Tag Archives: support

The Cycle of Life Part 3

I could write and write about the many lives I knew that were cut short in their prime but I will complete the cycle with this last blog about one of my oldest friends. His name was Nabil. We probably met as babies but the first meeting I remember was when I was 15 years old. We had moved to London the summer before and were getting settled in still. My mama came home one day and announced we had been invited to have dinner the Ibrahim’s on Saturday. Who were they? I asked. She explained that they were old family friends. The parents were my grandparents’ friends and although their children were younger than my mother and siblings, they knew them well as children. I am told one of the kids had even stayed periodically with my grandparents in Lagos when they were going to school there. She told me that the oldest daughter had 2 sons, one my age and I was going to meet them.

Although we both lived in North London, it was quite a trek as there was no direct tube route and we had to go on 2 (or was it 3?) buses. By the time we got there, my nose, fingers and toes were frozen and all I wanted to do was curl up into a ball and sleep by a fire. I needn’t have worried. As soon as we stepped into their house, I felt my frozen cells begin to stir. It was always tropical in that house. Mum and Baba (the grandparents) like it very warm so there was never any danger of being cold once you got in there. I was introduced to the many adults, face after smiling face. It was like a mini-Northern Nigeria. All the warmth, the noise, everyone speaking Hausa. The boys were called down, Nabil and his little brother. They were instructed to take me upstairs until it was time for dinner. Although Nabil was friendly, he was definitely the quiet one. His little brother made up for it. He was very chatty, still pre-adolescent and full of excitement about life. Back then, he was quite small too. Very cute!

Nabil played us some music and told me about how they had only been in London for a year so were new to town too. He explained who was who in the family and we made general chitchat with his little brother telling us his fantastical half made up tales. We were in the same year of school and I was older by 2 months. By the time we got called down to dinner, we were friends. Over the delicious dinner cooked by Mum (his grandmother) and his mum, we talked some more. We exchanged numbers when I left. We stayed good friends over the years. We went to visit every so often and they made the trip across North London a few times too. We text occasionally in between visits. The next year, we talked about finishing year 11 and applying for colleges. I told him I was doing all the sciences and Maths because I would be applying to do Medicine. He said he wasn’t sure yet what he wanted to be so he was still thinking about which subjects to choose. We talked about where to go and I must have been convincing because I suggested for him to join me in Barnet College and he promised to consider it. He wrote down his address on a teddy bear notepad I had so I could sent him information when I had a confirmed place.

Common sense prevailed and he went to a college more local whilst I went to Barnet College. We went to see movies together and we even ate out at this stage, being all grown up at the ripe old age of 17 and 18 years. Every time we went out, he would insist on paying for everything and I would argue him down so we went halves. His little brother had grown into pre-adolescence by then and would irritate Nabil endlessly. His patience was great and he would repeatedly ask him to butt out of our conversations. I didn’t mind. I had a sister too and as the younger sister, I knew what it was like to be the little one. When we applied through UCAS for universities, he finally had a plan. He was going to study Maths. I was shocked. I mean, I was a straight A student and I got my A in Mathematics, an A* even in AS. I was no slouch when it came to it but to do a whole degree in Maths? I was agog! Why would anyone in their right minds do such a thing? He took my teasing in his stride. He said he didn’t have a profession in mind like I did and he knew he could use his generic Maths degree to do a wide range of things. I accepted this but I still thought him mad. He gave me that calm smile of his. ‘You’ll see’, he said.

As is the norm, we saw each other less when we went off to different universities. I went to Birmingham and he stayed in London. We probably saw each other once a year but when we did, it was like no time had passed at all. Ours was a very easy friendship. He would tell me about his ‘crazy’ Maths course. He seemed happy. I would tell him about Medicine and how much of it there was. How I realised more and more that what I knew was only a small fraction of how much I needed to know. He was openly impressed by how well I coped with it. His support and belief in my abilities were unwavering. Just like his friendship. I knew he was there somewhere should I ever need a friend. We text and Facebooked more than we spoke face to face. I can count the number of times we spoke on the phone in all the years.

Over the years, I would tease him gently about his girlfriend, or lack of. As the Fulani girl, I should have been more embarrassed to talk about such things but he was so shy about it. It became part of our friendships. I would needle him about ‘her’ and he would counter by asking me about my many boyfriends. I wasn’t shy about it. I had very little in the way of boyfriends but I told him of every encounter and how I preferred not having a boyfriend. He never admitted to any love interests but his brother was a more open book and I know there was somebody special at some point. He graduated and started an online sales platform. Next thing, he was talking about going back to Nigeria for his NYSC (mandatory youth service). He settled in Lagos. I happened to go the Lagos route once in his time there so I got to see him. He looked way too skinny and I was worried. As a newly-qualified doctor, I saw ill-health everywhere and was concerned he wasn’t sharing. He reassured me that he was fine. I didn’t need to doctor him. I believed him because youth corpers do tend to look the worse for wear during their year’s tenure.

