Cytokine Storm

  The Ukraine war has made me aware of how insignificant life on this Earth might be. The period I spent in hospital following a covid infection and a cytokine storm made me realise how remarkable my existence on this planet might be. The experience all but concluded my life, and indeed, many shared my expectations. I am left with no doubt that I had reached the boundary that characterised the point of departure. 

I owe gratitude to the doctors who refused my appeals for them to withdraw and leave me to face the inevitable. I was so sick and in pain that it seemed to be a desirable outcome. 

During the first two weeks of January 2022, I drifted into a completely unknown world. Driven by outrageous dreams and horrifying hallucinations, I felt distressed, solitary and alone, often in a dark, infinite and featureless world. Short-term sensory deprivation sessions can be relaxing; extended sensory deprivation can result in extreme anxiety, hallucinations, bizarre thoughts, and depression. 

One morning, I awoke to find myself in a fantastic coherent world that made sense. I felt invigorated but was nevertheless wholly hindered by the loss of physical strength. There is no doubt that my mind and my sight had suffered the consequences of the experience.

I resolved to continue the struggle and did my best to recover. I had no desire for food, yet I picked out the most protein bearing and nutritious morsels I could find within the meals supplied. During the night, I would plan my next physical endeavour. I might decide to sit at the foot of my bed or walk along the bed clutching at the side rails, but I lacked the strength even to reach the foot of the bed.

Toward the end of January, I was visited by three physiotherapist carers who were to get me up and mobile. I rarely had visits of this nature and insisted that I return home to my family waiting for me. After several exhausting and harrowing events to satisfy the authorities, I and my wheelchair were winched up into a waiting vehicle to return home.

Once home, I was allocated three carer visits daily, evidently, to assist Myrtle. Myrtle's dedication and a more suitable diet nurtured me, and I quickly began to recover my strength. The visiting carers insisted I perform prescribed exercises daily, among other supportive duties.

It is now mid-May, and I am all but thoroughly recovered. I can walk freely about the house and attend to all my basic needs; I prefer to use a rollator or a wheeled walker when walking outdoors.

If I learned anything from my experience, that is to continue my exercises for as long as I live. I am now more mobile and physically stronger than I was before. 

Covid

I had Covid starting in mid-December 2021. I first became aware of it when I collapsed on the bathroom floor. At the time, a lady from Living With Covid called to check on us. On hearing that I had collapsed, the lady caller enquired about my blood oxygen percentage. Fortunately, Living With Covid provided us with a  blood oximeter. 

Upon hearing my blood-oxygen ratio, she was shaken and immediately arranged for an ambulance to take me to a hospital. The ambulance arrived within minutes, and I was placed in isolation upon arrival at the hospital.

I spent some time in this isolation room surrounded by the most depressing wallpaper. An elderly doctor entered, and after encircling my bed, he said, "You may never leave here." He went on to mumble something about intensive care. The staff who attended to my needs wore transparent helmets fed by air from an apparatus slung on their backs.

I was eventually transferred to a ward full of very sick people. I was finally discharged and sent home after two weeks.

I arrived home, and I began to run at a high temperature. At home, we could not control my temperature with the resources available. I returned to the hospital and remained there for the next four weeks. 

I have no recollection of anything during the first week in the hospital. No one could know what I was going through after that; my entire body was wracked with pain, and to cough was agony. The illness had entirely drained my body of strength, and I could only lie wholly paralysed. My mind constantly hallucinated, leading to outrageous dreams. It was so distressing that I have no desire to recall or discuss any of it. 

I would dream of being in an arid landscape of nothing but an endless terrain of nothing. I'd be walking, searching, knowing there was nothing to find, only darkness.

The nursing staff were mainly of foreign birth, knowing sufficient English for the job. Everyone was extraordinarily supportive; nothing seemed to be too much trouble. Still, I think few appreciated what I was experiencing—left to lie in isolation with no contact with the familiar outside world apart from an occasional call from home via the ward telephone.

Because I had no bladder control, the nursing staff constantly changed my bed linen and pyjamas. Meanwhile, other nurses lined up to insert fluids into my ailing body or withdraw the precious content.

