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from the July 2014 issue

Me and Mycobacterium tuberculosis

When I was given the news, I was quite overcome. I was told I was going to England. I was supposed to work with a company in London for a couple of years as part of my job. I was instructed to apply for my visa. Such unexpected good fortune flabbergasted me. No one in my family had ever traveled to England, or anywhere abroad. I remember when I was a child my grandfather would recite this ditty to me:

Th-a-a-a-m-e-s river has a bridge, beautiful, and then,
Ships ply overhead, while underneath walk men.

He would prolong the pronunciation of “Thames,” drawing it out. My grandfather found satisfaction in reciting such odes to the land of our once lords and masters. Of course, my father had a more modern experience with regard to the bridge on the river Thames—he had seen it on the silver screen. And now I would see it in real life, that bridge where ships plied overhead and underneath walked men.

I began compiling all the documentation required for the visa. It was an undertaking involving many pieces of paper, certificates, and forms. I stayed up late into the night filling out these forms with as much concentration as if I were sitting for the Higher Secondary Certificate exams. I researched and discovered that the British Consulate no longer accepted visa applications directly. They had freed themselves from the hassle of having to deal with us face-to-face on a daily basis. This responsibility they had granted to their local representatives. They merely pulled the strings from afar. When I went to submit my application to the local representative office, I was bewildered by the solemn atmosphere, the unassailable security, and the boundless caution that I encountered. Several people sat in the air-conditioned reception room holding their applications. A deep anxiety was written on their faces, as if all had been accused of some dastardly crime. And they were here showing up for the court case.

When I was called I held out my paperwork to be examined by the official, a fellow citizen. My fellow citizen checked whether I had filled out all the forms correctly. That was the limit of his responsibility. Then he would forward it to the British big boss. Of course, the act of checking the forms he carried out with the profound gravitas of a British potentate. His solemnity seemed to hint at some connection to royalty, even if he himself wasn’t a monarch. He corrected some minor errors here and there and accepted my application. I breathed easy. I was told to reappear on a certain day.

I waited. Everyone advised me to prepare myself by buying winter clothing. The very name of England brought to mind snow and ice. Just thinking about snow-encrusted winters made me shiver. But it didn’t seem good judgment to buy clothes before my visa came through. Still, I made a brief visit to Banga Bazar. I lost myself in the lanes and alleyways of that kingdom of clothing. From a secret storeroom the store owner extracted a blue overcoat made of a special thick material. I decided that I liked it, but I didn’t buy it. If, for whatever reason, my visa application was denied, then this overcoat would turn into dead weight. I’d have to make a trip to Panchagarh in the frigid days of winter to justify the money I’d shell out for this overcoat.

On the scheduled day, with fearful steps, I arrive at the office of the embassy representatives to ask after my visa. The visa applicants wait in the reception room with the guilty demeanors of those accused of burglary and assault. As if the court hearing is over and today the judgment shall be pronounced. As usual, the officials sail by us like royalty, completely oblivious to our presence. Occasionally they glance at the waiting applicants. Finally I am called. Someone hands me an envelope from the other side of the glass barrier. I ask whether my visa has been approved. Annoyed, he says, “Open the envelope and check the appropriate page on your passport. Then go to Counter 5.”

I open the envelope with some hesitation. I flick through the pages of the passport and see that indeed I have been granted a visa. I am giddy from excitement and relief. But the cautious and grave atmosphere leaves no scope for expressions of joy. Instead, as I walk toward Counter 5, I ponder the possible reason for the mighty annoyance that my fellow citizen is seemingly carrying around. Is it because he knew no matter what regal pose he adopts, he is merely the king’s messenger, who can only carry the king’s missives to others? Others receive those missives and travel on to the king’s country, whereas he, solemn-faced, can only stand behind the glass wall? At Counter 5, a female official checks my passport and says, “Since yours is a work visa, you’ll need to undergo some medical tests.” She gives me the address for the embassy medical center and tells me to go there the next day, where I would be told the rest.

