Fresh Air Fiend

by Paul Theroux

  Malaria is one of the worst and most persistent problems in the tropics. The prophylactics are not terribly effective, and all types of malaria are painful and some are fatal. In New Guinea, using a well-made tent with a mosquito net probably helped me more than daily Paludrine. It has become common for many sunny republics to underreport their cases of malaria (or dengue) so as not to discourage tourism. This denial regarding the AIDS risk is common throughout eastern and central Africa, where AIDS patients are seldom treated and almost never hospitalized. Regarded as doomed no-hopers, a waste of hospital space, they are sent back to their villages to die. The Kenyan, Ugandan, and Malawian secretaries of health are technically correct when they say there are no AIDS patients in their hospitals. But no one ought to be fooled by this smiling assurance. Keep your immune system away from Ugandan and Kenyan prostitutes, an inordinate proportion of whom, according to World Health Organization estimates, carry the AIDS virus. Half the population of Botswana is infected with HIV.

  AIDS is the nightmare, but there is another illness that is mentioned only in whispers, and that is kuru. This disease of the nervous system, related to mad cow disease, is found in eastern New Guinea, principally among the Foré people. The word kuru means "trembling"—one of the symptoms. You go mad, and then you die. And the unique feature of kuru is that it is contracted by people only after they have eaten human flesh.

  AIDS is avoidable. So is gonorrhea, yet through sheer stupidity I did not avoid it. (I have given fictional expression to my venereal episodes in my novel My Secret History.) Malaria is very hard to avoid; but the trouble with most equatorial fevers is that they are almost impossible to diagnose or name. Many people have flu and think it is malaria—the initial symptoms are often similar. The worst fever I ever endured was at a leper colony in a hot, low-lying place in Malawi called Mua. This was a mission hospital run by Dutch White Fathers. When I fell ill, one priest told me I might have blackwater fever, another said it could be malaria. Yet more priests speculated and prayed for my soul. I assumed it was malaria and dosed myself with Chloroquine. I sweated for three days, hallucinating, my ears ringing. After the fever had broken I could barely walk upright. Diarrhea came next, and I had to negotiate the latrine, a long-drop privy, where bats attached themselves to the edge of the toilet seat. Whenever I entered, they let go and flapped in loud batty circles in the pit beneath me.

  Compared to this ghastliness, the leprosy seemed almost a trifle. It was common in Mua—a thousand lepers in this one hospital compound—but it was not dangerous to me or to the priests. Leprosy is neither particularly contagious nor infectious, and though it leaves permanent and unmistakable scars, it has a straightforward cure—sulfa drugs. My experience of the leper colony at Mua was a paradox, a sort of golden period of innocence, my Eden almost. It was 1964. I loved this clearing in the jungle: the simplest bush conditions, the lepers from all over the country, many different people brought together by a blight called khate, not Hansen's disease. AIDS was unknown then. The priests and I played cards by lamplight and listened to the lepers drumming; the only urgency was the constant bandaging. I have often thought of writing a novel about this strangely happy place.

  Most ailments go with the territory. I remember an American I met in India who boasted of his constipation—he was unique in Delhi, city of bowel-shattering meals. Cut yourself on coral anywhere in the Pacific and you often end up with a serious infection. One of my memorable foreign lesions was a septic knee in Hawaii. In Singapore, what we used to call dhobi's itch or Rangoon itch (in Rangoon it is probably called Singapore itch) was a fungal infection, and everyone had it, as everyone eventually had sand fly bites or lice of some sort.

  "Grab lice or bhodhee lice?" an Indian pharmacist asked me much too loudly in the Victoria Chemist Shop, on Serangoon Road in Singapore in 1971, and every customer turned to stare at me.

  It is impossible to travel without coming down with something, yet no one should stay home for that reason. Apart from terminal boredom, Twinkie overload, and severe trauma to the brain from watching television, there are plenty of illnesses available at home. Paranoia. Nits. Dog bites. Bedbugs. Botulism. Sexually transmitted diseases. Lyme tick seizures. Rocky Mountain spotted fever. Whatever. I was made miserable by paronychia (an infection at the base of a fingernail) in London, and several years later got the same thing in New Guinea. The first bout I cured with antibiotics; the second, in a village in the Trobriand Islands, by boiling my thumb twice a day for a week, much to the puzzlement of the local children.

