When attempting to avoid the oft-terrible, sometimes-fatal parasitic infection that is malaria, there are a number of chemicals you can introduce to your system to keep Plasmodium at bay.
Be careful which one you choose.
One day, you may be traveling to an area of the world where malaria is almost a certainty. Your doctor may insist upon your taking mefloquine, commercially known as Lariam. Perhaps you’ve done your homework and seen the considerable amount of evidence suggesting that Lariam can cause permanent psychosis, PTSD-like symptoms, or even death. Especially in families with a history of depression (not unlike your own).
But the doctor (who has never been to the tropics) insists.
So you take Lariam.
There are a few things you should be concerned about, now.
1) As soon as you take the first pill, you may begin to hear a constant buzzing behind your thoughts, as if there were a receptionless television left on in the back room of your brain. It will be little distracting, but if that’s the worst to be expected it’s not so bad, right?
2) Once you’ve flown out of country, and are alone in a hostel in a strange city, you may be so tired that you immediately fall asleep.
And suddenly, there you are.
Wandering barefoot through the halls of a labyrinthine, low-ceilinged warehouse. The concrete walls are dripping with a dark wetness. The air is cold and thick. Every few steps, you can see inch-thick, yellow foam mattresses on the ground, wedged against the walls, seeped in cold and dirty water. On each mattress is someone you know. Friends, family, even acquaintances. All completely drained of affect, will, and life. You wander like this for an hour or more, until you find a mattress that’s empty. You put your hand into the spongy mattress, and feel the chill of the water pull you slowly into the damp foam, the cold water quickly soaking into your clothes.
And everything just drains out of you.
From somewhere behind you, an old film projector strikes up, and a square of light appears on the wall across from you. You can’t get up, nor do you want to. You can’t even move your head. So you watch an old, familiar movie that used to make you afraid, and later made you laugh. About a young mother sold into something terrible by her ambitious husband and zealous neighbors. You watch the movie, frame by frame, feeling absolutely nothing but the chill of the water in your skin. Until the end. After the credits, a new scene is showing. The young mother, with her pixie cut and hollow eyes, is pushing an ancient bassinet. The camera focuses in, and several things happen at once. The baby springs up quickly, like an automaton, staring directly into the camera, into you. A shriek so high-pitched that it’s almost beyond hearing stabs into your ears, and you begin to convulse.
3) Are you awake? You’re convulsing in a bed. Actually convulsing. Uncontrollably. And you are so terrified that you’re crying. Sobbing out loud. But you can’t stop shaking. After a few minutes, the convulsions stop, but the crying is still wracking its way out of you. You look around.
You’re in a pitch black room.
And something is there.
Something that wants to hurt you.
You try to stifle your crying because you know that it can hear you. You want to turn on a light, but if you move it will see you. If you reach out to that lamp, it will open you up. It will hurt you. So you cry. Quietly. And you try not to breathe. Because it can hear that, too. And you wait long hours, alone in the dark, for the sun to rise.
4) The next day, you may wisely decide not to take your next Lariam pill. But you’ll still think, throughout the day, that the people you see on the street are quietly trying to follow you. Why, you ask yourself, would they want to do that? Because they want to kill you. It’s ok. They won’t. And you can tell yourself that all you want. But you won’t really believe it. Not until a day or two later.
So if you are traveling to an area of the world where malaria is almost a certainty, and your doctor prescribes you mefloquine (commercially known as Lariam), think twice.
And ask for doxycycline instead.