I grow anxious as I wonder what the “rest” might be. I had no idea that I would have to surmount this mountain of difficulties to cross the borders of my country. I think of Marco Polo, Hsuan-tsang, and Ibn Battuta. How easily they traveled from one end to the other of a visa-less world. A few days ago I noticed graffiti painted on a wall: We demand a world without visas. I wonder who was making this demand. Then I think, perhaps soon I should join this movement.

All my friends and family are happy that I’ve been awarded a visa. Relatives become very active in organizing a farewell dinner. I keep delaying the date for the dinner. My mother tells me to take out an advertisement with a photograph in the newspapers that says: “Soon to depart for foreign lands for higher studies. Beseeching prayers and good wishes from all.” I tell her I’m not going for higher studies, perhaps I could say for higher work. She tells me it’s all the same. I draft the text for an advertisement. I go to Banga Bazar again and reevaluate the overcoat. But I don’t buy the overcoat, don’t publish the advertisement, don’t organize the party. Without the medical test, it’s impossible to say whether I shall get to see the bridge on the river Thames or whether I shall have to remain satisfied with the one across the river Buriganga.

I show up at the embassy medical center. Those present here already have the visa stamped in their passports, meaning they had crossed one Pulserat, that final bridge that spans hell and grants entry to heaven. Thus, their faces display a smidgen of triumph. They are at the gateway of the ultimate triumph. But there remains another bridge to cross. And so there is no end to their anxiety as well. We, the group that have half-triumphed in our bid to travel to England, sit awaiting our medical tests.

After a while a doctor appears in a white lab coat. A young doctor, a fellow citizen, who seems quite eager and happy. He says, “Why are you all sitting here so glum-faced? There’s nothing to worry about. I’m not going to test your blood, urine, or feces. I’ll only take a look at your chests. Not the outsides of your chests, the insides.” I try a dry laugh at the doctor’s humor, but the others look on impassively. Everyone is eager to flee this trial by fire as soon as possible. The young doctor continues, “The thing that the British are afraid of is tuberculosis. They’ve eradicated tuberculosis from their country many years ago. Now they won’t let anyone carrying tuberculosis within the bounds of their kingdom. So we’re only going to look at whether any of your bodies are carrying the tuberculosis bacteria.”

We sit up. He leads us all to a classroom. We sit in front of him like obedient students. The doctor draws little squiggles with a red marker on the whiteboard hanging on the wall. He says, “These are tuberculosis bacteria. This Mycobacterium tuberculosis was discovered by the scientist Robert Koch. Many of you know of this disease as TB.” We receive all this knowledge about tuberculosis with intense concentration.

The doctor continues, “Tuberculosis is generally quite the gentleman. He can enter a human body, travel to the lungs, and sleep there quietly. He says nothing, creates no damage. But if the body is rendered vulnerable in any way, the tuberculosis is awakened from his sleep and he turns aggressive. He leaves the lungs and emerges. His mode of exit is either the nasal passages or the mouth; either sneezes or coughs. He arises from his slumber in the lungs and distributes himself in the outside air through coughs and sneezes, as he searches for another healthy pair of lungs. This is how he spreads from one set of lungs to another. We don’t fear the slumbering bacteria; it’s the ones that are awake that we’re afraid of. So first we shall X-ray your chests. To check whether Mr. Tuberculosis is napping in there. If we find any tuberculosis there, we shall do a sputum test. There’s nothing to worry about. If we find nothing in the sputum, then even if there are tuberculosis bacteria dozing in your lungs, you’ll still get the visa.”

Although the doctor’s humor lightens the atmosphere somewhat, our anxiety doesn’t disappear. We remain immersed in worry about whose lungs Mr. Tuberculosis has chosen. One by one we enter the X-ray room with its contraption. This is the gadget that will snap a picture of Mr. Tuberculosis. We proffer our chests reverently to the machine. The technician tells us to hold our breaths. We stand with bated breath. He clicks an image of our chests. We are told to return in two days for the results.

