Wanderings of the lost boy – 5

My name is De-Graft. You can choose to call me Digi/DeGi/De-Ge/DeG…etc, whichever works for you. I am a medical student in my 5^th year of study. As part of our requirements for the medical school programme, in 5^th year we are posted to various districts to experience medicine outside the boundaries of the teaching hospital. We also collect data for our final year project work and thesis. I hope to take you along with me on my exciting trip with these memoires. Enjoy!

 

Episode 5 – Fear Man

 

1

 

Let me start off my storytelling on a light note, just so you don’t feel cheated if you don’t find many “light noted” touches of the story in this episode. The taxi I sat in had this warning to all passengers. Not that it’s out of place but I’m impressed. And as you’d guess, I had to exercise all sorts of caution to get this shot.

…

 

I had so many grandiose plans before coming to Abetifi. For days, months, years… I have always wanted to instill the habit of exercising and working out… But for days, months, years… I have always failed, miserably! So when packing, I had one separate travelling bag for my exercise material. I packed up my exercise kits, sneakers (more like camboo (camp boots)), push up bars, skipping rope, etc. I even packed different training kits for different weathers. So I had a track suit from Secondary School for morning jogging when the weather was expected to be cold, and then the jersey my class team used for last year’s Medical Students’ Association Games (don’t ask what our position was) for afternoon/evening workouts. I mean, I was so prepared! Literally armed to the tooth (because I took my toothbrush along too – Okay you can forget about that, everyone carries a toothbrush when travelling). But I mean I was prepared to get back fully into my fitness mode by the time I’m out of here. But I’m sure you’ve deduced by my plenty talk that I haven’t spent a single second working out since I stepped foot here. At this point, I’m not proud of myself at all!

But then, inspiration was on its way! Let me introduce you to two people I owe it to.

 

 

 

Here is Uncle Gideon. He’s in his late 50s and goes jogging for 10 kilometres, three times a week! And he follows through with his schedule no matter which country he is in.

 

 

Here is Auntie Esther. Also in her 50s and goes on brisk walks of between 10 and 11 kilometres almost every day!

…

For the rest of you who have dreamt like I have over the past years, shame! May you be inspired to repent and get started!

I am inspired! I ask Uncle Gideon for tips and he’s very helpful, advising me to start with light jogs and shorter distances. He has been doing this for 20 years (for almost as long as I have been alive). He also sends me links to apps I can use to track my progress. On Wednesday evening, I decide to start my workouts and jogging. I start from home, go round the block, then to the main streets of the town. I continue on the road that leads to Abene and Hweehwee and I keep jogging till I get to the outskirts of town. Fearing for my life (as it is now dark), I turn back and make my way toward home. Honestly, it is quite difficult, especially for the first 10 minutes or so since my body has to get used to this. But afterwards, I am fine and I keep up for about an hour. The hills of the mountains make it a real struggle too – especially at the parts where I have to climb. I am unable to track how many kilometres I run though as my phone’s battery is low and I can’t use the applications.

 

When I return, I feel so refreshed and tell myself that this should happen more often. I am tired too and I sink into some sleep for about an hour and half. When I wake up, I start working on my presentation. Tomorrow is the clinical meeting for the hospital staff and I have been asked to do a presentation on respiratory tract infections. I stay up till like 2am to be able to finish with it and I go through it to get more familiar with the transitions and order. I also have to give most of the presentation in twi and so I prepare adequately with that in mind.

 

2

 

On Thursday, I get to work at 8:30am. Today too I am supposed to go for the Child Welfare Clinic (CWC) in the community. At work however, I am asked to go to the consulting room by the nurses who work at that section. Considering a lot of factors, I oblige and work there with Bro. Sammy. We hope to finish early though, so I can also benefit from the CWC program. We don’t, and at half past noon, we are reminded of the clinical meeting. There are no patients now and I take the opportunity to go through my presentation again. At 10 minutes to 1, we are already setting up the place for the meeting. Sister Becky tells me though that she got me kenkey and asks if I will eat right now. The temptation is real, and it’s one I don’t plan to resist. I tell her I will eat but then we have to set up the projector first. We finally manage to set up the projector and at this point, it’s already 1pm – time for the meeting to start. My kenkey is also calling out to me. With careful evaluation of the situation at hand and with much forethought, I decide it is best for me and for everyone gathered here at this moment if I patiently and innocently walk to the office where she has set up the table, close the door, quickly hammer the kenkey, devour the fish, wash my hands and wipe my lips – like nothing ever happened.

