Kiss of the Tropical Spider

She turned her head toward me, her dark eyes softening and moist. "War is the worst thing," she said. 

Four nights

in the hospital seemed like a death sentence. I begged for release yet I knew that staying there in that horrible bed with that horrible food starring at the seconds ticking on the radial clock on the wall in front of me was my best hope.

I thought about tropical diseases and Vietnam and how some of my contemporaries who went there to fight must have found themselves riddled with infection lying in rice paddies. 

I turned to chanting and word play. I toyed with favorite memories, attempted zazen and decided to dedicate my suffering to the children who were seriously suffering in war-torn places like Ukraine and Syria.

How does that work? I wanted my pain to alleviate theirs. 

When new complications arose, I figured this was it: I really would spend the remainder of my now shortened life in room 3316, third floor, one floor below the COVID patients.

Fever digs into the subconscious, a trickster that gave me nightmares as a child, but as an elder man it doesn’t scare me so much. I go with it, knowing what I know from the experience of a lifetime. I've had it pretty good.

Yet my emotions became very fragile and I felt my heart breaking with only a glimpse of starving children on the TV news. I turned it off for good. It would be just me and the nurses and aids and doctors who passed by my bed.

They became my family and entertainment. Of course Barbara visited me every afternoon and I couldn’t wait to tell her about the people I was meeting, new ones every day. That part of being in the hospital was like being swept up in rich, living theater.

My emotions tingled, vulnerably, from my deepest thoughts to the surface of my prickly, painful swollen purple skin that burned my leg like a hot furnace. I remembered seeing my father cry when Hospice arrived. I found his humor in my conversational replies to those in the room. No matter how far we roam, we carry passed-down characteristics.

I bragged to a female nurse that my mother had been a nurse and worked the same 3 to 11 shift. 

I listened to a male nurse from India, Pooran, tell me how he immigrated first to Arizona but found  a more comfortable environment in the Bay Area where he works three-month stints as a traveling nurse, 12-hour shifts. He arrived in my room at midnight.

"I sleep all day," he said.

I learned about Eritrea, an East African country, more than 500-years-old, colonized by Italy then annexed by Ethiopia, then 30-years of civil war. I had to look it up on my iPhone after Nurse LemLem told me her story. We wore masks, spoke through our eyes.

"Halie Selassie is all I know of Ethiopia," I said. "And I remember a great marathon runner."

"You must be in your seventies," she said.  "Haile Selassie [former Emperor of Ethiopia] is what people your age say when they hear Ethiopia." My reference came from reggae singer Bob Marley who spoke of Selassie as a savior.

"He was a bad man," said LemLem. "He did nothing yet was praised for simply appearing before the crowds."

She grew up during the 30-year civil war in Eritrea. "My father was a freedom fighter. He left home and I never saw him again. It was like Ukraine today." She hesitated, then cast her eyes toward mine. I saw terror and sorrow.

"War is the worst thing," she said, the palms of her hands coming together as in prayer. "God bless America."

"Yes," I said. "God bless America."

The COVID pandemic has decimated the number of health care workers including nurses in our hospitals nationwide. Immigrant workers have helped satisfy the need for employees. To assist pandemic-weary hospitals, twice as many green cards -- 280,000 -- were allotted in the U.S. this year to fill professional jobs including nursing. Hospitals are relying more on traveling nurses as well. (San Jose Mercury News, 2/4/22)

I found myself under the competent charge of Dr. Shivani Reddy, DO Infectious Disease, and her team of doctors at Kaiser Hospital, Santa Clara.

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I began to shake uncontrollably and shiver with chills. I thought for sure I had COVID .                                                                                                                               

It seems 

that everyone who resides on the island of Kauai for more than a couple of years will feel the bite of a centipede: a sharp pain and release of venom into your blood. It won't kill you but I hear the sting hurts and swelling can occur. Even my 4-year-old grandson, Mystiko, has already felt its wrath. 

You find centipedes in dark, covered places like underneath leaves or deep in grass. The fear is that you may find one underneath your bed sheet. Not all Hawaiian centipedes bite. They were introduced from Asia and the feral chickens that you see pecking around enjoy nothing better than finding a four-to-six inch centipede to snack on.

If I see a centipede skirting across the floor, I grab a pair of pinchers to catch the multi-legged  anthropod, squeeze hard and walk outdoors where I hurl the squirming insect into the jungle as far away as possible. Thick and rubbery, centipedes are not easy to kill. In fact, word is that if you cut one in half, you have created two centipedes. If you squash one to death, a lingering taint of the insect will attract another centipede.

I was not bit by a centipede because I never felt a sting, only a burning sensation on my shin just above my left ankle. Sitting on the couch hunched over my laptop in deep thought, I hardly noticed. A burning sensation? Huh, that's weird. Oh well.

We were due at Kalihiwai Beach to celebrate Misty's fourth birthday. I closed my laptop and grabbed my ukulele. Barbara had prepared a kale salad and we had a gift for our grandson wrapped in colorful paper.

Most family get-togethers on Kauai take place at the beach, of which there are many to choose from. Kalihiwai is a cove beach fronted by tall ironwood trees with a river at one end whose mouth is shallow during summer, banked with sand, creating a wide body of water perfect for little ones to play in. We brought two boogie boards that were quickly snatched up by Viva and her friends for floating and paddling up the still river water.