The last time I saw Nabil was in Life Camp, Abuja in 2011. He happened to be visiting Abuja whilst I was there on a 10-day holiday. He was staying with a friend who brought him over. Again, I thought he was too skinny and he laughed it off. ‘Maybe I was always meant to be skinny like you’, he said. We chatted for an hour and he had to go. As we hugged goodbye, I felt how bony he had become. Life in Lagos was a hard one for a young man trying to start a business. My parting words were ‘You need to eat more. You should look after yourself better.’ His reply was a laugh and a ‘Yes doc!’ I stood at the door and waved until the car was out of sight. Not for a second did I imagine I was saying goodbye for the last time. The fuel subsidy crisis in Nigeria was the last thing we ever chatted online about. He became very involved in the demonstrations. I worried about his safety and he sent photos of himself and his friends at Lagos marches, looking happy and less skinny. He had found a cause to believe in. I was proud he was making a stand for a cause.

News that he was ill came out of the blue. I was in Yola, having taken a year out from working in the NHS to see the world. My mama got a call from one of his relatives saying that he was in hospital with a bleeding illness, cause still unknown. It was pretty serious and they were considering transferring him abroad as the healthcare available in Lagos was deemed inadequate. When my mother related the facts, I wanted to know more. What sort of bleeding? Was it related to a fever? Was Lassa fever the suspected cause? When my spoke to them again later, she was given more details. He had woken up that morning and told the friend he was living with that he wasn’t feeling too well. I think there was mention of a headache. He had been well the night before going to bed. His friend had gone with him to hospital and he either vomited or peed blood. The exact sequence is hazy but the gist of the story was that he had become sick rather quickly and what started out as an isolated bleed was now bleeding from multiple sources. He had been given a transfusion, we were told. He was conscious but seemed to be deteriorating.

When my mama related all of that news, I immediately thought the worst. When I burst into tears, she was alarmed. ‘He is alive,’ she said to me. ‘Don’t write him off.’ I tried to explain what I was thinking. I didn’t want to be a pessimist but unexplained severe generalised bleeding had a poor prognosis even with the best medical care. And he was not getting that. Not yet anyway. I had 2 professional experiences to draw on, both rather negative. My first experience of a patient with uncontrollable bleeding was in Malaysia on my medical elective in the 4th year of medical school. He was brought in by his heavily pregnant wife and a male relative to the A&E where I was working. He was very quickly diagnosed with Dengue Haemorrhagic fever. However, before any real treatment could be commenced, he went into cardiac arrest. With the medical students and his wife watching, the doctors performed CPR. It was horrific. He began to bleed from every orifice imaginable. His ears, nostrils, mouth. The blood was coming up the tube he had inserted into his lungs to ventilate him. The only part visible with no blood streaming out of it were his closed eyes. It was over as quickly as it began. It was obvious to everyone that he was far too ill to be saved. His wife was led away with the news.

The second experience was indirect. I was working in FMC Yola (Federal Medical Centre) and although Yola was ‘free’ from Lassa fever at the time, there were new cases being reported further south of the country. In fact, about 6 months before I had started working at FMC, there had been a patient with Lassa fever there and 2 of the doctors had contracted it from him. Unfortunately, 1 had died and the second had got to the Lassa Centre down south in time to be treated. He was one of the registrars on the paediatric team I was working with. So although he was okay, it seemed that mortality was quite high and only those who were diagnosed early and treated before they started actively started to haemorrhage (to bleed) were salvageable. Nabil’s story didn’t quite fit the bill because he had not complained of a fever and indeed had no fever in hospital. But it was my best guess with the facts I had and I feared the worst.

I pulled myself together eventually and prayed and waited with my mama. Next time we got an update, it was to say he was worse still, I suspect barely conscious at this stage. He was still bleeding despite all efforts and his parents were with him (they don’t live in Lagos). An air ambulance had been organised and he would be transferred abroad as soon as possible. We even heard he was being placed in the ambulance and I thought maybe there is some hope after all. That hope was short-lived. We got a call a few hours later to say that although his parents were in a flight to London, his air ambulance had never taken off. There were complications and unfortunately, he had not made it. I was so upset! All I could think is how his parents had no idea he had died and how they would have to make the return trip with that news weighing on them. To be honest, I have not asked them what happened exactly but it could only have been a terrible day.

I think the initial reaction of tears had taken the edge of my grief. I had started my grieving process before he was gone. I sat around in disbelief as my mama asked if I would be okay. As we made arrangements to go and visit his family, I could not stop thinking about how final death was. That was it for him, in this life anyway. I have no brothers so I whilst growing up, I found a handful of boys/young men to be my shining examples of decency in the male sex, my torch bearers when I felt dark about men in general. Nabil was one of them. Here was a gentle, calm, positive young man who believed in doing what was right, what was decent. He was respectful of God, his parents and our culture. He was a great friend and it was clear from the few times that I spent with him in the company of his family and friends that he was an all-round good guy. Losing Nabil was losing a little of the light in the darkness that sometimes surround men for me. Nabil was a good guy. Now he is no more. It took just over 2 days for a healthy young man in his mid-20s to sicken and die. Muslims would say it was time to go. I accept that but did it have to be such a horrible death? What did he ever do to deserve such an end? Why him?

Advertisements

The Taboo of Domestic Violence

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Here are some facts and statistics from Women’s Aid (http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220041&sectionTitle=Domestic+violence+%28general%29) by way of introduction:

  • Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.
  • The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.
  • Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle.  Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.
  • The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.
  • Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.
  • The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.
  • The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.
  • Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

  • Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)
  • 60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).
  • The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).
  • 76% of separated women reported suffering post-separation violence (Humphreys & Thiara, 2002). Of these women:

– 76% were subjected to continued verbal and emotional abuse.

