Friday, February 7, 2020

Dottoressa events in the USA

I want to be sure all my blog readers know about two free public presentations in the USA in March of my memoir Dottoressa: An American Doctor in Rome. If you have friends within range of either of them, consider letting them know.
In Berkeley: Tuesday, March 10th, in conversation with Katharine Michaels (writer, restorer of old stone farmhouses in Italy, widow of Susan's literary mentor Leonard Michaels). Time: 7.00 pm. Place: Moe's Books, 2476 Telegraph Avenue
Event page at Moe's Books website.
Event page on Facebook.

In New York City: Monday, March 16th, in conversation with Alexander Stille (author of Benevolence and Betrayal, Excellent Cadavers, The Force of Things...). Time: 6.30 pm. Place: Italian Cultural Institute, 686 Park Ave (between 68th and 69th St.). An announcement will soon be appearing at the Institute's Events webpage.

There will also be an event on March 13th at the American Psychosomatic Society conference in Long Beach, CA, hosted by Bill Lovallo, but that’s open to conference attendees only.

Monday, February 3, 2020

Nilotic Jeopardy: The Prequel

drawing by Suzanne Dunaway

Even before I went bottoms-up on Nile water (see Nilotic Jeopardy, Part 1), the medical dangers of southern Sudan had literally landed on my head. Our plane from Khartoum touched down in Juba, my ex and I took a taxi to our hotel, the cabbie opened the trunk, I leaned in to pull out a bag, and bang! down came the lid on my cranium. Blood all over the place. That’s normal for a scalp wound, and it’s a welcome form of self-cleansing. Plus it offered Andrea plenty of gore to stanch in addition to the dirt to scrub painfully away and the ragged bits of torn skin to try and disinfect.
But as soon as the immediate emergency was over, a larger problem sunk in. Every roadway – even in Italy, even in the United States – harbors vast armies of tetanus (a/k/a lockjaw) spores, with their general headquarters in the feces of those charming creatures that bear Carabinieri on their backs in Rome and pull carriages through Central Park in New York. In subsaharan Africa, e.g. Juba, animals are ubiquitous and the contamination on every outdoor object is a hundredfold, a thousandfold greater. 
Like most physicians I’m sloppy about my own health, so I hadn’t bothered to get a tetanus jab preparatory to the trip. To count back to my last one, I needed all my fingers and all my toes. More than ten years and you’ve likely lost your immunity, so there we were, only just landed, condemned to start our sojourn in southern Sudan tracking down a booster shot of tetanus toxoid, the vaccine we all get as kids followed by boosters every ten years, and some immune globulin (serum), the antibody soup you’re supposed to get shot up with if you have a contaminated wound. 
Andrea and I dedicated our first full day in Juba to the hunt. First we tried the public hospital, a crumbling structure whose furniture consisted of nothing but bed frames armed only with springs, no mattresses. They were jammed into every available space, each holding two patients arranged head to foot, and were surrounded by encamped relatives. I explained my issue to the head doctor but he didn’t seem to know what I was talking about. 
The year before, visiting a mission clinic while we were travelling in Kenya, I saw that the only tetanus medication they had was serum harvested the old-fashioned way, from horses. That product had been a miracle of modern medicine in 1911, but it had an unpleasant tendency to give severe and even fatal reactions, so the medical world heaved a collective sigh of relief when a more benign, more effective version of immune globulin, derived from human blood, arrived in the late ‘60s to replace it. But here in Juba, a beggar and not a chooser, I was starting to think if someone offered me that toxic horse serum I’d kiss him.  
After the hospital fiasco we set off to do the rounds of all the half-dozen private clinics in town. One chief medical officer after another said nope, no booster, no horse serum, no human serum, no nothing. As a traveler and a scientist I could muster some anthropological interest in our odyssey, since it was giving us an inside view of every medical facility in one of the major cities of a country one fifth the size of the USA. But as a patient I saw no plus side. 
Finally at the last clinic, run by missionaries, I hit the jackpot. Or at least I found someone who knew exactly what I was talking about. An earnest Dutch doctor kindly explained that tetanus toxoid, the booster I needed, was completely unheard of in southern Sudan. But he said if I wanted he could get me some immune globulin. And this immune globulin wasn’t even that toxic kind they used to make from horses – it was of human origin, like the products used in Europe and the US. Except for one slight difference, my saviour confessed: the serum he had to offer was not a sterilized commercial product but a concoction hand-produced in Juba from the blood of local people. 
It took me a minute to realize what this meant. Unprocessed serum from south Sudanese blood could be – would be – loaded not just with antibodies but with germs. Nowadays the most-feared culprit would be HIV, but this was years before AIDS (or hepatitis E, or West Nile virus, or Zika fever) had appeared on the scene. Nonetheless even in 1979 the list of blood-bourne diseases was already long. The biggies were malaria, syphilis, and hepatitis types B and C (then known as “non-A non-B”); a somewhat less serious category included brucellosis, toxoplasmosis, Chikungunya, and Dengue fever; and an obscure-but-deadly blacklist featured trypanosomiasis, babesiosis, leishmaniasis, and Ebola. For a south Sudanese patient who had never had a tetanus shot and had already been exposed to most of those other infections the risk from the serum might have been worth it. For me? Not on your tintype.
The outside incubation period for tetanus is six weeks. Though a few days later I downed my unfortunate chalice full of Nile water, initiating a countdown as I waited for myriad diseases to strike, lockjaw may have been the scariest – even with modern medical care, it’s still frequently fatal. Fortunately, the six weeks passed without my jaw ever giving a twitch.

