Chapter 12
The Clinic with the Blue Door
Shamim did not say a word.
She opened the blue iron door in Katwe, at four in the afternoon, with a bag of washing on her hip, and saw who was standing on the step. She took in the suitcase. She took in the face. Then, with great economy, as one handles a thing that might break, she put down the washing and held out her arms.
Nabirye walked into them.
It was so simple. She had thought of it all the way from Entebbe, in the back of the taxi, with her mouth rehearsing a speech. I'm sorry. I should have listened. I know I said I'd come. She had meant to explain. She had meant to say it all, in order, with dignity. But when the thin arms closed round her, and the familiar smell reached her, hot oil and hair spray and cheap sweet perfume, every word went out of her at once, and she stood in the doorway with her cheek against a pink T-shirt and shook.
"Shh," said Shamim. "Shh. I've got you."
"I'm so..."
"Don't. Come in."
She was led into the little room, and sat on the narrow bed, and a cup of tea was put in her hands. The curtain was drawn back. On the other side, the pink mattress was exactly as it had been, with the heap of cushions and the shelf of coloured threads and the poster of a woman in a gold dress. The wigs stood in a row on their stands, silent and patient, with their blank faces turned toward the wall. Nothing had moved. Nothing at all.
"I told you," said Shamim. "I said, I haven't touched it."
"I know."
"The wigs are fine."
"I know."
"I had a man in here last week who wanted to rent your side. I said, No, it's reserved. He said, For whom? I said, For a queen." She sniffed. "He did not understand. He was a very stupid man."
Nabirye began to laugh, thinly, and then she was crying again, and Shamim sat beside her, on the narrow bed, and put an arm round her shoulders, and said nothing at all. They stayed like that for a long time. The light moved slowly across the cement floor. A baby was crying, somewhere in the lane, and a woman was shushing it, and the whole warm shabby smell of Katwe came in through the window and wrapped round them like a shawl.
When it was over, Shamim took her face in both hands.
She did not speak. She was looking, from six inches away, at Nabirye's eyes, at her cheeks, at the skin stretched thin and shiny over the bone. She was looking at her mouth. She drew down the lower lip with a gentle thumb, and looked, and her own face, under the paint, went very still.
"How long have you had this?"
"A few weeks."
"Don't lie."
"Since October. It went away. It came back."
"And the cough?"
"Since June."
"June." Shamim let go. She sat back. She said nothing for several seconds, with her hands on her knees, looking at the red floor. Then, in a voice that was low, and level, and so unlike her usual one that Nabirye hardly knew it, she said, "We are going in the morning."
"Where?"
"To the clinic. The one in Kisenyi. With the blue door."
"I know the one."
"Of course you do. You wrote it in a book." She looked up. Her eyes were full of tears, and her face was fierce. "I'm not asking you. I'm telling you. I will take you by the hand, and I will walk you in, and I will sit outside the door with a magazine until you come out. And if you run, I will chase you in my wedding shoes."
"I'm afraid."
"I know."
"I'm so afraid."
"I know, my love." Shamim's voice cracked. "So am I. That's why we're going in the morning. Not tomorrow evening. Not next week. Not when you feel stronger." She wiped her cheek with the heel of her hand. "I had a sister. Did I tell you? In Jinja. She was twenty-four. She had a cough. She said, It's nothing."
Nabirye did not breathe.
"She said it for a year," said Shamim. "And then she did not say anything. And then she was in a box." She smiled, a wet, crooked, terrible smile. "I'm not going to say it a second time."
The Blue Door Clinic stood on a corner in Kisenyi, between a hardware shop and a place that fixed bicycles, and it was exactly as she remembered, from a hundred small imaginings in the night.
It was a low brick building, painted a pale yellow, with a tin roof and a veranda. The door was a vivid, cheerful, slightly chipped blue. Over it, hand-lettered in black, on a board: BLUE DOOR COMMUNITY CLINIC. HIV Testing, Counselling and Care. Free. Confidential. Walk In. A line of women sat on a bench along the wall, with babies, and plastic bags, and the patient, absent, inward look of people who have waited a very long time. A man in a wheelchair was reading a newspaper. A small girl was drawing, with a stick, a picture on the dust.
It was half past seven in the morning. The sun was already hot.
"It's not as bad as you thought," said Shamim, quietly.
"No."
"It's actually nice."
"It has a bench."
"Everything good has a bench." She squeezed her hand. "Go on."
She went in.
The woman who received her was perhaps fifty, small and plump, in a white coat over a purple dress, with a round, warm, tired face and a head of short grey curls. Her badge said SR. AGNES NAKALEMA — COUNSELLOR. She sat behind a plain wooden desk, in a small whitewashed room with a window onto a yard. There was a calendar on the wall, from a seed company. A vase of plastic flowers. A box of tissues, a stack of leaflets, a jar of sweets. A large poster, in bright yellow, with a drawing of a smiling woman holding a pill. I TOOK MINE TODAY.
