#Diary: Running with Malaria chapter 1 - Mortality
Therapeutic account of a six-week pause in Running with Mushrooms
It’s been a while since I last posted. November in Nairobi saw me curled up in foetal position, in and out of hospital with severe malaria.
Freshly galvanised after road tripping Uganda’s popping mushroom scene, we arrived in Nairobi ready to explore Kenya’s wild mushroom culture. Instead, Running with Mushrooms ran with medical systems. Six weeks may seem like a hiccup, but as a startup consultancy, losing this time has been a big hit!
This is chapter 1 of 4 of a therapeutic diary of that time. It’s long and I don’t expect you to read it.
If you’re curious, it’s an honest account of life on hold while a lot happens and a lot is learned.
CHAPTER 2 | CHAPTER 3 | CHAPTER 4
We’re home in London now and I’m much better so it’s back to work.
Mush love, Jess ✌️
Turmoil
Reading time: 11 mins
Location: AirBnb in Nairobi, Kenya
Thursday 2 November
On 31 October I started to feel unwell. Fever, body aches and headache—classic malaria symptoms—meant it was time to see a doctor. Annoyingly, initial tests at the nearest medical centre showed a negative malaria result. To my dismay, the doctor prescribed a broad-spectrum antibiotic for a “bacterial infection” and sent me home.
Monday 6 November
My symptoms are much, much worse.
I’ve deteriorated into feverish turmoil alternating between intense heat and uncontrollable shivering. Paracetamol, Panadol, Ibuprofen, BetaPyn…nothing is relieving the insistent head throb. Clearly, antibiotics aren’t doing shit.
Apart from being frustrating AF, misdiagnosis surfaces a fundamental resentment for the injustice of systems not working how they should, but the anger fades as my body collapses into depressive drowsing.
I try not to dwell on missed opportunities in Nairobi—canceled plans with friends, postponed mushroom ethnographies, and the regret of missing an event like Sauti Sol’s Last Dance after 17 years of pioneering African pop (😭😭😭). This sounds trivial compared to serious health issues, but the FOMO is real!
Foetal position
My body writhes, instinctively curling into foetal position. This behaviour is psychological and physiological. I’m self-soothing, tapping into the comfort, security and containment of the womb. I’m activating the parasympathetic nervous system, promoting relaxation and attempting to reduce stress. I’m relieving one side of my throbbing head for a brief minute before thrashing over to the other side.
Sleep, when it comes, is a rush of nightmares. Restless minutes drag on, but waiting for daylight is futile as the headache, fever and surreal delirium don’t distinguish between night and day, sleep and function.
My Husband the hero
Malaria robs you of objective observation and critical decision-making. Unable to move much, I’ve started relying on Husband for meals and medicine. My bones are at war with the tendons and muscles that usually hold them.
The dim, windowless living room of our mid-range AirBnb feels oppressive. Blankets are both a sanctuary and suffocation. Writhing between couch and bed, drenched in extravagant sweat that soils every duvet, sleeping bag and item of clothing, I have become unable to realise that I am actually very, very ill.
Husband saved my life. With the ability of a healthy human to form coherent thoughts and Google a better doctor, Husband booked a consultation at Nairobi’s Centre for Tropical & Travel Medicine.
Time to see the professionals.
Mortality
Location: Nairobi Hospital
Tuesday 7 November
The second human to save my life was Professor Chunge. Prof’s team at the Centre for Tropical & Travel Medicine (CTTM) moved decisively. Dr. Ashe rang the alarm and Dr. Ruth Chunge in the lab confirmed: Severe Malaria.
My blood slide has become a novel spectacle for the doctors and nurses on duty crowding to take turns at the microscope: “Have you seen this??!” Apparently 22%+ malaria count is rare: the clinic hasn't seen a similar case since 2018.
Waiting on a plastic-covered hospital bunk; IV in one arm, Husband’s hand nestled in another; the hours pass by slowly, mimicking the syrupy drip drip drip of the IV. With time to ponder the reality of being unwell I can’t help the unhelpful thoughts: What if we hadn’t caught this today?
After hours of consultation, blood tests, meds, needles and dramatic statements from the medical team such as ‘You are lucky you got here today’… I’ve been admitted to Nairobi Hospital.
Hospital or hotel?
Hospitals are puzzling—not a hotel, but you’re treated like a guest. Reception allocates a room; waiters take a food order. When dissatisfied, you feel entitled to call the manager... Alright Karen.
After crafty negotiation, we persuaded Head Nurse to allow Husband stay overnight, given our late discharge from the ER around 3am. I credit this rule-bending to Husband’s wizardry, charming the nurses and securing an affordable private room with a spare couch, crucial for uninterrupted malaria butt-kicking.
