Tag Archives: pain

The Cycle of Life Part 1

As I said in the bit about me, I am a realist with a healthy dose of optimism. Apologies that I am again going to write about death. It may seem morbid to my blog followers but I do not always find talking about death negative. I dwell so much on it because it is my way of not forgetting those who have left footprints in my heart. Also because unfortunately, for someone who has been fortunate not to be from areas where death is a daily occurrence, I have seen more than my fair share. In the old and in the young. If you are squeamish, this may not be the blog for you.

I write this in the living room of my sister’s flat in Abuja and this was prompted by another blog I just read and also by a conversation I had with my sister. It was a long conversation but it ultimately lead us to discuss our mortality and how death can strike unexpectedly, about being a parent and planning for that eventuality to ensure your children are taken of and about writing wills etcetera. Despite the gravity of the conversation, it was quite an uplifting one. The words to follow are snippets of memories centred mainly around 3 deaths that have literally changed my life. These are young people who no one expected to die and their manner of death changed the way I think about death.

The first was of a classmate from Queen’s College, Lagos. It happened in 1999. She (I will call her Eve here) was not a girl I was particularly close to or even fond of. But I had known her for nearly 3 years when tragedy befell her. Eve was the daughter of a quiet unassuming teacher who I will call Mr Brown here. Mr Brown was the complete opposite of his daughter. Where he was quiet, she was loud. Where he was always serious, she was always laughing, finding the humour in things even when it wasn’t appropriate. She was tall for a 12-13 year old and he was a short man. She was fair where he was dark skinned. The comparisons were striking being that they were father and child. Anyway, Eve was the class joker. She was always loudly laughing or telling a joke. She was always planning the next prank or calling out funny witticisms from the back of the class. Sometimes, it was distracting so I wasn’t always laughing with her but I never thought her to be malicious.

We came back for the 3rd trimester of JSS3 and Eve didn’t. Soon rumours began to circulate about her being unwell. Then we heard that she was in fact really quite sick and was admitted in hospital. Then we heard that she had been victim of an acid burn. The extent was unclear but we did not expect how grave it was. Why we asked? And we kept asking. She was only a young girl. Why would anyone do this to her? I was pretty sheltered so I had never heard of acid attacks nor did I know the usual motives behind them. My more streetwise classmates told me that normally jilted or scorned (adult) men were the perpetrators were and the victims the poor unfortunate girls/women of their affections. It was mainly a Southern thing back then so I had never come across this despite my mother’s job.

This was the perplexing issue to us, her classmates. Why would a girl so young attract such affection? Soon, we again heard that the attack was aimed at her older sister (also in our school but nearer 16 or maybe 17 year old). We were told that Eve opened the door to their home unsuspectingly and she had acid thrown in her face. We were told that she was badly burnt and had been admitted to the hospital weeks before we were hearing of it and was in a serious condition. We talked about her non-stop for a week. There was a sombre mood in the class. It was as if no one felt right to take over her role. So there was no joking or pranking in those days. We all feared the worst as the news we heard was comprised solely of rumours. Like Chinese whispers, we were unsure who to believe.

One morning, the Day students (as opposed to us Boarders) came in talking about the 9 o’clock news on NTA (Nigerian Television Authority channel, national news broadcast). Eve had been mentioned as there was an appeal for funds. The attack on her and the resulting serious injuries were so serious that the doctors in Lagos could do no more and I think the thrust of the news was that her family was appealing for donations to take her abroad. This was when we realised just how bad things were. We sat around in silence, praying for some news. Mr Brown turned up in our class that morning. For once, no one needed to ask for silence. We all sat in our seats and looked at him expectantly. He spoke to us in his quiet voice. His eyes were red…from exhaustion or from tears – it was hard to tell which. He confirmed the rumours. Eve had been the unintended victim of an acid attack. She had been home alone when the men called and as she was so sick, she could not identify her attackers. She was in hospital in a stable but critical condition. He left. For the next few weeks, we continued to whisper about Eve. What did critical mean exactly? More rumours about who the intended victim was and the suspected attackers. About the extent of her injuries. Some adults had been to visit and they all agreed it didn’t look good. Despite all our fears, she remained alive but in a ‘stable condition’.

End of term for us JSS3 students came early and on our last day, some kind soul had organised a bus for those of us who felt up to visiting to go and see Eve. Most of the Northern girls declined to come. I was the only Northerner to get on the bus. In total, out of 90+ classmates, the bus held less than a dozen of us plus a couple of adults. The bus ride was made in total silence. You could smell our fear and the tension was palpable. I mouthed prayers, praying that I could handle whatever condition she was in. I don’t remember much of the usual Friday traffic and the heat. I remember walking off the bus in a single file and how much I was dreading what I was about to see. The smell hit me first and I felt my gut roll. My nostrils curled inwards, as if to block off my nose and the smell with it. I thought I would faint. It was the smell of decaying human flesh reaching the corridor outside her room. I could hear someone whimper and start to sob within our group. We all marched on following the adult leading us in. We stopped by the door as she announced our entrance. When she opened the door, the smell hit us harder followed closely by the sound of Eve taking breath after painful breath. My knees locked and a part of me wanted to bolt. I remember telling myself sternly that I could face anything. If she had to be here, I could visit her. Even if only for a minute.