For two days I huddle indoors. People keep asking things like when am I leaving for England, have I bought the tickets yet, etc. So I lie in bed and try to discover more about tuberculosis on the Internet. I instruct my mother to tell everyone I’m not feeling well, I am resting. In bed, in a sleepy daze, I keep dreaming that the red squiggly bacteria that the doctor drew on the whiteboard are wriggling all over my room.

Two days later I visit the medical center for my results. The doctor takes me to his chamber and shows me my chest X-ray plate held up against a bright light. He points to a shadowy portion of the X-ray. “You see these two things on either side, these are your lungs. And that shadowy bit you see up there, that’s the thing that has me worried. That shadow shouldn’t be there. I cannot say for sure that the shadow is because of tuberculosis bacteria, but it could be.”

As I listen to the doctor, I start sweating. Are my fears coming true? I gather my courage and say, “But, doctor, I’ve looked it up and there are other symptoms of tuberculosis. Like, night sweats and fever, decreased appetite. I have none of those.”

The doctor says, “You’re right. If these accompanying symptoms existed, we could be more certain. But even in the absence of such symptoms, we cannot completely exclude the possibility of the disease. By the way, I’m not saying that you do have TB. But I do need to conduct further tests to make sure you don’t. We shall do a sputum test. I’ve already told you, even if the X-ray indicates TB, if we find nothing in your sputum, it won’t be considered an open case. So they won’t withhold your visa.”

I stammer a little and say, “Well, if you’re not that certain that it is TB, don’t you think we can avoid this hassle of a sputum test?”

The doctor returns to his lighthearted manner. “Na rey, bhai. That’s not possible. I have to keep my job. The Chief Medical Officer here, this British guy, he does random checks on the X-rays. He might just pick yours, in which case he will ask me for sure why I didn’t do a sputum test. I’ll be in trouble then, bhai. Listen, don’t worry about it. I know it’s a hassle, but come back tomorrow. You’ll have to give us sputum samples for three days. Come early in the morning, on an empty stomach. I don’t think we’ll find anything.”

I leave the doctor’s room. The doctor believes I don’t have tuberculosis. But his belief means nothing. I think to myself, you damn tuberculosis, you couldn’t find any other place for your nap? You had to pick my lungs? As I sit in the rickshaw homeward bound, I think, maybe instead of visiting the shores of the Thames, I shall have to visit a tuberculosis sanatorium. Of course, these days, tuberculosis is no longer treated in sanatoriums. That used to happen once upon a time. In those days, tuberculosis was called the Emperor of Diseases. “If TB catches you/There is no rescue.” The patients would be packed off to gorgeous sanatoriums in the mountains. If I had to get tuberculosis, if it had happened during the sanatorium era, at least it would have been romantic. I saw on the Internet many famous people had died of TB. Famous writers like Voltaire, Anton Chekhov, Keats. The Quaid-i-Azam Jinnah had also probably died of tuberculosis. Once upon a time, all the heroes and heroines of Bangla cinema would die of tuberculosis. The tragedy would hit its peak when the tuberculosis-riddled hero would cough up blood and die. I remember the film Meghe Dhaka Taara, in which the heroine Supriya Choudhury died of tuberculosis. In the last scene, when her brother Anil Chattopadhyay shows up at the sanatorium and is chatting with Supriya about her mischievous little nephew, Supriya cries out, “Dada, I too had wanted to live!” Her words echo in the mountains around the sanatorium.

But thinking of Supriya’s beautiful sanatorium is of no use. I should think about my own tuberculosis. I probably won’t die like Chekhov because these days tuberculosis can be cured, but all those plans about visiting Buckingham Palace will be kaput.

I don’t tell my mother about the tuberculosis, I just say they need to do a few more tests. I tell my friend Faruk, “Dosto, I’m done for. I’ve got tuberculosis.”

