MarySmith’sPlace ~ AfghanistanAdventures#59 Ghastly things and lovely things

Jaghoray, Afghanistan, December 1989

Mazar Bibi Clinic under construction 1989

Mazar Bibi Clinic as it is today

Hussain had taken Rahimy, Sharif and Zahir, to see something more of the area and I was writing up my tour diary when Habib, one of the translators who had defected from Qolijou, arrived at Mazar Bibi with a jeep full of patients. I explained Hussain would not be back until late afternoon. He asked if I would examine the patients. I pointed out he had more medical training than I but he begged me to at least look at the most seriously sick of the patients, a seven year old boy. 

The child was carried into my room, deathly white, gasping for breath, barely conscious. Handing me a stethoscope Habib explained, ‘First he complained of a sore throat then he started coughing and now he has breathing problems. His father brought him to us this morning but we are not sure what to do for him and hoped Hussain could help.’ The child was seriously ill. When I looked in his mouth, I could see a kind of grey membrane covering in this throat. Diphtheria?

I turned to Habib, ‘You must take him to Rosanna at Qolijou.’ 

He looked at me, miserably, ‘Can you not give him medicine?  I can’t go to Qolijou because Moosa and the others will laugh at us and say we are useless doctors who cannot manage on our own.’   

I was incredulous that his izzat, his pride, would prevent him from doing all he could for the sick child. I knew Moosa and his colleagues might not know what to do either – Rosanna was the one I was counting on. ‘He’s desperately ill. We have to get him to Rosanna.’ Habib suggested I take his jeep and go myself with the boy. We piled into the jeep; the driver, a woman, another man, two more children and the boy’s father, who had wrapped his son in a blanket and was cradling him, as gently as he could, in his arms.  

Before we were halfway to the hospital, the father tugged at my sleeve. He gestured helplessly, wordlessly, towards his son, and I yelled at the driver to stop. The boy had stopped breathing. I wanted to try artificial respiration but as I knelt down beside the boy, his father shook his head. His son had gone; there was nothing more to be done.

Someone spread a patou on the stony ground and laid the child on it. His father gently closed his eyes, weighting them with two small stones, and tied his big toes together. Feeling totally helpless, and angry at the unfairness of it all, I broke down and wept, walking hurriedly away from the little, dry-eyed group gathered now in prayer around the child. I returned to the jeep wanting to continue to Qolijou – desperate for some reassurance from Rosanna that there was nothing I could have done – but the father wanted only to go home to bury his child. We returned silently to Mazar Bibi. 

When I saw Habib, and tried to tell him what happened, I felt the tears overflow and run down my face. I hurried off to hide in my room. A few minutes later Habib entered saying, ‘It is not your fault. No one could have saved him. Now, will you please come and check the other patients, so that these people can go home?’

I checked the two children, who both had high respiratory rates and prescribed antibiotic syrups begging Habib to get them to Qolijou as soon as possible so Rosanna could examine them.

The woman came in and lay down. Grabbing my hand she guided it to where I could feel a large swelling, about the size of my fist, in her abdomen. She told me that, of the six children she’d had, only one, born four months earlier, was alive. Again, I could only urge her to consult Rosanna. Along with my feelings of helplessness, was an overwhelming anger that so many people should suffer so needlessly. The war against the Soviets followed by a civil war had never seemed so utterly pointless.

Fortunately, there were happier times to enjoy back in Jaghoray. Jawad’s brother got married and Jon and I were invited along with Hussain and Rosanna.

The bridegroom (Jawad’s brother)

Rosanna between me and Jon at the wedding. We were all given beautiful embroidered handkerchiefs as remembrances

A young Jawad

One day, Baqul’s wife, Fatima, from Sangsuragh where our temporary clinic had been, came along with other friends to visit me. It was lovely to see them again. I took them to my room, where they insisted on coffee, in preference to tea, before settling to tell me all that had been happening in the village since I left. 

Latifa was now engaged to be married, her mother had recovered from the injuries received when her house had been hit by rockets, Hazrat had been released, unharmed, after Hisb-i-Islami kidnapped him and several women had had babies. It was a lovely afternoon and I was touched they felt the bond of friendship strongly enough to face a three hour walk – each way – to see me. They complimented me on the progress I’d made in learning Dari and our conversation flowed more smoothly than when we first met. 

Of course they all wanted to consult the doctor while they were at the clinic, but only if I stayed with them and personally supervised any examinations Hussain wanted to do. We trooped over to the consulting room where I was astounded by the change that came over them. In the privacy of my room they had been totally free and at ease, allowing their chaddars to slip off, breast feeding babies without bothering to do up their buttons afterwards. In front of Hussain, they once more shrouded themselves completely, and from conversing and laughing together at an ear splitting decibel level their voices were reduced to a barely audible whisper. Gul Bibi even refused to open her mouth to allow Hussain to examine her teeth yet, whenever he turned away, she would catch my eye, directing seductive looks at Hussain’s turned away back, eyes rolling, lips pouting. At the explosions of mirth from the other women, Hussain would whirl around, by which time Gul Bibi would have once more disappeared into the all-encompassing folds of her chaddar. The more irritated Hussain became, the more the women enjoyed their fun, but I was thankful when at last, consultations over, I could escape before Hussain’s anger erupted.

After my last post a couple of Hazaras left comments, including a YouTube link to a video of Sangi Masha bazaar and the bridge which some years ago replaced the scary one. I was fascinated by how different the bazaar looks and completely amazed at the new bridge so much so I sent the link to Jawad to confirm it was the same place. He replied to let me know the person who made the video, Mehdi Ahmadi, ‘is a cousin of my children’. Worth watching – it’s under twenty minutes, the bridge is about ten minutes in. ‘Meeting’ young Hazaras who are finding and enjoying my Afghanistan Adventures and sharing their own memories in the comments brings me so much joy and makes me feel I am still very much connected to Afghanistan and its people.