On wobbly legs, I followed. I inhaled and held my breath. The bedside cabinet was groaning under the weight of medication. Mostly topical and oral stuff with cotton wool and forceps in a metal tray. She was barely visible. Her head was uncovered and there was a lady (her mother?) whispering in her ear. Asking her to be brave, not to scream in pain as she had begun to do. ‘Your classmates have come to visit’ the lady whispered into the hole where her outer air should have been. She seemed to hear her and she lapsed into her painful breathing again. The rest of her body was covered. It was beneath a metal cage over which a sheet was draped. I could not see underneath but I was certain she had burns all over her body, which was why she was lying so. To prevent clothing coming in contact with her skin. We all took turns to step up next to her and tell her who we were. Her eyes were covered, she clearly could not see. The hair on her head was badly singed and what was left of it was in a clump, stuck to her skull. All of her skin was badly damaged. You could see bits of colour imbedded in the skin of her face and neck, clothes melted into her skin. Her nose was gone…there were holes for breathing but no nostrils. Her ears like I already mentioned were missing too. All that was left were holes leading to her middle ears. Her lips were also damaged and her mouth was hanging upon as she struggled to get air in. Through her open mouth, you could see her blackened shrivelled tongue.

She grunted when each girl said her name. We retreated to the back of the room and stood silently for some time. Her carer took a bottle from the cabinet and dropped it onto some part of her face when she started to complain of pain again. Soon, her bravery was unable to contain her pain any longer and she began to whimper. This very quickly turned into screams of anguish. She was clearly in unbearable pain. We all had tears in our eyes as we were ushered out. Her carer came to us and said ‘thank you so much for coming. I know Eve appreciates it’. None of us replied, we were too busy crying. We got back on the bus and gave way to emotion. I remember staring unseeingly out of my window as tears coursed down my cheeks. I wept for nearly an hour, until we got back to school. When I got off the bus, my face was dry. It was obvious I had been crying but the tears stopped. I had to be brave. I got my things and I went home. I did not speak much of it over the next few days except my family would ask how I was doing whenever the appeal for help with medical costs was broadcast. Her death was announced on the Tuesday after we visited. Although I didn’t say it out, I sent a word of thanks to God for answering my prayer. My prayers on the bus after we left was that He put her out of her misery. I was sad but life went on.

About a month later, 2 of my older male cousins, my foster sister, my sister and I had one of our late nights of playing cards by the light of a lantern on the veranda whilst most of Yola slept. It was around midnight and Yola was definitely in bed by then. We were suddenly famished and we rooted around in the kitchen to no avail. We decided to go out and buy some food. We walked in the quiet to the night market (‘kasuwan dare’), fearless in those days of anything untoward happening. Yola was that kind of town. Despite the fact that 3 of us were young girls, we felt safe enough in the company of 2 older boys. We bought food and came home, had a merry little feast and were in the middle of telling jokes and laughing when it suddenly dawned on me that Eve was dead. Just like that. She would have no more holidays, no more jokes, no more laughs. She was gone. Forever. The enormity of it hit me. The pain she was in, the senselessness of her death (her murder come to think of it) and the grief her family must be going through. How had she felt just before the attack happened and when she had the acid thrown at her? How had she borne the pain for so long? Could she smell her own flesh decaying? Did she realise how badly she had been hurt? Did she know she was dying?

From laughter, I dissolved into tears and I could not stop. The more I thought about her, the more I wept. The others were concerned. I told them through my tears not to worry. I was just remembering Eve. They were worried I could see but also understanding. This carried on for maybe half an hour. Eventually, my sister suggested that the boys go home. My sisters would look after me. I smiled through my hysteria and tried desperately to compose myself. I remember rocking as I sat on the ground, hugging my knees and trying not to hyperventilate. I was sobbing out loud, my eyes closed as I got flashbacks of Eve in her eventual death bed.

My sisters asked what the matter was when I did not show signs of stopping. I said ‘I will be fine. I don’t know why I can’t stop crying.’ Actually I did know. I could not stop imagining myself as her. Going through that ordeal, surviving for over 3 months with all the pain. Unable to talk, unable to move, unable to ask why. I thought mostly of her mother, who had to watch her daughter go through this. I thought about the inadequacy of treatment, how she was clearly in pain but there were no painkillers strong enough to control her pain. I thought of her sister, who was rumoured to be the intended victim. How did she feel? Did she feel bad her little sister had taken her place? Did she feel guilty by association? I thought of Mr Brown and his wife. I knew they would be devastated. I had seen it in their eyes. How were they carrying on? How could they bear the pain? If the pain I was feeling was so deep and I wasn’t even that close to her, how must they feel? How could they bear to be alive?

It took over an hour for me to calm down and stop the sobbing. I still cried. Until dawn that day but silently as my sisters lay next to me and went to sleep. I got it all out then and not once since have I shed a tear over Eve but I remember her whenever I think about life and death. The details are unclear to me now but I think her attackers were caught. Her sister was a witness in the case. I don’t know if they were convicted and what happened to them afterwards. We never got to go to the funeral because it happened over the summer holidays.

Life moved on when we returned to SS1. Without Eve. She had never made it out of her pinafore and into the skirt we were now wearing as senior students. Whenever someone said someone funny, we would refer back to what Eve would say. Mr Brown, bless him, looked devastated whenever we saw him, which wasn’t often. He did come to say thank you to all of us for our prayers and our parents’ donations. He especially wanted to say thank you to those of us who visited. He said we helped Eve. I hoped so. As the days turned into weeks and weeks into months, we gradually moved onto other topics. Other girls soon took up the mantle of class clown and the laughter returned. Still, I never forgot and I know at least within my circle of friends at least, none of us will forget her. She lives on in our hearts. What a senseless loss!

What does a Junior Doctor Do Exactly?

