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The TB Test

by Milton Schorr / Illustration by Sasan / 11.05.2012

I’m on a bench outside the TB office at Claremont clinic. I’ve been here before. I had TB last year so I know the signs. I feel sick all the time. So I’m waiting, watching the floor between my feet. I’m cold. My legs ache. I don’t want to be here. The office door opens and the nursing sister looks at me. “Be with you in a minute,” she says. I relax. I’ve been seen. I will be seen.

In her office, she asks how I am. “Not good,” I say. “It’s hard to breathe and there’s blood in my phlegm. Speckles and spots.” She nods and looks at my results. I tell myself I have it. I’ve got to take those pills, big fat thousands of them, so much medicine it makes me sick. I’ll lie in bed not going to work, too weak to move. I smile.

“You’re clean,” she says. “You haven’t got it. You’re not contagious.”
“But I feel sick.”
She thinks a while.
“Here,” she says, writing something down. “Have an X-ray. Go get it done at Woodstock, the Day Hospital on Mountain Road.”
I know the place.

Mountain Road Day Hospital has the best medical posters I’ve ever seen. Symptoms of high blood pressure. Tips on living with diabetes. Meningitis basics. The dangers of casual sex. Home tik tests. The number for a cancer buddy support network. Even TB medication tips. At the X-Ray department there are new posters. Self breast examination techniques. AIDs info. ‘Sex is a great desire, but without a condom, you play with fire!’ I get the X-rays done. It doesn’t take too long.

Back at Claremont Clinic I’ve got all my X-rays, old and new, in a big yellow envelope. I’m here to see the Doctor, feeling sick, achy, tired. A man holds a baby wrapped in a towel next to me. The baby is awake and calm. Somewhere inside the building another baby is crying. Big windows reflect the sun off linoleum floors. I can see a hazy mountain peak and warm Spring sky. Everyone here has TB. I know it. All windows should be kept open to combat the spread of the disease. Airborne and catchy. A sign shows a cartoon man opening windows, happy look on his face. Opening those windows. Letting the TB out. Nobody talks. Every sound here echoes. A young woman talks on her cellphone. Masticating words into her hand. You never know how long it’s going to be. Thirty seconds. Three hours. You sit.

The Doctor! About sixty-five years old. A grinning Indian with a briefcase. He’s a live-wire. Slaps me on my shoulder and tells me to sit.

“What’s the problem?”
“I’ve been coughing for months,” I reply. “I want to know what’s wrong with me.”
“Lets take a look at your folder.”
He looks at all the X-rays. Metallic blue outlines of a lung. Older ones misted over with spider webs, the new ones much clearer.
“These don’t show anything,” he says. “What do we do?”
We both look at the nurse. She shrugs.
“A rapid action culture?” she suggests.
“What have we got to lose?” says the Doctor.
“What is it?” I ask.
Apparently they dip my sample in chemicals and put it in a special tank which grows the culture at top speed.
“Action,” says the doctor, his eyes shining. “It’s great!”

I’m at Claremont Clinic again, waiting for the doctor. It’s time for my follow-up. It’s raining. The courtyard is wet and windy on the windows. The antibiotics the doctor gave me worked well. Back to normal until yesterday. He should be here soon. Two high school girls in uniform, around fourteen, are waiting. They’re both plump. I fall asleep and dream. When I wake up, I’m still waiting. The nurse calls to find the doctor for me.

She listens.
“That’s ridiculous,” she says. “We were told every second week!”
She puts the phone down.
“The Doctor isn’t coming today,” she says. “He only comes the second and last week of the month.”
She shakes her head.
“But let’s find out if they have your Rapid Action Culture results.”
She picks up the phone for another conversation. Later she puts it down.
“They can’t do the test if your first test isn’t positive.”
“I thought the point of the test was to find out if I’m positive? How can they find out if I’m positive only if I’m positive?”
She shrugs.

My lungs are bleeding. I coughed the most blood I can ever remember coughing this morning. I tell myself I better go to hospital.

The layout of Somerset Hospital has changed. The main entrance is on Port Rd not Beach Rd. I ask the guy at the boom which way to emergency. He says straight then right. A woman waits with two small children at Reception. I stand behind them. A little cooler box is wedged into a gap between a pipe and the wall, says ‘Human Blood’. The receptionist is a guy in a leather jacket with a bureaucrat-look on his face. I don’t like him. The woman tells him her youngest daughter, the one hiding between her legs, needs help. He punches into the computer. I bend to the hole in the glass when it’s my turn.

“I was here ten years ago,” I say. “I’m not sure if you still have my details?”
“What do you want?”
“I’m coughing blood.”
He points at a steel gate across the waiting room.
“Go get examined.”
“Through the double doors.”

The room has men and women on hard plastic-covered folding beds. They’re all lying funny, trying to hide their genitals with their gowns. Three women are talking around a machine.