"Sit, my dear," she said.
Nabirye sat.
"I'm Agnes. I am going to talk to you for about twenty minutes, and then, if you'd like, we'll do a test. It's only a prick on the finger. You do not have to. You can say no at any time, even at the last second, and I will make you a cup of tea, and we'll talk about something else." She smiled. "Do you want a sweet?"
"No, thank you."
"They are very good. They are from my sister in Mbarara. Take two."
She took one. It was a hard round pink one. She held it in her palm.
"What's your name?"
"Nabirye."
"Your full name is not necessary. I do not even write it. We use a number." She opened a ledger. "What brings you in?"
"I'm..." She swallowed. "I'm sick."
"How long?"
"Six months."
"Tell me."
She told her.
It came out differently than she had imagined. She had thought it would be a long, low, shaming confession, a thing to be said with the head down. But Sister Agnes did not look shocked. She did not look anything. She sat with her hands folded on the desk, and her eyes on Nabirye's face, and she nodded, now and then, in a slow regular rhythm, as one nods to a child reciting a lesson. She said, "Mm." She said, "I see." Once, when Nabirye's voice cracked, she pushed the tissues an inch across the desk, without comment, and went on listening.
At the end, Nabirye said, "I'm a nursing student."
"I thought so."
"How?"
"You said night sweats as a nurse says it. Not as a person." The corner of the warm mouth lifted. "Most people say, I get hot at night."
"I knew. I knew all along."
"Of course you did."
"I did nothing."
"No."
"I was..." She could not finish.
"You were afraid," said Sister Agnes. She said it simply, without reproach, as one says it is raining. "I'll tell you something. Everyone who comes through that door is afraid. It is the single most normal thing about them. The nurses are afraid. The doctors are afraid. I was afraid, in two thousand and one. I sat in a chair like that one, and I was shaking so hard that the man had to hold my hand."
Nabirye looked up.
"Did you...?"
"I have been living with it for twenty-three years." She smiled. "I take one pill, at eight o'clock every evening, with my tea. I do not even think about it. I have a grandson. I have a garden. I have a job I love." She lifted her hands. "I am fifty-three years old and I have never been in better health. My blood tests are better than my doctor's."
The room was very quiet.
"You... you are positive?"
"Yes."
"And you counsel."
"I counsel because. It's a different thing." She leaned forward. "Listen to me, my child. I am going to say the most important thing first, and then I'll say the rest. It is this. If the test is positive, and I do not know that it will be, you are not going to die of it. Not if you take your medicine. Not for thirty, forty years. You will live as long as I will. You will have children, if you want them. You'll marry. You will grow old. It is a condition. It is like diabetes. It is like a bad kidney. It is a thing you manage."
"I saw a girl, on the ward..."
"Yes. And I will tell you about her." Her voice was gentle. "She was very sick. But she was sick because she came late. Because she waited. It is not the virus that kills the girls on those wards. It is the waiting. It is the time. They arrive when they cannot walk, and there is almost nothing left to save." She paused. "You have come while you can walk. That is everything. That is the whole of it."
"I've been ill for six months."
"I know. And I am going to be honest with you. Your body has had a hard time. We will see what we find. But you are here, and you are sitting up, and you are asking me questions. That is a very good sign."
"I don't want to be sick."
"No."
"I don't want to be the person who..."
"The person who what?"
"The person who has that." She was crying now, silently. "The kind who deserves it."
Sister Agnes put down her pen.
She did not hurry. She sat, for a time, looking at Nabirye, with her round, grave, kind face, and her hands flat on the blotter. Outside, in the yard, a hen was clucking. On the other side of the wall, the voices of the waiting women rose and fell, a low, patient murmur, like water.
"Nabirye," she said. "Do you believe that God sends sickness to punish?"
"I... I don't know."
"I do not. I used to. I thought, It is a judgement. I have been bad. I lay awake for three years thinking it. And then one day I saw a baby, in a ward, three months old, born with it. And I thought, what has she done?" Her voice was very quiet. "A virus does not read your life. It does not know if you went to church. It does not care if you are a student, or a prostitute, or a bishop. It is a very small, stupid thing that wants to get into a cell. It does not judge. It only finds a door."
"I left it open."
"You did." She said it plainly. "You were a young woman who made a human mistake. Many of us have. It is not a crime. It's a thing that happened. I want you to hear me. It is not a punishment, and you are not dirty, and nothing you have done makes you less worthy of being well." She held up one finger. "The only thing that would be a sin is if you knew all this, and sat in a room, and did nothing."
Nabirye put her hands over her face.
"Now," said Sister Agnes. "Shall we?"
It took eleven minutes.