A letter written to Jeremy Hunt by a consultant currently working in England.
An excellent illustration of how indispensible ‘junior’ doctors are to the NHS and the public as a whole. I couldn’t have put it better myself so I haven’t tried to 😀

…………………………..

Dear Mr Hunt,

My name is Philip, and I am a consultant physician. Not so long ago, I was a junior doctor and like many others I am outraged and angry about what you propose to do with ‪#‎juniordoctors‬ and their ‪#‎juniorcontracts‬.

I thought that maybe, given you have not worked in healthcare, you might not understand what it is that doctors do (much like if I was made, say, head of Network Rail) so I thought maybe I can help you by shining a light on what I used to a few years ago as a medical registrar.

The medical registrar is the most senior medical doctor in the hospital out of hours. In explaining to my friends what we do, I tell them everyone who doesn’t need an operation right away, or doesn’t have a baby falling out of them, above the age of 16, is our business (and often we have to look after those too). We were the ubiquitous shirehorses that carried the hospitals medical workload day and night. And here’s a typical night shift I did at a general hospital. (all details changed and adapted from real cases to protect patient confidentiality).

I arrive at 8:50 PM for a 9:00 PM handover. It’s been a busy day and the emergency department is full. The outgoing medical registrar tells me there are no beds in the hospital. There are 10 patients waiting in A&E for the medical team, and a lot of patients need reviewing on the wards. He’s already admitted 36 patients during the day, and the consultant is still there seeing some of them with the daytime doctors. I wave hello at her as I head into the fray. I know the consultant and she’s not seen her kids since her on call week started. She waves back wearily.

My first patient for review was a young man with abdominal pain. My first thought as I walked into his cubicle, he looks sick. This is a skill you develop after years of training, when you look at someone and know that they are minutes from death. He’s grey, clammy and shocked. I immediately set about treating his shock and assessing why this has happened. Does he have a bad infection? Is he bleeding? Does he have a blood clot on his lungs? A quick bedside test confirms he’s bleeding badly, likely internally, and my surgical colleague (another junior doctor) and I urgently arrange for an operation. He hurriedly talks to his parents and completes a inacapacitated patient consent form as his condition deteriorates. I leave him in theatres with the anesthetists and surgeons as I have other patients to see.

The next patient was an elderly woman who has fallen. Although she has no hip fracture, she’s unable to walk and needs admission for painkillers and rehabilitation. I reassure her as best I can and stop many of her medicines potentially making her fall. There are no beds for her on the assessment unit or the elderly care ward, so the A&E sister arranges for a pressure support mattress and bed for her in the department overnight. She was lonely and depressed, and I spend some time talking to her about her worries and fears but after a while I needed to move on. She squeezes my hand and smiles, thanks me and settles for the night.

Next is a resus patient with an asthma attack. He is drunk and abusive verbally, though he’s too breathless to be too abusive. A blood test show his attack is life threatening and he he fights off attempts to treat him by myself and the A&E team, pulling off his nebuliser mask and oxygen. As I read out the blood test result to the intensive care registrar (another junior doctor) the man goes blue in the face, gasps and stops breathing. I drop the phone, run over and take over his breathing with a manual ventilator. He has had a respiratory arrest. Alarms blare, help comes running, we inject him with various medicines to help relax his airways and the intensive care doctor slips a tube into his windpipe to help him breathe. The consultant physician, still there, helps with what she could, running blood tests and helping to scribe in the notes. After a nervous period, he stabilises and we take him to intensive care.

It’s now midnight.

In the meantime I have reviewed five more patients, seen by the twilight team, and also my night SHO has discussed some patients with me. The consultant finally got home around 11PM. I’m now on the wards, a liver patient with severe cirrhosis is unrousable. I read through the notes. He has cirrhosis and is not suitable for a transplant. The team has tried everything. I sit and talk with his family, telling them I’m very sorry but there’s nothing more to be done. They cry, one of them screams at me that I’ve killed him, but I accept this as part of my job. With more assurance they’re calmer and I reassure them he’ll be kept comfortable.

My bleep goes off as I write in the notes. Is that the medical reg? The hospital is now totally full, can you please choose some patients to send to our sister hospital down the road? I groan, although I understand the necessity patients understandably hate it. I pick four stable patients and liaise with the registrar down the road.

2AM. I send my SHO off for a quick break as I review some more patients. A confused elderly man who might have a urine infection, a young man with severe headache, a diabetic patient with a very high blood sugar, a lady withdrawing from alcohol and hallucinating. The A&E sister makes me a coffee, lots of milk, lots of sugar.

3AM. I’m with a man in resus again, he is vomiting bright red blood in large volumes. He is jaundiced and looks unwell, very unwell. As the A&E team arranges for a massive transfusion to be set up, I ring the intensive care doctors and the gastroenterology consultant. He listens and says “I’ll be coming in”. I then slip a line into his neck under local anaesthetic, a practiced skill that’s hard at 3AM when you’re tired, but fortunately successful. We pour blood, clotting products, medications and antibiotics into him to halt the bleeding. The gastro consultant arrives at 3:40 and he’s taken to theatres where he performs a life saving procedure. The patient goes to ITU.

4AM. A brief moment to sit down for a quick break. I have reviewed three more of the SHO’s patients. This is the first time we’ve had a chance to sit down together, a quick chat and a cup of tea was interrupted by a cardiac arrest bleep. We run to the cardiac ward. A 54 year old gentleman admitted with chest pain by the day team has had a sudden cardiac arrest. The excellent CCU nurses are doing CPR and attaching a monitor. I ask them to stop as it’s attached, the rhythm is ventricular fibrillation.

