LOVE

Is it thinner than mirage, more penetrating than wine.

It is from a sweet-scented flower which is mingled in a vase of complaint.

 It is a heavy cloud which rains upon hearts and causes the growth of joy and happiness.

It nurtures the fruit of words, yet knots the elaborate tongue.

It has purity of intellect and a battlefield within the liver.

The trap of love only hunts men with purity in afflictions.

It turns the owner into the owned and the master into the slave, so that he would be mastered by his own slave.

Its victim is always sick with love and afflicted with uneasiness.

He brags with time and possesses an elevated thought.

By nightfall he becomes sleepless and at daybreak he becomes anxious.

Trouble becomes his fasting and complaint his “Iftaar”.

[Excerpts from مروج الذهب ومعادن الجوهر (ancient Arabic text: Meadows of Gold)]

A Broken Home

Although on an infusion of the most potent analgesic available, Njaga’s pain and agony only gets worse. He can barely open his mouth to utter a clear word, not even his own name. All that comes from him are the persistent moans, which change in character as the pain waxes and wanes. He has lost control of his voluntary muscles, and his body forms into postures too uncomfortable to bear. His back is highly arched, head forced backward, mouth firmly shut. He struggles to get out of this misery but to no avail. Between the peak moments of intense pain, a disturbing look of anxiety settles on his face, with evident fear of the subsequent episode. One can guess that his family has given up all hopes, believing that his death is imminent.

One of the residents will have to spend what is left of his call in the ICU next to Njaga. Although he had arrived only a few hours ago, Njaga is already the VIP for the night. The resident knows there will not be any sleeping for him but he cannot be bothered. For Njaga is at a crossroad, his prognosis evidently poor and his chances of making it very slim. But the resident will not give up on him so soon, this is a fight he is determined to win whatever it takes. He has no other preoccupation, no other worries; nothing else matters. His arsenal is fully stocked and nothing will make him leave the ICU before 8am the following morning, when he will hand over care to another doctor. Fortunately, the rest of the patients in the ICU are relatively stable and Dr Djiddi prays they remain so.

So far Njaga has only received symptomatic treatment to alleviate his pain. But it is certain that his only chance of leaving the hospital via the front gate and not the back is if a correct diagnosis is made and appropriate treatment administered. Hence someone had to give the history of illness, the main component in making a successful diagnosis. Usually the index patient is the preferred source of information because no one can possibly give a better account of the illness. And Njaga was almost a qualified candidate to be interrogated – he was fully conscious, old enough and did not suffer any memory loss. However, Dr Djiddi knows better than to question him because all that will come out of the interrogation will be worsening of “spasms” and all that they come with. Hence Dr Djiddi turns to the mother, Adja, who so far has been very cooperative and helpful.

There is a bit of a language barrier but the important aspects of the medical history are being elicited and clarified, often with the help of a nurse. Overall the collaboration was superb, and a definitive diagnosis likely. Then the door swam open and a middle-aged, bald headed man gently walks into the ICU. The instant change of look on the mother’s face is enough to tell anyone smart enough to see that this man is an “intruder” whose presence is not welcomed. At least not by Adja. The air around her became still, movements got stiff and a bit of reluctance starts to creep in.

The man introduces himself as Njaga’s father. And intermittently he attempts to give his own response to the questions being asked by Dr Djiddi, his versions mostly incriminating Adja. But what is even more striking is the fact that the parents will not exchange words or looks, not even by accident. A “silent” war is being fought here, and each parent seems to be more concerned with making the other party look guilty and responsible than helping the health care givers bring their child out of his state. The extreme variations in their stories threaten to snatch away Dr Djiddi’s hopes of making a correct and timely diagnosis.

It was when he took a family history that it all made sense. The parents had a divorce several years ago and the bitterness between them has not gotten any less. They can hardly tolerate one another, even though they have both re-married with children. The three kids they had together are fully grown, this 18year old boy being their youngest. But neither the kids nor time could resolve their differences. And right now, not even a life they share can do so!

