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Oftentimes, when you live in a developing country, you wake up feeling less than spectacular. Could be the cold chicken parts you ate on the side of the road, the water you dragged up from the well that had a rat in it that one time, or the moonshine you were told not to drink but did anyway because it would have been rude not to.
So when I woke up at 5 am on that Wednesday in Madagascar, experiencing abdominal discomfort, it didn’t seem weird at all. Probably just my old pal giardia –- I decided to stay in bed a little longer.
A couple of hours later, the familiar wave of what we volunteers fondly referred to as "butt-pee" came upon me. Only now, I was having trouble standing up, so I was compelled to use my po, which was a bucket with a lid that I kept in my room for circumstances such as this.
In training, they told us we had to use our po because if you go outside at night, the witches will catch you and ride you like a horse until you’re dead and your tongue hangs on the ground. A valid concern, to be sure.
I finally feel bad enough to call the doctors around nine; the additional symptoms of chest pain and trouble breathing are disconcerting. The doctor says, like he has a million times before, "Don’t worry, you have bacterial diarrhea. Take the Cipro, drink water. Eat bland foods."
By 11, my abdomen feels like it’s exploding into my ears and lungs and I can’t move to put on clothes and I really can’t breathe at all. Wrapped in the stinky sweat-soaked nightmare burrito that my bed has become, I call the doctors again. I said, “I think I’m going to die. I don’t know what’s going on."
They start to worry. Fortunately, there’s a car about two hours away that can come get me and bring me to a hospital.
They finally busted into my house at 6 pm, and I passed out twice on the way to the car. I’ve never fainted before –- the sensation was indescribably weird. I could hear my own voice in my head while I was out –- hurry hurry hurry to the car before I go down again -– but the words never came out of my mouth.
We arrived at the private clinic around nine. My friend showed up for moral support, and we swiftly dubbed the local doctor "Dr. Potato Head" because he was such an asshole (also, spitting image of Mr. Potato Head). They did a pee test. They came back and said I was pregnant.
My mind was completely blown -– I hadn't missed any periods; I had just finished one a couple of days earlier. How could I be pregnant? Nothing made sense. They put me on an IV and tell me to drink water. Then they come back and tell me I’m not allowed to drink any more water.
My phone rang and it was my real doctor, who was now in a car on his way from the capital. He said rather calmly, “You are having an ectopic pregnancy (which is when the egg gets fertilized and then doesn't get all the way to the uterus so the fetus starts growing in the fallopian tube), it has ruptured, you're having severe internal bleeding and could hemorrhage if we don't operate.”
I couldn’t breathe because my chest cavity was filled with blood and it had been steadily constricting my lungs for hours.
“Oh, my God.”
It then occurred to me to ask if there was a chance I would die. He said, “There's a big chance you could die, like 50/50.” I couldn't cry because of the breathing issue, but laughing was pretty painless. So my friend tried some jokes, and I didn't feel like it was time for me to die.
Sometime in the night, they came in and said they couldn't wait till morning to operate, because I would bleed out and be 100% dead. So, at 3am they took me to the Hopitaly be (the dreaded, horrible public hospital). A different doctor took off my shorts and underwear, shoved his hand into me and then stabbed a long needle into my abdomen. No explanation, no curtains, no sheets, no gowns. Also, no drugs, no bedpans, and no running water.
A toothless dude rolled my gurney down the hall; he forgot to unlock the wheels and kept bumping into walls and laughing hysterically, with my friend swearing at him in Malagasy the whole time to shut the fuck up and stop being and asshole. I positioned myself on a bare mattress covered with a blanket someone had thought to bring from my house. A woman came in and without warning, thrust a catheter into my urethra and left.
They wouldn't let anyone come into the operating room with me. I was in so much pain that I just didn't want to be awake anymore. I kept repeating, "Put me out put me out put me out."
They couldn't, though. Because they didn't know how much I weighed and therefore couldn't determine how much Valium to give me. They were making jokes about how fat I was.
I was frantic, asking if they had a calculator so I could convert pounds to kilograms, worried they wouldn’t give me enough and I’d wake up in the surgery and feel everything. They told me I should teach them English.
“Why does she have clothes on?” the nurse asked, “Why hasn’t anyone taken off her clothes?” I had to take them off myself.
I am naked on an uncovered operating table, and my nose is running. They finally put in the Valium after like three thousand years of waiting. I will always love Valium.
As I was going under, I said, "Izikoa tsy maty rapitso zaho, afaka mihinina pizza?" which translates to, "If I’m not dead tomorrow, can I please eat pizza?"
I remember this crazy nurse lady with funny 1950s glasses that kept saying, "Aza mataoatra" -– don't be afraid. I was utterly afraid. Until I fell asleep.
And then I woke up. On that same bare mattress, my own blanket and sweatshirt covering me, and surprise! I was still naked. I put up my legs and the catheter fell out. There was a drain coming from my belly that was leaking blood into a plastic bag.
My friend looked unbelievably ragged. She had spent the entire night alternating between crying and vomiting (ah, the joys of giardia), and after the surgery someone came and showed her a bucket of my guts to prove they had done something.
Then doctors from the capital had finally arrived. They cleaned the whole room and brought sheets; they bought me a pretty pink dustpan to pee in. This did not go well. I peed everywhere.
That first night, one of the doctors stayed in the room with me and told me that my only goal in life was to fart. If you fart, it means that your organs are working. So I tried to fart. Finally, in the wee hours of the morning, I let one rip, and woke her to tell her. Imagine being that happy about a fart.
I was flown to the nice hospital in the capital; I spent a couple of days there eating baby food and watching terrible TV dubbed in French, then I walked out. It was over and I was alive.
A few days later they had me talk to a counselor over the phone. At the end of our chat she sounded astonished when she said that I sounded fine, very healthy mentally, and not really in bad shape considering I had almost died in a third world country and would have a hideous scar to explain for the rest of my life.
I was thinking the same thing. I’m pretty fucking lucky. Lucky that I had a cell phone, that the car had only been two hours away, that they figured out what was wrong in time, that the doctor in the hospital agreed to do the surgery even though he was advised not to (because if I had died, he would have had a foreigner’s blood on his hands).
I still think about him all the time, and try to live my life in a way that helps me thank him for his bravery.