Internet access was denied, and no visitors were allowed. I was left to lie and reflect on my imagination and hallucinations. I felt like a caged rat in a laboratory, a living source of research material. It was probably the most horrendous period of my life, mentally or otherwise.

A doctor emerged out of the fog. Leaning over my bed, he exclaimed, "The trouble with you is that you are not cooperating." I had no idea what he was eluding to, for there was nothing much that I could do to please him. I pleaded with a visiting doctor on several occasions to go away and leave me alone and let me slip away peacefully.

After that experience, I was moved to various wards where life continued as before. Physiotherapist nurses were around visiting patients, but I received little more than promises for tomorrow. I had gained a little strength and realised that I should be trying to restore my mobility.

Doctors visited me but rarely spent any time with me. Finally, a doctor informed me that I would be transferred to another hospital when space was available and then to a specialist nursing home.

Early one morning, I was surrounded by three physiotherapist nurses who informed me that they were to get me up and mobile. I had a complete 'meltdown' and said I had as much as I could and would go nowhere except home. 

Peter had come out from Australia to be with the family, while John and Myrtle were eager to have me home. John had bought me a hospital bed, and all were prepared to have me return.

About three days later, late in the afternoon, I was awakened from an afternoon slumber. I was informed that a taxi had arrived to collect me. I was loaded into a wheelchair and finally winched into the back of the waiting vehicle.

It was a late winter's evening, dark and cold, and I was unsure of my destination. The journey took forever; I could not identify landmarks but assumed it was homeward. I texted John as best I could in the jolting taxi to inform the family that I was on my way home.

When we finally arrived after a gruelling journey, I was relieved and delighted to see Myrtle, John and Peter on the curbside waiting for me. However, I wondered how they intended to get me to a bed because  I was emaciated without any vestige of strength. It was a relief to find that the wheelchair could enter the house and take me to my bedside. 

It was now late January 2022; the month had been one of my life's most gruelling periods. Upon my arrival home, I could do very little for myself, but I did begin to recuperate. I steadily recovered, grateful for Myrtle's unwavering love and untiring support. Carers were provided and called thrice daily to assist and oversee my exercises. 

During February 2022, carers would arrive early morning, midday and evening; I seldom felt like tolerating their intrusion while washing or having a shower as they supervised. At first, exercise was such a burden; I knew I had to make an effort to recover and be more self-sustaining. 

Recovery was slow and steady throughout February. In March, I quickly regained strength and could get about quite easily with a walking aid. I could walk down our passage unaided by mid-March, much to my carer's astonishment and delight.

April, I can now walk about normally, except there is an element of weakness in my legs, and my balance is not good. Myrtle and I exercise every morning. Our regular session, provided mainly by the carers, leaves me exhausted. 

I have come so near to the termination of my presence on this ailing planet on more than one occasion I do not doubt that I have a benefactor in some undisclosed and secret place where I will live forever. 

Chapter 1

Introduction

Introduction

GLYN DANIEL KEARNEY

Life Experiences

Introduction

Durban in South Africa was a lively city in 1950, with a different pace of life compared to . . . today's fast-paced digital world. There was no television and cars were a luxury.Young people felt optimistic, and I started my career as a pharmacist trainee. We spent our evenings carefree, enjoying the company of friends and watching movies at the drive-in theatre. The beachfront was a safe place to be, with car-side service for coffee and toasted buns. Formality eagerly expected, with young men and women dressed in their finest clothes, dancing and enjoying the Tudor gaze of the Playhouse cinema. Saturday nights are expected with everyone looking forward to the velvet embrace of the theatre. As my career progressed, I learned how to adapt to the ever-changing world. My story is a testament to the shifting notes of life, and how I learned to embrace change.

Chapter One - 1935

Port Shepstone early years

The story begins with my mother, who was born in Cowbridge, Swansea, and was already in her 40s when I was born. She had moved to South Africa, accompanied by her 12-year-old daughter, shortly after World War I. However, the circumstances of her move shrouded in secrecy and embarrassment, which was typical of the era. Assuming that the anguish of WWI may have been a contributing factor to her relocation to a foreign land as a young woman, which could have been a traumatic experience for her, especially since she was probably rejected by her family.