She would remember it, afterward, as a long silence with a few details sticking out of it, like posts in a flood. A small white room with a high bed. A nurse in a blue apron, a thin young man, with kind eyes, who said, "Just a little pinch." A tiny bright bead of blood on the end of her finger, which he touched with a strip of white plastic, and laid on a tray. A clock on the wall, with a red second hand. A sound of a tap, running, somewhere down the corridor.
Sister Agnes sat beside her, on a stool, and held her other hand.
They did not talk. It seemed, to Nabirye, that she could hear the whole of the world in that room, the rustle of paper, the shuffle of a patient's feet, a child crying. She watched the red hand go round. She counted. She counted the way she had counted the roses on the wallpaper in Mama Agnes. Forty. Forty-one. Forty-two.
One line. Please. One line.
I'll go home. I'll finish my course. I will be good.
Please.
At fifteen minutes, the nurse looked down at the little white strip.
She did not look up at once. She went on looking, for what seemed a very long time, with his thin face still. Then he lifted his eyes, and met those of the older woman, and nodded, once, very slightly.
Oh, thought Nabirye.
It was not a thought. It was a sound, inside her, like the closing of a door. She felt it, in the roots of her teeth. She saw the strip, small and white on its tray, with a pale rose-coloured line at one end, and, a little further along, clear, faint, undeniable, a second.
Two lines.
"Nabirye," said Sister Agnes.
"I know."
"My dear."
"I know. I can see." Her voice was perfectly calm. She was astonished. It was a flat clear voice, the voice of a stranger reading a report. "It's reactive. We will need to confirm, with a second test, and a third. But the first screen is positive."
"Yes."
"I knew. I knew in June."
"I know you did."
"I knew in..." She stopped. Something rose in her throat. "I knew when I was nineteen. I knew when I wrote it in a book. I knew when..."
"Nabirye."
"I could have..."
"Nabirye." Sister Agnes had put both arms round her. She was a small, solid, warm woman, smelling of soap and plastic flowers and old paper, and she held her very hard, like a person holding a child at the edge of water. "Breathe. That's right. Don't say anything. Breathe."
She breathed.
She did not remember the next part. She remembered, in fragments, a wail, a long ugly broken animal sound, and discovered that it was her own. She remembered the nurse in the blue apron backing quietly away, and shutting the door. She remembered her hands clutching at the white coat. She remembered a voice, very close to her ear, saying, over and over, You are alive. You are alive. You're alive.
And she remembered, with an odd clarity, a sentence that came to her out of nowhere, in the middle of it, in her father's handwriting.
They will know.
Everybody will know.
I would rather go quiet.
"I don't want anyone to know," she said, into the coat.
"Nobody will."
"Not my mother. Not Shamim. Not anyone."
"It is up to you. It is your news." Sister Agnes drew back. She took Nabirye's face in her hands, and held it, and looked at her. Her eyes were wet. "I will never say a word. It's the law, and it's my promise. But, my dear, listen to me. I am going to ask a favour. When you are ready, not today, not this month, you will tell one person. One. Someone you trust. Because the thing that kills us is not the virus. It is the carrying. It is carrying it alone."
She thought of a woman with a sack on her head.
Maama.
"I can't."
"Not yet."
"I can't tell her."
"No." The grey curls shook. "Not yet. But one day. When you are well." She smiled, through her tears. "You will be well. I promise you that. I'm going to be extremely stubborn about it."
It took another hour.
They did the second test. They did a third, on a machine, which confirmed it. They took blood, in four small tubes, for a count of the cells that guard the body, and for a measure of the virus, and for the liver and the kidneys. They gave her a tin, and a form, and sent her down a corridor to a small room, where she coughed into a pot. They put her on a scale.
Forty-seven kilograms.
A doctor came, a young Indian woman, brisk and kind, with a stethoscope round her neck. She listened to her chest. She looked in her mouth. She pressed her abdomen, and the glands under her jaw. She said, "Mm," several times, and made a note, and said, in a low, plain voice, "The test for TB will take a day or two. I do not want to wait for it. Your count is almost certainly low, I would guess about a hundred and fifty or a hundred and eighty, so you are at risk of infections, and I want you protected at once."
"You mean now?"
"Today."
"I thought you waited. For the results."
"We used to. We found it was a mistake. The sooner we begin, the better the outcome." She smiled. "Do not worry. You will not feel any different at first. It takes a few weeks."
They gave her a paper bag.
It was brown, with the clinic's name stamped on it in blue ink. Inside, there were two plastic bottles, white, with screw tops. The first held large, flat, rather chalky tablets, a hundred and eighty of them. Co-trimoxazole. One daily. Prevents infections. The second held thirty small round tablets, pale yellow. They were smaller than she had expected. They were about the size of a pea.