Mazar Bibi Clinic in winter – such a glorious blue sky

MarySmith’sPlace~Cancer diary#08 Scan results

Monday, October 26: I had a week of feeling really well (yay) alongside a week of worrying about the scan result and meeting with the oncologist today (not so yay).

I won’t keep you in suspense – like the oncologist did me by first asking lots of questions about how I’d been after the cycles of chemo and carrying out an examination before finally telling me. The scan results show the tumour is stable. While it has not shrunk it hasn’t grown any – not one of the many scenarios running through my head last night as I tried to get to sleep. Nothing has spread to any of my other organs.

The oncologist seems quite upbeat about this result although I can’t help feeling disappointed. I’d so hoped the tumour would have started to shrink, even if just a tiny bit. She’s recommending I go ahead with the next two rounds of chemo followed by another scan. If things are as she hopes then four weeks of radiotherapy would follow.

The radiotherapy doesn’t sound fun. I know they have to spell out all the possible side effects and no everyone gets them all or not as severely but – apart from tiredness (she says even more than after chemo) I’ll have a sore throat and may need morphine for the pain – or, worst case scenario, a feeding tube – and the scarring on the lung may leave me breathless on exertion.

This, if all goes well, could give me an extra couple of years (she did say “or longer”, but I’m afraid to be too optimistic) of relatively normal healthy life. Presumably until it all kicks off again as it must if they can’t eliminate the tumour entirely.

I’ve said I’ll keep going. The alternative is a few months and I would like a bit longer – there’s a book to finish writing, Cairn Holy to visit with Sue, and the Callanish Stones, a trip back to Islay where I was born, maybe even a holiday somewhere sunny. Seeing family would be rather nice – this self-isolation business is the pits. Of course, being able to do most of these is dependent on bloody, bloody Covid.

When I went into the first meeting with the oncologist I knew I had a seriously life-shortening illness and suspected I had months rather than years before me. I’d sort of come to terms with that. I was expecting to hear more about palliative care rather than treatment options. Dying doesn’t frighten me (though I’d prefer it to be painless). The oncologist gave me hope I could have more than a few months and I left the meeting feeling optimistic. This time it’s harder to be as optimistic – all because the tumour hasn’t actually got any smaller.

The next cycle is on Friday – if the blood results are all right. I think this constant wondering and worrying, having tests and waiting for results is one of the biggest downers.

Still, looking on the bright side, the oncologist did not say (my main worry) there is no point on carrying on. I can feel a degree of satisfaction the chemo has at least stopped the tumour in its tracks. Two more cycles might finally make it start to shrink.

There, now, I’ve talked myself round from feeling pretty down when I started writing this to edging towards feeling a bit more positive.

MarySmith’sPlace ~ AfghanistanAdventures#58 ~ Skulduggery and spies

Jaghoray, December 1989

Nothing to do with Jaghoray – this is Jawad, one time driver, now programme co-ordinator, taken between Lal and Waras on a recent tour

Hussain had sent messages from Jaghoray, warning us against going there, because the translators at Qolijou were making kidnap threats. Mubarak said two of the translators, accompanied by several mujahideen had been to Malestan asking about our expected arrival date and future travel plans. There were rumours the hospital had been handed over to Nasre, who wanted increased funding for the hospital and our Toyota. We spent the morning in endless discussions and pointless conjecture.

Mujahidden

Finally, I suggested I go alone to see Hussain, who had a tendency to dramatise any situation, and meet the translators, and Rosanna, in Qolijou. If Rosanna believed the situation to be dangerous she and I would come to Malestan together and leave from there for Pakistan. If it was nothing more than the usual over-reaction I’d send word Jon should come to Jaghoray. Rahimy insisted he come with me. Zahir and Sharif promptly volunteered to accompany us. Mubarak arranged the hire of his brother’s jeep.

As Jon and Mubarak waved us off next morning, I felt like a spy being sent behind enemy lines on an intelligence gathering mission. A glance at my three companions – one fourteen year old youth who looked about twelve, one extremely nervous ex-mujahid, and one very deformed leprosy patient, who at least succeeded in assuming a suitably sinister appearance with his turban tail drawn tightly across his face – and I decided we more resembled actors in a farcical spoof. We hadn’t even a Kalashnikov or pistol, between us.

It was still warm in Jaghoray, the sun shining in a brilliant blue sky with barely a hint of winter’s approach. As we were ushered into the staff room in the Mazar Bibi clinic, only Hussain, with much rolling of the eyes and warning finger to his lips, indicated that anything was amiss. The others welcome me back with warming enthusiasm. Soon, though, Hussain signalled from the doorway I should follow him. He explained the translators knew we were withdrawing financial support and were planning to steal the vehicle and kidnap Jon until we agreed to fund their hospital. He was horrified when I said was going next day to Qolijou to meet Rosanna. 

Jaghoray’s jagged mountain peaks

The bush telegraph worked fast. Before the end of the day I received visits from the renegade translators who had recently opened their clinic in Angoori. They insisted Jon, Rosanna and I were in the greatest danger. Khudadad, my erstwhile travelling companion, still with the Qolijou team, arrived to assure me I was his sister, Jon his brother, and, of course, we were in no danger.