 

Fast forward to ten minutes later and I’m all sorted out sitting in the meeting and waiting to be called to give my presentation. With the tank (stomach) well filled and the machine well fueled, the presentation goes on so smoothly. Time and again I fumble with some twi words but it’s generally good.

 

 

After the presentation, I get ready to go home.

Now, the clouds have gathered and it is almost certain that the rains will pour. I try to get ready and leave before the rains start but I’m unable to. I actually run out into the rain to stand under a shed by the roadside hoping to get a car back to Abetifi. But with the winds blowing and the rains pouring sideways (I hope you get it) I am still fairly beaten up under the shed and I eventually give up and decide to run back for proper shelter in the health facility.

Under the shed on the rainy day.

 

3

Just around this period, a young patient (about 3 years old) is brought in with breathlessness. From a quick history I ascertain that he’s asthmatic and must probably be having an acute asthmatic attack. He already looks tired of breathing and every breath is forced, with puffs having to be let out from his mouth upon each exhalation. I ask that he be nebulized and that is started for him in the next ward.

After the nebulization, he looks relatively better after which a detailed history reveals he has had a cold for the past three days. I advise his mum to report to the health facility every time the boy has something that looks like a cold. I also write down some medication to be given to the boy. Because of the rains, they are also kept at the health facility till it stops.

 

We are supposed to have meetings this evening and I get into the consulting room – now empty to continue with my preparations while I wait for the rains to stop. The rains stop eventually (after about an hour) and I can try going home. Before I do, I check up on the young boy and notice he has got breathless again. I start to get worried and I request that he be given another dose of the nebulization. That is done for him and he gets better, but I am inclined to stay and monitor him for a bit before allowing them to go. Just about five minutes later, he’s breathless again and at this point it’s obvious he needs health care in a bigger facility. Here, we do not have the tools and material needed to handle such situations. There is no oxygen, and there isn’t even a pulse oximeter to measure his oxygen saturation. When I inform his mum that he will be referred, the woman is disturbed and pleads that I allow them to go home. But I try explaining to her that it’s necessary to do so as a precaution – In case this develops into a full blown attack. According to her, his Health Insurance needs to be renewed and the last time she tried doing it on her phone, she made a mistake with the details she had to provide so it didn’t work.

The expression on her face pierces me to the core and I really wish she would not have to go through the impending financial burden her visit to the hospital would impose on her. She even calls her husband to speak to him, then her husband’s sister who speaks to me and asks that I allow the child to go home. I am firm however and I write a referral note for him explaining the importance of seeking urgent care. They eventually agree to go and I hand the note to them. Now, my time here in the hospital is done and I can go home.

 

4

 

On Friday, I am up early – by 4am. At about 5:45am, the winds start to blow! They are so strong and so cold, I wish I could coil back into bed and sleep the day away. At half past 6, the rains start pouring and I am almost certain that there will be no work for me today.

At around 9am, the rains eventually stop and the skies start clearing up. I have to go to work still and go take my bath and get ready for it. I am at work at half past 10am and I get to work immediately in the consulting room.

…

On a cool morning like this, what could go wrong? Trust me, everything can.

A male nurse swings the door open and asks that I step out for a moment. Upon stepping out, I notice a skinny, wasted, pale looking man seated in a wheelchair with the blood pressure cuff on his arm. The nurse announces to me that there’s no blood pressure. I hear it as “low” blood pressure so I ask again to confirm and he tells me that there is actually no blood pressure. Suddenly, I’m alarmed. The first time I saw something like this happen was in first year medical school during the vacation nursing training. Kwasi and I were working at the Manhyia hospital Emergency centre and a man had come in in a similar state. As Kwasi checked the blood pressure, he couldn’t hear anything and he thought he was doing it wrong. So he asked me to come and check too if I will hear anything. So I took over with the stethoscope and the sphygmomanometer and also tried checking – but I heard nothing. Only for one of the hospital staff to tell us we weren’t hearing because the man was dead.

That’s Kwasi – In case you’re wondering

…

In a flash, this memory reverberates through my bones and I get alarmed suddenly! Ringers! Ringers Lactate! 1 Litre start. Set two wide bore cannulas and let it run! Squeeze out if necessary! I take over the wheelchair and I wheel him into the ward with such haste! I ask for the cannula and the male nurse who came to call me is tasked with setting the line.