My father was one of the British soldiers of the South African Mounted Riflemen (SAMR) formed in 1915 during World War I. He was sent to East Africa to fight in the war against Paul von Lettow-Vorbeck. He used to tell me stories about the harsh conditions, the relentless heat and humidity, and the constant threat of disease. But most of all, he talked about the frustration of fighting an elusive enemy who seemed to vanish into the bush, only to reappear and strike when least expected. Disease was another enemy, malaria, dysentery, claiming more men than bullets. The heat, the insects, the endless marching, it wore us down, but we pushed on, driven by stubbornness, a refusal to let von Lettow have it his way.The war against Paul von Lettow-Vorbeck in East Africa took place during World War I, which lasted from 1914 to 1918. Born in 1898, Dad must have been very young. Following his return to South Africa, he joined the South African Police Force in April 1920 as a detective. 

They married on the 25th June 1927 The outbreak of World War II in September 1939 sent ripples through our lives. My father, Detective Sergeant Kearney, moved from Durban where I was born in 1935 to a smaller town on the south coast–Port Shepstone near Durban in 1940. Port Shepstone had a unique flavour. Many settlers, primarily German farmers, called it home. I vividly recall the long journey there in our old Hudson, bumping our way across rickety river bridges. Forget smooth tarmac - the roads were mostly rough gravel or even beach sand. 

Our first stop was Mrs. Batstone's boarding house. Too young for school, I spent my days under her watchful eye while my parents completed the move from Durban. Soon enough, though, Mom found a gem–a lovely house close to the mouth of the mighty Umzimkulu River. Back then, Umzimkulu marked the border between Eastern Cape and Kwazulu-Natal provinces.

Behind our house stretched a vast expanse of pristine coastal bush, merging seamlessly with the river mouth. This became my personal playground, a world to explore. Mom's only rule (a far cry from today's safety restrictions) was to stay away from the river itself. Unfamiliar with the dangers lurking in the African bush, Mom didn't fully grasp the potential risks. I spent countless hours lost in that verdant world, venturing close to the riverbank. There, I'd watch brightly coloured river birds weave intricate nests in the reeds, or mesmerised by chameleons, their colour-changing abilities a source of endless fascination. Of course, with childhood curiosity came a healthy dose of fear. Whispers of the dreaded Black Mamba, a venomous serpent said to slither through the bush, sent shivers down my spine. Thankfully, my encounters involved harmless grass snakes and other less intimidating creatures.

As dusk settled, the landscape transformed into a magical spectacle. Patches of grassland twinkled with fireflies and the gentle glow of glow worms. Even the daisies in our garden seemed like tiny ecosystems, each one housing a beetle at its heart. The chirping symphony of crickets filled the air as the sun dipped below the horizon.Flying ants, those heralds of evening, emerged in buzzing swarms. Males and young queens on a nuptial flight, they'd leave a carpet of spent wings behind, especially near lights. It was a world teeming with life, a constant source of wonder for a curious young boy.

Chapter Two 1940 to 1944

Life in Port Shepstone

Life in Port Shepstone settled into a routine. My mother, ever the patriot, joined the Women's Auxiliary, her days filled with sewing clothes and raising funds for the war effort. Our home often opened its doors to war refugees, offering them a temporary haven. 

My father, a relentless investigator, spent countless nights pursuing elusive criminals. Whether it was investigating swastikas vandalising local roads or German submarines allegedly signalling off the coast, his dedication was unwavering. Unfortunately, to my knowledge, he never succeeded in capturing a submarine.

By the time I reached school age, however, a different storm was brewing within me. Looking back, it's clear I was an insecure child. What we now understand as autism and learning difficulties  labelled as daydreaming and inattentiveness. Unsurprisingly, punishment became my constant companion from day one. School was a battlefield, and I resisted its rigid structure with every ounce of my being.

Even today, the details of that experience remain etched in my memory. The headteacher's imposing figure, his office a place of dread. The veranda on the side, a makeshift punishment zone where I'd be a solitary figure yearning for understanding. These were the harsh realities of my school life between the ages of seven and nine.

Chapter Three - 1945 to 1949

Back in Durban

WWII ended on May 8th, 1945, but the world remained a fractured place. We returned to Durban at the end of 1945, and the new school I found myself in offered no refuge, only a different battlefield. Here, the enemy wasn't war, but a sea of orphans wrestling with their own grief and loss.