“Back on the chest please, charge defib to 150, charging. OK, off the chest, stand clear, top middle bottom myself, oxygen away, SHOCKING.” The patient jolts. “Back on the chest please.” I heard myself say.

Two minutes later he has a pulse. We repeat an ECG, he’s had a full heart attack. I call the cardiologist at the heart attack centre 10 miles away. He’s accepted and an ambulance crew transfers him for an emergency angioplasty. I send my SHO back to A&E as I write a transfer note.

5AM. The resus doors burst open. Another patient, an elderly woman with breathlessness. The A&E F2 listens to the chest, pulmonary oedema. She’s given the emergency treatment but it’s not working. I decide to start her on positive pressure oxygen. Strapped to her face was a tight mask blowing oxygen to inflate her lungs, buying time for the medicines to work. The plan works and pints of dilute urine fills her catheter bag, her breathing improves and she says thank you through the mask. Despite the fatigue I smile and give the F2 a fist bump for a job well done.

7AM. Four more reviews. a patient with kidney failure due to medications, a depressed young man who took an overdose, an elderly nursing home resident with pneumonia, and an elderly man with a broken hip whom I assess with the orthopaedic surgeon. I start to round up the patients for the ward round. 18 patients overnight, five transfers out, one death. A relatively quiet night. I check with the clinical site manager and SHO that we’ve not missed anyone and click save on the list. No one is waiting to be seen, a good feeling.

8AM. The consultant from last night arrives, she looks tired but asks us how we’re doing. OK we said. We start in A&E as most of our patients are still there, the site manager is worried as some of the patients from last night are coming up to 12 hours in A&E. We review each patient’s story and tests, and talk to them about their condition. We visit ITU for the two new transfers there.

11AM. The ward round of the night patients are done, and I have completed a death certificate for a patient overnight. I climb into my car and listen to the breakfast show as I drive home, an hour away. I’ll be in bed by 1PM , and back for the night shift after 6 hours sleep. A relative luxury from a relatively quiet night.

This would be a relatively quiet night for a junior doctor and I am sure many registrars would laugh at how easy I’ve had it! But the people doing this work are junior doctors, who show dedication, commitment and goodwill beyond belief. They do lifesaving work up and down the country, working hard without complaining and sacrificing time with their families.

Please, I beseech you, treat them fairly and with the compassion they treat others daily. The new contract is not fair, and the extended hours it’ll cause is not safe. ‪#‎notfairnotsafe‬

I hope this little story will give you some insight into the vital work junior doctors and the NHS do. If you like, please come and spend a night at our hospital, I’ll come in with you and show you around. Please talk to my junior colleagues and listen to them, you may be surprised what you’ll learn.

Best wishes,

Dr Philip Lee

Being a Paediatrician

I knew I wanted to be a doctor when I was about 4 years old. I can’t explain now how I came to that conclusion or why I was so sure. I just knew and now I am a doctor. In my 2nd or 3rd year of medical school, as part of career guidance we were given a link to a website where we could input our data and get a psychometric analysis done on us. I had to answer a series of questions about how I felt about certain things, my beliefs, my principles, how I solved problems. Eventually, I answered the numerous questions and it took a minute or 2 to load. Then it gave me the list of medical specialities ranked according to the ones I am most suited. Pathology and neurophysiology came last as I would have expected but I was taken aback by the top 3 choices. It said: Paediatrics, Palliative Care and Neonatology. I poo-pooed the test and dismissed it. When I went into medical school, one thing I was certain of was that I loved children and I never wanted to see them sick and suffering. Therefore I sort of ruled out paediatrics very early on. Back then I thought I might end up being in Obs & Gynae (obstetrics and gynaecology) because it was a good mix of medicine and surgery and I thought the variety and acuteness would suit me. I also thought I could be a GP because it retained the versatility of all of medicine without having to make a choice.

During my Obs & Gynae posting as a medical student, I found that although it was interesting the speciality did not set my pulse a-racing. There was no eureka moment. The specialists were nice but I didn’t feel any kinship with them. My paediatrics was my last medical school posting and the moment I stepped into the Children’s Hospital (BCH), I felt an excitement. Even though most of it went over my head and there seemed to be a lot of calculations and there was the issue of small people who were not well, I felt right at home. Over the 6 week placement, I grew to love BCH. I loved the patients, the child-friendly wards with their play areas, the kindness of the nurses and most especially, here were doctors I wanted to be like. Who I enjoyed spending my time with. Who seemed to derive pleasure from their work even as they were rushed off their feet with the number of patients. By the end of that placement, the career puzzle for me was solved. I was going to be a paediatrician. And to my surprise, the patients I loved spending time the most with were the little premature babies born with complex problems needing surgery to survive.

As an FY1 (first year after graduation from medical school), I met a patient in her 30s who had inoperable incurable ovarian cancer. We bonded as I tried hard to get some blood out of her for some tests her consultant had ordered. When the ordeal was over, I thanked her for being patient and she called me back to say she thought I had a way about me that would be perfect for palliative care. She said she didn’t know if I already had my career mapped out but that I should think about going down the Palliative care route. I thanked her for her kind words and left in a reflective mood. Despite my psychometric prediction, I had never given it much thought. I considered it over the next few days and concluded that although I was a listener and when it came to my patients very patient (unlike in my personal life then), I wasn’t sure I could handle all the emotions that are linked with patients who are dying. So I filed the idea away under ‘unlikely’ and didn’t give it any more thought until just recently.

