Hospital

Esau’s Pottage

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When I was still single, I had this patient who was middle-aged; a politician with a lot of cash to throw around. The reason he got my number(which I usually withheld) was that I referred him to an ENT specialist and he requested to be able to call me to speak to him if need be. Subsequently, he kept in touch, calling occasionally just to say hello and so on. The staff of course loved him cause he was a big tipper. Whenever his posh car with the government license plate  rolled in, even those who should have closed for the day would hang on, hoping for a “blessing”.

One day, he called me in the afternoon.

“Good evening, sir”, I greeted. (Note he had a leadership position in church that came with a title).

“My doctor! How na?”

“Fine sir.”

“I am eating **** in **** restaurant. Would you like to join me? Let me send my car for you.”

Now picture me, fantasizing about myself being chauffeured in that posh car with good air conditioning, insulated from the harsh Niger Delta sun, arriving said restaurant like a ‘queen’, being served all sorts of delicacies, where I proceed to eat myself to stupor. The smell of hospital antiseptic jars me back to my senses.

“No, thank you sir. I have had lunch.” (Aunty long-throat whispers in my head ‘Liar! You have not!” but I ignore her voice.)

“Are you sure? They have**** and ***. Have you tasted****?”

(By this time I am shaking my head like MFM prayer warriors muttering in tongues to bind the devil)

“No, thanks again. Have a good meal. I have to see a patient. (Another lie!). Bye now.”

He never asked again even though he called me for many other reasons through the years. A few years back, I was married and living in Lagos at this time, he called me out of the blues. I greeted him heartily.

“Doc, I don’t know how to tell you this. I need a favour.”

“Shoot.”

“Well…it’s just that…I wish you were in town I would have come to see you to ask for advice.”

I wonder why he is stuttering. What could be making him so nervous?

“Why not tell me what the problem is; I could be able to help even though I am far away.”

“Is it not all these small small girls? They don’t know how to do the right thing.”

“Small girl? Is your daughter ill?

“No, not my daughter. It’s one small friend I have…(Big shot actually sounds sheepish). She said she did not see her period.”

I am tempted to sound obtuse and ask him to go to her house, take permission from her mother and help her find it but “Not today Satan! Stay professional Dr. N!)

“How old is she?”

“19”

“Haba! That is too young. An older girl might have known to use protection. Why didn’t you use protection?”

I can feel him squirming over the phone…even MTN can feel it. His money, cars, connections cannot protect him from the wrath of an Igbo woman.

“I used condom. She said…I don’t even know what she said…”

“Are you sure she is pregnant? Have you done a test?”

“She showed me the pregnancy test she did. It was positive. Doc, how do we flush it out? Is there any friend you have who can do it for me?”

“You know I don’t do such things!” I scolded.

He winced. “I know but maybe your friends?”

“I don’t have friends who do abortions. You know it is illegal. Why not keep the baby?”

“Ha! You know my status. I am an *** in church and she is a small girl.”

I thought for a while. There were 2 possibilities.

  1. She was pretending to be pregnant to con him out of money
  2. She was actually pregnant and if I didn’t intervene he would take her to a quack and she would end up with a septic abortion or even worse die.

“Go to the hospital, call one of the doctors aside and tell him you need to ask him something privately. If he is willing to get involved, tell him your predicament and he will make sure it is done right. But first, he should do another test to confirm she is actually pregnant. If you insist on going ahead, ensure it is done under the strictest of sanitary conditions, and keep an eye on her afterwards to prevent any complications.”

“Okay, doc. Thank you.”

“Sir…you need to choose your girlfriends carefully. 19 years is too young!”

He mumbles something unintelligible.

“And you need to use protection. Carry a condom around. You will protect yourself from scandal and protect Madam from catching something. These girls are not loyal.” I was speaking fast because I knew he had had an earful and would soon end the call.

“Thank you”

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I never heard from him again.