My teacher, Miss Thompson, stands out in my memory: a thin woman with gaunt cheeks painted a harsh red with rouge.  Every day seemed to bring a fresh batch of mistakes on my part, each one leading to an inevitable call to the front of the class for punishment.  Her weapon of choice was a three-foot-long cane, wielded with a venom that defied her frail frame.  I can still see her drawing herself up, taking a deep breath before unleashing a blow with such force that it seemed to lift her off the ground.

But the cane wasn't the only torment I faced. Being the "new kid" in a school filled with hungry orphans made me a prime target. Every break was a gauntlet of bullying, a relentless assault fueled by a mix of hunger and cruelty. The vast playing fields became our hiding place, a corner far from the watchful (or perhaps nonexistent) eyes of any teachers. Many, it seemed, were yet to return from the war.

Returning home with bruised arms and blue cheeks, I'd face my father's concerned questions. The answer, however, was always the same: "Be a man."  It was a simple yet brutal solution, offering no comfort or protection in the face of relentless torment.  Those were the harsh lessons learned in the hallways and on the playing fields of my new school–lessons of survival, not education.

During my first year in that school I ran an unfathomable temperature. A doctor, summoned to our home and all I can remember was his presence in my room. I remember nothing else until I awoke and found myself in a hospital ward with a pile of Bugs Bunny comic books on the table beside my bed. I do not know how long I remained in hospital or even any recollection of other children in the ward. 

After a period, I returned to school and as far as I can recollect, life was less harsh. For me, from that time on all is unclear. I know that my mother arranged for me to go to an alternative more cultured school but my memories are vague and I can only recall part of the first year in that school and the many afternoons that I had to remain after school to reconstruct earlier work, particularly Afrikaans language.

My experiences set the stage for the future of my entire school career. Not intentionally but I kept my distance from anything that looked like a teacher, I enjoyed no connection with teachers and viewed other boys with suspicion. I had few friends and found ways and means to entertain myself. My new school focussed heavily on sport and that meant further harassment and punishment for noncompliance. I hated rugby and thought it to be a barbaric pastime. I could never see the sense in cricket while standing in the field waiting for a leather bound ball to come my way. I was far away in my world when a ball came flying by.

While writing this account of my past, I realise that I have a very scant recollection of the events from the time of my hospital experience late 1946 to early 1949.My parents were always on the move. When my mother sold the house in Port Shepstone, she realised she could make money buying and selling houses. We were always on the move occupying, renovating and selling houses. I lived mostly with my sister and her husband and therefore never settled down to a life in a home of my own

Chapter Four - 1950 to 1953

High school years

I had just completed my end-of-school examinations and was ready to face the real world. Two years earlier, I had written the school leaving examination, and I had failed. Upon returning to school to repeat the failed year, The head teacher summoned me and gave me the choice of being promoted or repeating the failed examination. He reminded me that if I failed my end-of-school examination, I would have neither a school leaving nor a university entrance certificate.

This momentous event was quite unanticipated. One might expect that having to make a decision of this nature required consultation with parents or guardians, but I instantly agreed.

I was living with my sister and her husband at the time. I had no idea where my parents were living or what they were doing. 

Living in this world, I was truly an alien. No one understood me, and neither did I understand the objectives and values of the neurotypical. When Leo Kanner's 1943 paper on autism was published recognising autism as a separate condition, the world was not ready to accept or understand the gravity of the situation. All my life, I have lived a life of indifference and mostly responsible for my own destiny.  

I was never in an institution-like environment or intensely supervised. At all  times at home I was left to pursue my own interests that by no means was commensurate with the norm. The family comment was that if you wanted to know how Glyn was doing at school you started at the bottom of the published exam list. 

I never understood the concept of competition. I just did what I resolved to do without seeing a coming examination, for example, as a challenge but something that had to be done.

I had no friends with whom I could consult. On being in the vicinity of the pharmacy school after completion of my school career back in 1954, I resolved to register and qualify as a pharmacist. In spite of the myriad of unsuccessful students in circulation, I was undaunted and finally qualified as a professional pharmacist in 1959.

