Category Archives: profession

Abdul-Ra’ufu Mustapha: 24.07.1954 to 08.08.2017

This is easily the hardest thing I’ve ever written. I have been wanting to write it since I came out of the acute grief that I felt when he died. It’s hard to order my thoughts and feelings for my uncle Ra’ufu even today, 2 years and 7 months after he left us. His death has left a big hole in my life. Today, the grief is as fresh as on that sunny August day. Other days, I can rejoice in the good times we shared. First, I am grateful he died pre-Covid-19 because it would have destroyed me and his wife and kids not to be there with him in those last days. Thank God for small mercies.

I have decided a letter to him directly is the best way to do this. In between paragraphs, I will add names of songs that remind me of him or make me think of him now. He loved music so I am sure he would approve of the inclusion of music in my tribute to him. You’ll read it in the words below but I’ll say it now: I loved him so much and I miss him every day. He will live on forever in my heart and I am so thankful for the 16 years of consciously knowing and loving him. He was not perfect by any stretch of the imagination, but he was generous in all the ways it counted and he is one of the best men I have ever known. My father in all the ways it matters.

Dear Uncle Ra’ufu,

In 2000, I had a little brown address book. In it, I wrote the landline numbers, addresses and email addresses of the people in Nigeria that I didn’t want to forget after I emigrated to England. In it, I wrote in blue ink your name, phone number and address. My Mama said to call you if I was in trouble in England before she joined my sister and me. That was the beginning of my journey of knowing you. Of course, you knew me as a baby but for me, this was my first contact with you. I remember looking at your university of Oxford address and thinking ‘wow! He must be amazing to work at Oxford uni’. I had wanted to study medicine there, so it was like a fantasy institution for me. I didn’t need to call thankfully.
‘Light Up’ by Leona Lewis

We met in December 2000. Mama, Charo and I came on the Oxford Tube to Oxford and after a bit of confusion, on a cold dark December night, we found our way to Edmund Road. My memories of that night are a jumble. The sound system and shelves of music CDs, the Christmas tree, the smell of Nigerian food, the kids. Asma’u and Seyi – they were great kids. Despite the fact we had booted Asma’u out of her room (or was it both of them in that room?), they were both so warm and welcoming. As you and aunty Kate were. In the overcrowded living room, it was evident that this was a family where love resided. For the first time since moving to England, I felt relaxed and happy. My tummy was full of Nigerian food. I could be myself.
‘One Sweet Day’ by Mariah Carey and Boys 2 Men

So many memories but the singing stands out. You’d sing Barry White in your lovely baritone and the kids would groan and be embarrassed especially when we were out. You loved Robbie Williams ‘Rock DJ’ and every time it played on the radio (it was a big hit that year so they played it A LOT), you’d sing along. You pretended he wrote the song about a northern Nigerian woman called Dije (nickname for Dijatu, particularly in Fulani parts). The kids would argue until they were blue in the face that it was about a DJ. You stood your ground and I chuckled at the family drama.
‘Over the Rainbow’ by Israel Kamakawiwo’ole

Hand in hand with the singing was your cooking. Your cow leg pepper soup special was blow-your-head off hot with chilli, but I could never resist it. I also learnt your efficient way of chopping okro. You took me alone to a bookstore in an ancient Oxford building one day and bought me the hardcover of the complete Lord of the Rings book. It was mahoosive. I hadn’t ever heard of it and I wondered why you chose that book. I hefted it back to London with me and it was a transformative read. That was the first of many presents you generously bought me. I will treasure that book forever. And I will die a LOTR fan. What a book! You knew me so well even in those early days. Your house was full of books and my visits became defined by how many books I could read in my waking hours. I’d stay up all night finishing book after book. You and aunty Kate never got fed up of my laying about reading. I don’t think I helped around the house as I should have, so focused was I on devouring all those lovely books on your shelves and in piles all around the house. It’s not a surprise your home quickly became my 2nd home. How could I resist a home where music, books and good food were so central?
‘Hey There Delilah’ by Plain White T’s

Fast forward to 2013, I called and asked if I could bring George to meet you all. As always, there was no hesitation. He was my boyfriend, so he was welcome. You validated him. You and aunty Kate might have had reservations, but I was never made privy to them. We were in the kitchen alone one evening and you asked me if I was sure he was the man I wanted to marry. I said yes. You said ‘ok!’. That was it! Without you, I don’t know how we’d have organised the wedding. I asked you to be George’s representative when none of his family or friends would or could come to Nigeria to stand beside him. You organised the religious side of the wedding in Kaduna, bore all the costs without question. You even paid the sadaki on behalf of George. I wasn’t there so you organised for a photographer to record the day for me and delivered me a beautiful album. In March 2014, you were George’s father. You did a marvellous job and I know George will be forever thankful to have had you by his side during all that. Thank you.
‘Amazing Grace’ by Judy Collins

As if that wasn’t enough, I asked Asma’u if she wouldn’t mind if I borrowed her father to walk me down the aisle. She said yes without hesitation. She figured that you could practice being father of the bride on me before her wedding day. Little did we know that I would be the only bride you’d walk down the aisle. I asked you if you would walk me down the aisle. Yes, you said without hesitation. You asked me what to wear and I asked for traditional Nigerian. When I saw you outside my bridal room on my wedding day, preparing to walk me down the aisle, I felt so proud. You looked so wonderful in your green outfit. You said something calming to me (it’s all a blur now) and you walked me down the stairs and then down the aisle. One of my best memories of the wedding was when you and aunty Kate broke into traditional Yoruba dance. I was so happy in that moment and so proud to have you all by my side as I started my new chapter.
‘With You’ from Ghost the Musical

Every Christmas or NYE I could, I spent in Oxford with you. You taught me about music, about politics and religion, about caring for the world around us and giving back. The trips to Bicester shopping village on Boxing day was a tradition I loved. Even if I didn’t have much money to spend and I wasn’t a big fan of shopping anyway, I loved it because we spent that day together. Getting out of the house was always a mission. We were never out at the planned hour. We’d then struggle to find parking but we would find a spot eventually. We always had to stop in the Bose shop and listen to their demo. We always stopped at Eat for lunch. We’d finally traipse back to the car laden with shopping bags, exhausted. Then spend the 27th recovering from our exertions. When I started working for the NHS, these traditions were invariably interrupted and I only partook in them partially. It was the only reason I minded working over Christmas to be honest.
‘Happy’ by Pharrell

In June 2014, I remember jumping into my car and driving down to Oxford to escape the house where my in-laws were staying after the biggest fight I’d ever had with George. I was so upset. I sat at the table with you and aunty Kate trying to hold back tears. I didn’t want to share it all with you to be honest. I was always mindful of the advice not to share your husband’s worst faults with parents because they won’t forget long after you’ve forgotten. I remember you seeing my red eyes and you looked angry. Angrier than I’ve ever seen you look. You clenched your jaw and you hurriedly walked away from the table. Aunty Kate and I talked for hours. She cried with me and consoled me. You came down when she had worked her magic and I was calm again. When I left the next day, you hugged me tighter than you had ever done. It helped.
‘Umbrella’ by Rihanna

In November 2016, I came for a visit a day after my birthday. I had spent most of my birthday alone. George had gone to Abu Dhabi for the formula One. I was left with my Velcro baby, exhausted beyond belief. Tete (Lorraine) and Kudzi took her off me for 3 whole hours whilst I treated myself to a child-free meal and a whole-body massage. I came back feeling better than I had since giving birth and they surprised me with a birthday meal. It was lovely. But the next day, I wanted to be with my family so I got on the train and came to Oxford (Savannah hated being in the car so it didn’t occur to me to drive down). You were at the station to pick me up. Savannah must have had the sense that you were my people because she went to you and aunty Kate and let me rest my aching arms. I had tummy issues so couldn’t have your cow leg pepper soup. I remember your crestfallen expression when for the first time ever I turned down your offer to make pepper soup. It turns out that was the last time you’d offer it to me. I haven’t eaten it since.
‘All of Me’ by John Legend