Now the moral of the story… Esau was so hungry that he sold his birthright for Jacob’s pottage. If I had gone out with this man, even if I didn’t have sex with him, I would not have the temerity to call him out.

We are in this world as a light to expose the deeds of darkness. Make your standards evident once people meet you and they will leave you alone.

There are men who cannot call out their friends who are beating their wives just because they are indebted to them. Stop borrowing money you cannot repay to impress people who do not care about you.

There are ladies who paid people to write their exams, now they can’t raise their heads when people who know you were an arts student wonder how you ended up an Engineer.

Stop laughing at crude jokes in order to be politically correct. Even if you are not bold enough to speak against things, stand up and walk out. Psalm 1 talks about how blessed is the one who does not sit in the seat of scorners and mockers. You believe…who knows?

Making your stand known also protects you from undue pressure. I remember my husband telling me how a colleague at work was about to invite him to hang out with him in a club when another colleague interrupted and said “Leave him O! He doesn’t drink or hang out.” One day when the ribbing got too much, I told him to accept their invitation if he felt like it. He was such a bore at their outing cause while they were getting wasted he was worrying about the work he brought home and wishing he had his laptop. Suffice it to say they never invited him out  again.

You have the power.

JUST BE!

Cheers, Dr.N

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If you would like to chat send me an email @ drnsmusings@yahoo.com or find me on twitter @nenabekee

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Well Within My Rights

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I have often spoken of my experience working in a very busy hospital in the Niger Delta, where I was the only female doctor. My MD was a very intellectual man. He would drill us on every patient we were managing, during the morning rounds. If he felt you were giving less than your best, he would give you a tongue-lashing in the presence of patients, nurses, and all.

Now, as medical students, we were trained to accept such criticism humbly, and even thankfully. The belief is that the privilege of holding human life in your hands, does not come lightly. You should be thick-skinned enough to handle verbal abuse. Even when we qualify as doctors, our superiors still have the right to come down hard on us. I’m not sure how many other professions encourage this.

female dr

One day, I was in the consulting room, when a young lady of 20-22 years was shown in. She was really pretty and shapely. Her complaints were, Mucoid and bloody dischage and vaginal bleeding. I later found out that she had post-coital and inter- mentrual bleeding. That means that she bled after intercourse, and in between her periods. I concluded that she had either cervicitis or early stage cervical cancer. Without alarming her, I asked her to go for some tests. Particularly, she was to do a pap’s smear. I also told her to abstain for a while and bring in her partners for tests.

The next day, I was summoned to the MD’s office. I was surprised to see her sitting there, looking worried.

“Come in, Dr. N”, he called when I opened the door. “Are you the one who sent this young lady for these tests?”

I took the sheet of paper he was extending to me.

“Yes sir” I replied.

“You sent her to the government-run laboratory? “, he smirked. “They are laughing at you!”

“Sir?”

“How can you send such a young girl for this test? Your diagnosis is wrong! See how you made a fool of yourself! “, he ranted.

“I don’t understand…..” I stammered.

“How can you not get your facts right? Leave my office! I just called you to tell you how you messed up”

Crest-fallen, I left. I was fuming inside all day. Why was I not allowed to defend myself? For whose benefit was this show? I had not given her any medication. How harmless could a non-invasive test be? I went home mad in my spirit. There was no way I was going to let him get away with it. I prayed and decided to confront him.

Though I didn’t want to be fired, I couldn’t take it any longer. I had worked with him for a year and proven myself. Letting him talk to me that way, would open the door for far worse. I didn’t want to blow up in front of his staff.The next morning, I was very calm as I knocked on his door. I had downloaded on my laptop, current information about her symptoms. That way, he wouldn’t say I relied on old textbooks. He let me in and smiled.

“Sir, I have something I want you to read”, I began.

“What is that?”, he asked.

“Just something I downloaded”

“Tell me what it is”

“It’s all about Cervical cancer, HPV, Cervicitis and more”

“Is it because of yesterday? Forget about it, now”,he cajoled.