Earlier this year, I stumbled across an online course on paediatric palliative care and signed up to it. As I worked through the course modules, I realised that I was into all the issues that were being raised and although a lot of it was challenging, it was exactly the kind of challenge I relished. A lot of it was to do with talking about options and choices. About spirituality and counselling. About co-ordinating care. About letting the dying patient and their relatives dictate the terms about how these last days/weeks/months should be handled. I realised that palliative care is not just about the advanced care pathway which outlines what to do when death is imminent but also about actively keeping the patient well enough to reach certain goals. It is about enabling the patient to die in a way that is most acceptable to them. It is about being there for the patient and their family so that when things become scary or unexpected, there is a comforting presence to guide them through the darkest hours/days. So I have come full circle and now I know that I would like to sub-specialise in paediatric palliative care. I wish I knew where my Obs & Gynae patient was so I could share the news. I wonder if she is still alive today.

I love being a paediatrician by the way. If I don’t end up sub-specialising, I would happily be a general paediatrician. There is a different vibe on a paediatric ward or in a paediatric hospital like BCH. There is a friendliness that is missing in adult medicine. People seem to go out of their way more to be helpful in the paediatric world. Nurses do not seem to be as difficult or as disconnected as they can be in adult medicine. The paint on the walls is brighter happier colours. There are toys, music and games everywhere you go. The best bit about my job is the children. It is such a privilege to work with kids. They are amazing little packages, mostly untainted by the negativities that come with growing up. They come out with the best statements and questions that make you stop and think or laugh until your belly hurts. Their bravery is comparable to none and watching them as they struggle with illness and develop ways of coping is inspiring.

Of course paediatrics is a complex speciality by its very nature. Our patients are often too young to tell us how they feel and exactly what their symptoms are so we have to be more observant than our adult counterparts and we have to go on what other’s (parents/carers) impressions are more than the patient’s own words. Many do not understand why they feel poorly. They just know that they are not happy and they want it to be fixed. Parents are often not at their best when they meet us because they are anxious and stressed about their sick child and are frustrated because they have no solution to put them out of their misery. So yes, it is often the most difficult part of the job having to face irate upset parents who want to find someone to blame for their helplessness. Who want to take out their frustrations on someone else and make demands because it makes them feel they are doing something…anything. Sometimes, these parents do cross the line of anxious and stressed parents to parents who are abusive (mostly verbally but occasionally physically). Unfortunately, it comes with the job but we deal with it in our own way. Usually by being patient and reasoning with but where necessary we call on services to support and protect us. Luckily, these horrible encounters are not an everyday occurrence.

I have so many examples of the beautiful little people I have come across in my job but I will tell you about a recent one. I was on-call over a weekend and covering the haematology ward (haematology deals with diseases involving the blood cells). A 2½ year old boy with severe haemophilia B came in with bruising which meant he needed an injection of factor IX (the bit of blood he doesn’t make enough of which is essential to prevent you bleeding without much force). It was my job to treat him so with his parents and a fellow doctor assisting, we held him still and I injected the medicine into his vein. He cried as I did it and when it was done (it only took a minute), his parents prompted him to say thank you. Through his tears, he turned to me and said ‘thank you’. Then as I tidied up, they got their things together to leave and he waved and said to me ‘bye lady’. With no resentment. Despite the fact that I had just poked him with a needle for reasons he was too young to understand. I thought wow! Only a child would be as forgiving as that. The momentary feeling of guilt for making the gorgeous little boy cry passed with that exchange and off I went, to do more things to other children which might make them cry in the short term but looking at the bigger picture, everything I do is in their best interests so when I go home and I go to sleep, I feel happy and satisfied. And thankful for another day where I have done all I could to make another child’s life that bit better.

I Had a Son

I used to think having a baby boy was as bad as not having any babies. Over the years, I have come to embrace the idea of a being mother to a baby boy and even hope that my second will be a baby boy. This hope came from another one of my vivid dreams. This dream happened 5 years ago.

It was one of those busy dreams with a lot of running around and stress. I don’t recall most of the dream but the first bit I was aware of featured a heavily pregnant me in a room with several other women and in the first stages of labour. I remember being very hot and I was perspiring as the labour progressed and I got instructions on what to do. For some reason, no one in the room was in focus. I could not tell if my mama and my sister were amongst my birth attendants. I suspect there was at least one midwife. All I know is that I felt in control despite the alien event that was unfolding within my body.

Next thing, I was half-sitting, half-lying down with my legs in stirrups and pushing the baby out. It wasn’t real time…time seemed to be moving very fast as I watched myself going through the process. I felt a searing pain deep in my pelvis and I thought ‘I don’t think I can do this’. Then there was a more solid pain that threatened to break me in 2 and I looked down to see a baby. I blinked and the baby was clean and in my arms, all wrapped up in the softest cream-coloured blanket and a baby blue hat. I had a son.

As I held him, his dark brown eyes popped open and fixed on mine. As our eyes met, I felt a surge of love deep in the pelvis which he had just reluctantly exited. The only way I can describe the feeling is that of falling deeply and irrevocably in love. I felt the warmth of my love for this tiny boy spread out to every fibre of my being. It felt like the whole world fell away and the only thing I could see in its full glory was my son. The rest of the room was a blur. I could hear dimly conversation in the background but all I could make out was his breath sounds. My olfactory nerves jangled with the smell of him and even my taste buds tingled like I was gorging on the most delicious meal I had ever tasted. My skin prickled as if electrified and the hairs on it all stood on end. My muscles quivered. Tears dripped out of my eyes. I wanted to laugh and cry at the same time. I felt like I was simultaneously floating on a cloud and being sucked towards the centre of the world. I was in free fall. I was in love.