The bridge which terrified me

Next day, an unwilling Hussain took me to Qolijou where Rosanna was bursting to tell me all the news. When the defectors left to open their new clinic, there had been resentment on the part of Moosa and the others, but no open hostility until Dr Pfau’s visit. At a meeting with the remaining translators, she’d been asked about future financial assistance and said we couldn’t finance the hospital. She also told Zaman that the others, in Angoori, liked him and he was welcome to join them there, told Khadeem that he hadn’t enough knowledge for medical work, was too stupid to learn and should go home. To round things off she informed Moosa that he was a thoroughly bad and dishonest person, who did not deserve any help at all. Then she blithely left for Pakistan, leaving Rosanna trying to smooth ruffled feathers. The disgruntled translators had run to the Nasre political party saying we were closing the hospital.

Hussain – taken earlier in the year

Moosa assured me there was no kidnap plan but they did want to talk about the future of the hospital – a reasonable enough request, I felt, so I sent a message with the clinic driver to tell Jon to come to Jaghoray. I didn’t know Hussain had sent a contradictory message. Bewildered by the conflicting advice, Jon decided on a long detour, which would bring him to Mazar Bibi, without having to enter Sangi Masha bazaar.

Usually a two day journey, because of snow on the passes, and having to wait for someone to bring chains for the vehicle, it took four days. During one of his overnight stops, my camera and ten rolls of exposed film were stolen from the Toyota – something over which I still grieve and about which I remind Jon whenever he shows any inclination to play cloak and dagger games or doubt my judgement of a situation.

Out for a walk

While waiting for Jon’s arrival I attempted to calm Hussain’s mounting panic. He’d convinced himself that, if the translators found themselves without financial support, they would with Nasre’s help steal his clinic’s medicines and money. The building work was finished. The new clinic was very well run, and kept immaculately clean by Ismail, who was also responsible for the beautifully kept stock in the storeroom. Around twenty five patients attended clinic each day, and Hussain now had eighty leprosy patients on his case load. If the Qolijou problem could be solved, I would feel reasonably content with the work achieved in Jaghoray.

A meeting was called, attended by Commander Irfani of Nasre, Hajji Bostan, one of the party’s leading lights, the Qolijou staff with Jon, Rosanna and me. Moosa provided us with an excellent dinner during which nothing controversial was discussed and, only when the tea arrived, did the real talking began. Jon explained our initial support had been given, on a temporary footing when the French organisation left, on the understanding the translators looked for another organisation which could provide long term assistance. Leprosy work, which the staff at Qolijou did not wish to do, must remain our priority, and we already faced problems in finding sufficient funds for our work.

In reply, Hajji Bostan, ignoring all Jon had said, gave a long rambling speech recounting the history of Qolijou – which everyone already knew – and spent a full twenty minutes on giving flowery thanks for all that we had done. I squirmed at the hypocrisy of the man who, because we insisted on remaining independent, refusing to be under his Party’s control detested our organisation. He asked Jon to give a reply. He, in turn, added the necessary bit of soft soap by referring to the warm relationship which existed between us and the workers of Qolijou, how much they had done to meet the health needs of the people, how he hoped their fine work would continue – with the aid of an organisation better able to support them than we were.

I thought, soft soap and flannel having been lavished on both sides, we could move on to the business of discussing how they were to find such an organisation. Hajji Bostan took the floor and began to repeat all he had already said. As all the speeches were being translated I feared the proceedings would take all night. Noticing that Commander Irfani, who hadn’t said a word, was actually nodding off to sleep, I asked if I might say something.  

Commander Irfani opened his eyes. I said that, although we were aware of the struggles the translators had faced in the past and that our inability to continue funding presented yet another obstacle, this meeting was to discuss the future, not the past. I suggested we use the time to start making proposals to present to aid organisations, and talk about the ways in which we might be able to help the translators secure future funding. As Moosa translated, Commander Irfani straightened up, looking relieved that the tedious speechifying had at last ended.

Hussain and I enjoying dinner

I volunteered to help write up project proposals if the translators would give me the information required on the kind of work they were planning. After further discussions, made lengthier than necessary by Hajji Bostan’s continued interference, the translators agreed they would start a trial tuberculosis control programme. When I was back in Pakistan I would write up the proposal, one of the translators would bring completed budget figures and would be steered in the direction of as many likely organisations as possible. Commander Irfani seemed to accept the points Jon made about our inability to continue to finance the hospital and appeared satisfied with the outcome of the meeting. Only Hajji Bostan was far from pleased – he relished making trouble.

MarySmith’sPlace – #WordlessWednesday – White Cairn Burial Chamber, Glentrool, Dumfries & Galloway

Can anyone identify this one?

MarySmith’sPlace – Cancer diary #07

Cancer diary #07

Monday, October 19: The beginning of this week was horrible; horrible enough for me to absolutely dread the next round of chemotherapy. Apart from the heartburn (and thank you everyone for your suggestions – it has gone – for now) I had a cough, my stomach hurt, my scalp hurt, my mouth was sore (the poor cat has been quite distraught because she enjoys sharing my usual bedtime snack of baked cheese and onion crisps and I couldn’t bear to eat them), and I had diarrhoea (a change, though not a particularly welcome one, from constipation). On top of those side effects was the dreadful tiredness which dragged me down into a trough of despondency and apathy. And temper. Oh, good grief was I bad tempered!

I couldn’t see any point in going through this, for what might only be an extra year – not least because with all that is going on with Covid-19 cases rising and lockdowns all over the place the prospect of my current self-isolation continuing for what be the rest of my life didn’t bear thinking about.

And, with the worry of my kidneys not functioning as they should I was glugging down my two and a half litres of fluid every day so my tummy felt bloated and I was constantly nipping to the loo – including several times during the night.

In the beginning, I talked with doctors about wanting to have quality of life for whatever amount of time I had left – this wasn’t what I mean by quality.

Also, I had a painful foot. Come on, guys, lung cancer is quite enough, without throwing other minor problems at me. And did I mention I was bad-tempered?

