Influenza

Influenza

“A physician is not angry at the intemperance of a mad patient,

nor does he take it ill to be railed at by a man in fever.

Just so should a wise man treat all mankind, as a physician does his patient,

and look upon them only as sick and extravagant.”

Lucius Annaeus Seneca

[NB. Back in the days when another, thankfully less virulent virus was running its course around the world, I contracted swine flu. Below is an account of my ordeal. It suffices to say that swine flu was sufficiently awful, so I am grateful to have avoided covid-19 thus far. In light of the current crisis, I thought it might be useful to re-post this tale.]

I. Incubation

It was the summer of 2009. I had always been churlishly disinclined towards anything so exhibitionistic as ‘panic’: the growing public alarm at the prospective swine flu pandemic met with my typical cold and tight-lipped disapproval. I had been at Singapore airport at the time of the bird-flu hysteria, and had tutted at all the poor fools scampering around in their ineffectual face masks. The scaremongering surrounding bird flu had been conclusively proven to be bogus, and I was thus ill-disposed to humour the breathless threats of swine flu. So people were dying – bah, people die of ‘common’ flu, and a million other things besides. If people stopped dying – then would be a time to worry.

I was particularly incensed by the blind condescension of the public health proclamations: call me fastidious, but I was already in the habit of washing my hands more than once a day, and of throwing away used tissues (did some people collect them, perchance, and dry them on radiators for later re-use?). Perhaps the government feels it incumbent to assume that general standards of hygiene are not much improved since the age of typhoid and cholera; or indeed that people in general are stupid (predictably there is no argument from me on that score).

As the spread of the contagion grew more tangible, I took the time to note the supposed symptoms (in my guise of Health & Safety Officer, I am obliged to feign a little interest). Like TB, depression, and apparently syphilis, flu may be deemed one of the Great Imitators, insofar as its numerous symptoms are easily mistaken for something completely different (how often do we hear the term ‘flu-like symptoms’ used to describe any undefined malady?). Indeed on any given day I could feasibly present with half a dozen supposed symptoms of swine flu: headache, tiredness, nausea, loss of appetite, aches, and general malaise. Such of course are equally symptomatic of melancholia, and as such are as commonplace as waking and breathing and scowling.

When I noted that my headache was persisting for a fortnight, I began to suspect that this was a more than ordinary malady. Back in my heyday of weekly migraines, I did study the surrounding subject, and drew meagre consolation from reading of numerous cases of chronic headache lasting several years. Thankfully the introduction of temazepam into my diet has drastically curtailed my disposition for the sick headache (now two or three a year, rather than 50), but the mild variety of the headache remains a frequent visitor.

But I digress. My two-week headache had quite outstayed its welcome; given the supposedly short incubation period of influenza, it was safe to say that the mal de tête was not in itself an indicator of the flu. Furthermore, I had been in contact with no known contagious vermin, indeed I had been more brutishly unsociable than usual.

By week two of the recalcitrant headache I also had a temperature. I did not deem it a fever (my benchmark being the festering frenzy of my succeeding root canal/urinary tract infections last year, of which I have written with sordid glee). Given that a fever and/or sudden cough are the two key signifiers of swine flu, I grew warier of my gradual accumulation of symptoms, but not to the extent that I feared for my life. My temperature was still ‘hot’ but not quite feverish. By the Wednesday I was decidedly out of sorts, more so than usual for a mid-week malaise. I deposited myself in bed by 9pm (rarely am I a-bed much before midnight).

II. Manifestation

When I awoke it was no longer a playful fancy that I was harbouring the dread disease. My brow was flushed, I had the energy of a broken-backed sloth, and I ticked more than enough boxes for the NHS Direct swine flu diagnostics to condemn me as a suspected patient. And yet (I told myself, clearly already convulsed in the sticky embrace of delirium) I must go to work, for no one else was around to open up the office. One might argue that it was a tad reckless of me to shamble onto public transport when at the height of contagiousness, but I could always reason that I was merely returning the favour: given that I had been in contact with no confirmed carriers, and had not received any ricin-flavoured missives in the post, it was my conclusion that some scabby mongrel on a bus, or perhaps a phlegm-fingered checkout assistant at Tesco, had contaminated my noble sanctum.