“Excuse me?”
They turn to look at me. One is a plump, motherly looking nurse. Dyed hair with a perm, spectacles.
“I’ve been coughing up blood.”
She points at another woman.
“You’ll have to speak to the doctor,” she says.
The doctor’s young, my age, black. I don’t trust her. I want a nice white doctor.
“I’ve been coughing up blood,” I say.
She looks me up and down, her hand going to her hip. She’s tired.
“I had TB last year,” I say. “I’ve had lung problems all my life and in the last two days I’ve been coughing up more blood than ever. I’m worried.”
“Where do you live?”
“In Woodstock. But I’m staying here in town over Christmas.”
“We can’t test you for TB here,” she says. “There’s no point.”
“I probably have pneumonia, or bronchitis.”
“We can examine you,” she says, “but it’s going to take a while. You’re not an emergency. You’re not in your area. Some have waited 18 hours.”
She’s sympathetic, but firm.
“Alright thank you,” I say. “I’ll go.”
She nods and turns away.

Back home I clean up. I take the cat shit from the litter box and put it in the bin. Someone screams, a heart-wrenching scream outside. I hurry to the window. A homeless woman staggers down the road, deep in grief. “He was living for seven years!” She screams. I’m tired.

I’m worse. This morning I brought up a shiny red gob of blood about the size of a five rand coin, slopping in the toilet bowl. “Shit,” I thought, and smsed the GP I see from time to time.

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.

A while later.

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

He’s right. I sigh. I think that I could go to Cape Town Medi-Clinic first and see how much a consultation costs. It might not be that much more than Groote Schuur. Then I won’t have to wait. I make my way, happy with a plan.

“Good morning,” the lovely young receptionist says.
“I’ve been coughing up blood,” I say. “How much is it to see a Doctor? I don’t have medical aid.”
She has a beautiful smile.
“Four-hundred to start, then, depending on what the doctor says, the consultation is six hundred and any procedures go on top of that.”
She’s articulate and professional, a breath of fresh air.
“Do you know how that compares to Groote Schuur?”
She doesn’t.
I wonder if I have Pneumonia. If I do then just an X-ray would cost an arm and a leg.
“I’m going to see how much it costs at Groote Schuur.”
She looks at me like I’m mad.
“It’s okay,” I say. “I’ll just go find out.”

At Groote Schuur I try my luck.
“I’ve been coughing up blood,” I say to the boom guy brightly, “I need to park close to the entrance.”
He looks me up and down. It’s a quiet time at the hospital.
“Okay,” he says.

There’s Christmas tinsel on the walls, green, purple and red. A Christmas paramedic passes by in a Santa hat. The chairs are comfortable. A solitary man does the public hospital shuffle, IV in one hand, gown in hand over groin in the other. The Doctor appears. She’s young and sexy, and white. A name on her lapel says ‘Dr S Kraus’. I’m glad I came. She speaks, her voice low, like she’s trying to sound calmer than she is.

“I haven’t eaten in three days!” says the man in the gown. “They told me I’d have the exam two days ago! I’m hungry! Why am I being treated like this?”
“I’ve already explained,” says Dr Kraus.
I fancy her name’s Sarah. Sarah Kraus.
“I’m hungry!”
“I can’t help you. You have to wait for the exam,” says Sarah Kraus.
“I’m hungry!”

Later she sends me for an X-Ray. She holds them up to the light when I return.
“There’s nothing here,” she says. “Do you smoke?”
“I used to.”
She compares the sheets in the light.
“I used to smoke drugs too.”
She looks at me sharply.
“What kind of drugs?”
“Weed, Buttons, Heroin.”
“And now?”
“I’ve been clean for two and a half years.”
“That’s good. Did you inject?”
“So you did everything?”
She seems to think I’m interesting.
“Take off your shirt.”
I do. She taps my chest.
“Sorry my hands are cold.”
I concentrate on her fingers on my skin. Her stethoscope is colder than her hands.
“Breathe deeply.”
She’s looking at my tattoo.

Sarah hops up next to me, my folder between us.
“I’d say you have a viral infection, but I’m going to give you some antibiotics in case there’s something floating around in there.”
She gestures towards my nose.
“I need strong antibiotics,” I say. “Anything less doesn’t work on me anymore.”
“I’d say you have Chronic Obstructive Pulmonary Disorder,” she says.
She explains to me, using her hands when she speaks. Her nails are neat. Her hair is clean. She’s got tiny freckles. Her breasts are small, but there.

“Apart from your lungs you seem fit. So just be careful.”
I put my shirt back on.
“It’s a pity,” she says. “You’ve damaged yourself.”
“Damn,” I say, making a joke out of it.
As she picks her things up from the bed I ask if I can take her out sometime.
“I’ve got a boyfriend,” she says, laughing, already leaving. I pass her doing paper work at the front desk on my way out. I wave and say bye. She turns red. I’m smiling.

Back home in bed, I throw off the wet sheets. Sweat runs down my body in the darkness as I cough. I never fetched the results. Never went back to the clinic. I’m fairly certain I don’t have TB because my symptoms aren’t consistent. I’m cold now, shivering. It’s my body. That’s what it is. This body of mine. I look down at it, taking it all in. The sweat, the shivering, each stunted lung. I’ve been damaged. I’ve damaged myself. I pull the duvet over my head and try to fall asleep.

*Illustration © Sasan.

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