Wednesday 8 November
The allure of a posh private room has worn off. The unauthorised (by me) and steady flow of nurses checking vitals, drawing blood, introducing themselves, saying hi in the morning and bye in the evening, maintenance staff checking curtains and bathroom fixtures, waiters checking meal orders and nursing students gawking at my malaria blood count... Nairobi Hospital is the optimal place for treating a tropical disease, but this uninterrupted hubbub is exhausting.
The Karen in me questions the persistent intrusions. Head Nurse kindly installs a ‘do not disturb’ sign on the door, which I never see because the door is miles away. I know I’m being a grouchy asshole: these people are helping me.
I have to commend Nairobi’s excellent medical care. At risk of unpatriotically criticising the UK’s problematic NHS, I am very, very grateful to have diagnosed malaria in Kenya, where treatment protocol is near-perfect.
True to the Kenyan welcoming nature (Karibu sana!, Swahili for ‘You’re very welcome!’, is a regular sing-song in my room), my nurses are friendly, caring, attentive and professional. My medical team, experts in parasitology, are jazzed up, inspired by my unique case.
The fatigue is restraining my visible display of excitement, but internally I’m as jazzed up as they are for the medical intricacies of this treatment process. They approach it with the precision of a Japanese sword master, demonstrating respect, mastery and meticulous skill in their craft.
Despite my swollen hand from the 4th IV insert on a bony wrist, I know I'll be okay.
Death dreams
Malaria is famous for bizarre, grotesque dreams and hallucinations. Facial features, possibly mine, sprout mushroom pinheads, fragmenting into swirling geometric zigzags around the galaxy of what used to be my head.
Husband and I are walking at a woodland festival. Blurred green tree stems distort into jelly legs. My vision splits as a geometric shitshow floods the top left corner. In the bottom right, a 4K hyper-realistic yet macabre fish-eye close-up of the nurse’s face creeps me out as she draws near to draw blood. The nurse is real, the rest is not.
These visions have been interrupting my sight in broad daylight; they’re fleeting but freaking me out: is this what near-death looks like?
Deranged Liver
Prof Chunge dubs my liver “deranged” due to extreme damage and potential Hepatitis A, likely from food poisoning. Luckily the HepA test is negative, but my liver needs daily monitoring, tender care and special vitamins.
I’m too scared of the unrecognisable to look in the mirror, so Husband is monitoring the jaundice: today my eyes and skin have subsided from school bus yellow to a paler mustard.
Thursday 9 November
I wake up feeling trapped. Three sleepless hospital nights existentially questioning mortality has me unsettled and anxious. Will I actually die?! I’m not ready. Can anyone really be prepared for death?
Husband and Sister are visiting but the unsettling feeling lingers. We play crosswords while I keep the feeling of overwhelming, stifling fabric to myself; this illness is enough of a burden on them.
Doctor advises at least one more night for the parasites to clear completely before considering discharge. Meh.
Set and setting
Are hospitals designed to keep people in as opposed to helping them out?
In psychedelic-assisted therapy, ‘set and setting’ is crucial. Set refers to your mindset, psychological state and expectations, while setting is about the physical and social environment where the therapy is taking place. A supportive, safe, and comfortable setting, plus a positive mindset, can profoundly influence the therapeutic outcome of the psychedelic experience. Practitioners put a lot of curation and thought into set and setting to create trust, security and a space conducive to openness and healing.
My brain is too fogged to focus on reading, watching content or thinking, so the long hours in between the treatment routine are spent breathing, lying down, staring at the wall and mostly listening to the hospital.
Have you ever listened to a hospital? The sound environment of non-stop bleeps and bloops with a backdrop of rhythmic medical equipment hummmmmmm. Unidentified mechanical noises monitoring people, heart rates and blood pressures. Electric alerts when patients need assistance. Nurses, doctors and visitors on the other side of the curtain. There is always something to listen to.
Linked up to a monitor by finger-clips and a blood pressure cuff, the rhythmic beep…beep…beep… of my heartbeat is soothing and reassuring. It’s a sonic reminder that I am alive. But why did the beat just quicken? Beep.beep.beep. What’s going on?? A wave of panic floods my chest, causing my heart to beat faster. Is there something wrong with the blood transfusion? Is my haemoglobin dropping? Am I going to pass out??! Wide-eyed Husband reminds me to slow my breathing, and the heart rate recedes to normal. By hearing my heart rate I’m causing it to quicken.
How impactful would it be for a hospital to revolutionise its setting? There must be a quieter way to monitor vitals, allowing a patient peace and rest. Surely machinery can be heard only where needed, without intruding in other peoples’ soundspace? Cleverly designed sound, visual aesthetic and aroma can create a much more comforting and supportive setting.
