Posts Tagged ‘hospital’

CYANOSIS


Mrs Aderopo looked around her the room; marble tiled fourteen square feet furnished with a refrigerator, a thirty two inch flat screen television with cable channels, and a mahogany reading table. Only the quaint curtains and the mechanical bed reminded her that it was a hospital. The curtains served their purpose well enough; it is that way with hospitals – decor that always remind patients that they are not at home. She did not feel at home anyway, since she arrived, there has been no kindred spirit. The nurses just come in, do their rounds and draw Omosalewa’s blood endlessly; no one to spare a smile or empathize with her. Nobody to say a word of prayer with her, the things she often neglected when nurses at home did them for her.

Hospital room

She met some other Nigerians in the common room; she usually stops by on her way to and from the neonatal intensive care to see her baby. She conversed with three other women; Mrs Okonkwo who had brought her father for bilateral hip replacement, Mrs Belabo came with her husband who needed oesophageal stents after some road traffic injury and Mrs Agedah who was there for a common thyroidectomy. From their discussions, she realised there were more like them. Also, they were all referred by people who had been here before. They were all people of means, those who could afford health care elsewhere. She did not like their company because she did not belong in their group until recently. But they all had the same complaints – no shoulders to cry on, nostalgia for a country that could not provide what they seek outside and the wish to never return here. Omosalewa would finally have the surgery tomorrow, which was hope enough for now.

She waited in the common room again the next day when Omosalewa went into surgery. She sat there in silent expectation with Mrs Okonkwo, the hip replacement was also underway. Mrs Okonkwo was a different kind of woman; tall, graceful, beautiful and sophisticated. They talked at length, each describing their different lives and the paths that brought them here. Ann Okonkwo had left Nigeria as a teenager with her siblings when her father sent them to his brother abroad in search of greener pastures. They all did well and are presently scattered at various locations across the globe except Nigeria. While the old man who prompted it all never lacked money, he lacked the attention of his children, they seldom returned home to see him. She was forced to go back home when she heard that Baba had not walked for sixteen months because the arthritis had eaten into his bones! Finding solution automatically became her duty being the eldest and the only female. She heard they performed great surgeries here; she will send Baba home after the surgery and return to Dubai to man her business. Sade Aderopo brushed back her short hair, she might not be as beautiful as Ann but she knew her advantages. She turned the better side of her face to Ann and told her about her shop on Opebi road in Lagos where she sold clothes for the bourgeois. She talked about her husband’s flourishing private enterprise and the emerging social influence of her family. They exchanged details and Sade promised to visit Ann next time she was in Dubai to buy goods.  

They moved on to small talk, little chit chat about the weather and the different environment where they came to seek health. About two hours into their wait, a doctor appeared in his scrubs and motioned to Mrs Okonkwo. He explained some things briefly, they were far from Sade – their words inaudible but she saw her newfound friend slump slowly. She ran to her side to hold her, something had obviously gone terribly wrong. The doctor walked away slowly, Sade held Ann in her hands gentling consoling her as the latter sobbed uncontrollably. Thirty minutes later, Omosalewa’s surgery was announced successful, Sade was still holding her friend when the nurses came to ask Ann what to do with the remains of her father. They spelt out the options glumly; put the body in the morgue before going to Nigeria, bury at a land provided at a fee by the Catholic Church or make your own arrangements. For a moment, Sade thought she saw the young, beautiful nurses in their white sparkling uniform show some emotion, but they had turned around before she could confirm her suspicion. She felt cold, confused, she held Ann closer in a tight grip.  Graceful Ann, still genteel in grief shook herself loose and turned to her friend “Sade, I will bury papa here”

“Why?”

“There is nobody to go and meet at home and it would amount to a waste of money!”

“What about your brothers? Will they be happy about it?”

God's Angel

“I will explain to them, they have to understand, the village has not been kind to us and the only person that would have objected is mama and she died a long time ago. We cannot waste money carrying a dead body back to a hostile people.”

“I am so sorry” She consoled her friend endlessly.

Sade led her to her room, tucked her in bed and excused herself because she needed to see Omosalewa.

She cradled the baby in her arms, the surgery was truly successful. The child’s colour has changed, no more blue, pink had returned. She looked at the oxygen tubes going inside her baby; eager for them to be discontinued – they said seven days. She could not wait to go home, to tell her stories, to have shoulders to cry on and to cry and have people ask “why?”     

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Her names were Omosalewa, Omobolade, Omobolanle, Oluwabusayomi, Ayomipo, Mayowa, Tokunbo, and Elizabeth Aderopo. In this part of the world, we give children a lot of names, because the names have meanings. Usually they are prayers for the child and the parents or appreciation to God for the gift of life. When names are prayers, they can’t be too many in this rigorous journey of life; also you cannot thank God enough for the bundles of joy called children. Eventually the child only bears two of the plenty names; a first name and a middle name but the other prayers surely abide with the child through life’s journey. Omosalewa’s naming ceremony was especially grand and well attended. After the pastor performed the rites of naming, collection of offerings and the numerous prayers, the party began. The music was flowing non-stop from a local band that had set up their equipment in a conspicuous corner of the spacious compound of the Aderopos’. Food and drinks were surplus and inevitably well-wishers thronged eternally.

