Wednesday, June 10, 2009

STI: I was a suspected H1N1 patient

June 7, 2009

I was a suspected H1N1 patient

Tests galore as a bout of fever on a plane led to storm of activity by plane crew and health officials

By Feng Zengkun

For 30 hours two Saturdays ago, I was a suspected H1N1 case.

My very own, personal, ER drama did not start at triage, however, but several thousand metres above ground.

It begins on an airplane - Flight SQ 325.

En route from Frankfurt to Singapore, I develop diarrhoea and then a fever.

At first, I consider toughing it out. In the dark of the cabin, I tell myself: 'It's probably nothing.'

Until a vicious stab of pain has me climbing over my sleeping neighbour for the airplane loo.

That's when a stewardess catches sight of me and the party in the pantry begins.

She gestures me to a cabin crew fold-down seat and whips out a temperature kit. Another brings in two men in suits. The space begins to feel very crowded and I start to get frightened.

The heat strip in my mouth climbs to 39.1 deg C. When the number is announced, it changes everything.

As I sit in the pantry dictating my particulars, travel history for the last month and future plans, the stewardesses spread into the economy cabin.

They relocate passengers in a one-person square around my seat, tear and disseminate contact sheets to the 45 people closest to me, answer questions and pacify passengers in the inevitable fallout.

A toilet is disinfected and blocked off.

I learn that above the vacancy indicator on the toilet door is a hidden, sliding bolt that unlocks it from the outside.

I am returned to my seat, spotlighted by an empty square. I hide behind my face mask.

For the remainder of the flight, the cabin crew is so solicitous I think I am sitting in first class.

I am embarrassed - and mortified - when told that the Ministry of Health (MOH) has been notified. I imagine masked men sweeping through the airport, thermometers holstered.

My fear takes on an added dimension when my fever begins to subside, helped by the application of Panadol and cold water. The thermometer reads 36.8 deg C, otherwise known as normal body temperature.

I have never been so embarrassed to be in better health.

I spend an hour hoping for a resurgence of the fever.

That doesn't happen. I spend it hoping the ministry will send just one person. That doesn't happen either.

I am perversely relieved to still have diarrhoea.

The plane is met at the airport by a team of MOH professionals, who take the temperature and contact details of every single passenger.

Needless to say, it takes a long time, during which I sink into my seat and pretend to be asleep.

When I am the only passenger left on board, three blue-smocked women set up command in the business-class cabin.

A tornado of activity ensues, of which I am the eye.

My temperature is taken again. The doctor pokes both ears, one of which registers a more hopeful 37.1 deg C. She records that one.

I am thankful for the small gain and realise I have truly moved to Bizarro Land.

The other two women record my name, address, IC number, home and cellphone numbers, symptoms, travel history and future plans, transmitting all this in a series of overlapping phone calls.

After the storm subsides, despite all likelihood to the contrary, the doctor decides on testing to provide peace of mind.

Because I was in New York a week ago, I may still be a carrier.

My luggage is taken to the tarmac. A Customs official comes on board to process my re-entry into Singapore. My parents are contacted.

A driver parks a tan civic ambulance 15 steps from the plane. I know I am being transferred to a new authority because his smock is green instead of blue.

For the ride to Tan Tock Seng Hospital, a police motorcycle tails us, red and blue lights flashing.

I feel a tiny, private thrill. It is my first time in an ambulance, and my first time being escorted by the police.

How many people can claim to have been escorted by the police?

I mean, besides criminals.

We arrive at a hospital loading bay, its inner end drafted into service as a waiting room. The driver hoists my luggage off the van, chats with the woman on duty and wishes me good luck.

Again, I am asked to disgorge my particulars and travel history. But the woman also wants flight numbers and seat assignments. Considering I have taken seven planes in seven days, this is no small task.

The woman collects what she can and pages the doctor.

He is a hulking young man hidden behind a face mask.

I learn what newspapers mean when they say 'further assessment at the laboratory'. Three samples are extracted: blood, and throat and nasal swabs.

For the uninitiated, let me say that a nasal swab feels like shoving a pencil up your nose, and then using it to write a novel on your brain.

By the time the doctor withdraws the cotton tip, I am tearing up like a character in a Korean drama. The doctor makes a joke, and I make a joke, and he deposits the tip in a test tube.

I am just getting to like him when he gestures to the other nostril.

An elderly man drops by to hand me porridge and hot Milo while I wait.

Because the analysts have regular working hours except in cases of probable infection, I am to spend the night in one of the Communicable Disease Centre's isolation wards.

This turns out to be a spacious room, fresh, appointed in soft white, almost friendly but for the biohazard collection box - a bright neon dumping point for the hospital's toxic chemicals.

Masked and green-smocked women descend on me to show me the toilet, how to carry the saline drip and put on the hospital's version of pyjamas.

A bulky button is clipped to my groin. It is a thermosensor. It has a bar code and a point of blinking red light.

I suppose an alarm goes off when my groin gets overheated. I try not to think about this.

Thankfully the night passes uneventfully. My blood pressure is taken periodically with a wheeled- in machine. Another machine beeps me awake when the saline bags run dry. I thumb the bedside call button and doze while the nurse replaces my drip.

Because of my diarrhoea, I also record my bowel movements through the night, filling up two containers with my watery stool.

Sleep comes easily despite this.

The next morning, refreshed, I have only one thought: When can I go home?

The nurse who takes my blood pressure guesses I will be home within the day. The analysts start work at 8am and the tests take six hours. I do the math and estimate dinner at home.

As I wait for the hourglass to run down, I notice the room across from mine is occupied. The woman in it paces, gesticulating while on her cellphone.

For the first time, I think about the other patients in this place.

We are like bees in a hive, each shuttered in our individual cell.

I wonder how long she's been in hers.

At 3pm, a nurse slips in to tell me I have tested negative.

I have to wait for the doctor's official clearance, but already my spirit is lifting and winging its way home.

The discharge happens in three stages.

The doctor arrives flanked by nurses and a trolley station of blood pressure machine, folders and computer.

She pronounces me fit enough to be 'off-blood, off-drip', meaning the intravenous contraption on my hand that provides both is removed.

Next, a nurse comes bearing documents.

These concern my medical state - 'Any flu? Any fever? What about tummy aches?' - at the time of discharge, and I sign them after she completes the checklist.

Finally, the pharmacist comes to give me my drugs. She declines to take a photo with me.

I change back into my jeans and T-shirt, and try to ignore the overnight smell and stickiness.

The floor is busy with people. The woman across the corridor is now looking out of the window.

I say bye to the few faces I recognise. Three nurses, seeing my luggage, take over and escort me to the exit.

My sister called earlier and said she would pick me up at the Emergency Department. I have an hour.

I lug my suitcases to a nearby seating area, where people wait for the valet to bring them their cars.

Two teenage girls are there, one of them stabbing a flimsy container of fruit. An N95 mask dangles from her ear like a floppy earring.

Her friend is complaining about some feckless friends.

It is a conversation filled with unadulterated 'wah lao ehs' and Hokkien.

It convinces me that I am home free.

The writer, who is with The Straits Times, just graduated from New York University

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