Pretty sure I’d heal faster with fewer beeps.
Over-medicating
Are all of the medicines really necessary, or are hospitals just racking up more bills? More pills to treat more symptoms caused by more pills.
My malaria meds and painkillers cause nausea. My anti-nausea meds prohibit appetite. My appetite facilitator is also an anti-psychotic. I’m on meds which cause bloating and fibre to move the bowels. My antibiotics kill the good bacteria, and probiotics counter.
My medicine box is a small pharmacy, and I wonder how much it’s costing my body and my bank balance.
“In five years we haven’t seen anyone at 22%. Fortunately we know how to handle it; we’ve seen a lot of malaria cases. Most people with 22% are in ICU, because they don’t drink enough. You have to keep washing the toxins out.” Professor Chunge
4-6 litres a day
Prof is enforcing a consistent drinking ritual to avoid renal failure and flush the parasites and dead blood cells. I’m averaging 4-6 litres a day of water, electrolytes, fruit juice, soft drinks and tea.
“ORS” as Prof calls it, or oral electrolytes, are feeling so right for my body and I develop a crazy craving for the delicious electrolyte potion that Husband perfected for bad London hangovers. Rebellion has always been in my nature: I convince him to smuggle in the ingredients. Sadly, hospital policy is stricter than I thought. The security guards confiscate our contraband fruit juice and water.
Despite the many valid and logical reasons for a hospital to ban outside food and drinks, I’m upset: the system is unjust!
Not dying
Morbid thoughts are racing and flickering without direction and herding them is impossible. I’m immobile in bed but stumbling, hurtling, out of sync, out of balance and terrified of dying.
These disagreeable thoughts are pointless. Bad thoughts happen to everyone, but today I remember that discouragement can be beat by encouragement. Two thoughts can’t occupy your brain simultaneously (sorry but ‘multitasking’ is a farce), and I start writing down the good things. This simple tactic forces a bit of balance, even if temporary.
Prof says that I am strong: my body is showing this nasty little parasite exactly where it can fuck off to. Bestie replies in the WhatsApp group, “That's my girl 💪 it's the mushrooms making you so strong!!” I hope so.
I am subject to death but I will not die now. This is a relief.
Gratitude becomes an anchor, as I start listing the good people in my life—in particular Husband and Sister who’ve given up 100% of their lives to care for me. I don’t know how to thank them. I’m holding their love close.
My family are feeding me all of the smiles, checking in on our Sickypants updates WhatsApp group with sharp memes, poop emojis and caring health checks. How lucky I am to have this bunch.
Here’s Sister turning Jess into a Snakwich Maker. A Malaria Taco.
Friday 10 November
Discharge day
Prof arrives and I’m ecstatic: his daily visits demonstrate his level of personal care for his patients. Each day he’s accompanied by a different nursing student from the university, eagerly hanging on his every word and frantically scribbling notes. It’s adorable and endearing.
Prof: “So I’ve come to discharge you.”
Husband and Jess: “Yayyyyyyy!”
Prof has rules which I promise to follow religiously:
Rule #1: Use your eyes, not your legs. Traveling nearby is fine but no hiking up Mount Kenya, no camping in the Maasai Mara.
Rule #2: Don’t forget to medicate at the same time every day. My malaria blood count has reached a phenomenal 0.01% — practically obliterated from the 22% earlier this week. Coartem can be self-administered to complete the treatment protocol.
Rule #3: Check your temperature. In theory, the fever should end today. In reality, sneaky malaria can hide in the system, showing up days or weeks later.
Rule #4: Expect to be tired, weak and irritable. Husband laughs; I guess ‘irritable’ is already manifesting. Despite a promising 9 Hb, destroyed red blood cells means a risk of haemoglobin levels dropping.
Husband and I query the need to book a check-up at CTTM. Prof laughs, “You don’t need to book. Everyone knows you there!” I’m a topic of entertainment for CTTM as well as the hospital staff; earlier today Head Nurse exclaimed, “You are white! Why are you here? You should have been in ICU!” Prof proudly replied, “You are here because you are under Chunge!” And I fully believe him.
By the time Sister arrived I could feel my posture straightening, my features animated, eyes bright, and, in my mind at least, glowing playfully. I cracked a genuine smile, hugging her and holding back happy tears as I shared the news: “I’m coming home”.
Thanks for reading. You can find the next chapters here:
CHAPTER 2 | CHAPTER 3 | CHAPTER 4
Mush love, Jess 🍄❤️
WOW!!!! What a scary story!!! It sounds like a very bad Nightmare! It seems you had a guardian angel looking out for you, and you survived to tell the tale. I look forward to the next episode. Till then, Take care.