My tummy issue turned out to be a treatable condition called microcolitis which when it was finally diagnosed was treated. I didn’t admit to you and aunty Kate that I was worried I had cancer. I had lost more than 10% of my body weight in the 6 weeks since onset of symptoms, I was exhausted and felt very unwell. I was worried about dying and leaving my infant without a mother. When aunty Kate called me 3 weeks later to discuss her concerns about your reflux, cancer was already on my mind. I remember telling myself not to be stupid even as a corner of my mind became anxious. Aunty Kate called back the next week to say you’d gone to your GP and were on anti-reflux medications only but your symptoms were worse. I remember talking to you then, urging to go back. You were reluctant as it was over Christmas with reduced GP hours. I had a bad feeling in my gut, it didn’t go away. Still there a bit now. You went back and they put you on the 2-week wait pathway, confirming my fears of cancer were reasonable. I had a heart to heart with aunty Kate and admitted to her that although other things were possible, cancer was the most likely and for her to prepare you for that possibility. Now looking back, I wonder how she bore it. She was so calm in the face of the turmoil she must have felt internally. I remember coming off the phone after one of those talks and crying. I knew then that you had cancer.
‘You Make Me Wanna’ by Usher

It was confirmed on histology weeks later but the appearance of the ulcer and description was quite conclusive and I told you both. I was devastated. I hadn’t been able to see you during this time between working and trying to get some rest with the Velcro baby. I regret not coming down anyway. I should have been there in person. For you and aunty Kate. I should have come with you to the appointments to ask all the questions I felt weren’t being answered. Relaying my questions via aunty Kate felt inadequate and cruel to be honest. I was working hard to keep your hope alive whilst I was losing all hope myself with my medical hat on. I had seen this story play out with my patients. Little did I expect to be on the other side, living the nightmare.
‘We Are Here’ by Alicia Keys

Eventually, we realised that the cancer had spread more than we first knew so it wasn’t a curable cancer. We started looking into trials for you. Things didn’t go so well clinically and chemo was recommended by your oncology team to slow down the progression. Once chemo started, you went downhill. I think I was afraid to see you in person so I put off seeing you for months. I saw you in February 2017 and the change in the 3 months was shocking. Aunty Kate had been kind in her descriptions of you. You were clearly gravely ill. The chemo rendered you ineligible for trials. Aunty Kate and I talked about trials in India but by April-May, it was clear you were too weak from the chemo. I cried and raged when I was alone. One day, it was just me and you sitting down on the dinning table and you apologised to me about not making my biological father step up and be a father to Charo and I. I was so sad at your words. I remember saying you had nothing to apologise for. He is an adult and it was his failing and not yours. You insisted that you could and should have done more. I was angry that you were taking on his failing as a father. I remember lying in bed that night angrily wishing that it was him with the cancer and not you. It is not a charitable thought I know but I still feel that in moments of anger that I feel for losing you.
‘Castles’ by Freya Ridings

At this point, you were in and out of hospital as your vomiting and poor oral intake was becoming an issue. I was at a loss for words to make it bearable so I took to sending you videos, jokes and photos of Savannah. You always replied and that reassured me that even if physically things were bad, mentally you were with us. On another visit, I sat with you and you admitted the worst thing about the chemo was your mouth soreness and how dry and tender your hands were. Asma’u gave me some Vaseline intensive lotion and you let me massage that into your hands. You smiled at me and it felt good to give you some comfort, even if temporary. In May or June, you called me out of the blue and in your weakened voice, you asked me directly if it was time to get your affairs in order. It was the first time you and I had talked about your death. I remember closing my eyes as my heart broke once more. After the longest pause, I said yes.
‘ABC’ by the Jackson 5

You stopped replying to my phone messages shortly after this conversation and couldn’t speak on the phone so most of our communication was through aunty Kate between visits. She and Asma’u told me about how hard it was for them to watch you not eating. They told me how grumpy you were about taking the medications. In July, with the agreement of the oncology team, most of your medicines were stopped and palliative care started in earnest. You enjoyed lying on the lounger in the garden, soaking in the sun. You were cold despite the heat of the summer sun. You barely spoke. Your words were few and far between. The most alive part of you were your eyes. Sunken into your face. I couldn’t look at you mostly because when I did, I had to face the reality of your impending death. Still I remained fully at work. I should have taken time off at the end of July. Why didn’t I come for your birthday? Even if it was a full house? I could have driven down for the day. I knew it would be your last with us. I didn’t come then. The next week, I woke up one morning and the feeling in my gut was stronger than ever. I called George to ask him to pick Savannah up from nursery. That I needed to see you that day. I spent the day with you and I knew your days were numbered. I tried to warn aunty Kate. I think she knew anyway. I sent George down to see you that weekend and say his goodbyes. I didn’t want him not to have the chance.
‘Alive’ by Sia

On the 7th of August, I came down again, without Savannah as I wanted my focus to be you and you alone. You were bedbound by then. I sat downstairs chatting with aunty Kate and Asma’u about the funeral and where you were to be buried and how to navigate the conversations with your family in a culturally sensitive way. We all knew that the end was nigh. Seyi left us to it. I guess he wasn’t ready to talk about it. Selfishly, I argued for you to be buried in Oxford so I could keep you close. I had to concede your preference was probably Ilorin even if you left the final decision to aunty Kate. Aunty Kate was due at the Nigerian High Commission the next day to apply for her emergency visa so she could come with you on your final journey home. I went up finally, alone, to sit with you. That morning, my intention was to thank you for being my father and to reiterate that you weren’t to carry the guilt of my father’s failings. I even practised what I would say to you on the drive down. When I sat next to you, you roused yourself to answer my formal greetings in Hausa. You were breathless and so weak. I couldn’t say my practised words to you as it would mean admitting to you and me that I was saying goodbye. Instead, I held your thin hand in mine and told you about Savannah. When you started to drift off to sleep, I whispered thank you and I love you. I stood in the doorway composing myself and watching you snooze.
‘Perfect’ by Ed Sheeran and Beyonce

I planned to be back on Thursday with Savannah. As I left the house, I didn’t think that would be the last time I saw you or touched you or spoke to you. The next day, I got a message from Idris asking me to confirm the news. It was then I realised you had left us. I text aunty Kate: ‘is it true?’. She text back ‘yes’. You had left us. The rest as they say was history. I came on Thursday with George. We helped aunty Kate prepare to take you home. We talked. We cried. We listened to Josh Groban’s Take me home as per aunty Kate’s request before they got in the car without me and accompanied you on your final journey. I was on-call that weekend and the NHS doesn’t give leave for non-immediate family member. Aunty Kate hugged me tight before she got in the car and said, ‘I will look after your father for you’. I should have told the NHS that you were my father. I didn’t. I should have gone to Ilorin with you. I will regret that forever.
‘Survivor’ by Destiny’s Child

I hope you knew how much you meant to me. How much I love you. How much I valued your love and all the time you spent with me. I hope you know how much you have helped shape me. How I am planning my hospital because you inspired me with the philanthropic work you did. I don’t know if a part of you is here. I hope it is. I feel you here. Whenever I see okro or cow leg, whenever I hear a deep belly laugh like yours or hear someone speak with your accent. I feel you whenever I see the Bose logo, when I hear 70s and 80s music you introduced me to. You will be part of me forever. You will never die fully as I hold a piece of you in me and it will live on as long as I live. When I show her a photo of you (which I do often), I asked Savannah ‘who is that?’. She always answers ‘Uncle Ra’ufu, your father’. Right out of the mouth of my baby. Rest well my father.
‘Missing you’ by Puff Daddy

Your daughter.

