28 days. I will be on Combivir for 28 days. For the length of a first timer’s stay in rehab, the length of time of an average menstrual cycle, I will be on this drug. Post Exposure Prophylaxis. It makes me nauseous, tired, and I struggle to keep my bowels about me. And yet, because of the events of a split second of my life, I will not cease it’s ingestion for 28 days.
It’s like the beginning of a pregnancy, I suppose, but opposite. The fluids of two bodies were exchanged, and I hope and pray to all that is holy that there is only one line on that test I will take in 28 days, and that it’s negative. I’m nauseas as hell, and usually in the morning, and should not drink alcohol due to its effects on my liver. I must remember to take it at the same time every day morning and night, and plan my day’s activities around my water intake and nearness of bathroom facilities. All this fun and I didn’t even get to have sex.
I will live through a month of uncertainty, in some ways better than the other uncertainties in my life here, as it has an end date. This makes it a bit more bearable, but still, the not knowing. Despite all the facts and figures being thrown at me, all the information available, and my dear friend in the States spending an hour on the phone with the CDC, the statistics of less than 1% chance doesn’t reassure me completely, as there are more than a few variables in my particular situation. I have nothing tangible to do but hope. The odds are good but not completely 100% and so there still remains an element of uncertainty. And nothing left to do but hope and pray against everything I know that after this month of not knowing I will remain HIV negative.
How did this happen? Quite simply, quickly, ordinarily as most moments do, even those which have the potential to change your life.
I was at the clinic. It was Friday, nearing lunch time, and one of the nurses was trying to finish up with the last patients that were in the waiting room prior to lunch. It was a mother and her child; they had traveled to the clinic from Gunitsoga, about a thirty minute drive down the horrible dirt road out of Seronga, towards Gudikwa. It would be difficult to catch a lift out that way regardless, but I shuddered to think of the mother and baby trying to hike in the midday heat. If they didn’t get finished before the lunch break (the only thing that ever happens promptly on time in Botswana) they would have to wait and leave after 2. In the interest of everyone involved but myself, in order to help everyone get where they were going in a timely manner, I agreed to perform the small task that would change my life.
The mother needed a consultation and the baby needed a vaccination. As our injection area at the clinic is incredibly cramped and small, there is no room for a proper table on which to sit a baby who is getting a shot. Usually the mother just holds their child, while the nurse gives the child the injection in their upper thigh. As the mother was in the consultation room, I agreed to hold the baby for the procedure.
I propped the baby on my lap, speaking in my strange language to the back of his little 4 month old head, murmuring something about how in just one quick second he was not going to be very happy, but not to worry as it would only last a moment. The nurse swabbed the area and prepared the syringe. He pressed the needle into the baby’s thigh. The baby predictably cried and squirmed. The nurse removed the needle and went to wipe away the tiny bit of fluid that seeped out of the baby’s thigh.
And accidentally plunged the needle into my own thigh.
He recoiled immediately.
I looked up at him in surprise, unwilling to completely believe what had just happened, but unable to deny it as a droplet of my own blood appeared on my skirt.
I look down at the crying child in my arms, the tiny possible carrier of such a deadly disease. I stammer, “What is the baby’s, is the baby, the mother,” I want to hand the child off to someone, to get away from it, and immediately feel guilty, judgmental, but my fear quickly overrules these emotions. The nurse, just as shocked as I am, quickly says “It’s ok, this baby is negative.” I look at the baby, fat, and healthy looking, it seems right that this is true. “The mother? The DBS? (Dried blood spot.- the test in which blood is taken from a baby’s heel and blotted onto a paper, sent to a laboratory in Gabs, and analyzed and returned to the clinic via the mail. It is the way to determine the HIV status of a baby.) Where is the baby’s DBS?” The baby is still in my arms and squirms and cries and I want to be away from him, far, away. I am nearing panic and am trying to remain calm so as not to drop this child, this innocent child, and trying to remind myself that he is just that, and innocent child.