In such hypotensive states, the superficial veins are hard to locate but we are fortunate this time and we get a vein on the first try. We set the line and the first 500 litres starts running. There is no time, and with anxious hands, I squeeze the bottle to force in the fluids and expand blood volume as soon as possible. I mean even if there is going to be a referral for definitive treatment, a feel responsible for stabilizing him before referring.

…

In the meantime, the male nurse tries to set the second line and fortune evades us. Try as he does, he is unable to find one. I rush into the consulting room and reach for the locker that has the cannulas and take out a smaller bore hoping we can locate a vein with it. The sick man looks confused and dazed. He is hysteric and with a seriously altered mental state. He doesn’t seem to know what is going on around him and tries to hold us off when we want to get a vein. His bones and joints are all so stiff. He developed a stroke three days ago as I later find out. His legs covered with fungal and scaly growths and he looks classically as someone who has been abandoned. While struggling to get him haemodynamically stable, one senior nurse advices that I write him a referral as soon as possible. I mean, we could be stuck on him and just watch him slip out of our hands since we don’t have the materials and tools he may need.

…

All this while, something about the relatives baffles me. They don’t seem to care about what’s going on. None of them has accompanied him in and they are sitting on the benches in the walkway conversing casually. I step out and ask someone to come inside to give me some details. A man in his mid-fifties to sixties steps up and comes into the consulting room. I take some primary details from him and the information he gives me suggests that the patient is someone everyone is frustrated about. I really don’t want to believe that they don’t want him to survive this experience.

Anyway, I tell him to go and get a taxi as soon as possible and carry their relative off to the large Government Hospital at Atibie. When he goes out under the pretext of getting a taxi, I go back to check on the guy and I notice the IV – the only one we set has stopped running. My heart skips a beat and my first instinct is to squeeze it to force it out. When I encounter some resistance, I check his hand where the cannula was placed and it is out. When I go out, I meet the male nurse who tells me that the man in his altered mental state pulled out the cannula. At this point, there really isn’t anything else we can do but to refer.

 

5

 

I go out in hopes that by now they would’ve got a taxi to transport him to the District Hospital – Only to find the relative I asked to do that gallivanting about.

At this point, I am getting furious and I ask the man why they haven’t got a taxi all this while. He comes up with a useless, flimsy excuse of the taxi he planned to take him in having to go and drop someone first. I am starting to really boil up and I ask sternly if that’s the only possible taxi he could get for him. I mean, just in front of the clinic is a main road that is abused by taxi drivers and he is here giving me this useless excuse! He asks another one of his relatives to go and get the taxi.

He walks back toward me and I demand to know why they have all adopted such a sluggish approach to their dying relative? Then he blurts out, “Doctor, so are you sure it will be worth spending money on this person? Will he even survive?” What he says is enough to leave me disgusted, putrefied, annoyed, tip me over to totally mad! I erupt in a frenzy ditching all feelings of respect and courtesy that a man of his age would deserve from me. Honestly, I can’t remember everything I say to him but essentially, the message I carry across is, ‘If you really wanted him to die, why did you carry him all the way here to die in our health facility?’ I mean, they could’ve left him to die at home. Rather than pretend they care just so it looks like they tried to save his life. It causes quite a stir and creates quite a scene as I order that they carry their relative off and ensure they take him to the hospital.

I go inside and get some help to put him on the wheelchair again and I wheel him out for them to take him away. Earlier this week, I was shaking because I was nervous, but today anger is the cause of my trembling. Right then, I know why I have always hated getting angry and why I manage to keep such a calm composure at almost all times. This time is different though – as I witness the most wicked words I have personally heard a human being utter about his fellow human.

 

Eventually, they get a taxi and we help the man inside. I am struck though, by this sick man’s resilience. Ordinarily, all people I have seen in that state have passed away shortly after admission and a part of me in hope wishes he makes it. When they leave, I go back into the consulting room, sink into the seat and cover my face in my palms saying to myself… “This profession I have chosen…”

 

…

6

 

Today, I am going back to Kumasi for the weekend. I leave work a little past noon and the taxi I get uses another route to descend down the Kwahu mountain. I get to Nkawkaw soon and in a short while, I’m on my way to Kumasi.

 

I gaze upon the mountains on which I have spent the past two weeks. The top seems all misty from down here with the apices seemingly meeting the clouds. Isn’t it amazing, that I resided in those clouds and mist!

 

…

The future is exciting… even when the mist seems to cloud our view.

 

 

De-Graft, 2019