Covid-19: The Fallen NHS Heroes

You may have seen on the news that the first 4 doctors to die on the NHS frontline are all male, African and 3 out of 4 of Arabic (Sudanese) origin. We, in the medical family, have understandably been analysing this news with super-critical microscopic gazes. I will take you through the most prevalent theories and one of my own at the end.

  1. Genes: maybe something in the African DNA makes the coronavirus more dangerous to us. In the early days of Covid-19, there were a lot of false theories about the virus not liking the heat and that this was why it didn’t strike in Africa for so long and is still relatively contained. Possible I guess but as it is an RNA virus and viruses like to attack DNA, it is more likely that it’s more to do with DNA than environmental factors such as temperature and weather. Perhaps we have particular DNA sequences unique to Africans of that region (Sudan and northern Nigeria) that means the virus is more likely to successfully infiltrate our cells to replicate and overwhelm our defences. Maybe Africans are not getting infected as often as non-Africans but those that do, get a more severe disease?

Advice: don’t be foolhardy fellow Africans. As we can’t alter our DNA (yet), we need to follow the shielding/self-isolating/hand washing rules very strictly. No visiting family guys. This is serious now.

  1. Vitamin D deficiency: it is a known fact that in the UK, a large proportion of non-white people have either insufficient or deficient vitamin D levels. Many of us don’t know this unless we go to our doctor with generalised symptoms such as tiredness or non-specific widespread aches and pains and we have a blood test. Or if you’re a woman when you see someone for pregnancy or menopause related appointments. When I was in medical school, the importance of vitamin D was just starting to emerge outside of bone health. I remember an Ophthalmology consultant telling me to look up vitamin D in cancer and that if I was to learn anything from him, it was that I should take vitamin D supplements every winter for the rest of my life. Anyway, it turns out that vitamin D is central to many of our metabolic processes – in other words all those things your body is doing at cell level to keep you alive and functioning. It has something to do with Cancer, all autoimmune diseases, brain function, eye disease, mental health. You name it, vitamin D probably has a role. Therefore, it is a solid theory that these 4 doctors could have had that in common.

Advice: probably worth being on vitamin D if you live anywhere like the UK where the sun don’t shine most of the days. Or relocate back to the Homeland (lol)

  1. ACE inhibitors: there has been a link proposed that people being on these anti-hypertensive (BP) drugs having worse outcomes from Covid-19. In simple terms, those on these drugs (common ones Elanapril, Ramipril, Captopril) are more likely to die if they get sick from coronavirus. African have the highest incidence of hypertension in the UK so it makes sense that these 4 men might all be on an ACE inhibitor.

Advice: do not stop your anti-hypertensives without seeking advice from your GP. Even if this theory proves right, if you practice shielding/self-isolation and good regular handwashing, your relative risks will remain very low. You are at risk of complications of high BP too (heart attacks and strokes) and it is a balancing act.

  1. Inadequate PPE: this is likely to be a huge contributing factor. I think this is most likely the issue. Despite Bojo and his Government officials making grand announcements about PPE availability for NHS staff, it is not so in reality. Doctors across England are reporting a lack of PPE and feeling forced to see patients regardless. As a group, medics are prone to putting themselves second to the needs of patients and whilst that is admirable, it is also unwise. Up to 25% of healthcare workers will be infected with Covid-19 according to statisticians. This number should be much less. Of those 25% it is estimated looking at global data (particularly China, Italy and Spain) that between 5 and 10% will die. Maybe more as data is incomplete. If you look at the number of NHS staff, those numbers are huge! We medics are not indispensable. We are a limited resource and no, despite Jeremy Hunt’s claims of yesteryears, no one can magic up 1000s of doctors in the next few months. Not even if you paid them double of what you’re paying them (remember the junior doctor contract bullshit everyone?). No amount of money is worth dying for. Especially if you’re a locum and your family don’t even get a death in service pay out to compensate them in a little way for your loss.

Advice: if you are a healthcare worker, do not go within 2m of a probable Covid patient without an FFP3 mask and full gown as per WHO guidance. Help them from a distance if you must. If you are put under pressure to go closer, walk out. What are they going to do? Fire us all? A sick or dead doctor won’t do the patients any good. Trust me.

  1. African Bravery: I really don’t mean this to sound like I am victim blaming or being flippant, but this is my take on it. These 4 men probably had risk factors that meant they should not be frontline. Be it due to age or comorbidities (existing illnesses as per Government guidelines like Asthma/COPD, chronic heart disease, autoimmune disease, on cancer treatment). But they decided to be brave and put the need of their patients first. If they are like the African men I know (I come from Northern Nigeria like Dr Alfa Saadu), they would have prayed (all Muslim too) for protection and gone to serve with inadequate, despite knowing the risks. Whilst I admire that bravery, I really do think it needs to be discouraged at times like these. We cannot afford to lose medics who are essential in combating this pandemic. We need the Government to step up to the plate and provide correct PPE for all frontline staff. All of them. The Government/NHS says full PPE only for those performing aerosol generating procedures. I put it to you all that one of the commonest symptoms of Covid-19 is a cough. That is an aerosol generating procedure. As you cannot predict when a patient will cough, you should always be in full PPE. Simples. Only patients who are ventilated are not at risk of coughing on you if you go in close.

Advice: don’t be a martyr. You are more useful to the NHS alive and well. Demand full PPE or work from a safe distance from all possible cases of COvid-19. Walk away if you must. Go and work at another hospital that will provide you with the right PPE.I quit the NHS and clinical medicine 2 years ago in March 2018. I had many reasons but basically, although I loved my paediatric patients and a lot of my peers and the paediatric nurses, I felt that the NHS was a poor employer and didn’t care about the individual. I couldn’t see me working for 30 years as a consultant in the NHS. Couple that with Jeremy Cunt and the junior doctor contract debacle which forced me to see that the public we serve generally has no appreciation for the sacrifices we make as doctors in the NHS and think that it has to do with pay. My health and wellbeing was beginning to suffer and I had a baby to put first. So, I quit and moved onto a non-clinical medical role. I took a pay cut to do it (it really isn’t about the money folks) and lost the security of my NHS pension and sick pay. Despite all that, in my new job, I am treated with respect and feel appreciated. My mental health is much better. I am in a better place career-wiseThen bam! Covid-19. I am one of those doctors whose licences have been restored by the GMC. I have agreed to return to serve the NHS through this time. In February, I was very ill. With hindsight, I think I have had and recovered from Covid-19 (which would be great as that’ll mean I am immune going back into the viral soup that is the NHS). But my recent illness and exacerbation of asthma puts me in the higher risk group. I am also an African Muslim which is beginning to look like a risk factor. I am on vitamin D supplements and not on ACEi.Whilst I am happy to sacrifice and serve, I will not be going to the frontline without adequate PPE. I intend to stay safe and alive. My daughter will have her mother for many years to come if it is in my power to insure that. That is my promise to myself and my worried friends and family. I aint going nowhere without a fight!Stay safe folks. Peace and love

Physician Heal Thyself

Yet another doctor has committed suicide recently. The 3rd in the past year in the UK that I know about. There are probably more. It is so sad. On the face of it, many people might think what do doctors have to be so depressed about? The public still imagine that being a doctor comes with a good job, good income and the respect of the population in general. Those of us in the profession and our loved ones know better. For most doctors, the work is relentless. The NHS is no longer fit for purpose. There are too many patients with less resources to care for them. There is more and more paperwork borne out of the NHS having too many ‘managers’ who analyse medical errors and harm and feel that creating another form to fill in will prevent future incidents. They fail to realise that what is needed is more funding to employ enough staff for the numbers of patients we treat. They fail to realise that they need to invest in their staff and make them feel appreciated and valued for their hard work and for doing more than they are contracted to do. They need to examine the levels of sickness and absenteeism and realise that burnout is real and so is depression. Above all, they need to realise that without preventative measures, doctors will continue to work themselves until they simply can’t.