Faruk laughs it off. “Hey shalla, nobody gets tuberculosis these days. I’ve never heard of anyone in our social class getting tuberculosis. Quit fooling around.”

I share my Internet-gained wisdom with Faruk. “Do you know how many people in the world die every year from tuberculosis? The same number of people who were killed during our liberation war: thirty lakhs. What guarantee is there that I will not join the ranks of those martyrs?”

Faruk looks serious. He says, “Is that really the diagnosis? ”

I say, “No, not yet, but they suspect it. They did an X-ray and now they will test my phlegm.”

Faruk breathes a sigh of relief. “That’s just those fuckers playing around. They just want to make the visa application process complicated, you see, to discourage people from applying. They’ve looted our lands and now they don’t want to let us into their country. Don’t you see all the measures they’re taking to kick out the immigrants? But you’re going there with a job already. You’ll have no trouble at all. Go and cough it up. They’ll find nothing.”

I realize Faruk is trying to keep my spirits up. But the anxiety remains in my heart. I go to the medical center again the following day. This time I am directed to a different room. There I find, again, a group of anxious-looking people waiting in the lounge. It’s a smaller group though. A handful of unfortunates, whose lungs are suspected of playing host to Mr. Mycobacterium tuberculosis. They still have hope. If Mr. Tuberculosis does not show up in their phlegm, they are the lucky ones. I sit in the lounge. One by one, we are called in. From the next room waft the strange and discordant noises of various people coughing.

Finally it is my turn. I enter the room fearfully. An elderly nurse hands me a small container. She says, “Take a deep breath. Then cough loudly and deposit the phlegm in this container.” I take a deep breath as per her instructions and cough hard. My coughs are dry and no phlegm comes out. The nurse is annoyed and tells me to cough harder. I cough with all my might but no significant phlegm emerges from my mouth. Suddenly a foreigner, a white doctor, saunters into the room. The nurse moves busily, like a rabbit. I realize the white man must be one of the big bosses of this medical center. In the presence of the white doctor, the nurse becomes ever more eager to extract the sputum from my chest. She thumps me repeatedly on my back. I continue to cough with all my strength. It seems to work somewhat. A little bit of phlegm emerges from the passage of my throat. The white doctor has left. The nurse takes the sputum container into her gloved hands and says, “This little bit will be good for nothing. You’ll have to cough better tomorrow. And remember to fast in the morning; you must come on an empty stomach.”

I sigh in relief at my escape from the nurse. My ribcage is aching from this constant coughing effort. I recite in my head, “T-h-a-a-a-m-e-s river has a bridge, beautiful and then,/ Ships ply overhead, while beneath it walk men.” Perhaps not exactly my heart’s blood, but shall I need to give the phlegm from my chest to see this bridge? I think briefly: why don’t I just forget about it. Let me withdraw my visa application. But I don’t feel brave enough to do that.

The next day I wake up and again show up at the embassy medical center with an empty stomach. I’m hoping that this time I shall be able to supply them with the requisite sputum. I enter the testing room and see the elderly nurse. She asks me, “You haven’t eaten this morning, have you?”

I shake my head. “No.”

She hands me a small container like the day before and tells me to cough in it. I cough up like a good boy and deposit the bodily fluids that have exited through my mouth into the container and show it to the nurse. The nurse says, “But this is spit. I need phlegm. Don’t you know the difference between saliva and phlegm?”

I say, “Apa, I’m trying. What can I do if nothing comes out?”

The nurse says, “Take a deep breath and cough from deep inside.”

I try again.

The nurse asks from beside me, “So what kind of visa did you get?”

I say, “It’s a work visa.”

She wants to know, “How long will your job be?”

“Three years.”