“Sir, you traumatized me. I didn’t sleep or eat yesterday because I was so embarrassed”, I joked.

“O! Pity about that”, he evaded.

“You have to make it up to me. The only way I will be pacified is if you buy my lunch today”

He laughed. “Lunch? Is that all?”

“Yes”

He rang for his personal assistant and ordered her to buy me whatever I wanted for lunch. I left with a smirk. That was the only apology I was going to get but, he would think twice before calling me out again.

“Wetin you do wey oga dey buy food for you?”, his assistant asked.

I mean, it was unheard of that he would release a penny. I winked at her and held my tongue. Now, it has always been my ambition to have a great reputation where I work. I work hard, complain as little as possible, give extra, and try to be humble and courteous. This is particularly because, females tend to have a bad rap in the work place, as being obnoxious and lazy.

However, there comes a time, when you have to speak up for your rights. You can’t be a footmat. If you have established that you have a good work ethic and get along with others, you don’t have to be ashamed to say, “No, I won’t take that!”. Some people are just waiting for you to lose your temper. As a Christian, I advise that you delay responding till you are calm and have mapped out a strategy that is win-win for all involved.

For instance, I could have engaged him before the patient, told him off, and quit. He would lose face, I would lose my job, and the patient would lose confidence in both of us. By going back later to correct him in private, I gave him the chance to call her back and do the right thing, without feeling ashamed. Yes, she may doubt my capability in future but, that is a small price to pay, I think.

So, dear muses, you may be well within your rights but, choose your fights wisely. Till date, I am one of the few who have worked for him, that he speaks well off. Many bosses have the power to destroy your credibility when someone calls them for your referral.

On another note, if you are sexually active, you want to protect yourself from STDs. Particularly prone, are those with multiple partners. You might want to try abstinence or being faithful to your spouse. It may save your life.

Cheers, Dr. N.

Developmental milestones

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In medicine, there are abilities a child should develop at each stage of life. These are called milestones. At birth, the baby would be noticed to have a ‘dangling head’, be unable to sit, stand or crawl. By 3 months, he should hold his head upright. Teething usually occurs by 6 months, and many babies will sit between 6 to 9 months. A professional can tell if there is a delay, or the baby is just taking his sweet time to achieve these abilities.

This particular patient came in with her 11 month old son. He had a wound that needed to be dressed. Why would an 11 month old have a wound so deep it needed to be dressed in the hospital, I wondered. She deflected my questions, insisting that the nurse should not touch the child.

“So who will dress the wound? She’s the most experienced nurse here and you usually get along with her”, I asked.

“She offended me. I asked her to come and dress it at home and she refused”

“Let me see the wound”

Reluctantly, she let me open the ulcer on her son’s hip. I stiffled an exclamation.

“What happened? “, I asked.
Boy Crying

“I brought a native healer to massage his legs so that he would start walking. She tied a bandage on his legs to ‘bring out his nyash’. After 2 days, I noticed it was too tight and loosened it. That’s when I saw the wound. I even poured tetracycline on it”, she narrated.

Dear muse, I was screaming mentally! What! Don’t wait for me to interpret the pidgin, I can’t. You may google it.

Now, a brief background. She was not only educated, but well to do, and married to an educated and wealthy man as well. This was her 2nd child. I cannot fathom why she believed it was abnormal for him to be unable to walk at 11 months.

“Why didn’t you bring him to us, if you were worried?”

“Eh, I wanted him to start walking. The lady said her method would work”

“Can he sit?”

“Yes”

“Can he stand? ”

“Yes”

“Does he attempt to walk with support? ”

“Yes, but his legs are weak. He often falls”

“But you have a 3 year old daughter. Why were you so worried?”

She kept giving excuses. I told her the nurse was right to refuse to come to her house as such a wound should be dressed in the hospital. It was a large ulcer and already had some dead tissue, coloured yellow by the tetracycline. She was not convinced.