Chronicles of an intern

He suddenly remembered his mobile phone. As he reached out for it in his pocket, Udom could swear he felt the vibration. The narrow screen was still illuminated, two missed calls it says. Lately, a minute hardly goes by without his phone buzzing, majority of them being message alerts. He has just graduated from Medical school, and is still struggling to adapt himself with his new status: being a medical doctor. Acquaintances from the world around are sending congratulatory messages. He deserved every single gesture, for it was indeed his longest and toughest ride thus far. And unlike the previous months when his phone was seen as a distraction and a potential enemy, now he actually looked forward to hearing the ringtone, his favourite piece of music.

One new number. It was his cousin Ousman. He had seen him the previous day, and they were to meet that afternoon. Ousman’s wife, Mboseh, had invited him to lunch and he certainly was not going to miss that. Mboseh was blessed with such culinary skills that she would have been a Messiah if our purpose in life was merely to eat.

Hitting the call back button and waiting for the call to get connected, Udom was already rehearsing his lines in his head. Lines reconfirming his coming and the menu for the day. But the tone on Ousman’s voice was not his usual. Udom could instantly tell this was not what he expected.

“Boy are you in the hospital?”

“No”, Udom replied. “Anything?”

“Yes, how much does a pint of blood cost?”

“Umm, blood is not sold at the Hospital. Friends, family or volunteers donate. And if it is an emergency, patients are given blood if available”.

“I have a friend whose wife needs blood,” he started. The fear and uncertainty in his voice made Udom realize Ousman was not just calling to ask a few questions. When he concluded, the only thing Udom could do was to promise to assist. And he was going to, after his lunch!

He had not come within several miles of the Teaching hospital in more than a week. He made a conscious effort to stay away, making sure he has a good holiday. The last time he had any real break was in 2005, four years ago, when he finished his pre-clinicals. Although nothing has changed, Udom still felt somewhat different as he walked through the huge metal gates of the hospital. It was late evening and past the normal patient visiting hours, but he had no problems entering.

“Good evening doctor.” The security at the gate greeted. Udom’s heart skipped a beat, for it felt even different hearing that title within these walls. He smiles at him, walking a bit faster to escape the scene. The walk to the ante-natal ward was punctuated with regular “interruptions” by nurses, orderlies and students, all saying the same thing: the older among them making prayers, the younger ones congratulating. They all had one thing in common though, genuine sincerity in their eyes, voice and words. This made Udom feel at ease, gradually getting back into his lively holiday mood. Then again he remembered his phone but this time there were no notifications.

As he hit the swinging wooden door that gave entrance to the obstetric wing of the hospital, Udom was greeted with the characteristic stench that made him dislike this place since the first day he ever came around, seven years ago. He tried to distract himself by fidgeting with his phone but the sharp piercing scream of a supposedly young primi in the delivery suite brought him back to his reality. The corridor was wide, well lit, with fresh blood staining the otherwise clean tiles. There was a woman marching majestically up and down its length, both her hands resting lazily on her waist and her back arched forward further protruding her belly. She forced a smile when Udom passed by. At the other end of the corridor is a flight of stairs, and just before that are two entrances facing each other on either side.

The antenatal ward was opposite the labour unit, which was made up of a few cubicles. Udom remembered his first experience in there, fluid all over the floor; the screams, the cries, the painful moans, it was all just too much to handle. Yet he was certain that he will have to spend six months of his internship working there, having to deal with the worst that may come his way. Six months; 180 consecutive days! The mere thought made a knot in his belly. He wish he could avert that part of his future, that a miracle will happen that will exempt his from “doing time” in this unit. But that was all he could do, wish.

He pushed the door to the ante-natal ward open. The room was stuffy, a wash hand basin by the door leaking water flooding the entrance. The nurses desk was empty and the sound of the TV too loud to allow Udom to hear anything else. For a moment he was grateful as this blocked out the unpleasant sounds coming from the ward opposite. He paused for a while at the door, not sure what to do. Ousman had not given him the name of the patient, which Udom could have used to know which bed she was in. But he had the husband’s name and telephone number, which he looked up his phonebook and started to make a call. At the other end of the ward, a man dug into his breast pocket and brought a mobile phone against his ear. “Hello,” a voice said. Udom thought that must be his guy and so without saying a word he walked gently up to the bed by which he stood.