I kept looking back to the days following the first chemo and thinking, well I was fine by Tuesday so maybe tomorrow I’ll be all right again. Tomorrow arrived and I wasn’t all right. Aware countless people have gone through chemotherapy with much worse side effects made me feel I was being a complete wimp.

On Friday evening, a full week after chemo, it was as though someone had flipped a switch and I was back to being me. Just like that. Extraordinary! Life was sweet again. On Saturday my brain was functioning enough for me to do my Afghanistan blog and reply to some of the many outstanding emails. The DH and I had a grand day out on Sunday, visiting the White Cairn burial chamber followed by hot chocolate at the Glentrool Visitor Centre – just an ordinary, normal outing, which a few days earlier I couldn’t have imagined being able to do again.

White Cairn burial chamber, Glentrool, Dumfries & Galloway

Something which really gave me a huge psychological boost and kept me going was a private message from someone who had read my cancer diary. She’d been prompted to have a lump in her breast – which she’d been ignoring, hoping it would disappear – checked out. She does have cancer but will have surgery soon, followed by radiotherapy and probably won’t need chemo. I’ve worried about my cancer diary being a bit self-indulgent but this has made me feel it really is worth doing.

Another nice thing was a phone call from the cancer specialist nurse to say my bloods show my kidney function is improving – yay! Huge relief – though it does mean having to continue getting those litres of fluid into me. But, now I know it’s working, it’s a small price to pay.

And, Kim Ayres sent through the photos he took last week. One I deleted immediately as it showed up all the wrinkles – and my goodness, there are many – on my face and neck. The DH and I can’t decide which we like best – the one to frame and put on the mantelpiece – the one which says, “This is us”. 

Which do you think?

Finally, this week of huge downs and sweeping ups ended with having CT scans today to see if the tumour is shrinking – or spread anywhere else. I won’t know until next Monday when I have an appointment with the oncologist. If the tumour is shrinking – and my kidneys are up to it (the particular drugs I’m on apparently can cause kidney damage, something which is in the six pages of side effects but hadn’t sunk in) – I’ll continue with the chemo. If it’s still growing, then we need to have a whole different discussion. It’s going to be a long week, but at least I’m feeling well and able to do things to take my mind off worrying about it. I might even get some writing done!  

MarySmith’sPlace – Falling off a mountain – snow, ice & wolves AfghanistanAdventures#57

Afghanistan, December 1989

As we prepared to leave Arif’s clinic he became unusually quiet until, as he was saying goodbye, I realised how upset he was by his young brother, Sharif’s departure. He was coming with us to Pakistan where Arif had arranged for him to attend school in Karachi. I promised to take care of him, and with tears in his eyes he finally released Sharif from a tight embrace. If Sharif felt similar emotion, he concealed it well, appearing self-possessed about the prospect of not seeing his family for several years.

Leprosy patient, Zahir on the left, Arif’s young brother Sharif preparing to travel to Pakistan

We stopped for lunch at the edge of Naoor where I noticed Sharif patiently helping to tear up Zahir’s nan before requesting a spoon for him, without which it was impossible for him to eat. His right wrist, which had previously flopped about, had now been firmly splinted.  We feared a bone was broken (in fact X rays in Karachi showed the bone had not broken, but had crumbled away, attacked by pus bacteria which had presumably started life in an old, infected wound.) Despite his sorry state, Zahir still retained his high good humour, dissolving into his terrifying asthmatic giggle at the slightest thing. He was also becoming less self-conscious about his appearance, no longer keeping his face hidden behind his turban tail.

As there was only another three hours travelling in front of us to Malestan we decided there was no need to re-fill the thermoses at the chaikhana – more fool us. As the road began to climb steeply, becoming increasingly twisty and treacherous, we found ourselves, once again, in a snowy landscape. There was nothing to be seen, except a few rocks, appearing bald-headed, where wind had swept off their snowy caps.

Piles of snow drifted along the edges of the road, often obscuring dangerous ice patches. The single set of tyre tracks preceding us indicating how rarely this lonely stretch of road was used. We cheered ourselves by thinking of the welcoming tea we would soon be sipping in Malestan.

Near the top of the pass Jon had difficulty negotiating a tight corner. Reversing, to make another attempt, one back wheel slipped off the edge of the road. Further attempts resulted in all the wheels going off. Tyres spinning in the snow, the vehicle slid a few yards down the mountain. For the next two hours we struggled to get the vehicle back on the road.  

We unloaded everything and tried pushing, to no avail. We attempted to build a “road” with suitably flat stones, laying them in front of the Toyota like offerings to propitiate some angry god – which is how it felt by then. Nothing worked. By the time the sun began to sink, resulting in a dramatic drop in temperature, we had to admit we were well and truly stuck and we knew no other vehicles would come this way before morning. Jon decided to walk back to the bazaar, hoping to find someone with a truck and a tow cable. Realising we may have to spend the night on the mountain, Rahimy, Sharif, Zahir and I made ourselves comfortable in the Toyota.

We had plenty to eat – dried fruit, toffees and busrock (a deep fried biscuit) but no hot water for tea or coffee. Very soon the inside of the windscreen iced over, and we were all becoming shivery. I switched on the engine, turning the heater up full. This alarmed Zahir, huddled in a blanket beside Sharif in the back seat. ‘Turn it off! The jeep will run down the mountain.’ I tried to assure him this was extremely unlikely but he was not convinced, afraid I would fall asleep in the warmth, nudge the gear lever and send us crashing to our doom. I switched off the engine, suggesting Zahir try to sleep but he refused. Sharif sat quietly, as always, seemingly unruffled by events, calmly chewing toffees.  