The heat and pain were forgotten in that instant. My head emptied of all thought and all I could think was ‘here he is’. Like that was the moment that all the preceding days of my life had been leading to. Together with that love came the overwhelming urge to protect him from the big bad world. I shivered as the protective tigress in me snarled to life with a ferocity that scared me. In that instant as I gazed into his eyes, I felt love, pride and an irrational fear that he could be hurt. I knew then that I would love him more intensely that I had ever loved. That I would celebrate every achievement of his with a purer joy that any I had ever experienced. That I would feel his pain like it was mine. That I would move heaven and earth to ensure he was happy. That I would die to protect him.

I was frozen to the spot, staring into his unblinking eyes when I snapped awake. The power of my feelings stayed with me for the rest of the day. I felt exactly as the great romance writers describe being in love. I had butterflies fluttering in my tommy. The colours of the world seemed sharper, brighter and more intense than usual. The weather was perfect regardless of whether there was rain or sunshine. My creative juices were flowing. I had ideas coming out of my ears. I did not feel thirst or hunger. I just felt ridiculously happy and I walked around all day on a high, humming to myself and doing little dances when no one was looking. So, I thought, this is what so many mothers feel when they finally hold their long-awaited baby in their tired arms. What an incredible feeling! I only experienced it in a dream and the depth of the feeling was immense. It was like a high to end all highs (not that I know what an actual high feels like but I can imagine!). No wonder some women carry on popping out babies long after everyone thinks they should stop. No wonder there are women out there who admit to being addicted to being pregnant and giving birth to babies. All I can say is that I pray one day I will have this experience for real. Because it felt damn good. The best feeling ever!

Allah (swt) is Al-Jabbar: The Mender of broken hearts

The words that follow were written by a lady called Asmaa Hussein who lost her love and reflects on how her relationship with God is helping her through it all. It struck a cord with me because this is the Allah I believe in and worship. The loving, merciful incredible God who promotes peace and love, not war and violence.

 

It has been a year since I got that most-hated phone call, a year since I stood over Amr’s body at the morgue and tried to memorize every feature of his face before I would have to let him go, a year since we were attacked in the graveyard by people who hated the truth and righteousness that Amr stood for.

People wonder how I was able to hold myself together. They wonder why I haven’t collapsed or given up hope in Allah or in the goodness of people.

I don’t have an explanation from myself, but the answer can be found in the story of Prophet Musa’s mother in the Quran. She was instructed to place him in the water if she feared for his life at the hands of Pharaoh’s army:

“And We inspired to the mother of Moses, ‘Suckle him; but when you fear for him, cast him into the river and do not fear and do not grieve. Indeed, We will return him to you and will make him [one] of the messengers'” (28:7).

I often wonder about what kind of strength she must have possessed when she placed her infant child into a basket, and pushed him into the water without knowing where he would end up, or whether she would see him again. She did one of the most difficult things a mother could do. But she held herself together with the help and guidance of her Lord, and watched him drift away.

Musa was accepted into the house of Aasiya, but he refused to breastfeed from any woman and his sister who had been following him, led them to take the baby back to his mother.

What was the purpose of Allah (swt) returning Musa to his mother? Musa could have breastfed from any woman without returning to his mother and still grown up to be the messenger of Allah, not decreasing anything from his righteousness or his remarkable journey and story.

But there was a reason Musa had to come home to his mother:

“So We restored him to his mother that she might be content and not grieve and that she would know that the promise of Allah is true. But most of the people do not know” (28:13).

Allah caused Musa to return to his mother simply so that she wouldn’t grieve, so that her heart would be at ease and that her faith would not waiver.

Allah (swt) cared about this woman. He mended her heart, not so that the course of history could change or some big momentous event could take place. He mended it because He is Merciful and Loving to the believers. And so that when we read her story, we can know the extent of His Love and Mercy. That is all. And that is enough of a reason.

Allah (swt) doesn’t wish for the believers to grieve, and He wants them to know that His promise is true. I’ve lived it this past year. Every time I was about to reach a breaking point in my despair, or to fall into the darkness of losing hope, I would receive some news that would lift my heart. Someone would have a beautiful dream of Amr, someone would perform ummrah on his behalf, or establish some charity on his behalf. I would receive words of support from people I love and respect, or encounter some verses in the Quran that would take me by the hand and hold me steady.

I remember a few months ago sitting one day after I had prayed Asr. Tears were streaming down my cheeks, my heart was aching and I didn’t know how to rid myself of the immense pain. I raised my hands to ask Allah (swt) to help me be able to somehow visit His sacred house to come closer to Him and for that to be a part of my healing. Before I was able to even make the dua, my phone rang. It was Amr’s parents calling me to tell me they were just at the Ka’bah making dua for me to be able to visit it. And I thought – how strange that this dua has yet to come from my lips, and Allah (swt) has put the same dua on the lips of people beloved to me in such a blessed place.

My heart was lifted so much in that moment that the tears of sadness turned into tears of joy.

None of these things are coincidences. And none of these things happened because I am particularly good or worthy. They happen because Allah (swt) cares about the hearts of His slaves. I know that He cares about me and about my daughter because I’ve lived in the realm of this immense Mercy this past year…every ounce of pain was met with some inexplicable beauty and serenity that no human effort could produce. And it was from Him. All of it.

If you believe in Allah alone with no partners or intermediaries, and you worship Him alone, and you sacrifice that which you love in order to come closer to Him alone, you will see wonders in your life. Your difficulties will become blessings. Your heartaches will become healing. Your duas will be answered in ways that you could have never imagined. He doesn’t want you to grieve, and He wants you to know that His promise to the believers is true.

