About 12 days ago I had to take my son, who already has several chronic illnesses, in for an appointment with a specialist, but it seemed like he had the flu on top of allergies. We were shunted from one office way downtown to another...we waited for ever...finally the nurse and the residents began checking. Then I saw that half-cocked-head, half-frown that doctors get that means "We're not liking what we see here."
Then the questions began. This symptom, that symptom, temperature, aches, coughs? any trips outside the U.S.? Or anywhere? Or? Resident after resident came in, checking and checking. The chief specialist came in and made a really thorough exam -- and then went over everything again. I was puzzled. What was all this? Were they having one of those typical "teachable moment" intern days or had I just drawn a science nerd from the deck? More and more questions, then doctors exiting, and hearing them in consultation in the room. Hours had passed by now. I felt as if we were being detained. "We're sorry we're holding you so long," said a nurse several times, taking supplies out of the closet. More and more doctors. I began to think if we weren't sick before we came in here, we would be soon by the sheer number of people coming in and doing exams. I noticed that they didn't seem overly zealous about washing their hands but then some of them had gloves on -- of course asking you if you had a latex allergy.
More waiting. The chief guy came in with even more obsessive questions. Blood tests were needed. No, they couldn't be given because you can't be sick when having some of them. No, actually, they will be taken, but this wording here, see, on this form, isn't worded properly for managed care to bill. Phone calls to the insurance company and instructions to go back to the primary caregiver and have him write the right thing on the order for the blood tests. No, say "test" not "evaluate". No, he's not in now but we've left a message. All typical managed care stuff that routinely eats up a day -- and I routinely allow a day for these visits with all their machinations.
But again, the chief specialist came in with that cocked-head, half-frowning look, just as we were leaving, and himself, personally, listened to my son with the stethoscope, again and again, while he was already standing up and dressed. I began to think I was in some sort of strange Groundhog Day. He admonished me to take my son back to his primary pediatrician to be sure. Etc. OK, more hours spent on more managed care, yada yada. All this was before I had even read in the papers about something called "swine flu".
Soon, I was paying attention, as we were to go to doctors several more times, with more tests, with bungles, with more instructions and still more tests to come -- but finally a clear-cut response that it was "flu, but not THAT flu". Nobody ever seems to give a clear list of symptoms of the pig flu anywhere, even on blogs, I guess because the people who have it aren't bloggers and may not even have Internet connection. (Actually, you can find bloggers once you start looking, just as you can just about anywhere these days, complete with twitters about "love in the time of swine flu".)
But once we got looking through the AIMs and Facebooks and such, it turned out my daughter's best friend's cousin had it, because she was in that Catholic school, but she was already getting better. and the AIM FB chat consensus was that you'd really know if you had it because you will be sick as a dog, and very nauseous, and dizzy. Also with a "burning" throat, as the 5-year-old boy who first got sick in Mexico seemed to describe it.
"Lethargy" is another symptom, and it's hard to know exactly what the means when sleep deprivation is chronic, but when you feel so sick you don't even feel as if you care if you have to get out of bed to go and see if you have swine flu or not - that's the lethargy they mean! Lots of people in the schools and church and apartment complex all have the flu now -- but not that flu -- at least they all hope. Of course, we'll get better from this flu...and that will free us still to get sick with that flu, if we're not careful...except hadn't we washed out hands a lot anyway, before all this?
But then...don't we always? Flu is something we constantly get every season, and the flu shot does absolutely no good. I always look at the lists hanging in clinics and doctor's offices urging you to warn the receptionist if you have flu-like symptoms -- signs that have been there for years as far as I recall -- and I half-wonder again -- but they must then have thousands of people telling them they have flu-like symptoms. How can they tell any of them apart?
Years ago, right after 9/11, we all got a really awful, horrible flu. It was the kind of bone-wrenching, aching-head clutching blackout flu that just made you lie in bed for 3 days barely able to drink a cup of orange juice. Terrible sore throat. My solution for these times is to chew Aspergum and drink Odwalla protein drinks. Nothing worked. With that horrible awful flu, my son came down with various complications of strep and was sick for a year, launching him on other illnesses, although mentioning "that awful flu" got absolutely no attention, back then, ever because, well, so what? Flu is a dime a dozen. A co-worker who got some kind of bad flu ended up in the hospital and suffered partial paralysis for a time but I don't recall that there was ever any flu sample sent to the CDC. Flu is always bad, ranging from annoying to serious, and has always been awful and every year, I hear of at least somebody who knows somebody or extended family relative somewhere who actually died of the flu, usually a very old or very young person but no one starts searching through their networks to find that cousin of the kid's best friend who might have THAT flu... What's different about swine flu?