I did not linger long at work – long enough to communicate electronically with the rabble to the effect that I was plague-stricken (which of course I could have done from home), and to hand over my suitably sterilised keys to the only poor soul who was in that day.

I retired to bed with Britney and Girls Aloud. I was not tired enough to sleep: who indeed could sleep when such enticing sirens were caressing the ear with their gorgeous melodies? I then changed tack and reclined to the bittersweet indulgence of Burt Bacharach. There can be no setback in life that the music of BB cannot ameliorate. Unfortunately it proved too efficacious, insofar as my mood was lightened as by the lambent flame of dawn, and I felt more than capable of getting out of bed and bouncing around (not literally, I hasten to add).

By early evening the sense of sickness doubled back on me. My body ached abominably. My ribs, my shoulder blades, my midriff, my thighs, my upper arms, all vied to crush me with a senseless pain. At least a bruise or a broken bone has good reason to hurt, but why should pain enshroud a body for no obvious cause?

NHS Direct, or whichever offshoot thereof now cares for swine flu, had earlier that day deemed my malady insufficiently grievous to warrant Tamiflu. Such is the beauty of the automated online system that it was perilously easy for me to re-enter my details and tick all the right boxes to ensure an approval of antivirals. That was easy, notwithstanding having to write down the epic authorisation code. What was more troublesome was getting hold of the actual drugs. Yes, it was now gone 17:30, but there is a local out-of-hours pharmacy on the list of Tamiflu providers. Armed with proof of her ID, proof of mine (my passport), and my authorisation code, my expeditiously appointed ‘flu friend’ (my mum) was still unable to obtain my drugs. They would be ready to collect in the morning, apparently. I was too weary to solicit detailed reasons, although it did little for my faith in the health service (if it is vital to begin a course of antivirals as soon as symptoms develop, then making someone wait another day for said medication is surely not a very helpful procedure).

III. Isolation

And so began in earnest my quarantine from the human race. I will not waste valuable paragraph space in declaring that, under other circumstances, I would scornfully welcome any such avoidance of social contact. Such was the unsettling effect of my (suspected) diagnosis that I soon discarded any sense of one-upmanship; there was a frisson of fear – people had died of this – and the accompanying acknowledgment that for all my Weltschmerz, I was not in fact ready to be extinguished.

The next morning did bring Tamiflu, and the realisation that ‘flu-like symptoms’ is not simply a euphemism for feeling like shit. The one saving grace of aching all over is that one does not focus on any specific pain, although I rapidly concluded that if this creaking bodily discomfort is a precursor of old age, I should very gladly spill my heart’s blood sooner rather than later.

And what of Tamiflu? I have been asked if it helped, and can offer only vague observations. It does not promise to cure influenza, merely to detain the virus from spreading further in the body (hence the importance of taking it straight away and not losing a day – oh wait…). I cannot say that my symptoms worsened once I began the course, although I could shrug and say that only coma and death would have been worse than the way I then felt. I cannot reasonably say that my symptoms improved once I began the course. I did experience initial nausea, but given that nausea is equally a symptom of the disease as of the cure, and that furthermore I have a touch of nausea on most days, I did not permit it to alarm me.

But what of the fatigue? Just as a migraine is not simply a bad headache, so now did I realise that flu is not just a bad cold. Indeed other than a slight cough I had no real symptoms of the classic head cold. Flu inveigles itself far deeper into one’s core. I freely admit to laziness – I celebrate it. I love to crown a lazy weekend afternoon with a little nap. Laziness is a choice, an indulgence; brain-sapping, muscle-sapping tiredness is not. Much as one who has never experienced depression cannot fathom the true hopelessness of the void, one who has never been floored by fatigue cannot imagine its paralysing weakness. On one occasion I dragged myself to the kitchen to make some tea and toast; the simple necessity of standing up for more than a few seconds, and the negligible manual effort of preparing a little sustenance, was so shattering that I then had to go back to bed. As I write this, it seems pathetic and laughable; at the time I was going out of my mind. Now, it seems monstrous that I permitted such a lapse into invalidity, but I actually did reach a stage of such whimpering self-denial that I felt incapable even of putting on a CD or DVD, so onerous was the concentration demanded, so unflinching was my sickly certainty that I could not be entertained.