– 41% were subjected to serious threats towards themselves or their children.

– 23% were subjected to physical violence.

– 6% were subjected to sexual violence.

– 36% stated that this violence was ongoing.

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.

The Expiry Date

This morning I read drkategranger’s blog regarding her expiry date (she is a doctor with terminal cancer who talks about death so candidly, it inspires. I would absolutely recommend!!!). The blog and some of the responses to it got me to thinking about death. I have already written about dying and the fact that I fear it not so much. As a Muslim, I tend to see death as just one of those certainties of life so I treat it quite matter-of-factly. This blog is will be further musings about my experiences of death. I will start with a quote from Hadith (Islamic teachings) which summarises how I generally see life and death:

Al-Hasan Al-Basrî said:
‘The life of this world is made up of three days: yesterday has gone with all that was done; tomorrow, you may never reach; but today is for you so do what you should do today.’ Al-Bayhaqî, Al-Zuhd Al-Kabîr p197

I am generally an optimist or more accurately an optimistic realist so I try not to be morbid and I am generally not one to dwell on death. However, I have had times in my life where the thought of dying has crossed my mind. Last winter was a pretty bad time for me. I was working in the hospital that inspired me to become a paediatrician (which still inspires me) but I was in a job with a particularly toxic individual who succeeded in poisoning the atmosphere. I became depressed after 6 weeks of this. So much so that I hated waking up every morning I was scheduled to work. It got to a point that I would lie in bed, sleepless and think ‘would it be that bad if I didn’t wake up in the morning?’ As soon as the thought came to my mind, I would feel guilty and terrible. Guilty because I knew that my life really wasn’t that bad and that there was so much for me to be grateful for. Terrible because I knew my death, although insignificant in the grand scheme of things, would be horrible for my nearest and dearest. My mama especially. I got through those 4 months because my husband was there and would not let me sink into the depths of depression that kept pulling at me. Thank you George!

I am now back to my normal sunny self despite some current work horrors. As a newly-qualified doctor back in 2009, I dealt with death day in, day out especially on my first job on gastroenterology at a busy inner-city hospital. After the initial shock, I got used to it. Not that I didn’t care or it didn’t bother me but I dealt ok with it. There are 2 patient deaths from those days that have stayed with me. Both died of alcoholic liver disease. Both men in their 40s.

The first patient died slowly from hepatorenal syndrome (HRS). Basically with chronic liver failure, if your kidneys too fail, you will die soon because that means 2 of your 4 vital organs are dead or dying, unless you get brand new organs (i.e. transplants). As things currently stand, you cannot be put on the transplant list for a new liver if you are still abusing alcohol because the new liver will get damaged just the same and it is considered a waste of an organ that is in high demand but short in supply. So with my first patient, who I will call Patient A, when his kidney function tests declined rapidly and nothing we could do medically fixed it, we diagnosed HRS and my registrars and consultants had a meeting with his wife to inform her of the diagnosis and what that meant for the patient. He too was told in due time but because of his liver failure, he was confused and did not fully grasp the fact that his condition was terminal.

He deteriorated slowly over a few weeks but in the meantime, he would ask me daily when he could go home and travel to India to be blessed in the Ganges River. I would mutter something non-committal and beat a hasty retreat out of his side room. Initially, it was clear that his wife knew his death was near. But even she began to belief he would miraculously recover from his liver and kidney failure. Every week, she would say something that made us worry we hadn’t prepared her for the inevitable. Every week we would remind her gently that although she couldn’t see it, he was in actual fact deteriorating judging from his biochemistry lab results and worsening oliguria (he was weeing less and less).

In the week of his death, he suddenly looked well again. If I wasn’t the doctor patiently doing bloods on alternate days and chasing those results and noting the relentless rise in his urea and creatinine, I too would have started to believe in miracles. His wife upon seeing the light return to his eyes and his demeanour brighten plunged headlong into denial and joined him in planning their trip to India to the Holy Ganges River. Less than 24 hours before his eventual expiry date, it was devastating for me to watch her grief as the light in his eyes faded rapidly and he shrunk back into himself. Within 12 hours of his final illness beginning, his strength was gone and his mind with it. His utterings became incomprehensible and he became completely disorientated. The look on her face said it all when we came in to see him on our ward round that morning. We returned the look and she ran out of the room to sob in the corner. He was anuric by then (had stopped weeing completely) with a creatinine of over 400 (in other words, his kidneys had packed up). His liver function tests painted an equally damning picture. We completed his end of life paperwork that morning and when we left work that evening, he was hanging on by the tips of his fingers. We came in the next morning to the news that he had died before the end of the day before. The side room he had occupied for many weeks stood empty, awaiting its deep clean before the next customer.

Patient B was a young alcoholic who had developed liver cirrhosis in the months before I started the job. He had just turned 40 and I don’t think had any idea how serious the consequences of regular alcohol binges could be. Reality hit when another patient who was his ‘neighbour’ on our ward developed HRS and died rather quickly. All of our words of warning had somehow not sunk but with this other patient’s death, his mortality was clear to him. He called me over urgently that afternoon and said ‘Doc, I am ready to change’. I was pleased and felt a sense of accomplishment when I referred him to the rehabilitation programme. His wife found me the next day before they were discharged home to thank me for getting through to him. I was honest to say it wasn’t anything I did.