When we could no longer see out of the windscreen because of the layer of ice, I’d turn on the heater, just long enough to melt the ice, and stop us all from freezing to death before the rescue party turned up. Rahimy became quite chatty, using the opportunity to practise his English. I asked if he would miss his family very much and he began to talk about his two wives and children.

I was interested in the way Rahimy spoke with evident fondness for both two wives. His first marriage had been arranged when he was young, and seemed to have been happy enough.  Then Rahimy had met and fallen in love with the woman who became his second wife. He was worried about how his second wife would manage without him. Her family had disowned her when she married Rahimy, and she lived far away from his first wife and the rest of Rahimy’s family. Before I had a chance to ask how and where he’d met his second wife, Zahir made us all jump by suddenly crying out, ‘Gurk! – Wolf!’

I peered excitedly out of the window at the expanse of snow gleaming in the moonlight, ‘Where?’ I demanded. Zahir explained he hadn’t actually spotted one but they were everywhere around here. He was now worrying Jon would be eaten before he reached the bazaar. I reassured him that, as winter had only just begun the wolves should not yet be hungry enough to tackle Jon. 

Jon, the previous winter.

After about four hours, when I was thinking we really ought to try to sleep, we caught the sound of an approaching truck. We listened intently to the faint but unmistakable sound which, though still a long way off, surely signified help was on the way. Zahir, however, now started to worry about robbers and we looked helplessly at our piles of baggage heaped at the edge of the road. At last, an ancient truck rumbled into view, stopping a few yards in front of us. Jon leapt out of the cab. 

The first tow rope snapped as soon as the truck took the weight of the Toyota but, finally, after a great deal of shouting and yelling between all parties, the vehicle inched slowly forward, until it was standing safely back on the road.  

Jon paid our rescuers and I urged Zahir to stay in the jeep while we re-loaded our baggage.  He was turning blue in the bitterly cold night air, coughing and wheezing in a terrifying way, as he struggled to help lift heavy bags with one hand. At last, we set off, everyone sitting in silence until Jon negotiated the last of the corkscrew bends and then, feeling the worst was over, we relaxed a little. Rahimy, Sharif and Zahir soon fell asleep, so they missed the next pass which was even more hair-raising. The summit was 3,600 metres and the bright moonlight illuminated the frozen snow, the hairpin bends and the sheer drops in a way which was both awesomely beautiful and terrifying. 

Although exhausted, I was reluctant to sleep in case Jon, who must have been even more tired, did the same. It was a great relief to reach the valley and know that we were almost “home” in Malestan. At the clinic, Khala and Baba, unperturbed by our arrival at three o’clock in the morning, hastened to provide tea. Then we collapsed into bed. 

Baba and Khala outside the Malestan clinic.

MarySmith’sPlace – Cancer diary #06

Cancer Diary #06

Monday, October 12: I’m a day late with this week’s cancer update but I was too tired yesterday to type it up.

Second treatment was on Friday morning. I’d had blood taken for checking on Wednesday; on Thursday’s pre-chemo assessment call they said the bloods were fine. I was asked about side effects and how I was and able to say I was fine and had, in fact felt really well over the last couple of weeks. Even so, I was slightly nervous as I pulled on my kick ass boots because of hearing how the side effects can become worse with each successive treatment cycle.

I didn’t need another ECG so there wasn’t so much hanging around as last time, apart from what seems the usual wait for the pharmacy to send the drugs down. One of the nurses informed me they were slightly worried about my kidneys – not enough to prevent treatment going ahead, but to make them want another blood test in a week. And I should drink more – lots more – water to prevent dehydration. Of course, I immediately though of my friend’s husband who experienced kidney damage during his cancer treatment and had to stop the treatment all together. I know each of us is different, and the nurse was reassuring, but …

I drank so much water (and soup and orange juice) I had to be unplugged and make my way, guiding my drip stand, to the loo, desperate to pee. That was all a bit of a palaver, being only able to use one hand. Memo to self: don’t wear tights next time. Came home, cooked dinner, went to bed quite early and slept well.    

On Saturday, I wrote and put up my Afghanistan blog post. In the afternoon, the DH and I went to Carrick Shore to meet up with photographer friend, Kim Ayres for a photo shoot! Kim very kindly offered to take a photo of me and the DH (before cancer and treatment changed my appearance) because as he rightly suspected, we don’t possess a photo of the two of us together. It was cold at the shore but the sun came out from time to time and it is one of the most beautiful places in Dumfries & Galloway holding many, many happy memories for us both. We thoroughly enjoyed the afternoon – great to visit Carrick after so long and wonderful to meet up – socially distanced – and chat with a friend.

It made me realise how circumscribed my life has become because of Covid restrictions and the cancer treatment. Apart from walks in the countryside with the DH, I’m more or less confined to home in case I pick up an infection, which would postpone my treatment – and it could be any kind of infection, not necessarily Covid. My white blood cell has halved since the first treatment so there’s not much there to fight off bugs.

On Sunday, I described myself to someone who asked as feeling ‘low grade yucky’. I’d wakened several times in the night because if I drink two plus litres of water throughout the day, I need to pee – and I had heartburn. The last time I had heartburn like this was when I was six months pregnant and had the only glass of wine – white – during my pregnancy and had to spend the night sitting up against my pillows. That was almost thirty years ago. I’ve been lucky to have a very efficient digestive system and I’m not happy at the thought of having heartburn or indigestion as a side effect of treatment.

I wanted to go for a walk – the sun was shining and who knows how many more days of sunshine are left as we rush towards winter – but by Sunday afternoon I understood the expression ‘bone tired’.

