“Something felt weird about that day from the moment I woke up. I was not sure what it was till it hit me that I don’t have pills to take today. I couldn’t believe it has been four years since a day passed without anti tuberculosis tablets. I left home feeling I forgot something really important. I tried to go through the past four years in my mind while the taxi was driving me to work. I felt that I really had to thank each and every one that helped me get through those dreadful four years and started texting. I never thought the replies would make me so emotional. I burst into tears. Those were tears of joy, gratefulness and feeling alive. The “happy for you” replies kept on coming and made my tears fade away into a smile. I thought of my patients who has gone through times much worse than mine and thought if this was almighty’s plan to make me a better physician. I was so thankful in many ways. Of all, I was thankful that I was given a chance to say ‘TB tried to stop me but hasn’t slowed me down a bit’.”
When I was first diagnosed with Tuberculosis, I was a medical Intern at Jimma University Specialized Hospital, Ethiopia. As a medical intern our main concerns were getting our job done, care for our patients and acquiring all the skills from our teachers to become a good physician. We literally were selfless. Skipped meals, sleepless duty nights, thirty-six hours of work with no rest… were no stranger to us.
Self-protecting materials like gloves and masks were a luxury. I believe this experience is similar in most of the third world countries’ medical schools. Needle pricks, blood splash, getting soaked in amniotic fluid… were our daily stories. I was one of these selfless ones. I can’t remember the time I put a mask on to examine a coughing patient & nobody hasn’t warned me about that too.
I was diagnosed with chest x-ray halfway through internship year. I started treatment as soon as I was diagnosed. For all I knew, tuberculosis was easy to treat once diagnosed. Little did I know getting treated was not as easy as it seemed. I was not sure if I was unlucky or something, but things were not getting any better despite treatment.
I had repeated visits to internists and pulmonologists, tried different additional antibiotics and even steroids, but was still coughing. Climbing stairs was a struggle. Waking up without sweat soaked pyjamas and bed sheets became unthinkable. Being hundreds of kilometers away from home made thing much worse.
Despite my “Not so improving” tuberculosis, I managed to do my thesis and complete the internship and graduated in the top three from my class. I went out of campus with a doctorate in medicine and TB in my lung. I still don’t know where I got the strength to do that. I was not 100 % a loser. I was the luckiest unlucky intern on campus. I had amazing mates who were selfless and supported my struggle in every way with no discrimination.
I was the luckiest unlucky intern on campus
I came back home. Home is Addis Ababa, the capital city. I started working as a general practitioner and at the same time continued looking for cure for my lungs. I took re-treatment for nine months with two months of injections. Things seemed a little better just to get worse again at the end of the treatment.
I didn’t stop visiting the famous senior physicians and pulmonologists in the country in the meantime. One of them even told me that the illness has eaten me up so bad, it is impossible for me to recover. I panicked. I felt helpless. Drug-resistant tuberculosis was what I had. But it needed a confirmation. When I went to collect my sputum culture and sensitivity result, but after three months of longing for them, the response I got was “what samples??”.
One of the doctors even told me that the illness has eaten me up so bad, it was impossible for me to recover
I went to St Peters hospital here in Addis with little hope left in me. There MDR-TB was diagnosed and started my treatment at home. I took injections with average of twenty tablets daily for nine months. And tablets only for a total of two years.
After two weeks treatment, I woke up in bed with dry bed sheets. The drugs were miraculously helping me recover, but coping up with the side effects was no piece of cake. It was tough with lots of ups and downs. Lucky me, the worst side-effects didn’t happen. My improvement was significant and I had to suck it up and continue fighting.
Passing through TB, I’ve grown to be a better physician
And I won. I was declared cured on October 2013. It was quite a rollercoaster ride. Even after treatment, TB has left its scars in my lungs. Going through TB was tough but so was I.
They say “challenges are not sent to destroy you. They are sent to promote, increase and strengthen you.” And I say “challenges are sent to completely change you for the best.”
My challenge was Tuberculosis. Passing through it, I’ve grown to be a better physician though I still feel the pain whenever I see a patient with TB. I don’t want to see anyone going through the rough patches I went through. I wish our future generations live in TB free world. It just should stop. We need to end TB today.
There were lots of things that helped me get through those times and there are plenty that I feel could’ve been better. I had great friends and family who supported me in every way. But I guess that’s not the case for every TB patient. I remember I was desperate and wanted to talk to someone who is going through similar hardships. There was none. There were times I felt lonely while I was not alone. I wish there were TB treatment support groups. I wish diagnosis was much easier and treatment was much shorter with much less pills.
I know we have better drugs now which are, unfortunately, are not fully accessible to the most deserving ones. If these things were there, I believe my struggle would’ve been much easier. I see struggling TB patients every day and I think of many ways to help them. But clearly TB is not a one-man struggle. We all should play our part and get rid of it for good. It just has to stop.
Dr Wubshet Jote Tolossa (Internist).
Currently a nephrology fellow at St Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Member of TB Proof and Volunteer Health Services.
20th month of treatment (final) TB&Me: Abatgul’s diary part 4 - The consequences of self-treatment