Unfortunately, he came in a few weeks later unwell with an infection which caused his liver function to deteriorate badly. I was encouraged to hear that he had no touched a drop of alcohol since his last admission. He developed litres of fluid in his tummy and I had to put in a tube into the side of his tummy to drain out all that fluid. He was in a lot of discomfort and fearful for his life and he asked me ‘Doc, am I going to die?’ I hesitated over the words I used but in the end I made no promises. Just that I would do everything I could to help him get through this. At first, it looked like the drain and intravenous antibiotics were effectively doing the job and the next day, the fear was gone from his eyes. I was encouraged by his blood results and left having ordered some more routine bloods for the next morning. Coincidentally, at I was securing his abdominal drain, I carelessly dropped the needle I was using to suture and when I went to retrieve it, gave myself a needle-stick injury. I had to get a co-doctor to inform him and take blood samples off him to check that he didn’t have any blood borne infections I could catch. He apologised every day after the event like it was his fault I had stuck myself with a contaminated needle. He asked me about those results daily – he seemed genuinely to care for my welfare. This went on for over 2 weeks as he slowly improved.

I was doing the ward round alone one morning when I was called urgently to his side. He was in a great deal of pain and was writhing in his bed with his abdomen larger than before we drained him. He was pale and clammy and his eyes looked like a man staring down the barrel of a gun. I could barely make sense of his words and as I changed his prescriptions, called the blood bank for blood products and prepared to get a new drain inserted. I could see the life begin to ebb out of his eyes. In a panic, I called my registrars and told them I needed them on the ward ASAP because patient B had taken a turn for worse and nothing I was doing was making a difference. The registrar told me to leave the drain for the meantime and focus on reassuring the patient. After I asked the nurses to call his wife in, I went to him and I held his cold hand. I looked into those eyes and I knew in that instant that he was not long for this world. I remember saying a mental prayer that he could hang on for his wife to be by his side.

‘Doc!’ he cried. I squeezed his hand and responded ‘Yes B?’

‘I am dying aren’t I?’ he asked. I looked down and swallowed the lump in my throat. ‘I am here for you B and I will do everything I can to help you. Your Mrs is on her way in.’

‘Stay with me,’ he entreated fearfully. I nodded and again I had to look away because the fear in his eyes was too powerful for me to take in. The rest of it was a blur. His wife made it in before he died but not in time for him to know she was there. He was delirious by the time she got to the ward and as he was slipping away before our very eyes, there was little time to have ‘that conversation’ with his wife. The consultant whisked her away and broke the news to her. She could see that treatment was futile by then and knew that he was on maximal available medical treatment. We had no more to offer. She signed the DNAR (do not attempt resuscitation) forms and we set about making him less agitated. When we finally called it a day, he was less distressed, still mumbling incoherently and his eyes had started to take on that distant look I now associate with death. I came in the next morning to a request to come to the morgue to complete his death certificate and Crem forms so that his wife could lay him to rest. I got a call 3 days after his death to say his blood tests for blood borne infections had come back negative so I was in the clear. I cried in the staff toilets. He would have been relieved not to have put me at risk I think.

What did patients A and B teach me about death and dying? Firstly that when it is your time to go, it is your time to go. Life unfortunately doesn’t usually give you a clearly labelled package with an expiry date on it. Secondly, although death is scary for the person dying, it is actually worse for the person who loves them who has to watch them lose their battle to live and battle their fear of the unknown. Who has to go home and face life without them and rebuild their lives around the hole left by the dead loved one. Who for a very long time will think about their dear departed every morning when they wake up and every night before they fall asleep. Lastly, every human is unique. Despite having the same disease and modifying your risk factors, your body will do its own thing. We doctors can try to influence outcome but whether we succeed or not is not within our power to control. That is beyond science and medicine. That is life. That is God. That is reality. May we all depart this world in the easiest swiftest way possible. Amen

My Very Own UN

My sister is (or should that be was) a social butterfly. She always had more than friends than she knew what to do with and she never had issues making new ones. A classic extrovert. I considered myself an introvert for most of my youth. Now with more self-awareness, I know I am more of an extrovert than an introvert but I am pickier than my sister, the true extrovert. Because I have been so picky, I think I have ended up with the best friends in the world.

Some of the people I am talking about might not realise how much I value their friendship or indeed that I am talking about them but I hope when I describe how fabulous they are, they will realise how great and valued their friendship is to me. When I was little and my mama was my only role model, one of the things I thought was absolutely amazing about her and her life was her array of friends. They were young and old, some local, many from far afield (and being in Yola that is quite something I tell you). Some Muslim, some Christians. Some skinny, some fat. Some beautiful, some not so beautiful. Some quiet, some loud. Many feminists like my mama. All sorts. The one unifying thing about them was that they were kind and caring, they spoke to me like I mattered and they were passionate. If she ever needed anything around the world, all she had to do was pick up the phone or send an email and the cavalry would arrive. Subconsciously, as I grew up, I think I looked for all those things in my would-be friends. I think I succeeded in developing my very own passionate, kind, caring, loving, helpful and loyal circle of friends. The inner circle is a small one compared to my mother’s but I happen to believe the best things come in small packages. I will talk about my current inner circle in no particular order as I value them all fairly equally. I won’t mention my mama and my sister but they are my best friends and are the core circle.

