Ad Nauseam (16 page)

“Yes, of course.” She removed the thermometer and held up a finger to prevent him from speaking as she scratched more numbers down. “Now what were you saying?”

“There’s a worm in my eye.” Though his tone was calm, Mark’s insides twisted just saying it.

“A worm in your eye.” The nurse frowned.

“Yeah.”

“Any other symptoms?”

Mark thought about it for a moment before answering, doing a mental inventory of his body. “Some soreness in my joints, a rash that comes and goes, and a lot of pain in my eye when it moves.”

“It
moves?”

“Well, yeah. That’s when I noticed it.”

The nurse stood, giving him a strained smile.

“The doctor will be in to see you.” She said, handing him a blue and white gown. “Take off your shirt and slip this on. You can keep your pants.”

“No foreplay then?” Mark joked, as she turned on her heel and left the room.

“I guess not.” He said with a sigh, slipping into the gown and sitting on the exam table with his hands hanging between his knees.

He wasn’t afraid of the doctor’s office, but wearing the thin linen gown made him feel like a child. Though he’d been healthy most of his childhood, it seemed his entire youth had been spent in rooms like this one. His mother had been a paranoid sort, rushing him in for every sneeze and sniffle.

“Hey Mark, how’s it going?” Dr. Alex McDonald didn’t knock before entering; they had been friends for many years. He sat on his stool and wheeled over to shake Mark’s hand.

“Been better, Alex.”

“What’s going on with you?” As he spoke, Alex palpated Mark’s neck, checking the lymph nodes, then looked in his ears.

“Well, I guess there’s a worm in my eye.” Mark cringed as he said it.

“A worm in your eye?” Alex laughed, his brow furrowed.

“Yeah. This morning I had a bad pain in my left eye and when I looked in the mirror I saw it. Not much thicker than a thread, but fairly long. It wiggled across the white of my eye, under the surface. Freaked me the fuck out.”

“Can you feel it now?” Alex looked concerned, his smile fading. He pulled back Mark’s eyelids and peered into the left eye with his ophthalmoscope.

“Not really, but my joints have been aching off and on and I keep getting a rash that fades after a few days. I thought maybe I was getting the flu.”

“How long have the other symptoms been present?” Alex scribbled on a notepad, much like the unpleasant nurse.

“Oh, maybe a few months.” Mark felt the sting of tears in his eyes, his palms sweating. He knew parasites were a job hazard, could handle the thought of a tape worm or chiggers, but in his eye?

“Okay, Mark. We’ll get to the bottom of this. From the looks of your chart, I gave you a malaria shot around three years ago. You were going to Africa, am I right?”

“Yeah. I went to the Congo to photograph a group of western lowland gorillas.”

“Yes, yes. I remember that now. Stunning photos, by the way.”

“Thank you. Do you think I picked something up in Africa?”

“Possibly. I have an idea what’s going on here, but give me minute to do some research. I’ll be right back and we’ll figure out what to do, bud.” Alex patted Mark on the shoulder and disappeared out the door.

Mark waited on the table, nervous. After what seemed like an eternity, the doctor walked back in the room and sat on his stool, his mouth set in a serious line, though his eyes danced with excitement.

“Well Mark, it looks like you’ve picked up a case of loiasis. Have you heard of it?”

“Sounds vaguely familiar. What is it, in
English please.”

“What you saw in your eye is a Loa loa worm, otherwise known as an African Eye Worm. You can get it through the bite of an infected mango fly and it may take years to present any symptoms. The worms themselves can live up to seventeen years and cause all kinds of trouble from colonic damage to testicular swelling. We will have to do a blood test to be sure, but I’d bet my eyeteeth that’s what it is.” Alex laughed when Mark cringed at the term
eyeteeth.
“Sorry, man. I know it’s freaky. I would’ve never guessed I‘d actually get to see a case of Loa loa in person.”

“Glad I made your day, Doc.” Mark said sarcastically. “What do we do now?”

“Well, from what I’ve read, the best chance of detecting the microfilariae in your blood,”

“
English,
Doc.”