Although the UK rates highly in a lot of economic and living standards indices, being a rich developed 1st world nation, it doesn’t do so well with mental illness. The positive news is that the UK had made it into the top 20 of the world’s happiest countries in 2017 (it was previously 23rd and is now 19th) for the first time since 2012 when the world happiness report started being published annually.

In March 2017, the Mental Health Foundation commissioned a survey to look into prevalence of mental health in the UK and to identify the factors about individual that make them vulnerable to suffering from a mental illness. It found that 7 out of 10 women, those aged 18-34 and those living alone had a mental illness. Only 1 in 10 of the whole population are happy most of the time. Women are 3 times as likely as men to suffer a mental illness. Stress is a growing problem. Majority of people suffer from either a generalised anxiety disorder, depression or phobia. Self-harm and suicide are not classed as mental disorders but are a response to mental distress usually cause by mental illness that has not been recognised and treated.

With these statistics in mind, it is easy to see why young female doctors are at risk of mental illness. Couple that with the fact that medicine attracts people with a type A personality who are high achievers and do not like to admit they have a ‘weakness’ or that they need help. I have already described working conditions in today’s NHS. No wonder so many young female doctors are struggling and every year, we lose a few to suicide. What I find particularly difficult with this is that when colleagues pay tribute to those who have died, there is always a huge sense of shock. Unfortunately, these women hide their illness so well that often even their closest confidants have no idea how much despair they are in. Their friends often describe them as ‘superwoman’, someone who ‘has it all’, always helping others, taking on incredible amounts and managing to ‘juggle it all’ somehow. They give so much to others that they forget to give their selves.

Caring. Freedom. Generosity. Honesty. Health. Income. Good governance. These are the things that increase happiness and promote mental well-being according to the Mental Health Organisation. I would sum it up as friendship. I think human beings are social creatures (yes, even the introverts) and need to have at least one good nurturing relationship. This is intrinsically linked to self-worth. Many people who have attempted suicide and lived to tell their story say that depression and anxiety eroded their self-worth to such an extent that they felt useless and that the world would be better without them in it. Depression interferes with rational ordered thinking. When it is severe, it is like being in a deep dark hole, full of doubts and lacking in any hope. Far from being selfish, I believe people who contemplate suicide are (in their warped thinking) being selfless and believe in that moment that they are un-burdening those around them.

So is there anything we can do to turn the tide? Most experts agree that by the time a person has planned to commit suicide, it is probably too late to do anything. The depression has taken over and has them fully in its grasp. Where we can make a difference is at a much earlier stage. We need to prevent people with low mood going on to develop depression. We need to be that friend who validates their self-worth. The one who lets them know in words and action that their presence is very much appreciated in your life. We need to talk about mental health more so that someone at the early stages of depression feels able to confide in someone and seek help. If mental illness is so prevalent, why do we not talk about it more? Why are we ashamed to say, ‘I am depressed, I need time off work to get treatment/rest to get better’? Would any of us feel ashamed to call in sick at work if we developed appendicitis, had to have surgery and needed a few days to recover? Just because mental illness is invisible doesn’t make it less valid. I think this ultimately is what will turn the tide. Talking about it, admitting we have a problem and asking for help early, taking time out now to prevent getting to the point where all hope is lost and we feel like we have no other option other than suicide.

If you are reading this post and can identify with the desperation that mental illness can induce, please reach out to somebody. Ask for help and support. If you are in the UK, there are some very good resources. Your GP should be your first port of call. If you are feeling suicidal, call the Samaritans on the free phone 116 123. Mind has help pages online that can be accessed at https://www.mind.org.uk/information-support/types-of-mental-health-problems/suicidal-feelings/helping-yourself-now/#.WX8lFojyvIU as does Turn2Me at https://turn2me.org/?gclid=EAIaIQobChMIvKCtr8Sz1QIVT5PtCh2D7QnCEAAYAiAAEgKyyPD_BwE. The Mental Health Foundation has some great guides for promoting mental wellbeing which can be accessed on https://www.mentalhealth.org.uk/your-mental-health . The app Headspace comes very well recommended for dealing with stress, anxiety and depression.

If you are a medic, there is a wonderful Facebook group called Tea & Empathy for peer support for all those working in healthcare. It was founded after we lost another one of our young doctor colleagues a couple of years ago and is a brilliant space full of supportive caring people. The Wales Deanery has published a booklet specifically aimed at helping medics cope with the stress of the job. You can access it here: https://www.walesdeanery.org/sites/default/files/bakers_dozen_toolkit.pdf.

Finally, I want to say to you all: You matter. You are loved. You are not alone. Be kind to yourself x

 

The Power of Dreams

My aunty forwarded one of those inspiring videos about life and happiness. One particular message struck me. It said something about having a dream then making it happen. Of course, it is easier said than done. It is not quite that easy to turn a dream into reality but those people who are the happiest are those who had a dream then put their all into making it a reality. I have many dreams. Through hard work and luck, many of my dreams are already a reality. I got into medical school, I graduated. I applied and got into speciality training and I am gaining experience as a paediatrician. I met a man with a big heart, fell in love and married him. We bought our lovely first home, a permanent abode after my many years of moving from flat to flat.  I fell pregnant when we were in good place and the baby has been growing well with the easiest pregnancy. I am getting ready to realise one of my biggest dreams – giving birth and being a mother. So yes, my bucket is overflowing.

This is about my professional dream.  I used to think I would be happy to graduate, specialise as a paediatrician, get a consultant post and settle down to a routine. With the recent political shenanigans and the more I work in the NHS, the more I realise I want more. I want more out of my life and I also want to contribute more than the daily grind. Don’t get me wrong, I know in my current role I do make a difference to lives. There is nothing more satisfying that when I have done a good job and I know that parent or child’s life has been changed for the better, no matter how small that change is. However, many days I look back after a busy day and think was that worth it? Those days which are all about paperwork and administrative tick-boxing exercises that contribute nothing except to some faceless manager’s satisfaction.

The part of the world where my life started (Yola) is lovely in a lot of ways but there is a significant poverty. In terms of economics but also in healthcare terms. Nigeria as a whole fails to cater to the healthcare needs of its population unless you have lots of money to go private. The North-East of Nigeria is one of the poorest when you look at health outcomes. In particular, looking at childhood. The statistics (where there are any) are shocking. Nigeria, for all its wealth, regularly features at the bottom of tables for health outcomes. We are in the bottom 5 for most outcomes including maternal and under 5 morbidity and mortality. For the non-medics reading this, morbidity refers to how much ill-health and disease (sickness there is) there is and mortality refers to how many are dying.

Mothers naturally should come in a low-risk group. Most should be healthy young women doing what is most natural – getting pregnant, growing a baby and then delivering the baby. Young children, although fragile because they are not mature yet biologically are despite all of that resilient on the whole and have bodies that are full of strong healthy organs with endless potential for healing. What we are failing to provide is basic care. Basic antenatal care, trained birthing assistants, hospitals to assist in difficult deliveries and facilities for emergency caesarean sections (surgery) for those women who cannot do it naturally. Infections, on the whole preventable and most totally treatable, cause a lot of the morbidity and mortality in Nigeria. Many of the other things we provide here in the NHS is simple supportive care, allowing patients own bodies to heal themselves in a secure environment.

So here is my dream. I would like to set up a women’s and children’s health centre. Big dream I hear you say. Yes, I am aware. It will be a huge task. I worked at the FMC in Yola for 4 months in 2012. I saw how much need there was and the things that were missing. I know a lot of the patients we couldn’t help were those who lived far away from town and did not come to us until their disease was too advanced for us to be able to do anything. Mothers died in childbirth because they did not have adequate antenatal care so predictable problems were not discovered until it was too late. Preterm babies died because they were born out of hospital in environments not hygienic enough and did not get simple breathing and feeding support and early treatment with antibiotics. Term babies were born too small because their mothers were undernourished and unwell with treatable conditions during pregnancy but were not diagnosed and treated. Very few of the patients we couldn’t help needed fancy expensive medicines or surgery. It was simply too little too late.