“Hi, I am Udom, Ousman’s cousin”. The man turned around, and with the look on his face, his dark tinted glasses and his walking stick, Udom could tell that he was visually impaired.

“Dr Gai. How are you?” He replied, outstretching his hand. “This is my wife, Kumba”.

On the bed were three ladies, the resemblance on their faces was enough to tell that they were three generations of Kumba’s family. Udom needn’t be told which one was Kumba. She was the youngest, couldn’t be more than 20 years old. A loose-fitting native outfit hung over her slender body. Except for a nod to acknowledge the arrival of this stranger, she lay motionless on her side, her tummy lying safely next to her. She seemed less concerned about what was happening around her, and Udom could understand why.  Although not in any obvious distress, a deep sense of worry formed a thick mask around her young beautiful face. She could almost be heard screaming out for help, as she awaits her “impending doom”. Udom could imagine what was going on in her head. He smiled reassuringly at them before turning back to Saihou. “What seems to be the problem?”

Saihou told the same story that Ousman had told Udom earlier. That Kumba was in early labour and the doctors requested two units of blood for her delivery. Since Saihou could not donate to her, a hospital staff told him they could get him the blood at a price. A huge sum! In despair, he started calling anyone he imagined may be able to assist, financially.

As he spoke, Udom was busy going through Kumba’s medical records. To his surprise, there was no request for blood transfusion nor was there any need for it. Her haemoglobin was good enough to permit a safe delivery, and the only indication Udom could think of was to get a pint of blood at hand in case something went wrong. For indeed something does go wrong quite often. When he finished, Udom spoke softly but firmly. He made sure his voice did not crack for he needed to convince this couple that everything seemed okay. And he spoke loud enough so that both Saihou and Kumba, who was now sitting up in bed staring at him, could hear. Kumba had sparkling white eyes with which she stared at Udom so hard that he thought she was trying to see deep into his soul. Now nothing else mattered, and she was growing more and more impatient as Udom went on with an insignificant introduction. When at last Udom reassured them that everything was fine and the blood was not as much of a necessity as they were made to believe, Kumba broke a smile revealing a perfect set of teeth against a dark tinted gum. This was common practice among elderly and rural women, and it was one form of beauty that was hard to resist.

A series of questions followed Udom’s “lecture”, among them the inevitable – why did a hospital employee insist that she needed blood? When he finally answered the last of their questions, Saihou changed topics and narrated to him how he met Ousman and all the good things he had done for them. That was when Udom remembered he had to inform Ousman. Before leaving, he also made sure to see the doctor in charge, drag him to also reassure Kumba, and informed him of the plot by an unknown staff to rip a poor family of something they did not even have.

Dr Gai was thankful that there was no need for much further action, at least not for him. He took a deep breath as he stepped out of the hospital. The air seemed to smell of jasmine, so pure! In his mind he counted how many days he had left before his calling would be official; before these walls would be his home, to spend all days and most night in. 17. Two weeks and three days, that was all he had left. Ordinarily that should be a long time, but to him right now it sounded almost like just a couple of days. And this made him to wonder, again, if he really was ready for the task ahead? Was Medicine his right calling, could fate have made an error? But tonight there was one additional question that was going to torment this young doctor’s days to come, the thought that his soon-to-be work mates are capable of such horrible things as he just witnessed. That not everyone in the hospital was there to help, but in fact some survived by exploiting the vulnerable. Going to extremes, with little regard for the people and lives at stake, just to make a few dalasis. He could not help but tell the cab to take him home. His planned night outing has just been ruin.

Salutem

Greetings and bienvenue chers amis!

Born out of intense boredom, Adaequatio inttelectus et rei, Latin for "Correspondences of the mind and reality", is aimed primarily at keeping me sane! I am hoping that writing and sharing will help fill part of the huge vacuum created by distance, fate and the hand of time.

The blogs shall be diverse but mainly centered around people, with whom i work; and issues affecting lives of individuals and masses, distant or near. An inclination to health related issues is almost inevitable, although a conscious effort shall constantly be made to keep communication effective and interesting for all.

I hope i don't disappoint you.