“The
baby worms.
Anyway, the best chance we have of detecting them in a blood test would be to wait until around noon tomorrow. That’s when they are present in the highest concentration. So you come back at, say twelve-thirty tomorrow and we’ll do the tests. Think of it as a lunch date with Loa loa.” Alex smiled and Mark grimaced.

“Funny. Okay, so then what?”

“If you test positive, we will get you on some medication to kill the worms.”

“Worms?” Mark felt his stomach lurch.

“Oh, yeah. If you have one, there’s probably hundreds more.”

***

The following afternoon, Mark once again sat waiting in an exam room for Alex. His blood had been drawn and they were awaiting the test results. The doctor finally entered and shook his hand again, before clapping him on the shoulder and taking his seat.

“The tests were positive. Your little buddy is in fact a Loa loa worm.” Alex did his best to look grave, but Mark knew he was delighted to add this to his list of unusual cases.

“Okay, so what do we do to get rid of my
little buddy?”

“There are a few options. We could surgically remove it, but we have to catch it when it’s actually crossing the eye, and that’s not going to be easy. Also, that would leave the rest of the worms in your system. There are a few drug options, some more effective than others, but they have risks of side effects. Most of the side effects happen in a person who is heavily infested, but the good news is that you are not. I would like to hit this hard with the most powerful drug, DEC. It runs the highest risks of complication, such as encephalopathy and death, but you are strong and healthy, with a relatively mild infestation.”

“All right.” Mark shuddered, horrified that he had the parasites, no matter how mild the case.

Alex scribbled his prescription on a notepad, then tore off the top sheet and handed it to Mark.

“Take this to the pharmacy. I doubt they have it in stock, but they’ll be able to order it. You will take the pills three times a day for the next three weeks.”

“Three weeks?” Mark said, dismayed at the thought of living with the Loa loa for three more weeks.

“Mmm-hmm. We will retest your blood then. Only about fifty-percent get by with one round of DEC. There’s a chance you might have to go another three weeks on top of that.”

“Fantastic.” Mark grumbled.

“And Mark, no alcohol at all during this time. A large number of subjects with adverse reactions reported to have consumed alcohol. So
no alcohol
, okay?” Alex fixed him with a stern look.

“Alright, Doc. I’ve got it. No fun.”

***

The Loa loa made its appearance five more times during the first couple of weeks Mark was on the DEC. It always started with a sharp pain in his left eye, coupled with the previously unsettling and now awful feeling of movement under his eyelid. Despite the ache in his eye, he could feel it
sliding
just beneath the surface, inching its way around.

Sometimes it felt like a bubble, wriggling and pushing against the lid. Mark found himself bolting to the bathroom each time to watch its progress. Just under the iris, his sclera would look bubbled, the thread-thin worm starting its trek that took from ten to fifteen minutes. Mark guessed it could be as much as an inch or two in length, but it was hard to tell as the worm wriggled its way across, just beneath the surface membrane of his eyeball.

By the third week, the Loa loa appeared to be dead, and lab tests confirmed that the DEC had removed the larvae from his blood. Mark breathed a sigh of relief and went on with his life. He pointedly avoided looking in the toilet after crapping, afraid he might see what looked like spaghetti in there.

***

One morning, nearly a month later, when the episode with the Loa loa was an unpleasant but fading memory, Mark awoke with a crushing headache. It felt as though someone was pounding the right side of his head with a hammer. Dizzy and disoriented, he got out of bed and staggered to the bathroom to retrieve some aspirin from the medicine cabinet, took four, and collapsed on the couch. At least it was Sunday, and he could stay in his apartment and watch football.

By the afternoon, the headache hadn’t subsided and, even worse, Mark noticed a change in his vision.

I wonder if this is what a migraine feels like,
he thought, returning to the bathroom for more aspirin.

He studied his haggard reflection in the mirror. Something was wrong. Leaning in close to examine his eyes, he gasped and took a step back.

“What the fuck?”

Mark looked at his eyes again and shook his head in bewilderment. His right eye was still the familiar pale blue, but his left pupil was now ringed in brown. Squeezing his eyes shut for a second before opening them again, Mark felt a sharp pain shoot through the right side of his head. He gripped the sink for support, his vision blurred.