"Tenofovir, lamivudine, dolutegravir," said Sister Agnes. "Three medicines in one tablet. You take it once a day. At the same time, every day. Not sometimes. Not when you remember. Every day. With food, or without. In the evening, if you like, so it comes with tea." She held it up. "This is what keeps you alive."
"For how long?"
"For ever."
"For ever."
"Yes. It is a very long time. But it is only a small tablet." She dropped it into Nabirye's palm. It was warm from her hand. "It is a promise you make to yourself every night. I am going to be here tomorrow. Do you understand?"
"I think so."
"The first weeks may be hard. Some people get headaches. Dizziness. A strange dream. It passes. If you have trouble, you come to me. You do not stop. Do you hear? You do not stop and you do not wait. If you are tired, if you are scared, if you do not like it, you walk through that blue door and you say, Sister, I have a problem." She closed Nabirye's fingers round the tablet. "Promise me."
"I promise."
"Say it."
"I promise I will take it. Every day. And I'll come back if I have trouble."
"Good girl." She patted her fist. "And you will come on the fifteenth, for your first review. I've written it." She tapped the card. "And if you do not come, I will find you. I'm not joking. I have a very large network of grandmothers."
Nabirye laughed. It was a small, cracked, startled sound.
She had not known she could.
Shamim was sitting on the bench outside, between a woman with a baby and an old man with a stick, with a magazine open on her lap that she was not reading.
She stood up.
She did not run. She did not say anything. She only looked, from across the little yard, at the face of her friend in the blue doorway, and her own face, under its paint, did a series of tiny things, like the surface of a pond. Hope. Fear. A flicker of dread. And then, as Nabirye lifted the brown paper bag, a slow, enormous, wondering collapse.
"Oh," said Shamim.
"Yes."
"Oh, my friend."
"It's all right."
"It's not."
"It is." She came down the step. She was walking oddly, as though the ground were a long way off. "It is. I'm alive. I have a tablet. It is the size of a pea." She held up the bag. Her eyes were swimming. "She says I'll live as long as she does. She has a grandson. She has a garden. She is fifty-three."
Shamim made a sound. It was somewhere between a laugh and a scream. She hurled the magazine into the air, and ran across the yard, and caught Nabirye by the shoulders, and held her, and they swayed on the red earth together like two drunks, sobbing and laughing, while the women on the bench looked on with the tolerant, immeasurable calm of people who have seen it all before.
"I'm sorry I did not come sooner."
"You came."
"I should have..."
"You came!"
"I'm so scared."
"So am I." Shamim drew back. She was holding her by the arms, and her whole face was running. "But you are not alone. Do you hear? You are not alone. I'm going to sit on you every night until you take it."
"I can take it myself."
"I'll sit anyway."
"It's the size of a pea."
"A big, strong, magnificent pea." She wiped her face with the back of her hand, smearing her lipstick. "A pea that is going to keep my best friend alive." She laughed again, a high wet gasp. "Oh God. Look at us. We are a disgrace."
They stood in the yard, in the white hot sunlight, with the sky very high and blue above the tin roofs, and the smell of charcoal and dust, and a boy mending a bicycle on the other side of the wall. People went by, in the road, with baskets. A bus hooted. The whole great ordinary noise of Kampala, which had been going on all morning, without any regard for her, came back, like the sound of a sea.
Nabirye stood with her eyes shut, and the bag against her chest, and felt it.
It was not what she had expected. She had imagined, many times, in the dark, that when it came it would be an end. A wall. A black door slammed shut. She had thought she would be a different person afterward, a marked one, with a stamp on her forehead.
It was not like that. She was exactly the same. The same hands, the same thin arms, the same ache in her chest. The sun fell on her face as it had on the day before. Somewhere across the lane a woman was singing, a high, sweet, cracked voice, a church song, and a radio was playing, and a child was shrieking with laughter.
So this is what it is.
It is only the world, still going on.
It was very strange. It was almost, in some way she could not name, a relief. Because the worst thing, the very worst, the thing she had run from for six months, for four years, for fourteen, had come to stand in front of her, in the sun, in a yard with a hen and a bicycle, and she was still standing. She was still here.
"Come," said Shamim. "I'm buying you fish."
"I'm not hungry."
"You are going to take that tablet with food. We're not going to start by being stupid." She slipped an arm through hers. "And then you will sleep. And in the morning, you'll feel the same, and that is how you will know."
They walked out through the gate.
At the corner, Nabirye turned her head. She looked back, once, at the little yellow building, with its tin roof and its bench and its chipped blue door. A woman in a purple dress had come out onto the veranda, and was standing with her hand shading her eyes. She lifted the other, palm open, in a small, plain, sisterly wave.
Nabirye lifted hers.
And then, very slowly, she put it in her pocket, where the paper bag was, and felt the weight of a pea.