  As I write, a funeral is being held for a Seattle youngster who died having eaten nothing more exotic than a hamburger at his local Jack in the Box fast-food outlet. Obviously that ought not to deter anyone from traveling to the Pacific Northwest. And simple accidents are much more common than infectious diseases, at home and abroad. Thomas Merton left his Trappist monastery in Kentucky, after twenty-seven years of seclusion, only to fall victim to a faulty fan, which electrocuted him in Bangkok. That, like the frequent tourist drownings in shore breaks, is a far more frequent story than, for example, the celebrated cases of Lassa fever—a grotesque, often fatal, but rare disease—which tend to mislead potential travelers to West Africa, who are much more at risk from, say, malaria, dysentery, and injuries sustained from being mugged.

  It can be extremely dangerous for a kayaker to perform an Eskimo roll in an English river. In the past decade, many kayakers in England have contracted Weil's disease, also called leptospirosis, from being infected with spirochetal bacteria. Many picturesque rivers are tainted with large amounts of rat urine. It is not unusual to read of an English kayaker making a so-called wet exit and successfully swimming to shore, only to fall victim to Weil's disease from the short swim. The consequence is often kidney failure, a hook-up to a dialysis machine, and a long convalescence—all this from a few minutes' splashing in a pretty tributary of the Avon.

  It is true that some doctors today resemble the overweight and chain-smoking golfers and scare mongers who thirty years ago gave me shots and sent me abroad with facetious warnings of crocodile bites and beriberi. The kind of enigmatic quack who measured the size of Marlow's head before his Congo journey in Heart of Darkness ("Some heads are different when they return") was until recently the everyday general practitioner. But many doctors now are travelers, as well as skiers, paddlers, rock climbers, and trekkers, as interested in preventive medicine as in doling out antibiotics. This has been an immense help in replacing the fear of illness in travel with an instinct for sensible precautions.

  I sometimes think I have caught almost everything catchable (and curable) in thirty years of travel.*

  Part Three

  A Sense of Place

  Diaries of Two Cities: Amsterdam and London

  Amsterdam

  APRIL 10, 1990

  Today is my 49th birthday. I knew I would be traveling to Amsterdam today, so last Saturday I pedaled my bike from London to Brighton, 49 miles. It was a terrible trip, because of the absence of cycling paths. I had to cycle by the side of the road, with the trucks and cars beeping their horns at me and roaring past. At roughly the 40th mile I felt 40, but by the 49th I felt 49. I dismounted and drank two pints of beer, ate an Indian meal alone, and then took the train back to London. Happy birthday. I keep thinking of my 50th, next year. George Orwell once wrote, "At fifty, every man has the face he deserves."

  Going from the bombed and rebuilt suburbs of London to the bombed and rebuilt suburbs of Amsterdam, there is no change: from the air it is visually the same awful postwar architecture—budget-conscious, blighting the landscape. It is not until one is in Amsterdam proper that one feels one is in a different country. In the plane, the pretty woman (Dutch) next to me said, "So you are going to spend your birthday all alone? How terrible." But she didn't offer to cheer me up tonight.

  I am met at Schiphol airport and brought directly to a radio station, where the interviewer and I have a lively discussion of my new book, Chicago Loop. Th
at is, after all, the reason I am here. I wonder whether authors should be paid to go on publicity tours—perhaps paid by the hour?

  Dinner at a restaurant in Hilversum, and I eat some sliptong. No one knows the name for this in English, but it's a small sole. We then go to the TV studio, another discussion. This one is videotaped, so they can put subtitles on it. The host of the program is intelligent and well dressed, and I feel stupid, slow, and badly dressed. Will the Dutch think I am showing contempt by looking so scruffy? And yet one of the great virtues of traveling in Amsterdam is that a visitor can dress casually. Here, I always think, neckties are superfluous.