After the world stopped spinning, he looked in the mirror again and closed just his left eye. His vision cleared and the dizziness retreated. He closed the right eye, leaving the left open and his stomach lurched.

Darkness.

Mark was blind in his left eye.

***

“I don’t know what to tell you, Mr. Hanks.” The ophthalmologist sat back and scratched his chin. “From all my testing, it seems your eye is working just fine. It reacts the way it should to light and other stimuli. I have no idea why you can’t see through it.”

Mark had called Alex right away, but was told his problem was beyond the scope of his practice and was immediately referred to an eye doctor. Now the eye doctor was telling him there was nothing wrong with his eye.

“What about the color change? What would cause that?” Mark turned his useless left eye away from the doctor so he could see him better through his right.

“That’s strange. I have heard of brown-eyed patients suddenly turning blue, but that is an anomaly that only occurs in centurions and no one really knows what causes it. But blue eyes turning brown? Not after two years of age or so.”

“Is there anything we can do?” Knowing he had been harboring a worm in his eye was bad, but it was nothing compared to the fear of going blind. Mark panicked, thinking of how many changes this would cause in his life, one of them being the end of his career as a photographer. “Is my other eye at risk?”

“It’s hard to say, but I doubt it. I’ve never seen anything like this, but if I had to hazard a guess, maybe the Loa loa did some damage in your left eye that I can’t detect. Short of having your regular doctor order an MRI, I don’t know how to proceed further here.”

“I’ll call Dr. Alex and ask for an MRI. I
need
my eyes.” Mark was frustrated by the ophthalmologist’s perplexed attitude.

“Okay, tell him I would appreciate it if he would send the copy of the report to my office right away.”

Mark walked out the door, the bright afternoon sunlight stinging his freshly dilated right eye, forcing him to put on his sunglasses. As he slipped into the driver’s seat, his glasses slid down his nose and he caught sight of his eyes in the rearview mirror. Despite the blurriness in his good eye, he could see instantly there had been a change. No longer just ringed in darkness, his left eye was now completely brown.

***

Mark was in the toiletry aisle of the grocery store the first time the voice spoke to him. It was so clear and close that he stopped immediately and looked around. He was alone.

Minutes later, at the meat counter, it spoke again.

“Nipe msaada!”
I need help!

Looking around again, Mark caught the eye of a man waiting at the other end of the meat case.

“Excuse me.” Mark smiled at the portly man, who returned the smile hesitantly. “Did you just hear someone speaking Swahili?”

The other man shook his head, then looked at his watch and mumbled something about being late before hurrying away.

The voice spoke to him for the third time as he sat at his kitchen table, eating a meal of beef stew and French bread.

After a thorough search of his apartment, including closets and under the bed, Mark came to the unsettling conclusion that the voice was coming from his own head.

Mark sat on his couch with the television on, but couldn’t pay attention to the show. That foreign voice in his head kept jabbering, sometimes laughing and other times sounding angry and harsh. His pulse raced as he fought to quell his rising panic.

What the fuck is going on with me?

Unbidden memories of his mother raced through his head. His mother worrying over a random fever, wringing her hands so hard her knuckles cracked. Her harassing phone calls whenever he went to a friend’s house, certain the other parents could never take care of him as she could. Then the time he found her in the shower, curled into a fetal position and shrieking. The paramedics took her away in restraints as she wailed for her son. She ended up killing herself with one bullet to the roof of her mouth after leaving a hastily scrawled note of apology to her only child.

“No.” Mark said to the empty room, then again with more force. “No!”

He was not going crazy. He had worked too hard to get where he was in life to let it be ruined by some inherited insanity. He would ignore it. He would
will
the voice away. He could do this.

Mark went into the kitchen and pulled out a rocks glass, filling it with ice. A bottle of bourbon sat on the counter, untouched since he’d started taking medicine for the Loa loa worm. He poured the amber fluid into the glass, his nervousness causing him to spill a bit on the counter. Not bothering to wipe it up, he started back to the living room, then returned for the rest of the bottle.