Today is the same. By this time after my first treatment, I was feeling OK, so I have to admit I’m already dreading the next treatment cycle, and the one after. This sucks. But, hey, at least I didn’t have constipation this time – there’s always a positive. And, feeling rough will be worth it if the drugs are shrinking the tumour – and I can regain some quality in my life. Hoping to be more upbeat next time!

MarySmith’sPlace – AfghanAdventures#56 – caught in a bombing raid

To de-stress after completing Arif’s accounts we went shopping in Tezak bazaar, where I’d spent the first night on the road, when travelling north with Khudadad almost six months ago.

The teahouse gossip concerned a recent bombing raid on the bazaar. The Kabul Government suspected mujahideen base camps were close to Tezak. I was puzzled there was so little evidence of bombing raids and was told since the mujahideen had acquired anti-aircraft guns, bombers could no longer fly in so low. The pilots were forced to drop the bombs from a much higher height, sacrificing accuracy for safety.

I wondered how I’d feel if I were ever caught in a bombing raid. Apart from here in Tezak, where the men assured us there would be no bombing for some weeks yet (how could they be sure?), our travels never took us near places of any significance in the war. However, on my second time in Afghanistan the following spring, I found out.

We weren’t supposed to be in Sia Huq the day it was bombed. A broken leaf spring, which refused to be held together any longer with bits of wire and string, forced us to make the detour. Sia Haq, once a tiny village barely two hours from Kabul, had become a major transport depot held by the mujahideen. 

The repair job meant an overnight stay, yet another unscheduled delay on our journey from the leprosy clinic in Lal sar Jangal to Jaghoray, en route for Pakistan. We decided to kill time shopping for our evening meal. After weeks in Lal, which has no vegetables, except turnip, nor fruit the sight of mangoes had Jon, Mubarak and I, who’d lived in Pakistan and knew the delights of mangoes, whooping with glee. Juma and Abdul Hamid, neither of whom had ever been out of Lal, were unimpressed. 

Our enterprising landlord, whose rooms were full of truck drivers, had erected a tent on his flat roof for our use and there we dined on spring onions, tomatoes, yoghurt and fresh, hot nan washed down with tea. 

Mubarak and I in our rooftop tent

In the morning, Juma and Abdul Hamid were doing some last-minute shopping, Jon had gone to collect the repaired Toyota and Mubarak and I were chatting idly in our roof-top eyrie. We are talking, strangely enough, about how many airports there had been in Afghanistan before the war, when we heard the first hum of a plane, high overhead.  Not used to such sounds I commented, rather obviously, ‘That’s a plane.’

‘Yes,’ replied Mubarak, ‘It’s a jet.’  We sat looking at each other for a few seconds and then heard a whump and a bang.

‘Was that a bomb?’ I asked.

‘Yes.’

Looking towards the transport depot

And what did we do?  Did we get off that exposed rooftop, run for shelter? No, we moved to the edge of the roof for a better view, seeing people running here and there, yelling, and screaming. A great cloud of dust spiralled skywards, indicating where the bomb had landed. ‘No damage done,’ murmured Mubarak, ‘it only hit the mountain. Still, maybe we should move, in case there’s more.’

Where the first bomb dropped

We were gathering together bits and pieces, with what I thought of as admirable calm, when Jon’s head appeared on a level with the rooftop. ‘What the fuck are you two doing here? Get down! Now! There’s a shelter behind the hotel. Get going.’ So, we “got going”. The planes came back time and time again, always flying too high to be reached by the anti-aircraft guns, which soon fell silent. Of course, the higher the plane, the less chance there was of the bomb scoring a direct hit on the transport depot full of trucks and fuel supplies: which meant – not a reassuring thought – the bombs could land anywhere.

The shelter, cut into the side of the mountain was full to overflowing.  Although the men offered me a place I decided to take my chances out in the open, hugging myself close to the rock. Mubarak on one side of me was murmuring over and over, ‘What a country, what a country’, while Jon on the other, was still nagging me for not running for shelter at the first sound of the jet. 

Emerging from the bomb shelter as the sound of the planes died away

Heading back into the shelter as the jets returned

During a lull, we decided to head further up the bazaar towards the depot, with the intention of moving the Toyota to a safer place. The brain must have some kind of pre-programming, because although I’d never been bombed before, as another plane flew over, I was suddenly face down on the ground, practically kissing the dirt. You do it by instinct. Like in war films!  I felt strangely embarrassed when I rose to my feet along with everyone else in the street. Fear is so undignified.

We met a man being pulled along on a handcart. Blood poured from a smashed elbow and we could see bits of bone, gleaming white amongst the crimson. Taking him into an empty tea-house, Jon sent me to fetch the first aid kit from the Toyota. As I ran along the almost deserted street, chaddar flying, a man tried to stop me, shouting at me that it was dangerous. When I kept going he, assuming I hadn’t understood him, ran in front of me, arms outstretched, making aeroplane droning noises, going BOOM at intervals, repeating the words khaternak, khaternak – dangerous. With no time to discuss the situation I threw out the words injured and doctor. Satisfied, he nodded and let me go.

Approaching the depot I understood what he meant about dangerous. The place was an inferno. Trucks and barrels of fuel were blazing everywhere; great chunks of metal were flying in all directions. No-one was about. Spotting the Toyota, mercifully not burnt to a cinder, I suddenly pulled up short. I’d forgotten the keys. Stupid, stupid, stupid, I scolded myself as I moved swiftly towards it, wondering if Jon would think smashing a window was justified. Luckily, the blast had neatly taken out the front passenger windscreen and I was able to climb in and grab the first aid kit.

On the way to the transport depot

Back at the tea-house Jon was gently cleaning the injured man’s arm. He dressed the wound, gave him painkillers and his friends set off to take him to the clinic on the edge of town. We knew the arm would have to be amputated. The raid was over and people were beginning to return to their shops and businesses.