The kids kept rolling in with their moms and dads carrying more food and presents that were placed on a table under cover of a large canopy. The birthday party ensued highlighted by our gathering together to sing happy birthday to Misty, who was surrounded by smiling faces, his chin barely reaching the table. He peeked around then focussed on his beautiful organically-inspired cake that Mama Bryna had made for him topped with four burning candles, the quintessential moment. Could he blow out the four flames?

With the determination of a superhero about to slay a dragon, Misty drew enough breath to turn each burning wick into smoke. He did it!

Yay!!!!!!!!! echoed through the air followed by much clapping!

Barbara and I decided to walk down the beach. We dunked into the temperate water and returned to a campfire where I began to shiver with unexpected chills.

Since we were scheduled to leave the island in less than two days, the following morning I went to work de-waxing my surfboard, washing windows, clipping hedges and organizing stuff in the shed which I had been doing for several days. The condo would be a vacation rental while we were gone.

The pain in my leg continued to increase and a bump formed where I had felt the initial burning. I researched online what might have bitten me and concluded that it must have been a Mediterranean brown recluse spider: burning sensation, followed by swelling and fever.

I surmised that I likely carried it indoors on my clothing from the many trips to the shed.

Bryna drove us to the airport the following day, our baggage, two kids and three adults all tightly packed into her Prius. I felt listless, allowed my eyes to close most of the way. Finally on board the plane, wearing a shirt, a cap, sweat shirt with hood pulled over my cap, down jacket and protective face mask, I tried to sleep. I popped a couple of Benedryls. I began to shake uncontrollably and shiver with chills. 

I thought for sure I had COVID.

I took a COVID test upon arriving home that night that gave a negative reading. I knew then that the bite had infected me. We went to urgent care the following morning, my leg swelling and painful. The doctor gave me an injection of antibiotic and a prescription for a broad-spectrum antibiotic in pill form. She also cultured an open cut on my toe. 

After two subsequent days of antitbiotics, my leg continued to swell, turn reddish purple, the discoloring rising up into my calf and thigh. My neighbor and surfing buddy Tony Loero had suffered a nearly identical infection in his leg a few years ago following a trip to Hawaii. He ended up in the hospital for 13 days. His infection was eventually surgically removed from his damaged leg.

Hearing of my infection, Tony began encouraging me to go to the hospital, texting me horrific photos of the open wound on the front of his leg, the same location as my spider bite.

"Watch out for the red line," he said.

I checked my leg and noted redness spreading toward my groin. I called Kaiser and was told to go to a hospital.

Barbara drove me to Emergency at Kaiser Hospital in Santa Clara. I was placed in a wheel chair and immediately admitted and given a series of tests and a room where I would receive IV infusions of antibiotics.

The lab test of the culture from the cut on my toe indicated heavy growth streptococcus pyogenes and moderate growth staphylococcus lugdunensis infections. These bacteria proliferate in the tropics and any open wound is an invitation into the body. The spider bite had triggered a severe reaction of strep and staph which filled my foot like a balloon. The diagnosis was cellulitis. Did we catch it in time? Would I lose my leg?

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All I wanted was a bowl of granola with some milk and maybe some sliced strawberries. 

It's been 17 days since I was bitten by the tropical insect I never saw. I am pleased to say that as of two days ago I can ambulate around the house without a walker. The bottom of my left leg remains a dark reddish-brown color and swollen. I continue to take 1200 mg of linezolid antibiotic per day and my improvement, although small and incremental, is well noted by measure of my mobility and reduced pain when I rise to walk.

Three of my good buddies called me while I was laid up in the hospital -- Paul Greene, Rick Chatenever and John Munoz -- and Tony sent me texts, and I received encouraging texts from my three daughters Molly, Vanessa and Bryna and my brother-in-law Tony Lombardi, from Rick and Marcie Carroll and a home visit and book from Greg Kohler. I feel extremely fortunate for many reasons, too many to count.

I could have lost my leg, or even died if the staph had reached my heart. Fortunately I was not infected with staphylococcus aureus, a common bacteria found in Hawaii that is resistant to antibiotics.

"Hawaii has the highest level of community acquired staph infections in the country. It's two times the rate of the rest of the U.S. That may be because of warm water here or because people are in the water more," according to Tracy Wiegner, University of Hawaii Hilo professor of marine science and one of the authors of a 2021 water quality report.

Bacterial counts in the water rise after heavy rainfall, especially near river mouths where run-off is greatest. Beach water turns brown and appears unhealthy. The Kauai Chapter of the Surfrider Foundation keeps vigilant count of bacterial levels at all the primary surfing and swimming spots around the island. It is well worth paying attention.

The chances of becoming infected are not high as long as you don't swallow sea water or go in the water with an open cut or sore. Even the smallest nick on your skin can provide entry for staph.

I had three little cuts and one scrape on my left foot from walking around in slippers (flip-flops). I washed the open sores but was cavalier about entering the water and walking barefoot in the sand. Who knows if I hadn't received the spider bite how long I could have gone without knowing I had staph or if it would have been a problem.

My neighbor Tony came home from the islands with cuts on his toes, but it wasn't until he banged his shin while riding his bicycle that the bacteria went rogue in his leg.

I look forward to the day when I can walk down a path or sidewalk with my dog Frida at my side. And of course walk with Barbara, although she tends to set a pace that is a little faster than my comfort level. In that sense, it reminds me of my own parents. "I just can't keep up with her," said my father about my mother.

The best thing, without a doubt, is simply being home, gazing across the open room seeing a flower in a vase and not a big round clock ticking seconds. All I wanted when I arrived home was a bowl of granola with milk and maybe sliced strawberries. And I never cared that much about granola before.