To every parent, please ask a doctor what to expect. Google is great but, you may need an assurance if there is cause for concern. Neighbours and friends will give you conflicting information.

Money can make you wish for everyone to be at your beck and call. Can you pay for your child to start walking early? Perhaps she wanted to be independent; No more lugging him around. The higher you go, the cooler it should become. However, do not let your achievements or wealth become a trap for you. Remain level headed.

Sometimes, I park my car and take a walk or ride in the 3 -wheelers (we call keke). I don’t want to forget that I am not any better than others. Death will come to us all. That certain luxuries are ours, should not becloud our sense of judgement.

So, I ask, do you remember where you came from? Cheers, Dr. N

Obscure motives

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People Looking Downward

I have mentioned in a previous post how averse Nigerians are to visiting orthopaedic hospitals because they fear their limbs will be amputated for no just cause. They prefer the traditional bone setters who offer you care for the fractures medical doctors refuse to ‘patch up’. At the time this happened, I was working for an orthopaedic surgeon. He was an excellent doctor, so we got lots of referrals from others.

A man was brought in unconscious. The doctor who admitted him told me later that he was brought in by some of his church members. I enquired whether he collapsed in church and he said no. The patient was an ‘elder’ in the church. He had complained of ill health and so they took him to their church, (location unknown), for serious prayers. His wife and children did not even know where he was. During the prayer session (which lasted several weeks), they observed he was getting weaker. At the point that he became comatose, they rushed him to the hospital intending to drop him and scurry off, like rats deserting a sinking ship. In fact, they called his relatives to come and take him away as he was close to death. It was his elder brother who agreed to pay his bills before they brought him. While trying to figure out the cause of his coma, his blood glucose level was found to be extremely high. Medication was commenced to correct this but, he kept slipping in and out of consciousness. His wife was not in the picture, his relatives were busy quarrelling amongst themselves, the church members prayed much but, would not cough out money for his drugs. It was frustrating. When you as a professional try to hold up the banner of Christ at work and others rubbish your efforts, you just feel like booting them out!

This man was brought in as a new patient and no one could give his past medical history. He had an injury on his right thumb which was causing the flesh of that hand to decay so, we were dressing the wound as well. 2 days into his stay, a doctor who had been on leave came into the ward and recognized him. It turns out the patient was a highly placed official in the local government and quite rich. His financial contribution to the church caused them to appoint him as an elder. He was so honoured and revered, he began to believe the hype. Soon, they convinced him his wife was plotting his downfall. They had him eating out of their hands because they knew how to stroke his ego. This doctor said he presented with a hand injury he sustained while fishing. When he mentioned he was diabetic, he was offered in-patient care, in order to prevent gangrene. He refused and left with some oral medication.

Few days later, the hand injury was getting putrid, he kept lasping back into coma after being conscious for some hours, his blood glucose was fluctuating. An Internal physician reviewed the case and suggested amputation of the thumb. This, he said, would enable us control all the other symptoms. Let me explain a bit. Infections and diabetes have a complicated relationship. Diabetes makes patients prone to infections because the increased blood sugar creates an enabling environment for bacteria and other organisms. As the bible says, where the carcass lies, vultures will gather. Diabetes also compromises the blood supply to certain parts of the body, especially the feet and hands. Healing is a function of the blood, as antibodies and other defense mechanism are transported by the blood. For this reason, their injuries are more difficult to treat.

Of course, both the family and church refused the amputation. We were weary of battling for his life. He kept me awake many nights, moaning in pain. The nurses were sick of cleaning his hand which was quite foul smelling, and the gangrene was spreading. Finally, we asked them to make a decision or take him elsewhere. Believe me, each time an instruction was given, the church would give their opinion, then the brothers, then the kinsmen. In all this, we never met his wife.