On the positive side, those that did come to us in time had better outcomes than those suggested by the statistics I read about on WHO and the likes. Those preterm babies born at FMC Yola thrived and majority survived until discharge. Sure, their progress was slower than here in the NHS because of a lack of basic equipment and provisions like oxygen and breathing support, working incubators, labs, fluid pumps, parenteral nutrition for those too young to feed by mouth or through the stomach. But survive they did because they are little fighters.

So what I dream is to provide all those basic things to the mothers, babies and children free of charge if I can manage to raise funds or at the very least at the smallest prices possible to give those with little the chance to quality healthcare. To go with that, I would like to provide an outreach service to those isolated villages. Run clinics, provide immunisations, antenatal vitamins and nutritional support, teach about prevention of infections and when it is vital to seek early medical help. Central to that idea is to train some of the villagers to provide safe simple birthing assistance, supportive care for new-borns and how to diagnose and treat the most common infections and provide first aid. All little things but added up should cut the numbers of mothers and children suffering unnecessarily and prevent the many preventable deaths.

My grandfather listened to me talking about my dream and was (rather unexpectedly) downbeat about it. He pointed out that it wasn’t as easy as I was making out. Actually, I know it will be difficult to do and as I have never done this before, it is a monumental task. There is so much to do to get this off the ground. However, here is my plan. I will start small and do this project in stages. I will deal with the complications as I get to them. A journey of a thousand miles has to start with that first step. I have taken my first step. I have dared to dream and I have written down my dream in black and white. Now onwards and upwards. Watch this space.

Don’t Sweat the Small Things

Sometimes in life, we allow small things which on their own are not significant to add up and turn into a massive problem. I speak from experience.  I am a creature of habit so I like things to be a certain way. To a degree, I do have obsessive compulsive traits. That is not unusual in a doctor. It takes a certain type of personality to go through medical school and then to work in hospitals and face all the horrors that can come with the territory. When I was living on my own, it was easy to use those OC traits for the good. Everything had its place in the little space I had. No mess was left where it was. Everything was clean and orderly. My personal life was organised to a T. In direct contrast, my professional life despite all my best intentions often felt out of control and at best, it was an organised chaos. Dealing with humans and ill-health is by its nature very unpredictable. You do all you can do and things get worse in some patients. In some patients, you barely have to do anything and everything gets better anyway. Which sometimes makes me question exactly how much we as doctors are able to influence and if it has more to do with patients than us.

Anyway…my lovely ordered life was turned on its head when I met and moved in with my husband. He is the spontaneous type who makes ad-hoc plans and also changes them (or should I say ‘forgets’) without warning. He is so full of energy that he cannot be neat. When he makes a mess, he would rather clean it up later. Later being in a few hours, days, weeks or even months in some extreme cases. I used to get really worked up about these things and ended up cleaning up after him because it was too much of a hassle to nag him into doing it. Then I started to resent having to come home after a long day’s work to organise everything again or use up my precious days off sorting. Now I have swung the other way. I have become an expert at turning a blind eye. I refuse to see the mess and I will generally not tidy up if it is not my mess. So whilst I complain less and I try to let him get to it in his own sweet time, it hasn’t lessened the stress it causes in my mind. I will literally obsess about the mess not being there.

Whilst I generally get on with my fellow doctors and nurses at work, there is inevitably one who is like a thorn in my side. In my most recent rotation, there was one such nurse. I will call her Nadine. She is a senior nurse with a lot of experience – this is usually an asset but in her case, she thought she could tell me how to do my job. I am usually quite laid back and approachable at work but I am certainly no pushover. I can’t be because as a registrar I have to take overall responsibility for patients out of hours. Well, Nadine decided because I was a new registrar that she had to question all my decisions, mostly indirectly. This really riled me because the decisions that I made were either straight forward or those which were more complicated were discussed with the consultant as per usual practice. I found that lack of respect very irritating and at the start of the job, I had to avoid any contact with Nadine until I could detach myself enough not to care. Once I realised by talking to the other nurses that it was not unusual for Nadine to give rotating doctors a hard time, I was able to maintain professionalism by communicating what was essential and just tuning out the negativity. What Nadine (and I) felt in the grand scheme of things was insignificant as long as I did the job I was there to do and I did it well. By the time I left, I think she had gained a grudging working respect for me.

I guess what I am saying is that I have come to realise some facts of life. Main fact being that most of life is not within my control. Fact is that there are many small imperfections and it is not always possible (or maybe even desirable) to make them perfect. I don’t always find it easy to let those little things go but when I do, it is less stressful. As long as I control those things I can control and make life as good as I can within my little bubble, I can live with the little things. Life is hard enough without sweating the small stuff.

Champion the Truth

If you don’t live in the UK, you may have missed the junior doctor contract row that has been brewing for a few years but has escalated over the last couple of months. If you live in the UK and rely on major media outlets to keep you informed, you may think the dispute is about junior doctors asking for more money. I would suggest you turn to social media for more accurate information from doctors, other NHS staff and more importantly their families. Long and short of it is that the dispute is about our Government deciding we junior doctors need to work longer hours whilst our pay is cut and refusing to do the simple arithmetic that would show that if you want more junior doctors working around the clock, you need to recruit more of them because we are already working long hours and we absolutely will not do me as it would put our lives and the lives of patients that we hold so importantly at risk. I mean, how is it fair that the Government has voted to pay its MPs more and they can still claim vast amounts on expenses yet the very same Government says we have no money in the coffers to pay for more junior doctors? Isn’t that ridiculous???

I digress, please read up on Facebook, twitter and blogs writing on the issue. Plenty of truth out there is you care. The baseline is that at least half of the junior doctors who have voiced their opinions have stated either that they have made up their minds to quit the NHS or are at the very least, looking into alternate careers or going abroad. The simple truth is we as a group of junior doctors think the bottom line is that the Tories have vested interest to tear down the NHS and privatise our healthcare and hence line their pockets. There is also strong evidence out there that the current fool we call our Health Secretary has been a champion of NHS privatisation for many years and probably owns share in private health insurance conglomerates like Virgin Health.

This blog is actually about the one good thing that has come from this attack on junior doctors. We now have an online Facebook forum called Junior Doctors Forum which is by invitation only. It has 63,000 members and counting. Not all of them are junior doctors. We have consultants, medical students, nurses, midwives, paramedics and other allied healthcare professionals plus a few lawyers, journalists and even politicians about the forum. What I want to do is big up the passion of those on the forum and champion them sticking to their guns and being honest about how they feel and what this is doing to us as a group. Never has there been so much unity within the profession. Medicine is a very hierarchical and competitive profession and although we all start as one, we generally sub-divide as we become more senior and choose specialisation programmes. Our world then shrinks even further so all we know is related to the one field eventually. Our only contact with the outside specialities is if they are part of the multi-disciplinary team that we need to make sure each patient’s care is optimal with the inclusion of all relevant expertise.

So it is all good news though? No. Unfortunately when you get 63,000 opinionated voices with the top 1% in terms of IQ and ability to rationalise, debate and analyse, you get varying opinions. I am all for freedom of speech and embracing our differences. However, as with all other aspects of life, some are excessively worried about how other people interpret our opinions. An article was published based around a discussion we had on the forum and people are getting all uppity about all coming across professional and un-emotional. Why? If this was about professionalism only, we would all continue our stony silence whilst we get attacked as we give our all for the greater good. This time, we have stood up and shouted NO because not only have they attacked us (we have thick skin because of the nature of being medics who take enormous responsibilities day in, day out) but they are threatening the very fabric of the health of our nation. Their proposals are not only ensuring that many of us want to leave because we choose life and living than putting ourselves in danger from physical and mental exhaustion, they are also meaning that we are now less willing to carry on doing extra unpaid hours for no thanks.

