'
'Well, thats good' she says.
'I know,' I say.  
'Did you inject?' she asks.
'So you did everything?'
'Pretty much,' I nod.  She is smiling at me.  I smile back at her. She seems nice.  She seems to think I am interesting.   
'Take your shirt off' she says.


Dr Kraus is busy tapping at my chest with her fingers. 
'Sorry my hands are cold.'  
'Thats okay.'  
She puts the stethoscope to my chest.  It's colder than her hands.  
'Breathe deeply.'
I do. She moves it to beneath my left nipple, under my large tattoo.  I can see her looking at it.   
I do.  She moves the stethoscope to under my sternum, on the right hand side, while she holds it there she presses the fingers of her right hand  into the left side of my back, steadying me against the soft pressure of the stethoscope.   
I cough.  Just a nice little one.


'Well,' she says, sitting to the left of my folder at the foot of the examination bed, 'I'd say you have a viral infection because there's a bit of wheezing and also because you're quite blocked up there.' She circles her hand at the height of her sinuses, but away from her to include me too. 'There's nothing I can do for a viral infection but I'm going to give you some antibiotics just in case there's something floating around there.'
'I need really strong antibiotics,' I say, still with my shirt off.  'Anything less doesn't work on me anymore.'
She nods. 
'I'd say you've got Chronic Obstructive Pulmonary Disorder,' she says, 'COPD.  Have you been told that before?'
'Off and on,' I say, 'what is it exactly?'
She takes a breath.  She holds up her hands.  She likes to use her hands when she speaks.  Nice hands.  Her nails are well looked after.  She's put that see-through stuff on that makes them look neat and the tips white.  Her hair is healthy and clean.  Red coloured lipstick, bit of foundation, mascara.  Her skin is freckled and her arms aren't as firm as they should be.  I'm trying to figure out what her breasts must look like beneath the three layers of clothing she's wearing.
'You're my age,' I hear her saying, 'apart from your lungs you seem like quite a fit guy, so I'd say you've just got to be careful.'
'Yes,' I say, reaching for my shirt and putting it back on. 'I'm on a daily Budaflam pump and Flixonase for the nose.'
She nods.
'It's a pity,' she says, 'you've damaged yourself.'
I sigh.  
'Damn,' I say, punching the air.  She smiles.


'Quickly,' she says, 'They close in about five minutes.'
I stand up with the prescription in my hand.  'Listen', I say as she picks her things up from the bed.  
'Yes?' she says, looking up at me. 
'Can I take you out sometime?'
A flush runs up her neck and she turns her face away from me.  
'I've got a boy-friend,' she says with a laugh while she's walking already, 'I don't think he'd approve.' 
'I suppose not,' I say to her back going away.  I collect my things and follow her out.  At the front she is doing some paper work.  
'Thanks very much,' I say, 'Bye-bye'.
I give her a funny wave.  
'Bye,' she says without looking up.  I could see she was red.  I was smiling.

17 March, 2009

Lying in my bed.  Sweating.  Wheezing.  I throw the wet sheets off.  I sit up.  The sweat runs down my body.  It's wetting everything.  I look at the dark room around me.  The things are the same.  I stand up, naked, the sweat runs.  I cough. 

I never went back to the clinic to fetch the results. I'm fairly certain I don't have TB because my symptoms aren't consistent, and because I've been like this ever since I can remember.  I'm cold now, starting to shiver.  It's my body.  That's what it is.  It's this body that I look down at.  Every line.  Mine.  Every hair.  Mine.  Each stunted lung. Mine.  I pull the duve over and get back into bed.