She says, “That’s good. Listen, if we find no TB, I’ll be happy for you. I can’t go to England. So if someone from my country can make it there, what problem do I have with that? I’m not the one giving you a visa. But I work here. I need to keep my job. You saw our boss that day, right? That’s Dr. Martin. He’s a twit. If I hand in this container without a sputum sample from you, he’ll just dismiss me. Now you try and cough a bit more.”

I continue with my various coughing strategies. A skirmish seems to be taking place between me and my phlegm. The fourteen floors of this timepiece of a body that the song describes, those fourteen floors have ten channels, well, I keep trying to make my sputum flow out of those channels like a river in full spate.

The next day I go again. Again the same nurse, the tiny container, again my phlegm. In the interim, my body has received the missive. The treasury of my body hoards such streams of wealth; from there, my body awards the little white plastic container drops of sputum. Like the poem, it says, Remember, I gift you this droplet of dew.

The nurse is happy. She holds my sputum container in her hands and says, “Listen, if you get the visa, don’t come back to this country. Why would you want to return to this wasteland? Just stay on in England even when your visa expires. There are so many ways to just stay on over there.”

I exit the nurse’s room. In the meantime, my sputum goes under the microscope. I will have to wait two more days to find out whether there are wiggly little red-hued Mycobacterium tuberculosis prancing around in there.

Now I’ve become kind of desperate. If I do have the king of diseases, then just like a king I shall cough myself to death right on this soil. As the poet said, You can travel wherever your heart desires. I shall remain to watch the jackfruit leaves as they fall.

Two days later I go back to the medical center to discover the final judgment. In my mind, I’ve decided that I am indeed a tuberculosis patient. I go to the doctor’s office. He asks me to wait and leaves the room. As if the plot thickens. I am impassive. Whatever the pronouncement is, I shall accept it with grace. So I shall never get to see the T-h-a-a-a-m-e-s. So, like the song, oh Mother mine, so what if I do not have clothes or jewelry this Eid.

But the doctor returns and pours cold water on all my drama. He holds out the test results and says, “Nope, there is no evidence of Mycobacterium tuberculosis in your sputum. You’re going to England.”

I cannot decide how to react. I listen to the doctor gravely. He says, “We’re giving you a certificate stating that you’re not a TB open case. However, you have to take your X-ray with you. They’ll want to see your certificate and the X-ray at Heathrow. So keep your X-ray at hand at all times. Don’t put it in your luggage. If you put it in your luggage you won’t be able to show it to them at Immigration. Now you better start packing for your trip. And good luck!”

He hands me the X-ray. It’s huge. I’ve never seen such a large X-ray before. It becomes quite a complicated procedure to manage it. I tuck it under my arm with some difficulty, thank the doctor, and go home.

At last I have surmounted all these hurdles. So I will get to see the bridge over the river T-h-a-a-a-m-e-s after all. I prepare for departure. I buy my airline ticket, buy the blue overcoat, put the traveling-abroad-for-work classified in the papers, attend farewell dinners with friends and family.

Finally the day of departure arrives. I have packed my bag and suitcase. As advised, I carry my X-ray in my hand. I fail to properly wave good-bye to all my friends and family who came to see me off because, in addition to my ticket and my passport, I am also holding an oddly shaped and oversized X-ray plate.

When I enter the airplane, even though I manage to cram my hand luggage into the overhead compartment, I cannot fit the X-ray plate in there. So I sit with the X-ray in my hands. The other travelers are giving my X-ray the side eye.

The plane ascends. There is both sadness and joy in my heart. I watch the clouds through the window. I think of England, I think of back home, I think of the X-ray plate that I hold. The X-ray sits in my lap like my anxiety made real, in between my happiness and my sorrow. They are preparing to serve food in the airplane. The flight attendant asks, “Veg or non-veg?” I am elated at the smile of this beauty in the sky and ask for the meat dish. I place the X-ray by my feet and eat all the tasty food they bring me. When I am done eating, I doze off. When I wake up, the plane is touching down in Heathrow. It is dawn.