It’s not any more complicated than that. It happened to me, and it’s still happening.

Alhamdulillah.

The Original Aisha A Joda

So my name is Aisha A Joda and I am the 2nd in my family of the name. I was named after my grandmother Mammie who died 11 years and 2 months ago. She was taken too soon but at the same time, she lives on in her children, us the grandchildren and now her first great-grandchild. Of our generation, the only people that remember her clearly are my sister (the 1st grandchild), me (the 2nd), Michelle (a.k.a Aisha the 3rd), Jeff (a.k.a Ahmed the 1st of our generation), Ahmad a.k.a Baby A (the 2nd grandson Ahmad) and maybe to a degree Huwaida (a.k.a Aisha the 4th) who was only 3 when she died.

As I have 18 years of memories to share, I don’t know where to begin with Mammie’s story from my perspective. I will start from the last time I spent with her. She came to visit in London and unfortunately had a last minute conference or board meeting she had to attend so she had to leave us together for 4 or 5 days and nights. In all my life, I could not recall ever it being just me and her. For the first time, it was just the 2 of us…Aisha Joda, the first and second. I remember worrying about what to cook for her and what we would talk about and whether she would be difficult to please. I had nothing to worry about. She was as sweet as sugar and warmer than a loaf of fresh bread just taken out of the oven. All she asked from me was help to bring down a mattress so she could sit on the floor when she was watching TV and then taking it up stairs each night when we went to bed. And she wanted 2 hot water bottles because she could not get warm enough despite the fact it was only October and it was a fairly mild autumn. Being a teenager, I remember being uncharitable enough to think she was just being difficult asking for the hot water bottles but still, she was my mama’s mother and so I did as she requested every night and I even took them up into her bed as she seemed to struggle going up the stairs. Every night, she would say thank you and I would think ‘what for? I haven’t done much’. She would hop on the bus every day for some shopping and come back with some lunch because she didn’t want me to bother cooking as I was going to college (A2 year). We talked as we never had and she told me stories that made her laugh so had her shoulders would shake and she would clutch her bosom.

On the 3rd day, she came to me and said she would run out of her oral hypoglycaemics (medication for her type 2 diabetes) the next day and she didn’t want to go all the way into central London to see her private doctor for a prescription. Looking back, her unwillingness was probably because she was feeling unwell. Perhaps from her rheumatoid arthritis. Anyway, I took matters into my hands by going to my GP and telling them I was home alone with my grandmother and she needed a repeat prescription urgently. I didn’t even know but OAPs in England, even non-residents were entitled to free emergency drugs and this situation qualified her for it. Within minutes, we left the GP surgery clutching a prescription and headed straight for a pharmacy. I will never forget the look on her face as she thanked me for sorting it out for her. I protested that she didn’t have to thank me; she would have done the same for me. But she said ‘I thank you anyway. You saved my life’ and I could have sworn she had a tear in her eye. Crazy Mammie I thought although secretly I was pleased I could sort it out for her and that she was so happy over the little I did. Also secretly I was ashamed that I had grumbled in my heart for one second that she wanted hot water bottles when it was such an easy thing to do. The other 2 nights, I did her hot water bottles extra hot and took them 15 minutes earlier than bed time so that the bed was toasty warm when she made it up the stairs. I also put on the heaters for longer because I figured my mama would rather her mum was warm than save on the bill. One memory I will never forget is of her standing by the living room radiator that I had just switched off before bed and pressing the backs of her legs and hands on the warm metal to get a final warm blast before we headed upstairs.

She was to go back on the Thursday morning on a 5am flight and my mama came back the night before. I remember waking up despite loving my sleep those days and watching my mama and her mum get ready for the airport. She was wearing a black abaya that last morning I saw her and it had little crystals on the neck and sleeves with a matching scarf. I remember saying how beautiful she looked and teasing her about wanting to look good for our husband, my granddad (long story about the our husband thing). She laughed and said she wasn’t going to see him for another couple of weeks as she was going to Kaduna via Lagos and he was in Abuja for a work thing. I hugged her as she left and said safe journey. I watched them head out the door, never thinking that was the last time I would see her or hear her. My mama later said she had got Mammie special assistance so that she would be driven on those airport buggies because the walk was too long and she didn’t want Mammie to get too tired. That was the last sight she had of Mammie I am sure…Mammie on a buggy/transporter thingy, facing my mum as they drove her to fast track check in.

My love of Disney movies comes from Mammie. She had the whole collection of videos back in the day and whenever she went to the US to visit her 2nd daughter (my only aunty), she would come back with all the latest and we would go over to her every day for a video until we had watched them all then we would go back to our old favourites. She had watched them so many times that she knew every scene and every time one of her favourite scenes would come up, she would recite the lines and laugh with them. She also always had a large box of Thornton’s chocolates and would allow us to choose one every night after dinner. Of course being children, 1 was never enough so we usually stole an extra one sometime before dinner. We thought then we were clever and she wouldn’t know but I know now that she must have known but she never said. And somehow she always had another fresh box waiting when the current box was empty. Dinner in Yola was always in the formal dining room until I was 11 or 12 years old. Before that, the table was always set with proper china and silver cutlery with a fresh linen table cloth and matching napkins. My granddad sat in the centre chair by the window and she always sat opposite him. Then my sister and I would sit next to our husband and tease her for not being next to him as we were. Despite the air-conditioning and the closed door, there would inevitably be one fly in the dining room and Mammie hated flies with a passion. She would spend half of dinner flicking unsuccessfully as this sole fly that seemed to want to play. She was a very slow eater anyway and it was made much worse by her fly obsession so by the time we were done with dessert, she would be just be finishing her mains. She would take her dessert (which tended to be fruits) into the parlour (sitting room to you) and eat it as the children watched TV and she and the grownups had a good old natter.