First one is my Ethiopian friend who I met in 2001 who I shall call Lizzie. We were in the same tutor group in Gladesmore Community School (10AH massive) and we both joined in year 10 so we had common group but our big unifier was where lived and that we had to get 2 buses to get to school. So, earlier than the other pupils, we were up and out, dragging sleepy bodies onto the 144 which I caught at the first stop in Muswell Hill and Lizzie would hop on 4 or 5 stops later in Hornsey. We were normally quiet in the 144 but by the time we got on the 41, we were awake enough to chat. It was on the 41 that I got to know Lizzie’s life story and about her very grown up relationships. At this stage, I had never had a proper boyfriend and despite having a crush at school, I wasn’t really interested in a relationship. So I lived vicariously through her. We also bonded over our love of heels (low enough to wear to school and get away from censure) and long braids. Also I have been mistaken for Ethiopian so we had a similar slim innocent look. We have remained friends over the years, closer after school than in school, through her babies and marriage, through my medical school. Lizzie was a bridesmaid at my wedding and she regularly makes the drive up to Birmingham from London to visit. Even though we had periods were we got too busy with our lives, she has remained a constant. We may drift (although not so much now) through complacency but we never fight and we are there to listen. So here is to my yummy mummy Landan friend. For being constant and loyal and inspiring me to be more glamorous and feminine.

Next is my Northern Nigerian friend who I shall call Halima. We met in 1996 in Queen’s College, Yaba Lagos and we were friends from the very beginning. It was the Hausa lessons that cemented the friendship and as we were both boarders, prep times and dinner times were there for us to foster the relationships. In another blog, I have mentioned Na’ima and I was close to a couple of other girls, 2 of whom were boarders. Halima was in a ‘House’ located all the way across the quadrangle which thinking about now wasn’t so far but during those years was enough to make visiting her during weekends a significant event. She was responsible for the one and only time I had periwinkles (the hairstyle) for Sports day in JSS2 (see blog on that). Those periwinkles make an appearance on my first ever British passport and my husband loves the photo so much he keeps it by his bedside. She was one of the only girls whose homes I would visit outside school too and I knew her family so that made her more special than many others. Post-QC, she is certainly the one who would always make an effort to come and see me whenever I went to Nigeria. I knew about her wedding as soon as she had a date in mind because she wanted me to be able to jiggle my doctor on-call to make it there.  I am so glad I did. We shared her pregnancy from across the distance too. In all these years, I do not remember ever fighting with Halima. She is probably one of the gentlest and sweetest women I know and her son and husband are so lucky she is theirs. Despite being many thousands of miles apart and despite our other friends from that era being on social media and living in close vicinity to her, Halima is the one of all that I would be able to count on today if I needed a friend in Abuja. What a sweetheart!

Then there is my Southern Nigerian friend, let’s call her Tolu. I met her through NLI which is a (NGO) Nigerian initiative to promote young accomplished Nigerians living at home and abroad to be the champions that make Nigeria great once again. NLI was in 2010, or was it 2009? I came from here and she came from the US. We bonded over our passionate pitches and speeches. Never before had I met a young woman who seemed so like me. She exuded integrity and honesty and passion. When I told my husband about her, the words I used were ‘Tolu motivates me to be a better person. I wish she lived nearby so I could be in her presence regularly’. Being next to her or chatting with her on the phone or on social media never fails to give me a positive boost. Tolu to me is everything a young Nigerian should be and she makes me so proud to be in the same circle as hers. If I could choose anyone for my baby to be like, it would be Tolu. She went through a very harrowing time a couple of years ago and being so positive and so strong, she didn’t say anything for a long time because she is that type of a person who will be everyone’s shoulder but have no shoulder to lean on herself. She has come through all of that in a way that is no less than heroic. She is generous and kind. She is a wonderful listener. She is passionate about life and justice and selfless in her outlook. Maybe I don’t want my baby girl to be like her, maybe I want to be like Tolu. Anyway, if you are reading this my love, I might not have said in so many words but your strength, honesty, passion and selflessness makes you wonder woman in my eyes and I could not be prouder of you. I hope your dreams for Nigeria and the world come through because this world is so much better for having you in it.

Following on neatly is my only fellow Iro-Nigerian, who I call Irish anyway. She is Irish in all the best ways possible except she lacks an accent being southern England-bred (sadly but she can put on a pretty good one). We went to medical school together and once again it was fate that brought us together because we met in student halls in 2004. Being the only two medics in the flat of 6, naturally we became close pretty quickly as we were together pretty much all day every day for the first 2 years of our medical school. We were up ridiculously early and gone all day. We couldn’t party any night of the week like a certain somebody we lived with. We had plenty of work and exams to keep us busy. The first thing about Irish is that she is a morning person. I am most definitely not. She would wake up at dawn even on weekends and whistle cheerfully. She had these dryer sheets that smelled of fresh laundry…even today, that lovely fresh scent equates to Irish to me. She has tremendous boobs (sorry Irish but I feel they need to be celebrated) and the loveliest bouncy hair which is NOT mousy brown as she used to claim. She is one of those friends I have never fallen out with. It’s strange to think but we don’t have fights at all. Perhaps it is because she doesn’t tend to get dragged into one of my deep philosophical conversations because she is quite squeamish with deep emotional stuff and would rather the happier topics. That is not to say that she won’t indulge me if I need to offload. She makes the best butter icing cupcakes and has managed to teach me to bake a couple of things. She loves sunflowers. That is in a nutshell Irish to me. She is little Ms Sunshine with a spine of steel underneath all the Gaelic charm. She will stand up for what she believes in and will call you out if you do something wrong but all with the sweetness of honey. She has dealt with family issues that would faze many but she remains unfazed and strong. She also has lovely blue eyes and dimples which I would give my little toes for. Oh and she gives the best hugs ever! If Tolu is the girl I want my daughter to grown up to be, Irish is the woman I want to be for my children. I want to be all sunshine and sweetness and quiet strength and I want to be charming just like her when I grow up.