Thursday, January 30, 2020

Dottoressa in Pieces

Dottoressa: An American Doctor in Rome will be one of the cut-up books featured in an exhibition at the Visioni Altre gallery in Venice, Fresh Cuts / Tagli Freschi / Exploding Red Piano Keyboard by post-Fluxus artist Coco Gordon. This installation will be on display from 1 to 13 February 2020, culminating in a SuperSkyWoman performance by the artist, 3 Dances for Paper Piano, on the 13th at 5 pm.

says the artist:

Coco Go aka
Fresh Cuts: Tagli Freschi

Cage, Duchamp, Fluxus da fondo a caso, da capo, tutte precedente esperienze gestiti: fare, stare, sentire, strappare, tagliare, scoprire—nascondere tra tagli spioncini, Il lettore esplosivo, trasvolgente, integrativo, honorato, riaperto, ritornato, risognato, ricambiato, rimprovviso, risupposto, ri-in gioco—richiavato nel suo pianoforte Rosso allungato a 6 metri, tesi a lungo cinque gambe cinque piedi per la collaborazione invitata alla Galleria VisioniAltre 
Mostra 1-13 Febbraio 

Invented this form. I began cutting my best loved & lived books in 2018 as a project to let go of them,
surprising myself by exploding outward, following clues of the books themselves to retain the essence I felt of them.

In 1981, I had cut centers the shape of fruits out of old paperback books & placed mushrooms at the centers
then filled my red paper piano keyboard with a proactive healing aim to stop clear-cutting forests.
This first pass of flowering out & opening the insides to view, is for honoring Fluxus friends.

Saturday, January 18, 2020

Nilotic Jeopardy, part 1

Nilotic scene, a Roman mosaic unearthed half a mile from my medical office
You can take a boat up the White Nile from Khartoum, but there’s no guarantee you’ll make it all the way to Juba. At least there wasn’t in November 1979 when my ex and I were traveling in the Sudan. Our native informants in the capital were unanimous: any tub that didn’t run aground in some dry-season meander would likely be hijacked by pirates.
So we decided to brave a flight on Sudan Airways. It landed safely, belying its nickname of Inshallah Airways, and soon there we were down south in Juba, admiring a real-life Nilotic scene. No hippos, no crocs, just cattle wading decorously into the water, cattle dropping cow patties into the water, people wading in to wash, other people dropping people-patties into the water. Plenty of local color but deserving a Keep Your Distance sign.
At the time Juba was a village of some 100,000 souls living in mud huts, arranged in circular compounds where pit latrines would have been too high-tech. It was so hot that government office hours ran from 5 to 10 AM. Roads all rigorously dirt, with almost no cars on them since you couldn’t find gas even on the black market. Little to do most days except hike the three miles to the market, where we could gawk at the squatting sellers, buy peanuts, and, if we were lucky, get some lemons we could turn into lemonade if we managed to score bottled water and sugar back at the hotel. We were staying at the town’s second-best. It boasted electric fans, which were functional for exactly four hours each evening, and served up a few leathery tidbits of meat on an otherwise empty plate three times a day, with milky tea on the side. I lost 10 pounds in two weeks.
A large percentage of that vacation’s total calories were gobbled down in one evening, at a vast whisky-drenched party with live music, thrown by a government functionary whose name we’d been given at the Sudanese embassy in Rome by their token southerner. “Government” was something of a euphemism, North and South being already separate de facto if not yet de jure. I spent much of that bash bizarrely reminiscing with our host about our respective times at Harvard, and listening to his cockamamie scheme to make a million bucks by peddling ice cubes to the inhabitants of refrigerator-free Juba.
One day we heard a local guy playing a kind of lute, strung with the kind of strings you tie things with. It was irresistible, so at our next market foray Andrea headed off to hunt for the instrument-maker to buy one. I plunked myself down at a rickety wooden counter where I could quench my thirst while watching the vultures swoop, and exchange pleasantries with the broad jolly woman running the stand. Soon it was 11.00, later than our usual time to be out, and much hotter. I drank glass after glass of sweetened black tea, figuring boiling would have killed off the germs. The other customers were guzzling water, which the woman behind the counter ladled from huge jars, buried up to their necks in the ground to keep their contents cool. She turned out to be not Sudanese but Ugandan, one of the tens of thousands of loyalists of recently deposed dictator Idi Amin who had fled to southern Sudan driving their herds before them. Her Queen’s English would have passed as native in Cambridge, England, where she said she hoped to send her daughters to university one day.
The heat was cooking my brain. After I had knocked back tea number six, which left me thirstier than ever, my hostess looked me in the eye and said, “But wouldn’t you really rather have a lovely cup of nice cold water?” It was her impeccable British accent that got me. I said, “Yes! Yes!” and gulped down a giant tin cupful of liquid that smelled, looked, and tasted like it had come straight from the Nile. Coolth and hydration spread instantly through my body in a rush as good as any junkies get from heroin.
Moments later the euphoria faded and panic set in, as the names of all the water-bourne infectious diseases I’d been taught in medical school floated to the surface of my mind and I started counting down incubation periods. Hours waiting to be hit by staph dysentery, days for salmonella and cholera, two weeks for giardia and typhoid fever, four weeks for amebiasis, six weeks for hepatitis A, a year for Guinea worm disease…
Miraculously, I never got any of them.