After about a week, they gave permission for the amputation of his right thumb. It was too late though. He died anyway. Immediately, the brothers went to his employers to get his benefits. They were asked to get a death certificate. We refused to give it to them until his wife showed up. A young lady of 25 or less, she and her children were kept in the dark till he died. She was told he was ill and in hospital but not how serious it was or which hospital he was in. They prevented her from speaking to her husband on phone or contacting him in anyway. Ethically, he who pays the piper calls the tune so we could have obliged them but, we kept the death certificate because they exhibited obscure motives.

Note that no one can love you more than you love yourself. Next in line, are your wife and children. Be suspicious of those who try to replace your family. Take your health in your hands, no one should make you feel guilty about seeking help. Prevention is always better than cure. While I prefer divine healing, not everyone will agree to pay the price. That is the reason for the proliferation of false prophets. People want someone else to read the bible on their behalf, pray for them, be holy in their stead. When challenges come, it is the spiritual muscle you have built up that you can use. If you dont have any, or the one you have is tiny, see a doctor and follow his advice, while you build your faith. Be blessed

Faith ,foolishness and presumption.

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There will be so many stories under this topic, sometimes I don’t even know where to start. Talking is not all we can do to change people but it’s the first thing to do. I can’t tell you how many people have died ‘in faith’. Before I go further, I must tell you I am a woman of faith. I have walked with the lord for more than 20 years now and so I know what it feels like to be sick and prefer divine healing to nasty injections. I had my two children without any pain (I’ll tell you about that some other day). It got to the point while I was in ‘labour’, some staff of the hospital were trouping into my room to see for themselves how I was watching TV at that stage of labour. This story and many more, is to open the eyes of those who mistake faith for foolishness and presumption.

First of all, if it is faith, it will work. It will work before you die. Being ill, getting worse daily refusing to seek treatment is foolishness. What scripture are you standing on? Have you prayed for headache before and got healed that you want to be healed of pneumonia. As I always say, medicine is not perfect but, God is not against medicine. He works with doctors just ask Luke the apostle.

A lady came in with her daughter of not more than 5 years. They were out patients which means they didn’t think anything was seriously wrong. As I turned to get the history from her mother, I observed the child was very weak, pale, and shivering despite how hot it was.

“This child is very ill”, I said. I got up and felt her skin. She was burning with a high fever. “Let’s admit her and start treatment. We can talk while I treat her”

“I didn’t come for admission”,her mother informed me.

I felt she was worried about the cost so, I triedto convince her that the child was too ill to scrimp and so she should let us treat and worry about the bills later. She still refused, shaking her head stubbornly.

“Okay, what is wrong with her?” I asked.

She told me her daughter had had a fever for 5 days. Also, she had diarrhoea and vomitting.

“Where have you been? Did you buy drugs for her?”

“I’ve been in church. The prophet has been praying for her”

“For 5 days?” I screamed.

“Yes”,she replied. “Today, he asked us to collect some drugs from the hospital to stop the vomitting so he can continue the prayers”

I felt like slapping her face. Just being honest dear reader, some things you hear in the hospital can make you act like a tout.

“Call him on phone and tell him I said I’m not giving you oral medication. This girl is too weak toswallow. She needs infusions (drips) to even withstand antibiotic injections”

The lady would not budge. I got some nurses especially those who spoke her language to beg her. I was almost in tears, it was that bad. The more we argued, the more lethargic the girl became. When I saw the girl was getting worse, I wrote out some drugs for her and pleaded with her to inform the ‘Man of God’, that her child’s life was in his hands if he would not allow her to he admitted. I even offered to pay the admission deposit. Madam Faith or rather Madam ignorance, left with her daughter who was by then, breathing in a shallow manner.

All the staff of the hospital knew how unhappy I was. I hid in the call room and shed tears for that innocent life that I knew I could have saved. I may not know the cure for HIV, but diarrhoea? ?? How can my patient die of a curable illness? It’s still so painful even as I write this, though it happened 4 years ago.

Please give me some time to get myself together. I’ll complete the post another time.