Sunday, August 24, 2008

Smecta -- mmm...dead people

Have you ever read the warning on the Immodium box to see a doctor if symptoms did not improve after four doses in one 24-hour period? Every time I have ever taken Immodium in my life, I have had it work after one single pill. In some strange foreshadowing, Lisa and I were joking about this a month or so ago when I was back in the staes. We could not imagine what kind of horrible sickness you would have to have to take FOUR doses of it. Well, now I know.

Since returning to Morocco, I became that very sad individual who took four doses and STILL had my ass planted on the toilet almost constantly. However, I was still hesitant to see a doctor here.

I heard a lot about Moroccans' ideas about medicine over the last few months and have been praying that I would not have any issues so severe I'd have to see a doctor while here. Can you believe some people in this country still operate on the belief that if you walk barefoot on tile floors, the cold will travel up your legs and into your chest and you will catch a cold> Or, that cumin seeds cure everything from headaches to diarrhea to infertility? (I just made up the infertility thing, but I would not be surprised if it were true.) These are not just instances of I heard from someone who heard from someone that their grandmother believes this. These are common beliefs of seemingly very well educated people who have traveled all over the world and know that antibiotics and aspirin exist.

My favorite example is of my Arabic calligraphy teacher, Mohammed, who broke a couple of bones in his hand after falling. He had it set by a doctor, but it did not heal fast enough for him, so he traveled to Fez, where he is from and sought out a traditional healer there. The healer had him remove his bandages and he proceeded to rub olive oil on his hand and massage the tissues every day for the next week or so. Mohammed, my teacher, believed that this would heal the bones completely and he could return to work as if he had never had the fracture. Imagine my surprise when he had to go back to a regular doctor who had to re-break his hand and re-set it because all of the massaging had messed up the original setting of the bones. Shocking. However, no one ever put Mohammed's hand in a cast or a splint. Both the doctor and the healer just wrapped it in gauze and told him (a man who makes his living from painting and calligraphy) not to move it. Brilliant.

Anyway, with this idea of Moroccan medicine roaming around in my head, I didn't really want to bother going to an actual doctor here.

When I finally had one day where my fever spiked so high, I found myself in the shower using all cold water, trying to bring my temperature down before I became delusional. I was all alone in my house, dehydrated from sitting on the toilet, sleep deprived, anxious and generally feeling like walking death. That was the last straw and what prompted me to make an appointment to see a gastrointestinal specialist whose name I found on the US Consulate website.

It turns out Fatiha, one of my host sisters, saw him in the past and told me that he basically was an idiot. Great, if a Moroccan says a doctor is not good, does that mean that he's really, really bad, or maybe really good in my eyes as a Westerner? Since I already had an appointment, I decided to go anyway. When I got there, I learned that the doctor was not actually in the building yet for the day and that he would arrive within the hour. Great. I wasn't sure if I could keep out of the bathroom for an hour, plus there were other patients who had been there for almost an hour already, waiting for him. It was a really hot day, I was already dehydrated and feeling like the walking dead. The last thing I wanted to do was to sit in this doctor's office, without air conditioning, waiting for some quack doctor who might not even show up at all, let alone within an hour. (Moroccans' ideas about time are much more fluid than those of Americans.)

I decided to cut my losses and go to an emergency clinic, figuring I didn't have any serious disease and just needed some medicine. I took the bus with Wafaa (my host sister) to another part of the city (although I would have gladly paid for a taxi, I got the feeling that this frivolous waste of money was looked down upon when a bus was so much cheaper. And, buy so much cheaper, I mean about 50 cents less than a taxi). So, we walked a few blocks from the bus to the clinic and walked into god-blessed air conditioning. Immediately, we were whisked into an exam room and a nurse was in the room within seconds to take my temperature and blood pressure. Now this was what I needed!! The doctor only took about 45 minutes to see me and with just a small amount of translation needed, I was out the door with prescriptions in hand. Although Wafaa speaks a little English, it's generally easier for me to speak to her in Arabic. She understands me well and uses words I know to communicate with me, or is very good with gestures. So, the doctor spoke to her in Moroccan Arabic, she translated to me into Standard Arabic (Fusha) and I spoke to the doctor in Standard Arabic which he could understand but for some reason not speak. I've stopped asking why this is usually the case around here. Anyway, about $30 later, I was out the door with prescription in hand. Even in the US, with insurance, I would have paid at least $50 as a co-payment. This was a private, very Western clinic and it cost next to nothing to pay out of pocket. The same turned out to be true for my medications.

After my appointment, we had to find a pharmacy that was open, no small feat on the weekend. There is always one pharmacy open in each neighborhood on the weekend, but it changes every weekend and you have to go on a little treasure hunt to find which pharmacy in the neighborhood is open. So, more walking. Fantastic. Forty-five minutes later (and probably 3 km), we found the pharmacy. At this point, I was close to passing out, badly in need of a toilet and completely dehydrated. I got the three prescriptions filled and we walked another couple of blocks to find a taxi.

Finally, we made it back home and I was able to take the first dose of medicine. There were three different boxes of concoctions, none of which I had ever heard of and I have no idea what any of them were for specifically. I just blindly trusted in the doctor and the pharmacist and began mixing my first dose of "Smecta." Let's just say that Smecta tastes exactly like it sounds...like crushed up dead people with a dash of vanilla. Or, really, really gross. However, it did the trick and within 48 hours, I was back in class and sleeping through the night. I now have more faith in Moroccan medicine and a bigger fear of getting sick again for fear of having to take more Smecta. It is an experience I do NOT recommend.

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