The NHS has been running on the goodwill of its junior doctors for a very long time and things have been in a steady decline for the past decade yet this is the first year that doctors have threatened to strike. We love the NHS and have been carrying its weight to the detriment of our mental, physical and psychosocial health for far too long. This is the straw that will break the camel’s veritable back. It is because we are passionate that we are fighting the proposed changes which may start with junior doctors but we all know will extend to the rest of the hardworking staff the NHS is lucky to have as its employees. How then can anyone ask that we lie about how angry and betrayed we feel? How upset we are that we are being made to reconsider our futures? Whether we can afford to have children and continue to be there for our patients? How the lies of Hunt et al are demoralising us? How we don’t feel it is worth it anymore to carry on in the NHS when all we get for breaking our backs for a pittance (£11/hr 6 years after graduating for me compared to a plumber who can earn up to £50/hr) is abuse and an Etonian ignoramus vilifying us for caring.

Well, I am here to say that no. I will not be unemotional. If I didn’t care for the NHS, I would have quit after my first foundation year when I became a fully licenced medical practitioner. If all I care for was the money, I would be abroad today with a private clinic, dictating my hours and pay. If I didn’t care, I would not be attending protests and spending what little I have left over after my living expenses and medicolegal expenses on supportive merchandise. I care and I am not afraid to show it.

Hunt is only the face of the Tory campaign to break the NHS and leave privatisation as its only viable option. The Tory Government is libellous, dishonest, spineless and un-democratic. If the general public continues to buy the bullshit the Government is peddling, it will be the British public who will pay the price in the next few years. So unless you are all dying with something that will kill you with certainty in the next couple of years, wake up and realise facts. Fact is the NHS as we know it will be no more unless the whole of the British public fights this. Just google how much it’d cost you to pay for your health insurance in the US and imagine the UK going the same. Doctors are in hot demand the world over. We can and will be forced to leave the UK and the NHS is this horror continues and we will be fine. I assure you. So the fact that I am getting emotional is not because I am a greedy lazy overpaid privileged posh kid as Hunt and co would have you believe. It is because I care and I am not afraid to show it. Fact!

Open Letter to David Cameron – Our Silent PM

This was written by the father of a UK doctor. He lives in Sweden but is speaking out to save our NHS. If you share his sentiments. Reblog or share my link. Please.

Sir,
Your silence in the matter of the NHS and Junior doctors is conspicuous and indicates your silent approval of the Health Secretary and his policies.

This is not a matter only between Mr. Jeremy Hunt, the NHS, and junior doctors. In fact, this concerns everyone, from a child yet to be born to the elderly person counting the last breath and every one in between. Therefore your intervention is of vital importance to the national interest.

It is also very painful to see how ruthlessly and insensitively you treat the elite youth of your society. The youth who have chosen to indulge in the service of people of your nation, day and night, ignoring their own comfort and social life. They are the foundation of health and wellbeing of your nation of which, I am sure, you are proud of.

I have seen the plight of junior doctors. They are working day and night, have no control over their week-ends or holidays, when on call they have to be available for up to 48 hours. They cannot think of taking leave irrespective of personal urgency. In spite of all this they are single-mindedly devoted to their duties and responsibilities and have never asked for a pay rise. They are just short of being slave driven. To add ridicule and insult to their calibre, Mr. Jeremy Hunt wants to reduce their pay and increase their working hours (while informing the public he is doing the opposite). All the while he has been projecting them as greedy and an unwilling work-force. You are watching all this silently.

The fact is that junior doctors are tired, fatigued, exhausted, demoralised and yet they stand erect and defend the health system of your nation.

I will spare myself the energy and assume that you know more than I can ever explain. You will be well versed on the internal workings of your own government, therefore, I will draw your attention to a few things which might have escaped your attention. I do not think that this has escaped the attention of Jeremy Hunt because it appears his is a well calculated mission.

First, all signs suggest that you want to privatize the NHS. If that is so, you should come out boldly and declare to the public that you want to do so. Firing the gun from the shoulders of the junior doctors and blaming them is not graceful nor is it worthy of a strong Government. The public who have placed you in the high office have the right to know your plans rather than manipulations. If your Government succeeds, cutting the pay of junior doctors and increasing their working hours, junior doctors will survive in one way or another. However, the entire population of your country will suffer. I do not think that they will forget nor forgive. Therefore, before you dismantle the NHS, it is imperative that you rethink your plans because the health and wellbeing of your country depends on it, and for this, you are directly answerable – even in the future.

Second, the Health Secretary has succeeded in downgrading and vilifying the medical profession as much as possible. Once again, you are a silent witness to this. He has taken away all the motivation and incentive from bright and elite students of your schools and colleges to choose the medical profession. If he is allowed to succeed further, you might find medical colleges left wanting for students. That would create an enormous shortage of qualified and quality doctors in the long run and an ever increasing burden on the health service.

Thirdly, if you and Mr. Jeremy Hunt succeed in privatising the NHS – I can see how this could be the interest of Mr. Jeremy Hunt. Your previous health secretary Mr. Lansley, has recently take a role in a company who is promoting privatisation of The NHS.

If The NHS is short of funds (and we know it is, through systematic underfunding by the government), it is not the fault of junior doctors. On the contrary they have to work even harder without adequate machines, equipment and staff. It is a simple case of mismanagement of finances and mismanagement of administration. Instead of pointing the gun toward the junior doctors – who are the weakest link in the chain of NHS hierarchy – aim your guns at cleaning and pruning the financial management of NHS. Look deeply into it as to why The NHS is in this position.

There are 53000 junior doctors. They are working for at least double that number. Each doctor is giving you output for at least two doctors. Instead of motivating them, patting them on the back, and incentivising them, you want to pull the carpet from under their feet so that all of them tumble down. More worryingly, you are willing to do this on the whims of a few people who may not think beyond their own interests at the cost of the health of your entire nation.

Your junior doctors are dedicated, hardworking and responsible. They are the future specialists, researchers and innovators. They are the backbone of the health system of your country. Give them the respect they deserve. Give them the motivation and sense of worth. Applaud them for having chosen the medical profession.

I have seen them working with dedication and without complaining in spite of all the hardships they face as my son is one of 53000 junior doctors.

This letter is the voice of 106000 parents who are proud of their children and their devotion to the service of people.

Best regards,
Anil Bhatnagar

Be Your Own Yardstick

I will start by admitting that I, like most other people, did not like the way I looked for a long time. More accurately, I had insecurities about some parts of my body, some of which remain to date albeit in a very passive way. So I understand that as humans, we always want what we don’t or can’t have. I have worked very hard not to measure myself against people who bear no resemblance to me. I realised very early on that my genetics are out of my control so wanting to be someone completely different was a futile aspiration.

I have always been skinny or more politically correctly slim. I used to hate the word skinny when I was a teenager because to me, it represented a person who was gawky, awkward, boy-like and unattractive as a young woman. I realise that most girls put on weight around puberty and looking at the stick-thin waifs gracing runways, magazines and Hollywood movies, it is easy to see why they would aspire to be skinny like I was. I was completely oblivious to this as I was quite the tomboy and did not have any time for magazines when I was around puberty. The movies I loved were mostly animation and even if the girls/women portrayed in most Disney movies were on the smaller side, they all had the beautiful curves I adored. My mother has lovely feminine curves and so does my glamorous older sister. Perhaps being African where the culture predominantly celebrates curvaceous women had a bigger influence than I was conscious of too. My celebrity role models were Halle Berry, Julia Roberts, Jennifer Lopez and later Beyoncé and Alicia Keys all of whom have (and celebrate their) curves. All of those things meant that instead of the usual Western ideals of being a size 6, I was self-conscious. I wanted to be bootylicious and packaged in a short petite perfectly proportion frame.