Finally, with no great effort, I passed the South African final year matriculation school examination, the minimum university entrance requirement. I favoured a career in Pharmacy although I think I would have preferred to study chemistry for I was mad about science.

Chapter Five - 1954 to 1959

Pharmacy training.

While registering to study pharmacy, I met a school friend who was known to be one of the brighter pupils. He knew me quite well and advised me to reconsider my choice of career as he was convinced that it was quite the wrong occupation for me. My family were not convinced about my career choice but in spite of their lack of confidence in me they still left me to my own devices and possibly not expecting me to enrol for pharmacy. At the time, pharmacy was thought to be one of the more difficult careers and, probably, there was some truth in it for there were many who struggled for years to pass the examinations or else withdrew.

I can still vividly recall the day I went to purchase my text books. I have a clear vision of the bookstore in the Durban high street, “Griggs Booksellers” was its name. I remember the young fellow who served me, he had to help me pronounce the word “pharmaceutical”. Looking back, I cannot believe I took life so casually yet I cannot boast of being confident or apprehensive. As I think about that period, I am reminded of my school years, my attitude to life and my destiny.

I can distinctly recall my first pharmacy lecture. Where I arrived without pen or paper. The lecturer strode in and delivered his lecture and at. the end he gathered his papers and departed leaving me feeling rather stunned. I sat in the empty lecture room and realised how alone I was. There was no one that I knew and all departed without a nod.

I had to serve a three-year apprenticeship prior to a full year terminating in a qualifying examination. An intermediate examination was necessary either a full year at college or two years’ part-time study during the apprenticeship period. I chose to study for the Intermediate examination during my apprenticeship years. I worked six days a week in order to pay for my lectures at the Pharmacy School and attended lectures three nights a week thus saving a year.  There were no University courses for Pharmacists in those days. My parents gave me a small car as there was no bus transport at night and the College was miles away from home. There was little time for pleasure as I had to work extremely hard. I had realised that I was not going to get by on minimum effort. I was delighted when I passed my final qualifying examination before my school friend who had advised me to choose another career.

Apprenticeship Years

During my apprenticeship, I worked in a dispensary surrounded by many stock bottles. Each bottle contained a solution of a medicinal chemical or compound used for dispensing doctor’s prescriptions. At the time it was not uncommon to dispense many medicinal mixtures for internal and external use. Technology and mass production had not yet been introduced. Each preparation would be individually compounded with at least 4 or 5 active ingredients and a sweetener or a flavouring would be added to make it more palatable. Dispensers needed to be extremely alert and not become confused while working under pressure. The measurement system used was grains, minims and drams. The doctor would order ingredients per dose and the dispenser would have to mentally calculate how much was needed of each ingredient for the number of doses prescribed. There were no calculators to assist with the calculations either. The pharmacist needed a good knowledge of chemistry to avoid mixing chemicals that might react negatively with one another in the bottle. Pharmacy was certainly a profession.

Bottles containing tinctures and infusions made from herbs to make medicinal mixtures lined the walls while oils and fats used for making ointments or emulsions for the skin were kept at a lower level. Many creams, ointments and lotions were prescribed and it needed professional skill and knowledge with a mortar and pestle to blend oil and water. They do not normally mix easily and it took hours of practice to learn the skill of knowing just where in the mortar the pestle would shear the oil globules small enough to be carried in suspension in an emulsion. Just the right flick while mixing was important to attain a successful dispersion for a smooth emollient.

There were a few proprietary pills, tablets and mixtures available for prescription use while many doctors had favourite recipes of their own.  Each morning as I entered the dispensary I relished the smells of eucalyptus and menthol among the others. It was much like an adrenalin rush, and a feeling of satisfaction that I enjoyed. It was an adventure and not just a job.

Every prescription dispensed had to be recorded by hand in a large prescription book. My first job of the day was to enter all the names and page numbers in the index for future reference. Labels giving directions were handwritten on gummed paper and either licked or moistened before fixing to the container.

I applied myself with my new found self-awareness and soon earned the privilege of being deemed trustworthy and someone of integrity who could open the pharmacy on time in the morning, and do the dispensing unaided and unsupervised apart from when dispensing hazardous material.

I finally reached my goal after years of toil at the end of 1959.