Then there is my Indian friend who around birth was inadvertently called One on some documentation and that is my name for her which I shall stick to. She is the only one of my friends who is younger than I am. We met whilst I was out doing clinical experience in SEWA rural, Jhagadia – a village in Gujarat State, India. She was out there too doing field research and being the only other single girl resident in the flats on hospital grounds, we instantly gravitated to each other and became fast friends. She is a biomedical scientist. We quickly found common love in tea and laughter and feminism. We quickly fell into a routine. She would come over after ‘work’ to put her water in my fridge and we would go over to hers for tea. I would usually drape myself all over her bed and even occasionally on the cool floor for it was pregnant with heat during my 3 months there. My friendship with her is very similar to the one I have with Safa except the age difference and my having a bit more life experience. And our life stories seem to mirror each other down to meeting the ‘wrong’ boy as defined culturally but actually believing them to be our Mr Right. Unlike Safa though, she is the only one of my friends who is shorter than I am so I feel refreshing normal size next to her. One is rather fearless I think and having lived in remote Jhagadia for a whole year, she then applied for a post-graduate course in the US and off she went to live in NY. Now she is in Malawi, again independently sourced job and seems to be flourishing. What makes her so special goes beyond her fabulous tea, her wicked sense of humour and independent spirit. She is also very honest and open, kind and supportive, generous and when she loves, she gives it her all. One is going to be great someday soon. Mark my words!

Last but not least is my youngest adopted mama, Farah for today. I met her in 2009 as a lowly FY1 doctor in the crazy world of City Hospital (Birmingham). She was soon to be medical registrar and had a reputation for being brutally honest and fierce. Did that put me off? No! I love my women fierce and fearless so we became friends in the mess when I was on surgery and actually had time to go to the mess every day. I loved her unconventional ways and I think she liked me because though small and ‘quiet’ on the face of it, I gave as good as she gave and never seemed to take it personally when that sharp tongue was pointed my way. Despite the difference in years, in the hierarchical world of medicine, we remained friends over the years and have grown closer since we stopped working together. She is another one from a Muslim background who was born into the religion and though respects me for practicing, is not of the same opinions about it. I respect that despite being from a middle-eastern background, she is honest enough to say this is how ‘I’ feel about religion and all that comes with it. I love that despite that prickly first impression she gives out, she is a big old softie with a heart that is good as gold. She is loyal and supportive and she is always there for me if I need her. She wore a polka dot dress to my wedding – if for nothing else, I will love her forever. What a woman! Farah I salute you. You are one of my heroes.

There you are dear readers, my wonderful array of close companions without whom I would be less of the woman I am today. I will take this opportunity to say that for the reasons I have mentioned above and for many more that I cannot put into words, I feel privileged to have met and befriended you all. Thank you for all the love and support. I love you all.

Can You Miss What You Don’t Know or Have?

This one is a hard topic for me. If you have been following my posts, you will know by now that my mama was a single mother for a large part of my life. I also had a step-dad for a good chunk of my childhood. I do not know if I have mentioned my biological father at all. I probably haven’t because there isn’t much to say. I can summarise what there is to say about him. He was my mother’s boyfriend in University and despite a lot of reservation from third parties, my mother married him soon after graduation. He is from Malumfashi in Katsina State (Nigeria) and is academically gifted. His family has royal links (small fry I understand). He is still alive and working in Katsina. He is tall and considered good-looking. He is married with several children.

That last point is the one thing of all that does bother me a little. Because of the way I was brought up and my closeness with my immediate family, I sometimes feel sad that I have siblings that I could be supporting but do not. I have siblings (majority female I hear) who I could be a role model to. I could make a difference to their lives but I am unable to because I do not exist to them. I do wonder if they even know about my sister and me. If they do, do they care?

My mama got a divorce when she was 5 months pregnant with me so I was born outside of that relationship. I have no strong feelings over him. I have met him. Twice in my life. First when I was 4 or 5 and then again when I was 7 years old. I also met a couple of his brothers when I was 8 or 9 years old. To be honest, I remember more what we ate when we had lunch with him and where that meeting took place. I remember feeling somewhat conflicted and wondering how I was meant to feel. I also worried that if I liked him, would I be disloyal to my mama who was the love of my life? My mama, amazing woman that she is, hid her upset quite well but with hindsight, I know she was upset that it took him so long to turn up and that he was putting us through emotional turmoil. I recall her sitting my sister and me down after he had turned up unannounced the first time and confirming that he was indeed our biological father. She gave us a choice about going to spend the afternoon with him and said we could decide to go or not.