Jon went off to see about the Toyota and Mubarak and I returned to our tent. Juma was there, wide-eyed and in shock, but of Abdul Hamid, there was no sign. Jon returned saying we could leave in about an hour. We spilt up and searched the bazaar for Hamid.

A Commander came to see us. ‘Five people have been killed. We know four of them but the fifth we can’t identify. It might be your man. Can someone come and look?’

Jon went, returning white-faced. ‘The man they don’t know has no head. Can you remember what colour of shoes Abdul Hamid was wearing?’

‘Brown and white,’ I replied promptly. I’d thought the two-toned brogues were hideous.

‘OK. This man has black shoes. Had.’

It was another two hours before we spotted Abdul Hamid, wandering through the bazaar, totally disorientated. We never learned where he’d been – all he could remember was the first bomb dropping and then running, running, along with everyone else. 

At the depot

We piled into the Toyota to leave Sia Huq, travelling in silence as we each came to terms in our own way with had had happened.  After a few miles, Mubarak’s soft voice asked, ‘Did anyone remember to bring the mangoes?’ 

We stayed overnight near Tezak. None of us slept well. Knowing how frequently Tezak had been bombed in the past, it was not the most reassuring of places to be. When the sound of an aircraft was heard above us, I asked hopefully, ‘That’s a commercial plane, isn’t it?’ 

‘No,’ I was told tersely, ‘but they don’t usually bomb us at night. It is too dark.’ I decided that under no circumstances was I going to go out to the loo with a torch in my hand. Just to keep us on our toes, after the plane had vanished into the night, two mujahideen from different Parties, posted at the Paygar next door to our hotel, had a disagreement. They attempted to resolve it with a shoot-out, until the Commanders stepped in to reprimand them.

Two days later we heard the Government had bombed Sia Haq again – this time, almost totally destroying the bazaar. It was in retaliation for the mujahideen hanging two Government spied in their midst.

Jon looking a bit bloodied – but not his blood.

Poor Abdul Hamid, who had never been further than Bamiyan, took a long time to recover and remained nervous until we reached the Pakistan border. He was fated to be an unlucky traveller:  his first meal in Pakistan contained a large, well cooked, but decidedly off putting, cockroach. In Quetta, the office cook, house-sitting our house while we were on leave was murdered and being a stranger, Abdul Hamid was arrested and held in jail for two weeks. On his return journey to Lal, the vehicle in which he was travelling was stopped by bandits who stole all his money. He vowed never to leave home again.

MarySmith’sPlace – Cancer Diary #05

Sunday, October 04

The countdown to the second chemo cycle has begun. On Wednesday they’ll check my bloods, on Thursday I’ll start on steroids again, on Friday I’ll have toxic drugs dripped into me and on Saturday I’ll take anti-nausea pills and, as they are what caused the constipation last time, I’ll have my liquorice at the ready. I promise I won’t eat too much of it!

I’m hoping it won’t be very much worse than the first dose but those in the know say the side effects become progressively more severe so I’m kind of expecting next weekend not to be great. But who knows?

I certainly didn’t expect to feel as well as I have this last week. The weather has, mostly, been pretty good, which always helps my mood. Yesterday it rained all day and I wasn’t out at all but on other days I’ve been out walking with my son, gradually increasing the length of the walks so I can manage two and a half to three miles comfortably on the flat. At the end of June when I had blood clots dancing in my lungs I could hardly walk a hundred yards without being out of puff. Today, I even walked round Doach Woods, which involves what feels to me at the moment, quite a steep incline.

Walking in Dalbeattie Forest

In between walks I’ve been busy in the garden: cutting back, tidying up, a bit of digging and planting bulbs (though I’ve forgotten what I put where, so if I’m still here in spring there may be surprises). I’m well aware this state of affairs will probably not last and I am truly grateful for this week, in which it has been easy to forget I have cancer.

A golden hedgehog in Dalbeattie Forest

This clearly surprises some people. When they ask how I am and I say, ‘Fine, thanks’ they say, ‘Oh, but how are you really feeling?’ The unspoken meaning behind the question is, ‘you have cancer, are on chemo and must surely be feeling dreadful and exhausted, not to mention be emotionally distraught and weepy and afraid.’

I’ve only had one dose of chemo, and, although I felt pretty tired and out of sorts for a few days, it was easier than expected (apart from the constipation!). And, yes, in the beginning when I first learned about the tumour, my emotions were all over the place, mainly at the thought of the DH, my son and the cat, oh, the poor cat, having to manage without me. When I first knew I had cancer I went from zero to 100 mph in seconds – telling my son we should put stickers on any of the paintings and art work he would like in case if his father remarried and his new wife turned out to be a grasping so-and-so and wouldn’t let my son have what was rightfully his. Fortunately, it’s not possible to live in such a state of heightened emotion for any length of time. That would be really exhausting and emotionally draining.

Would anyone remember to feed the cat?

I had a weep when my friend Sue received her, not good, biopsy result and I had another teary episode today when my son left to return to Glasgow. He’s only been gone a few hours and I’m missing him already but that’s all right, it’s normal – what’s not all right is not knowing when we can see each other again because of bloody Covid-19 restrictions and my need to be extra-vigilant about infection – any infection.

Let’s hope I won’t be feeling too yucky when I write up next week’s diary entry.

