BLACKWATER FEVER

“First, tell me about your original malaria attack. Where were you?”

Swanson drew a deep breath. “I was in a debriefing room about a mile or two from our LZ–Landing Zone. We had been in a firefight at a small hamlet. There was minimal collateral damage–only some animals and an old man wounded. Two suicide bombers detonated their loads before they could reach our perimeter. I was reporting these exact words when I began sweating and getting dizzy.”

“You were overseas.”

“Iraq. The Executive Officer recognized the signs and had me moved to the medical triage tent. I was very thirsty and cold. The sweats came first and then I couldn’t stop shaking. A medic was trying to start an IV and it took four strong nurses to hold my arm.” Swanson stopped and drank the contents of his water glass.

“You’re not having an episode now, I hope?” Nosh looked for signs of sweating.

“No. It must be the power of suggestion–the thirst. The sweats and chills seemed to go on for hours but they were over after the IV fluid, ice packs and medicine took effect.”

“Then what?”

“I was evacuated to a rear medical facility and once I was stable I was sent to a field hospital.” Their meal was served but Nosh still waited for more discourse.

“Go on David. Tell me the details of the first attack.”

“I felt very weak. The doctor told me I had lost almost a unit of blood from the malaria parasite and needed to maintain hydration to protect my kidneys, which were getting rid of the released red blood cell hemoglobin. If I didn’t pee out the red stuff I could get permanent kidney damage.”

“And then where did you go once the red urine cleared?’

“I was air-evac’d directly to Landstuhl Army General Hospital in Germany.”

Detective Furdus Nosh sat back. “Very good David. You remember everything about the first attack. How about the next attack?”

Swanson received a water refill and continued. “I was being followed by the New York VA system while I was attending economics and stock trading school. I had run out of my malaria prophylaxis pills and had an attack in a taxi. They took me to the VA ER at my instruction.”

“Do you remember everything about that malaria treatment?”

Swanson remembered every minute including the brief hospitalization.

“How is it you have all the details at your fingertips?” Nosh was writing as fast as she could.

“It was the most memorable attack. It was where I met Barbara Winn.” Swanson looked at his watch. “Look, Detective Nosh. Can we continue this another time? I have to get back to work and I will visit Lisa Feldman.”

“I’ll let you go on one condition. The next time we talk, which will be tomorrow, I want you to make a list from your medical records of all of your malaria episodes documented by the VA and Dr. Binelli.”

“I’ll do better than that; I have them already written down. I’m on a national malaria study and have to keep a file of every episode.” Swanson stood up and excused himself.

“David, I’ll call you about our next meeting.” Nosh sat back, her pulse racing. I have to find out why Swanson remembered his initial falciparum attacks, and not his later ones.