My sister had a vague recollection of him and was excited to see him so I didn’t object. Off we trundled to Yola International Hotel to his suite. We each had a chapman (love that drink, bright red fizzy non-alcoholic cocktail still popular in Nigeria) and I think I had a meat-pie because they made them nice and I was a fan. He must have tried to talk to us but I really don’t remember what was said. I remember saying that ‘everyone at home calls me Diya not Aisha’ when he kept calling me Aisha. I think he felt rebuffed. My sister and I soon got bored and we went off to play with the lifts and got up to mischief. He left the next day and life returned to normal. The only evidence was that he gave us some money which we promptly deposited into our savings accounts and forgot about.

The second visit was only slightly less awkward and I remember thinking ‘what does this all mean anyway?’ I mean, after the first visit, he made no effort to promote any kind of relationship. I firmly believe he would never have visited again if he had no business bringing him to Yola. Since then, I have not seen or heard from him. My sister got a couple more visits to her boarding school and then nothing since. It has been over 20 years since I have heard a peep out of him. I do not think I ever met my grandmother but we did hear that she was still alive about a decade ago. A friend of my sister’s sister-in-law last week got word to my sister through the sister-in-law to say that our grandmother had died. Our reaction was lackadaisical to say the least. First, we thought ‘erm yes our grandma died about 12 years ago in two days’ (October 6th). Then we clarified that this was our paternal grandma. We mentioned it to each other in passing and no more was said. We went to sleep that night without a second thought and honestly, I can’t say I feel like I have lost anything.

This brings me to the question I wanted to address here. When we were little, and some people still say this, we were told that despite not knowing our father and his relatives, we would regret it if we let him die without trying to get to know him. Apparently (somewhat mystically) we would feel his death and be deeply saddened. Well, my grandma has just died and it made not a dent on my life. I felt the same as I would for any of my patient’s relatives dying. Sad for a moment then life goes on.

So will I be sad if my father dies today and I have no relationship with him? I suspect not. Would I be sad if my siblings died and I know nothing of them? Probably a little. Would I be sad if I found out that they are oppressed and in need of assistance I could provide? Yes quite sad. Would I be sad if I could save them from some desperate need like donate bone marrow or a kidney to save a life and I did not because no one thought to approach me? Yes definitely. Of course I wish I could be a sister to my sisters and brother. I wish things had worked out differently and that my mama’s love had not been misplaced. I wish she had seen through her loyalty and love and chosen a different man who would have treated her and her child better. I wish she had never fallen in love with this particular man but she did. It would be a waste of my time to dwell on what ifs on behalf of my mama. She has moved on. So will I. Such is life.

Do Your Little Bit of Good

Desmond Tutu says: “Do your little bit of good where you are; it’s those little bits of good put together that overwhelm the world.”

What a great saying! I fully subscribe to it. I think the world would be in a much better place if everyone believed in doing their little bit of good and did it thus creating a lot of goodness. Most of the people I meet are very good people and have really good intentions but only a few are doing anything to put their good will into action to help change the world in their little way. I suppose I am actually privileged to work in healthcare though. Nurses and doctors do so much fund-raising for charity that we almost take it for granted. Most of my work mates will have badges, hoodies, t-shirts all bought for charity. Many of them are taking part in charity runs to raise money for great causes.

Many of our amazing little patients are also into their fundraising. You may have heard about Stephen Sutton who died from cancer a few months ago. He has just been awarded a Pride of Britain award post-humously. His story has inspired so many because instead of focusing on his bad prognosis (predicted bad outcome), he thought he would raise money to help find a cure for cancer for those who have the misfortune of following in his footsteps and to support those young people and babies with cancer. Even if he had raised only a £100, it would have been amazing because of the intention behind it. The intent was to improve the lives of others when it was too late for him. The intent was to make the world better for a group of unlucky people who have or will have cancer. Great news is that he has raised £5 million pounds so far and counting and his name has been immortalised for being so brave and selfless in his time of despair and illness, for making a difference. Stephen probably never dreamt how big his fundraising page was going to be but he did what he did anyway.

Malala who has just won a Nobel Peace Prize at 17 years old and is a fellow West-Midlander is another inspiring story. Her story started out small. I am sure she never thought she would end up living in the UK making speeches that are heard all over the world and getting complimented by the likes of Barack Obama and the Queen. All she did was speak out against the injustice of being denied an education because she and her friends were unfortunate enough to be born girls in Pakistan. She got shot for her pains but instead of being cowed by the real threat of the Taliban, she remains unrepentant and continues to be the voice for her fellow oppressed girls and young women. She has inspired thousands of girls in Pakistan and Afghanistan to insist on their right to be educated. A small thing that has metamorphosed into a huge thing for so many.

My mama has an NGO that works primarily to empower women and young people. Part of what they do is provide support in setting up small businesses and training in crafts. They also help find and pay lawyers for victims of domestic violence and rape. But their manifest is unlimited really. Whatever a child, adolescent or woman needs that they can help with, they do. They have helped end many forced child-marriages; they have helped girls/women get away from abusive relatives and start up a new life. They help women who are desperate to support their children train in simple skills that will help them earn a living so they know where their next meal is coming from and know that they do not have to go from door to door, asking for hand outs. They provide extra tuition for young people struggling with their education and their prospects of employment. They provide sanitation and educate on public health issues. They have even helped a young lady locate her birth father. The work they do is not exactly earth-shattering to read about and does not make the news but I know how much good they have done for the hundreds of people who have come to them for help. I know what a lifeline they have been and continue to be for so many. They are doing the little good they can do with limited resources but it is changing the world for those around them in Yola and beyond to the rest of Adamawa state.