Happy couple with the newborn

She was the third child of the family but the first female, but she came at a time when business was booming. Mr Aderopo had just landed a juicy government contract a few months before the birth of the baby – the good luck she brought also reflected in her choice of names. She was delivered in England; to ensure she was a citizen of a more privileged land. A great gift to our children since the citizenship of our own country is without benefits! The Aderopos’ spared no expense in the birth and associated ceremonies of Omosalewa’s birth; there were pictures and much video coverage to remind them of the memorable moments. She deserved it; one of her names Omobolade means she came with the wealth.

The day after the elaborate celebrations, Omosalewa started turning blue, first at the fingers and toes. Then it became difficult for her to breathe and in two hours the blue hue had started to spread to the face. The Aderopos rushed to the hospital, they had absolute confidence in their hospital; a reputable private hospital in Lagos with a grand structure and multi specialist disciplines. Though expensive, it offered good healthcare. The paediatrician – a young and petit woman who looked more like a baby herself – put Omosalewa on oxygen immediately, the familiar pinkness returned to her skin.  She pored over the baby some more, poking her endlessly with a stethoscope. Mrs Aderopo grew tired of waiting, she asked “What is wrong? Why is my child turning blue?”

“Cyanosis.”The paediatrician turned and told her with a bland face, like she was supposed to know the meaning.

“What does that mean? Doctor Olaolu, please explain.” Mrs Aderopo was on familiar turf; she had delivered and nurtured two children in this hospital.  

“It is the absence of oxygen in the blood.”

The doctor further explained the condition to the bewildered parents; they discussed the causes and suggested that Omosalewa’s case might be related to a congenital heart defect considering her age, rapidity of development of the disease and her examination findings. The baby would need an echocardiogram to confirm the diagnosis. They would need to go to the general hospital for the test; the hospital machine just became faulty yesterday.

The Aderopos hated the general hospital, it was always too crowded with long waiting time and without the personalised service they were used to, but they had to go this time. After waiting for two hours at the hospital, they finally got to see the paediatrician. A petit woman who seemed quite disinterested, she introduced herself “Good afternoon, I am Dr Bodunrin.”

Can you blame them?

 She confirmed Dr Olaolu’s diagnosis but gave them a date for two months to come for the procedure. Mrs  Aderopo got angry “Do you think this child will be alive in two months if we don’t do the test? She is turning blue!”

“Madam, the test will only tell us what is wrong, it is not the solution. I can’t tell if your child will still be alive but I have a long list of people waiting to have the same procedure and they need it just as much as you do.” The paediatrician replied her, dangling a list of names nonchalantly.  

“You don’t even care and you call yourself a doctor, how can you talk like that?” Mrs Aderopo had started boiling over when her husband dragged her by her arm out of the doctor’s office.

“Calm down Sade, we will do it tomorrow”

“Where, how?” she was already crying. “I have been carrying my child around in an ambulance, on oxygen and these useless doctors don’t seem to care, why?!”

“Relax, tomorrow we’ll go to Unique hospital, I talked to Dr Olaolu, she says there will be no problem once she is on oxygen.”

Unavailable

Unique hospital is one of the most expensive hospitals in Lagos, a private enterprise that flourished because that dearth of efficient alternatives. It boasts of great equipment and knowledgeable specialists, located in a high brow part of Ikoyi, the hospital is a reserve for the affluent. The Aderopos did not care about money any longer even though the echocardiogram would cost ten times the price at the general hospital. They waited for only fifteen minutes before they were called in to see the paediatrician, none other than Dr Bodunrin. Albeit, a different one, she quickly apologised for the misunderstanding yesterday, curtseying severally “Sorry about yesterday, I just didn’t want you to waste your time and money. The machine at the hospital is not as good as the one they have here. You have come to the right place especially for this kind of emergency.”

The Aderopos were dumbfounded – an emergency that could wait for two months, apparently Dr Bodunrin’s pay check at the general hospital and at Unique differ in similar terms to the prices of the echocardiogram. She pored over the baby endlessly after the procedure; she even called in another paediatric cardiologist to give a second opinion.

The final verdict in layman’s terms as the Aderopos demanded it; Omosalewa has a hole in her heart that would require surgery.  The surgery cannot be performed here because even Unique does not have the needed equipment. However, they would liaise with their partners in India to have the surgery done. The cost was unthinkable but the Aderopos had to save Omosalewa.

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Mrs Aderopo was at her shop just a week after she returned from India when she noticed that Omosalewa was turning blue again. She picked the baby up, called her husband and headed for the hospital.  She sped past every moving thing on the road, casting side glances at the baby as the hue increased towards the lips. At the last traffic stop before the hospital, she noticed that the baby had stopped breathing; Omosalewa was cold when she picked her up. The baby died before getting to the hospital, she was tired of a healthcare system that did not care for her or perhaps her names were not many enough.

