I rarely get ill. I put this down to my routines: a daily run, a swim in the river, a predominantly vegetarian diet and writing no more than about four hours a day. I also have little contact with grandchildren, rarely catch a bus and try to avoid visits to the doctor’s surgery, where it can seem that every surface is covered by sticky malignant bugs. I was last prescribed antibiotics in 2010 but that was for complications of malaria. I try to keep my beneficial bacteria happy and well nourished.
So it was quite a shock to come down with a cold or perhaps flu while on a winter holiday in Madeira. We had had a stressful few days, having been badly cheated by the traders in the markets and the restaurants. Although the sea temperature was around 20 degrees, the rocky coastline had few safe and accessible places to swim and everybody on the local bus into Funchal seemed to be coughing or sneezing.
Whenever I have got ill in the past, I am very curious about the symptoms. It’s an opportunity to understand what my patients might be experiencing. Why, for example, is nausea so often associated with yawning? How can belching make my heart irregular? So I viewed this latest illness as a learning experience.
It started with a tickle in my throat, which rapidly developed into a streaming nose and a hacking cough. Although I was undoubtedly suffering from a respiratory tract infection, not all my symptoms were respiratory. I had a headache, an ache in my loins, slight nausea and constipation. And I was off my food and was feeling very tired. It felt very similar to how some of my patients describe a flare up of IBS or their chronic fatigue syndrome. So did my illness serve to take my mind off the trauma earlier in the week?
I tried to beat the bug the next morning with a cold shower and a long trek, but by end of the day, I could hardly put one foot in front of the other. I came back, lit the fire, wrapped myself up in blankets and fell asleep for the best part of 18 hours. It was very similar to the experience I had several years ago in the Himalayas. I just wanted to find somewhere warm and retire from the world. I wonder if an overwhelming infection taps into the same neuro-humoral response as severe trauma when flight and fight is no longer effective and the body effectively shuts down and goes into a freeze mode, mediated by the dorsal motor nucleus of the vagus. Do cytokines (inflammatory mediators), released from white blood cells, bring about a state of dissociation? Is that why I seemed to lose time and have a series of bizarre dreams associated with speaking in my sleep?
Today, I feel more together. I have felt too tired to go anywhere or do anything but am more alert and aware. It will take another day or so for recovery to take place.