The worse part for me was having to go shopping. Again, another aspect where I differ from the norm. It probably started out because I used to accompany my grandmother to the market in Lagos and she used to take her time visiting stall after stall finding the best quality food for the best price. I would follow impatiently, wishing she would speed up and within an hour, I would develop a painful ‘stitch’ in my side, making me want to sit on the ground (a massive no-no as it was rather murky in Lagos markets).

As I grew older and had to start participating in shopping for my own clothes, it was okay because my mama like me is impatient with shopping and she used to be quite military with it. When I became an adolescent, my mama decided to give me money for clothes shopping and it became my responsibility. The shoes, underwear and bags were easy enough because it was just a matter of looking to see what caught my eye. Clothes on the other hand was a nightmare! I vividly remember days coming back dejectedly after 6 hours on Oxford Street in London and trying on top after top and jeans after jeans and none of them fitting well. I would look in the mirror and see this anorexic figure staring back at me. Some of those days, I would be so demoralised that I would cry. Thankfully, although I haven’t put on much weight over the years, I have acquired some (slight) curves which means that I am now a proud standard size 6 or 8 depending on the shop. I can confidently go out to buy new clothes knowing now I will find things that fit. It is just a matter of finding the style I want for the price I am willing to pay for it.

The lesson I taught myself early on was that there is no use aspiring to become curvaceous like J-Lo overnight. Rationally I knew I was going through puberty and it would take time before I developed curves. Also I had seen pictures of my mama in her 20s (pre-children) and she didn’t have much in the way of curves back then. I also looked around my family and realised that most of the young girls were rather skinny. Fulanis in general are skinny folk anyway (think Masai-like physique, same ancestry). I would tell myself that just because Britain was predominantly British and it catered to the genetic makeup of that population did not make me unattractive. Many of my friends and family told me countless times that they would rather have my body than theirs but I thought they were lying to boost my confidence. I only started to believe them once I grew my curves and became more body-confident and got strangers complimenting the way I looked.

I am still not a massive fan of the mirror and often forget to look at myself in it. I still find some of my features surprising and often when someone mentions something about my facial features, I have to go and look in the mirror to work out what they are talking about. I’ll give you a classic example of my lack of self-awareness. I was 14 years old when my sister and I went into a shop I had never been too. I turned a corner and caught sight of a girl who I thought looked vaguely familiar and I mentioned that to my sister casually. It probably didn’t help that at that age, I was still in denial about my short-sightedness so did not have perfect vision. My sister looked at with a smile like I had made one of my endless jests. I was confused. It dawned on her in seconds that I genuinely had seen myself and did not realise it was me staring back from the mirror. Oh well!

In general, I guess it is a good thing that I am not self-conscious about what others see when they look at me. I care more about presenting a professional look when I am at work and a ‘nice’ look outside of that. All my adult life, I have chosen an extra 5 minutes in bed over putting on makeup in the morning. Thankfully, being sexy or desirable are not issues I care about. My dear husband assures me that I have those characteristics in abundance anyway and it is only in his eyes that it is important I am those. To anyone else, it really doesn’t matter to me what they think of how I look as long as they see that I am a decent and caring girl inside.

My message is simple – I value what sort of a person I am inside more than out and because of that I do not compare my ‘beauty’ to others. I have simply learnt to embrace and even love the body I was blessed with. I see beauty in all body sizes and shapes, colour, height etcetera. As Christina Aguilera says in her song Beautiful and I paraphrase – ‘I am beautiful, no matter what they say. Yes, words can’t bring me down. I am beautiful in every single way. Yes, words can’t bring me down…Oh no! So don’t you bring me down today…And everywhere I go, the sun will always shine.’ Preach! Belief in your beauty, regardless of what people say because there will always be critics but that is their problem, not yours my friend.

Listen to Granddad

My grandad by everyone’s standards is a legend. He has seen and done so much in his lifetime and he continues to do so today at the age of 85. Look him up. Ahmed Joda is his name. I won’t bother to write about his many achievements because so many have done so over his many years of service. I want to write about the man beneath it all. My grandad who I call Baba. We all do, his children and grandchildren alike. Because before I realised what other people thought of him, through my young eyes, all I saw was an ‘old’ man who was my mama’s dear father. My only grandfather. The patriarch of the family who was also the main father figure in my life.

The first thing we all know about Baba is that he is a stickler for punctuality. Now this might not sound significant to you but coming from Nigeria, it so is. Have you ever heard of the concept ‘African time’? Did you know ‘Nigerian time’ constitutes even worse ‘lateness’? So a Nigerian who is always on time is as rare as hen’s teeth. His most precious possession is his watch. He looks at it every few minutes even when he has absolutely nothing to do. It’s like a nervous tick. And God forbid he forgets his watch at home, he will drive us all mad asking for the time every 5 minutes.

When Baba asks you to meet at 5pm, at 5:01pm he will be on the phone asking where you are if you are not there. If you make plans to go somewhere with him, be sure to get there on time because I kid you not, if you are more than a couple of minutes late, he will go without you. Whoever you are and wherever you were meant to go with him. I think I wrote a blog about how he invited his friend from Abuja to come to Yola (9 hour road trip) to join us all on a trip to Gembu (6 hour road trip). We waited for 20 minutes and despite the fact that it was 6am and we would get there by lunchtime, he declined to wait and left without them. Lord knows what they went through to find Gembu because Nigerian roads outside of Abuja and Lagos are poorly signposted especially places like Gembu and they didn’t turn up until the next morning! We in the immediate family are no strangers to his bark of ‘come on!’ which when I was little used to make me cry because it sounded so scary. Over time, I have learnt not to react so emotionally to it but still, when that bark comes because we are more than a minute late to leave for some engagement, my heart skips a beat.

I once asked Baba why being punctual was so important even when no one else (Nigerian) cared and why we had to be the first ones at every event. He explained and although I cannot remember exactly how he phrased it, the message is reflected in the following quote:

‘Know the true value of time; snatch, seize, and enjoy every moment of it. No idleness, no delay, no procrastination; never put off till tomorrow what you can do today.’

Lord Chesterfield

He certainly lives by that rule and as I have said before, he has achieved more than most people would in 3 or 4 lifetimes. Perhaps he is still going so strong at 85 because he is mindful of seizing every moment he has been blessed with. I certainly want to emulate that when I grow up.

So many things I love about Baba but one of them is easily how much he has empowered us all to speak our minds. He has never been of the school that children should be seen and not heard. From a very early age, he would ask our opinions on topics most adults would never broach with children and he would give your answer his undivided attention and take it on board. Many years later, he would repeat your words to you especially if you had learnt from experience that things were not black and white and he would invite you to explain why the change in opinion. This means that in the Joda household, we are all prolific debaters and will put across our arguments without fair of censure as long as we were being honest. Active debate is encourage actively and even the youngest gets heard as long as they want to contribute. I think what keeps Baba so young at heart and full of zest is that he surrounds himself with the young and he sees life through our eyes. That way, his ideas are always in date and he can converse about whatever you choose to discuss.

Somehow, Baba never asked me what I wanted to be when I grew up until I was 13 years old. I brought the topic up because when I was choosing my optional subjects for SS1, my mother expressed surprise that I didn’t want to do Economics. My response was one of surprise too because although I was good with figures and mathematics, I was always more into my science than finance. Turns out Baba thought I would make a great economist. Next time we sat around the dining table, I asked him why he thought I would make a great economist. I can’t remember his reasons but I promptly told him I was going to be a doctor and that there was no way economics would even feature in any options I would take for a career path. He expressed his disappointment that that was the path I had chosen but of course it was up to me. I was going to be the first doctor in the Joda lineage and thought he would appreciate my individuality.

