Jules Crittenden, 43, is a Boston Herald reporter who was embedded with the 3rd Infantry Division last March and April in Iraq and was assigned to Kuwait prior to the war. Crittenden has also reported on ethnic conflict and other issues in India, Pakistan, Kosovo, Israel, the Palestinian areas, Armenia, and Nagorno Karabagh.
It’s World Tuberculosis Day. My own special day this year.
On the advice of my children’s pediatrician, I had a TB test last week.
When he learned that I had spent part of last year in Iraq as an embedded reporter, the pediatrician told my wife he assumed the military had tested us all for TB upon our departure. I laughed when my wife told me that.
“They more or less kicked us out the back door of a C-130 out in the desert, pointed into the darkness, and said, ‘Kuwait City’s that way,’” I told her.
So I let a nurse jab my arm to satisfy my wife’s concerns. Within a day, a red bump the size of a dime appeared on my forearm, the redness around it the size of a quarter. My own doctor, who used to work in a TB clinic in India, opined that was an indicator of recent exposure.
I considered the possibilities. That kid in a Kashmiri refugee camp whose full-face cough I walked into five years ago. I remember thinking no good would come of that. The frightened Iraqi soldiers I coaxed out of their dirt bunker in Baghdad with my broken Arabic, when they held back and the GIs were starting to get tense and irritable about the situation. The Bedouins who shared their tea, sweet goat butter, dates, and conversation in a tent out in the Kuwaiti desert. Any of the Kosovar, Arab, or Armenian crowds I have jostled with in the last few years. God knows.
Tuberculosis is easily transmitted through the air. The docs say they virtually never see it in suburban America and based on the strength of my reaction, my doctor favors my recent Middle East sojourn.
Even here where it is rarely seen, the name tuberculosis holds some residual historic dread. Both parents of my father’s adopted brother in Australia died coughing, wasting deaths of it before World War II. It killed one in seven Americans a little over a century ago, according to the federal Centers for Disease Control.
In the rest of the world, tuberculosis is one of the leading killers among infectious diseases. There, it takes 2 million lives a year.I had no symptoms of an active infection last week, but I had a couple of tense days anyway until my chest X-ray came back clean. No lesions, no scar tissue. My TB is latent, non-contagious, the doc says. No quarantine, no need for panic in my office or my children’s school. No big deal. All I have to do is take antibiotic horse pills for the next six months to kill it where it is lurking in my lymph nodes.
I am a middle-class American. Only about 700 people die of TB each year in this country – most of them homeless or drug users, from immigrant communities or compromised by other conditions like AIDS. This is not Russia – where drug-resistant strains are emerging – or China, the Middle East, Africa, or Latin America, where it is rampant. In the rest of the world, tuberculosis is one of the leading killers among infectious diseases. There, it takes two million lives a year.
So it serves as another lesson, among many, of how privileged we are. My biggest concern is getting the word out to fellow reporters, professionals, and academics now traveling back and forth to the region in greater numbers, thanks to our ongoing wars and occupation of highly infected areas. You need to be tested.
Most of the colleagues I’ve spoken to were unaware of the risk. One freelance pal joked that if he’s got it, it’s a particularly exotic strain — only the finest Taliban TB from Afghanistan’s Sherbergan prison. I think that might trump my Iraqi POW TB.
“Don’t flatter yourself. Two-thirds of the Third World has got it,” said a Special Forces pal when I told him about my situation. He tested positive four years ago – Bosnia, he figures – and took his pills. The GIs are tested regularly, and hopefully those who get it will stick to the strict antibiotic regimen and not start cultivating a drug-resistant variety here.
For me, this unexpected development has become almost laughable, surfacing amid a rush of Iraq anniversaries: The death dates of men I knew are coming soon, along with those of some strangers I remember. A treatable disease, even with the dread name tuberculosis, is no more than a nuisance for me.
God knows what the future holds for the unknown person who infected me, someone who may not have access to the life-saving health care I take for granted, who is probably infecting others. Someone who may join the ranks of those two million who will die wretched deaths this year, or next year, or the year after that, due to the unmet challenge of containing this disease.