All of these people inspire me so much and as a result, I have made a promise to myself. I might not be anybody. I am certainly not rich nor am I famous. I am not extraordinary in anyway but I have been blessed with an amazing family, a few great friends, a fantastic job and a life mate (my husband) whose love is so uplifting. I guess you could say that I am extraordinarily blessed. So I try every day to do or say something that will do some good for someone. The best thing is that my patients are great recipients of my efforts. So many children just want positive reinforcement to shape them into lovely responsible adults. So I find something beautiful about them and tell them about it. I tell them how gorgeous their curly hair is. How special their rare blood group is. How amazing their natural red hair is. How beautiful their glasses are. How brave they are. How happy their hard work to get better makes me. How brilliant they are to do schoolwork when their health is failing. I say good morning to the cleaners that keep our hospitals clean and I smile every time I pass them in the corridors because their job is hard and their pay is small but they are absolutely essential in helping us make our patients better. I buy badges, hoodies and t-shirts for charity and I wear them with pride.

So I challenge you my dear reader. If you ever watch TV or read about someone who has done something and you feel inspired, do a little something each day to brighten up someone’s day. It doesn’t have to be big. It doesn’t have to cost you a lot of money; it doesn’t have to be recognised by anyone. As long as when you go to bed, you remember the feeling of having done something good for someone with no strings attached and fall asleep with a happy heart. Let us all do the little things that are easy and free in life and hopefully the sum total makes the world that much better.

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.

Nigerian Converts

The Glasgow Commonwealth Games have occupied many of my waking hours in the past 3 months (yes I recorded it all and have savoured the many hours slowly over 3 months instead of 2 weeks). The competition has been great viewing and I find myself from time to time wishing I had tickets for Glasgow. To be honest, I am puzzled about that still because I am sure if I had known when they were on sale, I would have tried to get tickets for some of it but that opportunity completely passed me by. Sadly.

Although I am a bit competition-mad and will watch most TV programmes with even a hint of competition and a chance to be awed by talent, as an amateur athlete myself back in the day I have a special love for the athletics. And these Games were very special for me for a puzzling reason. We Nigerians are pretty good at the sprints so we tend to feature throughout the rounds. The first heats were men’s 400m I think and when the Nigerian fellow was announced, I sat up in surprise. First his name was very ‘black American’ sounding (most Nigerians have at least one traditional name somewhere in their full name). Then, the commentators went on to say he was ‘one of the many Nigerian converts’. I was puzzled. I had never heard of a person converting to a country before. I mean I know people change nationalities for example but I have never heard it phrased as ‘converting to British’ for example. Odd choice of phrase but I was even more puzzled as to who these people were and why they were converting to Nigeria.

Turns out that these athletes are former American (plus 1 former GB) athletes who have swapped alliances to Nigeria. Now as a Nigerian, I have never been surprised to see a Nigerian name in a British, American, Dutch or even Qatar vest. Truth of the matter is, with the corruption in the Nigerian Government, there is practically no investment in Sport these days and our long-suffering patriotic athletes are forced to abandon ship for greener pastures. And I don’t blame them. If as an athlete for Nigeria I would have to work a horrible job to keep the roof over my head and food in my belly and juggle all that with training, I too would choose to go another team who would not only sponsor me so I can focus on my sport but also give me support in terms of coaching, psychology and physiotherapy. Rather, I was very surprised to see the movement was in the other direction. People actually joining Team Nigeria from other countries. So I investigated.

Apparently our Government has actually made real effort in ‘recruiting’ these former US/UK athletes in the hope of boosting our medal chances. I also discovered that the reason why these athletes’ names are suspiciously not-Nigerian is because many of them are many Generations American/British but according to the news on the internet, they are all bona fide Nigerian – by which I deduce that maybe some of them are 25% Nigerian but they were born and bred abroad and probably did not even have a Nigerian passport/citizenship until they were ‘recruited’. Rumours are that some of these athletes should not be representing Nigerian because their claim to citizenship is tenuous to say the least (I read about a girl who is Nigerian because her American uncle married a Nigerian, thus becoming Nigerian himself and somehow that qualified his niece as a Nigerian?). Dodgy if you ask me.

It is all well and good that our Government has finally sat up and taken note that we have been haemorrhaging all our talent to the West in the last 2 decades (at least) and is making an effort to correct things. However, I concur with their detractors on the internet who point out that allowing these ‘Nigerian’ converts to come in and out-compete our less experienced home grown talents and then for them not to win the expected medals is probably more of a con than a pro. What our Government should be doing is recruiting our budding athletes in schools and universities and creating a training programme with good support to allow our talented young people to hone their skills and become the elite athletes they have the potential to be. We should be investing in our athletes like the great sporting nations do so that we have professional athletes whose focus is all on their sport whilst they are in their prime. We should be there for our athletes so that they don’t have to go on strike before major sporting meets to get their just dues. We should go back to the 90s when we were all so proud of our sports men and women and we treated them like the superstars they were.

Nigeria with our huge population has plenty of potential. We really don’t need to leave our shores to recruit people in. All we need to do is invest time and money in those already there and I am sure in the years to come, we will be up there with the US, Jamaica and GB teams. Long live athletics. Long live our talented children. Long live Nigeria.