I began to wonder if the reason we are paying particular attention to this particular flu is that because we can. That is with all kinds of real-time news gathering and read-write web stuff twittering away, it's so much easier to watch and mark. Most of the time doctors wouldn't bother to send flu swabs to the CDC in Atlanta to see what it was. They'd just tell you to go home and drink more juice and wash your hands.
I noticed something different about this particular bout of illness I'd never seen before. For the first time, doctors and lab technicians who have always been HORRIBLY allergic to email, never, ever, ever agreeing to speak to you on email (in that, they've been like Catholic priests insisting on face-to-face confession or it's not a sacrament), suddenly decided that it was ok to schedule lab tests on email, and there is even a handy calendar thingy that springs up and tells you available slots, and even sends you reminders. Go know!
I have to say while temporarily in the thick of watching frowning, head-tilting doctors, I didn't even think to look on Twitter. Funny how when you are busy in RL, SL and Twitter literally seem to evaporate -- you completely forget about them. At least, I do. For three days, I only read the New York Times, got the breaking news emails from the Times (which is like Twitter now anyway), read the emergency mailings I get from the UN very carefully, and checked the WHO and CDC websites -- and of course called real doctors in real time. There is nothing like that cocked-head, half-frowning doctor's face that works to make you pay attention. (I was finally rewarded when one doctor last night, who had refused to shake hands with any of us at the clinic, "for understandable reasons" as he put it delicately, finally smiled after pronouncing "all clear" on a lung check and then held out his hand to shake).
The reason I read the NYT was simple: they weren't blogging about how President Obama shook hands with a museum director who later died of swine flu and was now infecting America (a story which I never did discover was an urban legend or not), they were interviewing officials, like the mayor, or the CDC people.
Now, of course I could have snarkily second-guessed these people and Twittered and searched the Internet for all kinds of #swineflu tags that were spreading faster than the flu itself. On the way there, I'd have to dredge past Twittering and Gawking geeks snarking about how it was all fake and nothing really terrible was happening, and if about 100 people out of 1100 died already, it wasn't so terrible (imagine, saying that, imagine saying that, and not realizing that if that was happening within a week, that was awful, awful) -- or flip past Second Life hacks making pig heads and Hamlet gushing about swine flu spreading in SL with pig avatars. Sigh. The rich are different than you and me.
Many people will question whether the WHO did the right thing escalating the pandemic to level 5. I think this decision had to do with the speed of infection, the lack of an existing vaccine (yet), the number of deaths as a percentage of those who were sickened -- etc. Of course someone will ask whether the fact that the cases in the U.S. were getting so much media attention, especially being in the media capital of the world (if New York is still considered that), whether it got more priority than the sort of routine diarrhea or cholera cases that kill thousands of children and adults constantly in Africa without anybody blinking.
I think the thought of an animal infection that leaps to a human also increases the fear levels.
In the back of my mind I was waiting for another sort of infection to start spreading -- and soon enough, right on cue, on the kids' Facebooks and Meebos and IMs it started to surface: "dirty Mexican". Racism. The belief that Mexicans are at fault. Or that pig-farmers are at fault. "I'll bet those homes in that Mexican village are a lot cleaner than your rooms," I said pointedly to the kids, looking at the painfully scrubbed, spare Mexican scenes in the newspaper photos, contrasting with rooms cluttered with fast-food containers, candy wrappers, wadded-up school papers, clothes strewn everywhere, and half-empty water bottles. They got to sweeping up quickly and thought about what I had said.
Flu, especiall flu related to pigs, already the butt of jokes, seems like a joke until you or your relatives have it, then it's not so funny -- and Internet insolence is just in the way. Google fretting about how it didn't pick up on people searching on Google in Mexico for expressions like "phlegm" (er, what is that in Spanish, and did they have Internet in La Gloria?) -- just seemed fatuous.
This time, once again, it was humans that triumphed -- the Mexican doctors and health officials, the nurse at the school in Queens, all the people who have been cleaning and checking and cleaning and checking again, live, and in real time, face-to-face, cocking their heads slightly, listening, listening...swabbing again one more time.
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