It wasn’t until I was qualified and he sought my opinion on some of his medications that I felt he was proud of the career path I have chosen. So was I right not to listen to Baba? I thought so until the recent NHS upheaval which might mean me changing career tracks this late in the game. He is almost always right my grandad after all. Maybe what he foresaw was that being an economist would be a better quality of life for the grand-daughter who was feisty and named after his beloved wife. Perhaps he knew that my hard work and talents would not shine the brightest as a doctor. Perhaps he even predicted that I would end up working in the NHS whose main shortcoming is its poor economics. Who knows? As of now, I think I chose the right profession. I knew I wanted to be a doctor before I even know what a doctor really does. I love the job itself now, more than I ever thought I would. However, the politics of the NHS now means I am questioning whether my love for the job justifies my continuing on in the career when it means me risking my health, my social wellbeing and happiness and giving up so many of my dreams. Watch this space!

Appreciating the Small Things in Life

I don’t know if I mentioned that I got married last year in April. I must have somewhere. We have made it through the first year baptism and we have grown as a couple so much. Of course it hasn’t been smooth sailing but I would not have expected that being that we are both passionate about what we care about, both rather opinionated and both not the types to shy away from an argument. My post is not to pretend it is all paradise, a fairy tale. Perfection. It is in fact about the opposite. About how it doesn’t have to be perfect but you can be perfectly happy especially if you stop sweating the small stuff and instead start appreciating the little things that make the relationship great.

My husband from time to time gets a little insecure (particularly after a few days of me getting increasingly irate when he is not doing his boring chores) and asks if there is anything I think is good about him. I always react with a bit of disappointment because I know what I am like and when anyone does even the littlest thing that makes me smile or happy or proud, I am the first to say it, usually using the word ‘amazing’. So this here post is to tell you about the little things the husband says and does that makes me go all  mushy inside and makes me forgive him when he does the big things that make me want to cry in anger or in frustration.

I will start with a little thing he does which always sets my day up nicely. He makes me a cup of tea or if I am lucky a sandwich for work. I will admit now I am not usually a morning person so finding that he has made time for me in the morning and so saved me some time makes me go all warm first thing in the morning. It just used to be tea in my travel mug to drink on the way to work or on weekends in a nice mug by my bedside. Today, he presented me with the flask pictured above. Not only has he made me tea, he has gone out and bought a little flask to keep it warm knowing how slowly I drink tea and how it goes cold before I get to the last drop. And the flask is in a colour I love and the writing on it is paying me a compliment. What better way to start the day I ask you? I look outside right now and it is a grey rainy Monday morning but my heart and soul are smiling like the sun is up and shining Yola-style.

The other day, he went out and came home in the early hours to find me in bed. I was curled up on my side, tensed up waiting to see if his hands were cold from being outside. Imagine the relief when he placed his warm hands on the small of my back. Better yet, his hands were covered in oil and he gave me the loveliest backrub I could have asked for. I drifted back to sleep and it was the best night’s sleep I had for over a month. That’s #2 of the small things he does. He gives me impromptu massages, backrubs, foot rub, head massage when I need them the most. When I come home after a 14-hour day at work and collapse in a heap and I am so tired I cannot muster up the energy to take off my shoes or eat dinner. In the same vein, he will also fetch my dinner and a drink and make me eat it all then when I start to doze off with my plate still in my hands, he takes it all away and even carries me up to bed. How could I help but love him?

He pays me compliments all the time. I am quite a low maintenance girl if I say so myself and I have a healthy appreciation of myself. I don’t have any great hang ups and my self-image is good. I do not need compliments but I do appreciate them. Who doesn’t? Like the compliment on the pictured flask, 4 years and counting since we met and I know he thinks I am hot. Let me be honest, I do not see myself as hot. I know some people think I am pretty, my mama and sister certainly say I am beautiful and so do my closest friends but I sort of take it for granted that they see the beauty within as well as without. I know I am not ugly and even strangers have paid the odd compliment to me. Omosede Ighile even called me beautiful many years ago when no one outside my family had ever and I won’t ever forget that compliment because those days, I was a little less self-confident and it meant a great deal. Anyway, I digress. Sorry. Some days I look in the mirror and think ‘niiiiiiice’. Some pictures I think ‘wow wee’ maybe he is right I am hot but mostly I don’t remember to look at myself because honestly I do not care how I look most of the time. He does though and what I think is too skinny to be womanly, he loves. He looks at me like I would expect a guy to look at Shakira, Jennifer Lopez or Halle Berry. He gives me a smile that I know means he thinks I am sexy and you know what, it feels damn good. Because I know with many men, after that initial honeymoon phase, they stop seeing your beauty and it all becomes boring routine. Not for my hubby. He sees my beauty even when I am at my scruffiest, usually post night shifts wreck and he tells me verbally and with his eyes. Aren’t I a lucky girl?

Linked to his complements is that he is proud of me. Not only does he think I am hot, he also thinks my brains are hot. I mean, I can’t pretend not to know I have been blessed academically. It’s all on paper from the time I was like 2. So yeah, I know I am no slouch in the intellectual department. However, being a doctor and surrounded by lots of doctors who are not just intelligent but many are in the genius sphere (unlike me), I do not feel as special as I did say back in primary school when I was the school’s big brain. But when I am around my husband or when I hear him talk about me to his friends, I go back to that happy place where my mama was bursting with pride at her baby’s academic achievements. When my sister used to tell everyone who would listen how much of a Brainiac her little sister was. He is so convinced of my intellectual prowess that he would rather listen to me prattle on about religion, nature, culture, psychology and even art than consult Professor Google or people in those fields. What is best is that despite not being medical in any way, shape or form, he swears I am the best paediatrician ever. Even after I was facing my first ever exam failure (post-grad paediatric specialisation exam, 1B). I laugh but really, I am delighted that someone has so much belief in me that even when I doubt myself, he is there to shake me back into believing and therefore being great again.

Following on from there, he likes to hold hands. Small thing #5. He is so proud to be my husband. He was proudly proclaiming that even before I agreed to be his wife. My sister and I used to try to curb his enthusiasm and point out he wasn’t even my fiancé at the time but he was irrepressible. It was ‘my wife’ this and ‘my wife’ that within the first year of our courtship. Silly man! I got used to it eventually but it took a while. Now he will get upset if I fail to hold his hand or kiss him long enough in public. I know he takes it seriously so I try but I am a shy Fulani girl. Public displays of affection (PDAs) do not come naturally. Particularly when it goes beyond a quick kiss. I still get embarrassed. Not because I am not proud of him but because I have been brought up a certain way and PDAs are a no-no in Yola. The attention it draws is just a little embarrassing for this Fulani girl. But I am working on it.

Last small thing in this post because I will be late for work otherwise. He will dance with me whenever I give the slightest sign that I am in the mood for it. As soon as I start singing a song or I start nodding my head to music, he will duet with me and he will want me to get up and do a dance. Unfortunately for him, I don’t have the energy he does after work (it is physically and mentally draining being a doctor if you are not one). So I will usually bow out after one dance but he will happily dance for me whilst I cheer him on. His energy and enthusiasm, whilst in need to curbing most of the time is an amazing quality and I might not say this to him often, it is what stops it being boring round ours and we are always up to something or the other. Keeps it all fresh and turbulent and exciting. Much better than boring which I have a very low threshold for. Might explain why I am a paediatrician. It’s a lot of things but so very rarely boring.

So there you are dear husband and dear readers. I have told you all today about some of the reasons why I love my husband so much and why despite all the big faults, I love him to bits. Tell me what little things you love about your husband/partner/lover/wife/girlfriend/fiancée too. I would love to hear it!

p.s this paragon of ‘small’ virtues is called George. My Georgey boo 😀