I stand in line for Immigration. I am carrying my hand luggage and that X-ray plate in a huge envelope. I am proud to be the first one in my family to set foot in England. I look around. Everything is neat and shiny-bright. And there are so many white people. I feel nervous. Suddenly I become very aware of skin color. I look around seeking a brown person, a black person. I now notice that the immigration officer at the counter where my line ends is a black woman. The immigration officer for the line next to mine is a white man. I feel comforted somehow. I think myself lucky to have chosen this line. I think, as a black person, surely this immigration officer will be slightly sympathetic to a brown person like me. Especially since she is a woman, surely she will be soft-hearted. Surely she won’t hassle me over my paperwork and documentation. I clutch my tuberculosis X-ray closer. At that moment, I recall the words of my coworker, Rahman bhai. He has traveled abroad many times. He had given me several travel tips before I left, and some regarding airports. He told me, “If you see an immigration desk with a woman officer, don’t stand in that line. Don’t think she’ll grant you any favors just because she’s a woman. My experience is that the female officers are the harshest. They keep nagging about luggage weight, paperwork. You know, women suffer from many kinds of insecurities. So they try to overcompensate for that sense of insecurity by doing everything by the book. They make no allowances at all.” My throat feels parched as I recall Rahman bhai’s advice. The officer I must face is not only a woman; she’s also a black woman, a minority, so surely her insecurities must be greater. The woman whose presence had at first delighted me now begins to cause me acute anxiety. This woman is probably going to go through every single line in my documents. She will probably hold up the X-ray plate against some more advanced gadget and tell me, “Look, here is the Mycobacterium tuberculosis. They couldn’t catch this with that contraption in your country. But we’ve nailed it. We can’t let you in.” Will they send me back on the next flight? Should I leave this line and stand in the white man’s line? But I don’t have the guts to do that. My heart races in my chest.

Even this early, the airport is terribly crowded. People have come from all corners of the earth. The black woman at the immigration counter is clack-clack-clacking stamps on passports one after another with her head lowered. The line inches forward. I watch the woman like a hawk. I don’t see anyone else in the line carrying an X-ray. Perhaps no one else has lungs as suspicious as mine. I watch the sleepless eyes of the woman at the counter. Finally it is my turn. I hold out my passport and other documents. When I put down the outsized X-ray on her desk, she asks me to remove it. I hold it for her, thinking she will probably examine it carefully later. The woman looks tired as she yawns several times and checks my paperwork. Then she stamps my passport without once looking at me and tells me to go. I hesitate. Did she really tell me to just go? I put the X-ray down on her desk again. This time the woman looks at me with annoyance, and tells me to move along quickly. She calls to the man standing next in line. I somehow manage to get all my papers together and move away from the desk before I compose myself. Slowly I walk toward the luggage carousel.

I cannot quite fathom it—have I really entered the borders of England? I feel swamped by confusion. I look around at the English hustle and bustle. I wait at the Underground station with my luggage. I buy a ticket to King’s Cross. It is dawn in England. I am wearing my blue overcoat from Banga Bazaar, beside me sits my suitcase and my hand luggage, clutched to my heart is that famous X-ray plate. I am still bewildered, wondering why they did not ask even once to see this X-ray obtained with such difficulty. So would the tuberculosis certificate have been enough? Was this X-ray unnecessary, merely a result of the overenthusiasm of my fellow citizen, the doctor? Or did the tired immigration officer merely ignore it to avoid extra work? Or perhaps there is some guerilla tuberculosis testing center somewhere in this city, where I shall be taken as soon as I enter the city. Or perhaps a patrolling policeman will want to check my X-ray. Perhaps even their regular policemen are also tuberculosis experts. I tuck the huge X-ray of my chest under my arm, and with slow, fearful steps, I enter the city by the river Thames. 

Ami O Mycobacterium Tuberculi, from Kesher Are Pahar. © 2012 Shahaduz Zaman. Translation © 2014, Shabnam Nadiya. All rights reserved.

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