Such was my prevailing sense of stagnation that I could not even muse on such idle themes as why Americans insist on calling paracetamol ‘acetomenophin’ (neither exactly flows off the tongue – could they not call it something catchy?). By the Tuesday – the day I finished the course of Tamiflu and so by rights should have felt some improvement – I had strayed into the most dangerous stage of any affliction: self-pity. On day one, the faint prospect that I could be dead in days played on my mind, but only as a teasing possibility (the way that the realisation of unlikely but statistically feasible death during a routine operation might flicker in one’s thoughts). By day five the sheer physical enfeeblement distressed me: if walking a few steps made me feel sick, what else was there to do but wallow in the cess-pool of lethargy?

A sick person has inalienable rights to feel sorry for him or herself – no nauseous sense of martyrdom or saintly acceptance of suffering for me. There is though a nebulous line between misery and self-pity. Harking back to my past experiences, even when I was finding blood and pus in my urine, and seething with near-hallucinatory fever, I did not entirely lose my sense of humour. Now however I could not look at my torments and smirk wryly, knowing they would pass and I would be a wiser man for them. I took no joy from my usual mordant Facebook posts and irreverent emails from friends. There was no consolation in cynicism – I really was unwell!

IV. Remission

In my greater than usual discomposure, I began to think of my isolation as a leper-like quarantine, yet here I am, capable of bouts of ferocious unsociability. Of course when a life of hermit-like reclusion is voluntary it can be a means to attain a freedom from the world and its invidious obligations. When house-arrest is thrust upon you to contain you from the world, it is a little less salutary (though to be fair, I had so little strength I wonder if I could actually have descended two flights of stairs).

By the close of the week my spirits had mustered themselves into some form of resistance, if only to preserve me from spending another afternoon groaning on the sofa in front of Channel 4’s afternoon film (yes, the 1959 Journey To The Center [sic] Of The Earth does not get any better). The aches and pains lessened, to the extent that I could stand up for long enough to make a sandwich. I could concentrate for long enough to read.

I could even see the light at the end of the proverbial tunnel, and actually see the real light of day, for one is no longer considered contagious on completion of a course of Tamiflu – with the key proviso, as my GP sagely advised, that one should still keep away from neo-natal units and the like (because the first thing anyone recovering from a potentially dangerous illness wants to do is spend time around newborn babies).

Suffice to say, my first outing was not to a baby unit. Instead, I took myself to Tesco. Stepping outside for the first time in over a week was jarring – I won’t belabour the point by making otiose analogies to a prisoner in a cave finally taking a step into daylight… but I had easily become accustomed to my absence from human society, and it was no joy to be back amongst the chattering, plodding hordes.

V. Reflection

What are the benefits of illness? That it forces us to rest, to abstain from physical activity, and thereby to take stock from what consolation the mental faculties can offer? To what extent is sweaty, nauseous self-absorption a benefit, when so much of existence is contrived to obviate the barren confines of the self? The melancholy penchant for navel-gazing loses its appeal when every last wisp of navel fluff has been teased. So no, in this instance I did not find the abundant ‘time to think’ therapeutic.

What else? Cynic that I am, it is obligatory to celebrate the fortuitous weight loss that illness so often brings. During the quarantine period itself I cannot have lost any weight – true, my appetite was diminished, but how many calories does it take to flop on the sofa all day? It was only with the return to everyday activities that the after-effects of flu could be noted. I was tired; my energies were low, and I still had lingering aches. Post-viral myalgia (muscle pain) was not an uncommon occurrence (so my GP advised me) – surprisingly, despite my leanings towards hypochondria, I did not dwell on whether this myalgia would blossom into fibromyalgia or some gloomy post-viral auto-immune disease (after all, it’s never lupus).

The upshot of this protracted sense of malaise was that half a stone dropped from my poor, myalgic frame as I soldiered on through the thankless rigours of existence. On the down side (to some it would be a positive) I had been so long without alcohol (those familiar with my gin-craving will marvel at this turn of events) that I lost all desire for it, and on my first night out with friends in my post-quarantine freedom, I wound up drinking tea (admittedly this was after several vodkas and a pitcher of Margaritas).