The next few minutes pass in a blur, phoning the PCMO, panicking, trying not to panic, rationalizing. I go into the defensive mode of denial for a while, and eat lunch. I walk through the blazing heat to try to make a copy of the baby’s DBS report to fax to the PCMO, as I am thinking this is essential information for her to have, and of course no fax or copy machines in Seronga are working and I am pissed off.
I try not to think "Why me" because why not me? I'm human, no different from anyone else, just as susceptible to this disease as the next person. But I think it anyways. And I'm slightly mortified by my previous and lasting sense of invincibilty. I'm indignant.
I wish for the strength to bear this uncertainty alone, willing myself to remain calm and not to burden anyone else with this worry but I lack that particular strength. It seems unfair to bring anyone that cannot feasibly do anything into this surreal terror but as is her tendency, no matter where I am on Earth it seems my mother can sense my turmoil as only a mother can and chose that exact moment to text me. I ask her to call. She does and I try to downplay the situation, trying my damndest to convince myself and her that this is no big deal and all will be fine. I speak sharply and try to speak factually, playing up the things in my favor and downplaying the ones that suggest the true risk. I hear the tears in her voice and I demand that she not worry herself with this, that I will be fine.
She asks me if I’m scared.
I blink back tears.... And I lie to my mother.
“No,” I snap, only realizing as I say it how frightened I really am.
I chase away these fears and thoughts by conjuring up the blameless denial that has gotten me this far in Africa. “This is not happening to me, I will not allow it,” just as sternly as any parent admonishes their child.
And in response, a small, small voice inside me, one that I haven’t heard for quite some time wonders, “Maybe Africa just doesn’t want me here anymore.”
As long as I’ve contemplated coming to Africa, and joining the Peace Corps, there has been many, many times in which the sheer force of my will has prevented me from even entertaining the possibility of leaving. When people have asked me what I want to accomplish with my two years in the Botswana, they are often uncomfortable at the forcefulness with which I pronounce that my accomplishment will be to stay the whole time. I’m generally quite venomous when people gently remind me that it’s ok if I want to come home. It’s telling that it took another event completely outside of me to push the question into my mind- maybe more than whether I want to stay in Africa, I need to question the other side of the equation, whether Africa wants me here. Through the thefts, the sickness, the difficulty, the adjustments, the homesickness, the disappointments, and the relationship that has crumbled at least partially due to my decision to come here, I have rarely, if ever, considered if I should leave. As anyone who has ever been in a relationship with me can attest, I never did know when to give in, or how to quit while I was ahead.
In my darkest moments here, I’ve trusted that the stuff that has been happening has all been for a reason, to teach me something, with the really hard things maybe a lesson I’m not yet ready to understand the meaning of. I swallow the lump in my throat and rack my mind for the bright side, something to make this fear and uncertainty productive. All I’ve found at this juncture is that I now know intimately the feeling of anyone coming in to be tested and having any doubts about what will be revealed to them.
Today it’s a week since the moment that upset the balance of my life. Other than remembering to take my medication, I’ve found I don’t want to think about it. I don’t want to talk about it. I can usually forget about the dark cloud looming over my future, and ignore the flattened plum-like bruise on the back of my right hand that indicates where they took my blood for the first round of liver function tests. I decline the wine at dinner and go to bed early. I reason that this is just like a completely irrational pregnancy scare and that in a month, and three months, and six months the tests I take will turn out just the way they always have, negative. Tomorrow I will return to my life in Seronga, where I left in a hurry one week earlier. I will continue my life as normally as possible. I will try to make it through the remaining three weeks of my sentence; I will try to adjust to the slightly off-ness of my new normal.
I will hope that by the sheer force of my will, I will be fine. I will repeat it like a mantra whenever I need to white knuckle way through this, even if my fingernails pierce the skin of my palms. I will breathe deeply and I will continue on in the only direction I know how to go, which is foward...
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