I think she went through the menopause when I was about 4-5 years old. I remember saying to my mama and sister that she was always grumpy and I know I always wondered why she was always complaining of being hot despite it being about 20 degrees in her parlour with the A/C on. She would fan herself on and off all day and mutter about how hot it was. And sometimes she was short-tempered with the house servants and occasionally us. Oh and she had house-clothes that she would wear when she was indoors for comfort. It was obviously clean but in my young mind, I just thought it was a little unhygienic and eccentric since she had wardrobes full of beautiful clothes. Talking about her fashion sense, it was impeccable. Her hair was always neatly plaited and looking at her pictures of her in her 30s and 40s, she used to have all the latest fros and perms. She loved her shoes too and had 2 large shelves of shoes in her dressing room. My fit used to fit into her shoes and I would spend hours trying them on when she was in the kitchen supervising dinner or talking to adults. Sadly, I outgrew her size 3.5 feet when I was 11. Her makeup was always Clinique and her latest perfume Estee Lauder.

Being Fulani with our pulaku culture, public displays of affection in adults isn’t the done thing but being a little girl, I cared not one bit for that societal norm. we spent a lot of time in the holidays in my grandparents’ home and my mum would join us after work with or without my stepdad. I would happily hang with Mammie and play with my sister Charo and their dogs and tortoises and run from the geese. However, as soon as my mum arrived, that would all cease. I would run to her and hug her like I hadn’t seen her in a whole year and not 8 hours and cling to her for the next few hours until we went home. My grandmother would look on in amazement and several times she would ask me ‘aren’t you embarrassed’. Meaning wasn’t I embarrassed to show such a blatant preference for my mama over everyone else. Being precocious, I would look her straight in the eye (another thing children don’t do) and say ‘no!’ as if it should be obvious that I love my mama above anyone else. She would shake her head in amusement and give me a playful nudge as I sat as close to my mum as humanly possible.

Another memory that stands out is when my mum had travelled and we were staying with our grandparents. Mammie realised we were bored and decided to brave the heat and take us out for a drive. My sister was feeling helpful so she took the keys from her handbag to open the car and let the heat out before Mammie was ready. Of course Mammie had no idea and came out the entrance hall where her bag was and opened her bag for the keys. She didn’t find it and looked high and low for it, never thinking it would be in the car. My sister and I got bored of waiting by the car and came back to see what was keeping her. The memory of the sight still makes my sister and I roll about in laughter. It was a proper lol and lmao moment. We watched as she frantically rifled through her bag and started to shake onto the rug in frustration and we realised she was after the keys we had taken. Woops. We were beside ourselves with laughter at the frantic way she searched and at the same time, our hearts raced as we thought of how we would tell her that her search was fruitless because we had the keys. I don’t remember who told her but one of us did and she was relieved and exasperated all at once. We managed to control our laughter but for days after, every time we were alone we would mimic her search and fall about laughing. We still laugh at the comical image. You’d have to see it to understand just how funny the image was. LOL.

Mammie never forgot a birthday or anniversary. She was like a walking calendar and she not only remembered her children and grandchildren’s birthdays, she remember all her friends and their anniversaries and she had a card for every birthday and for the grandchildren she always had a present to go with it. To this day, a lot of my jewellery is from Mammie and I am still reluctant to buy anything precious because most of my precious stuff was Mammie related. I am having my Yola wedding celebrations in the coming month and the intention is to wear of Mammie’s many sets of jewellery as my way of including her in the day. Because she also loved to celebrate occasions and would have been dressed to the 9s and sprayed us all with her mint notes, squirrelled away in case an occasion necessitating money to be sprayed.

The call came on the 6th of October at around 7am. I was fast asleep as it was a Sunday, the day of lie-ins in my house. I suddenly snapped awake and looked around in confusion. I got up to go to the bathroom thinking maybe I was woken up because I needed the loo. I sat on the loo and nothing happened. As I went to get up, my mother’s mobile rang and I stood by her door to listen, curious why someone would call so early. All I heard was a stifled cry and then nothing. I felt my heart sink as I stood frozen by her door and I assumed my granddad had died. After about a minute, I pushed open her door and she looked at me with eyes brimming with tears and choked out a word ‘Mammie’. I remember holding her as we both wept and not knowing what to say or do. We must have been there for maybe 30 minutes, eyes dry and staring blindly into space. We were awoken by the phone ringing. The first of dozens of phone calls from her brothers and sisters, cousins, aunties, uncles and friends. Our doorbell was soon ringing too.

I won’t dwell too much on the aftermath of Mammie’s death but I will say I am so glad I got that last few days with her. My name is from Mammie. My looks are from Mammie. I eat slowly like Mammie. I love Disney Animation movies like Mammie. I am heat-intolerant like Mammie. I can find a bargain like Mammie. I love to laugh like Mammie. I think one of the biggest compliments that someone has paid me in the recent years was to say that I am like Mammie because I love family and I make the time to go see everyone when I get a chance to visit Nigeria (that is called Zumunci in the lingo). I hope that I can continue to carry on some of the greatness of the original Aisha Joda and I hope that if Mammie is able to hear or see me, that she is proud of the woman I have become as she was always proud of us all. In fact I know she would have been proud that I am who I am today. Aisha Joda, Mammie, my grandmother. You may be gone but you will never be forgotten!