  A taxi back to Amsterdam in the rain, and at 10 P.M. we arrive. I was up at 6 A.M. And yet I am not very tired. I walk until midnight around the red light district, marveling at the monotonous meretriciousness of it all. But how motherly the prostitutes look. A woman in Amsterdam tells me the same thing. She says, "All these whores look as though they are saying, 'Come to Mummy!'"

  APRIL 11

  Woke at 7 A.M. and listened to BBC World Service. Trouble in the Chinese province of Xinjiang—Muslim Uighurs revolting against Han Chinese domination. I mentioned this as a strong possibility when I wrote my book about China in 1987, and I added, "The Chinese would suppress such a revolt without mercy."

  Breakfast with Dr. Mulder of Handelsblad. He wonders whether I would keep a diary of my visit to Amsterdam. I told him that I keep a diary every ten years—in 1970, 1980, and now 1990. I write all sorts of trivia and then marvel at it years later—at the prices and the minute details of life. I can't be bothered to keep a diary the rest of the time. After all, I have books to write, and a diary is simply an interruption. It is something that non-writers ought to do, for the edification of their grandchildren.

  Dr. Mulder has a background in criminology. I interrogate him about this, although he continually steers the conversation back to books. His insights on the prison riots in Britain convince me that the British have one of the least enlightened prison systems in the Western world—still rooted in nineteenth-century ideas of penal servitude. Indeed, most British people would like to ship prisoners to Australia or Devil's Island.

  An interview was supposed to take place at 9:30. The interviewer was late—about the rarest occurrence in Holland. But she mistook the time. Still, we talked for half an hour. I said I tried to be truthful. She said, "But what is truth?" implying that there is no such thing. I told her this is the sort of discussion that schoolchildren have, about truth, beauty, and the meaning of life. I would rather talk about sex and violence, or about cooking.

  Dr. Wolffers is shown in. He is a medical doctor. He also has an interest in books, my fiction, and the Third World. He has traveled in many parts of the world that I have, so it is a pleasure to talk to him. I try to steer him around to the subject of medicine. My great regret in life is that I did not finish my medical studies. I am like a woman of forty-five or so who knows that she is no longer able to have a baby. I think I am past medical school age, but Dr. W. encourages me to resume studying medicine. On the other hand, his interest is alternative medicine. I ask him a traveler's question: does he ever carry antibiotics on his trips? He says flatly no, never.

  "What do you do about diarrhea in the tropics?" I ask.

  "The important thing is to rehydrate yourself. Most of these other preparations are simply cosmetic."

  Then he gives me the formula. Let's say you have diarrhea in Bangladesh and have no medicine. You mix a pinch of salt with several spoonfuls of sugar in about a half liter of water. This will help do the trick. Brown sugar is best, because it contains potassium.

  I am delighted by this non-literary conversation.

  Lunch with the board of trustees of the John Adams Institute. One woman I met ten years ago in Washington; another man is a colleague of my brother, a lawyer; the rest are distinguished and all the men wear neckties. So I again feel scruffy and badly dressed. In spite of this, the director of the Concertgebouw offers me tickets to Verdi's Requiem tomorrow. The last time I was in Amsterdam, I heard the same piece in the same place.

  I feel I am seeing very little of the city, so I suggest to the next interviewer, from De Morgen—he is a Belgian called Samiel van Hole, a travel writer himself—that we go to the Van Gogh Museum. While I am looking at the paintings I will answer his questions, mumbling into his tape recorder. In this way I will have a glimmering of aesthetic pleasure. Samiel says that he is too nervous to look at the pictures. He reads his questions from a piece of paper; I carry his tape recorder and mumble. It is satisfactory, but exhausting. His wonderful news is that he has just signed a contract for his travel book with a distinguished publisher in Amsterdam. When he tells me that he is unable to drive a car, I am convinced he is probably a great traveler.

  Returning to the hotel to prepare my lecture, I lie down and fall asleep. I am wakened by the telephone. Too late to prepare, but I am well rested so am clear-headed. If I had notes or a lecture prepared, I would feel dull and earnest. As it is, I feel bright and eager. The Kuplezaal is filled, about 450 people. Dutch audiences always do their homework: they buy and read your books, they ask good questions, and they are attentive. So after a forty-minute talk and a short break for coffee, I answer questions. The best is "Have you ever experienced evil?"