MarySmith’sPlace – AfghanistanAdventures#55 – Pesky commanders, dentistry & an inside loo

l to r: Ashraf, Arif’s Field Assistant , Arif, and important people

Afghanistan, December 1989

When I requested a tour of the premises Arif led me up and down staircases and along passages and in and out of so many rooms I lost all sense of direction. From the guest room there were two exits, one leading through the kitchen down a flight of stairs to the storerooms below, one of which was filled with a supply of wood for winter heating. The second exit from the guest room took us along a short passage to the consulting room and the pharmacy. I was astonished to think this had been built as an average family home. Arif rented the premises from the owner who lived in Kabul with his family. He did say the landlord was a wealthy man, so perhaps his home was more splendid than average. I haven’t found any photos so I guess I didn’t take any – have included random pics for you to enjoy.

I particularly liked one of the upstairs rooms, which was empty and unused; a beautiful room with fret worked wooden designs decorating the walls and ceiling, arched alcoves in the walls. Sunlight streamed through two large windows which gave onto a view of the sloping hillside below us. ‘Why don’t you use this room? It is lovely,’ I asked.  

Arif agreed, ‘Yes it is a nice room but there is no heating and it is too cold. If we were going to stay here I would install a bukhari but as you know we are going to build a new clinic in Saydabad.’

The decision to move the clinic had been taken earlier in the summer. Arif was not from Day Mirdad and had faced difficulties in being accepted by the people who were suspicious of strangers. These problems had been made worse by the animosity between Pashtun and Hazara, both of whom came daily to the clinic. Frequent disputes arose as they waited in the compound to consult Arif. The Pashtun people did not trust Arif because he worked with Hazaras, and often went touring in Hazara areas to treat leprosy patients. The Hazaras were equally suspicious of him because he was Pashtun. There were no leprosy patients amongst the Pashtun in the surrounding district and they resented the clinic being closed when Arif went to his monthly tour programme to treat Hazara leprosy patients.

I spotted a staircase leading further upwards. ‘What’s up there? More empty rooms?’  

Arif replied, ‘The bathroom and toilet.’ Eager to see an inside loo and greatly intrigued as to what kind of plumbing system was used, I went upstairs. It was a hole in the floor, but the room had been constructed to jut out from the rest of the house so the waste dropped down a three storey lift shaft to a deep pit below. I’ve seen such arrangements in old Scottish castles.

Next morning Rahimy, bored with having no work to do, offered to help in the clinic. Jon frowned forbiddingly over Arif’s accounts. From time to time, Arif would take a break from his patients to come and see how things were going. As he became more manic, the more silent Jon became. The building estimates for the new clinic were too high, and Arif had already overspent on the work done. The difficulty in finding money from donors was explained and when I suggested he could perhaps manage with fewer rooms; perhaps an office and two guest rooms were not entirely necessary, he seemed agreeable to the suggested cut backs.

I was silently congratulating myself on how easy it had been, when he took the wind out of my sails. ‘Now it is winter the builders will not be able to work until next spring. You can go back to Pakistan and write your reports for the donors – I shall tell you many stories, sister, stories they will like – and get the rest of the money we need for the building to continue in spring.’

I repeated all the arguments and finally, the budget was reduced to an amount more or less acceptable to both parties, though I suspected we’d have the same arguments the following spring.

In the meantime, I was happy to hear Arif’s stories. Each month he travelled to one or other of the treatment points, established to allow patients from further afield to come for medicines. Once, on the way, he was kidnapped by a Party commander and imprisoned in a mountain cave. The commander and his men spent several days joy riding around in Arif’s jeep, almost wrecking it in the process. When Arif did not arrive at the expected time at the treatment point, the people began to worry about him, and when his jeep, mujahideen spilling over the sides, was spotted, they guessed what had happened. The villagers marched, en masse, to see the commander, demanding Arif’s release. The commander tried to persuade them it was in Arif’s interests for his clinic, medicines, equipment and money to come under the control of the commander and his Party – so they could ‘look after it’. The people insisted the clinic, the jeep and everything else belonged, not to the Party but to them. Sweeping aside the commander and his men, they released Arif from his mountain jail and carried him, shoulder high, back to the village.

Despite a tendency to tell stories which dwelt rather lovingly on his superior medical knowledge and his excellent public relations successes Arif was also able to tell stories against himself – such as his first tooth extraction. Not having any dental equipment other than local anaesthetic and dental cartridges, Arif sent his assistant to the carpenter to procure a pair of pliers. In the meantime, he prepared the anaesthetic. His patient, despite the pain his rotten tooth was causing, became slightly anxious.

‘Sister, it was dreadful. I forgot how hard gums are. When I tried to inject my patient the needle bent, just like this.’  He crooked his finger to demonstrate before continuing, ‘Most of the anaesthetic dribbled out of his mouth, so his lips went numb more than his gum. Ashraf brought the pliers and I tried to pull the tooth out. You know, Sister, I am a very small person – and that tooth was deeply rooted. It was a struggle. By this time, my patient wanted to leave, and tried to get out of the chair but I put my knee on his chest and pulled really hard. The tooth came out. There was a lot of blood, though, and the patient was not happy with me.  I did not charge him any fees for this service.’ Having been a lifelong coward in the dentist’s chair I could feel my toes curl as Arif told his story.

A butcher’s shop

Another commander objected to Arif working amongst the Hazaras and was trying to push him out of the area. When Arif was visiting a village on tour, he was asked to go to the home of an old woman who needed medical treatment. The woman had an eye infection which had caused her pain and distress for some time but it was easily treated. It turned out she was the commander’s mother. When Arif returned to check on the progress of her eyes, the woman asked if there was anything she could do for him. He explained the problems he was facing because her son did not want him to work there. She assured Arif he would have no more trouble and indeed, a few days later, the commander himself arrived at the clinic – bringing a gift of a chicken from his mother, and assurances that Arif could come and go and work freely in his area.

Bazaar scene