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AN ACCIDENT ON SATURDAY


Our hospital is a big tertiary centre located next to a busy major road. The road links two

major commercial towns and serves as an indispensible trade route; all forms of vehicles ply the road twenty fours every day. Commercial and private vehicles of all shapes and sizes race continually at speed the envy of formula one drivers. Expectedly, many end up at our hospital with different forms of road traffic injuries and we had a special trauma dedicated to catering for victims of these road mishaps. However, these accidents have seasons; usually weekdays and during the nights. Not weekends, almost never weekends.

Last Saturday, I was on call in the afternoon when I heard footsteps and the familiar sounds of confusion, the sounds of human anxiety rushing into the emergency room. I knew the porters would have rushed to meet the incoming party with trolleys and the nurses would soon start calling for the doctor. I thought in my head, maybe a drunken brawl, maybe a dying diabetic or an incompliant hypertensive but not an accident – not weekends. I looked up and saw policemen, about eight of them in full fatigues, gun totting, obviously enraged and  the smell of nicotine and ganja pervaded the room immediately; implausible diffusion. Right behind them was a ninth one, on the trolley, bruised and in pain. Finally, the unbelievable, an accident on Saturday, a different kind from the look of things. We got to work; the policeman had sustained a fracture to the right leg and minor injuries to other parts of the body. He had been knocked down by a private vehicle, a lone driver who did not want to stop at the checkpoint. While we were attending to their colleague, the other policemen were busy shouting orders into their radios and cell phones, dictating the plate number and describing the vehicle of the runaway driver. They turned on the frenzy in the room, cursing and stamping their feet, swearing in turns – they will surely kill the runaway driver once they find him.

Thirty minutes later, I heard sounds again, this time the sounds of human anguish. The incoming party was led by policemen again equal in description to the ones that came in earlier. On the trolley behind them was the man in anguish, middle aged, bruised and bloodied – the runaway driver. He had been beaten and battered, he was still being beaten on the trolley. As he was being wheeled in, the first set of policemen were having a go at him with limbs and guns. The new set of policemen also became angrier at the site of their colleague with his broken leg.

“Please, please can everybody wait outside?” I had to step in and exercise my authority.

“Doctor, Doctor please wait, let me break his head, let me break his own leg too” they kept trying to increase my workload! While some were moving out, others were still inflicting pain on the runaway driver.

Eventually, they moved out but continued the frenzied phone calls which brought new sets of policemen to the emergency room at five minute intervals. With every new set comes new pain and more injury for the runaway driver. It was becoming uncontrollable; the nurses started asking me for a solution. I was confused, I should call the police, but they were already all over the place trying to kill my patient.

Then, the runaway driver started to convulse; great jerky motions shaking his entire body fiercely. Suddenly, there was increased activity in the room, we, the hospital staff rushed to his side trying to control the convulsions, the policemen in the room ran out instantly probably out of fear. Outside, they resumed more charged phone calls. They started holding a meeting, discussing and arguing at the same time, they seemed to be in disagreement over something and later, an agreement. After some minutes, four of them came into the room; obviously representatives from the consensus of the meeting.

“Doctor, we want to take our friend” the spokesman, a burly and intimidating figure told me.

“Which one?”

“That bastard no be our friend, na you no allow us kill am. Na the policeman we dey talk.” I think pidgin is his language for expressing anger.

“Where are you taking him to with a fracture, his X-rays just got in. He will need a cast and maybe surgery.” I was trying to explain the situation to them.

“Doctor, no worry. We go take am.” He insisted. “Abeg, come write everything wey you wan write. We dey go.”

While I was trying to stand my ground, I was aware of the amount of guns on the premises, the urgency of the assembled men in uniforms and the lingering smell of stimulants.

I went to the injured policeman and asked him “your friends want to take you away, do you agree?”

“Yes doctor, please release me quickly.”

“You will sign that you discharged yourself against medical advice”

“Doctor, bring the book quickly, abeg. Please.”

While we were still discussing, the runaway driver convulsed again. This time, noisier and more violent; spilling frothy saliva from his mouth. We rushed to him again, I was about to sedate him when I saw him wink.

“Did I see him wink?” I asked myself. When people convulse, they don’t wink!

I withheld my needle, he stopped spontaneously. Meanwhile, the agitation on the part of the policemen had doubled; they had already started wheeling their injured colleague outside. I had to run after them to sign the discharge against medical advice form. They disappeared in a jiffy making screeching sounds with their departing vehicles. Peace returned to the hospital, we all got a moment of respite.

Five minutes after they left, the runaway driver sat up on his bed and coughed, the type of cough that says “I’m here.” He caught our attention and we all went to his bedside.

“Where did you learn to convulse like that?” I asked him.

“Doctor, I had to do something o. If not those people for kill me.” We all busted into laughter, he had truly saved himself from the helpless situation.

Everybody congratulated him for a job well done; it seemed more like we were congratulating him for hitting the policeman than for the convulsions. We gathered round and listened to his story, nobody condemned him for the terrible thing he had done. He did what we all wanted to do but have all been too civilised and well behaved to do. At that moment, by my patient’s bedside with the nurses and porters, everybody shared their different experiences of police brutality. We were bonded in the common hatred of the lawless who have become the law.

Finally, an accident on Saturday; a different kind though.