  A short walk, and then dinner alone, which I spent writing a fax to the States.

  My bedtime book is The Aspern Papers by Henry James. I read it twenty years ago, but am happy to return to it each night. One chapter a night before I sleep.

  APRIL 12

  After my first sound sleep I am interviewed by an Australian for the World Service of Radio Nederland. After the interview he tells me stories about Australia, and I tell him about my kayak trip to northern Queensland. He has been living here for twenty years, and like other aliens has taken root. He was part of the international sixties counterculture, which deeply affected Amsterdam even if it did not make much of an impression in provincial bourgeois Holland.

  I am picked up and driven to Rotterdam to sign books. On the way I learn a curious fact: the Dutch have taken to using mountain bikes. Mountain bikes in Holland? This is an example of the Dutch susceptibility to fads, their eagerness to be part of world culture. Sometimes it is overdone—you have to know when to stop. And the American junk-food places all over Holland make me sad.

  Rotterdam. Lots of book buyers at Donner's, "the biggest bookstore in the Western world" (so I am informed). I sign books. I eat a broodje. I return to Amsterdam, reflecting that I have spent five and a half hours going to Rotterdam to sign books. If I were the pope or Michael Jordan, I would understand the mechanism that requires a personal appearance. But I am a nearsighted writer who hates long car journeys as a passenger.

  A photo session ("Put your hand to your cheek") and two more bookstores—signing, talking—and finally, at 8:15, the Concertgebouw,—Verdi's Requiem.

  There are nearly as many performers as spectators—a whole choir, a huge orchestra. It is beautifully, thrillingly performed. But just after the thunderous second Dies Irae, when the choir is singing

  Lacrymosa dies illa,

  Qua resurget ex favilla

  a man in the choir suddenly collapses! There is drama: the choir and the quartet continue to sing the lugubrious verse as the man gasps for breath, and to the sad strains of the Requiem, he is carried out by four members of the choir and a man from the audience. Everyone present is a witness.

  APRIL 13

  I wake early, write in my notebook for the first time since I arrived—the beginning of a story. I feel at last settled enough to write. I ask the next interviewer to conduct the interview at the Yoshitoshi exhibition, at the Rijksmuseum. This turned out to be a pleasant conversation with a knowledgeable woman, as we were passing from one picture to another, looking at the Ukiyo-e prints, scenes of "the floating world." The Japanese these days are also susceptible to novelty. While they are buying modern furniture and pictures, they are selling thei
r antiques and prints.

  The Night Watch is undergoing restoration—a lunatic threw acid on it. The fact that he was shrewd enough to throw acid makes me think he's not a lunatic.

  Another interviewer: "The problem in Holland is not the young people. They spend one-point-three hours a week reading. Is that bad?"

  I said, "Not necessarily. Their parents spend six hours reading De Telegraaf. Is that good?"

  I am now preparing to leave Holland. I would like to stay longer in Amsterdam. And the fact is that it is only when I go home that I get culture shock.

  London

  OCTOBER 3, 1993

  Arrived at 7 A.M. after a ten-month absence, but really I have not lived in England for almost four years. And the last time I stayed in a London hotel was in 1971, at just this time of year. The lovely clouds, the wet pavement, the penetrating dampness, all bring back memories of that arrival, a little shivering family of four fresh from Singapore, without a job or a house or much money. Then eighteen years passed and everything happened, and now I feel like a ghost, slipping back into the country, to haunt and be haunted.

  The view from the Stafford in St. James's is rosy. There is an article about me and my new novel, Millroy the Magician, in The Sunday Times. I sound absurd. I put this down to the young English journalist's discomfort with being frankly appreciative. He knows that if he is nice to me he will be accused of arse-creeping, and so his admiration is turned into sniping. But who cares? The article will be lining the bottom of your budgie's cage tomorrow, and so will this diary the editor at the Guardian asked me to write.