Conversation with Azu

This is not a good time to talk about medical doctors, especially when those in the public sector are on strike to press for better conditions of service. But I didn’t choose this encounter; the encounter chose me.

And, in any case, my own experience was not at a public hospital. I have heard of all sorts of patient-doctor stories before and taken a good many with a pinch of salt.

Too often, we hardly get to hear of the extraordinary courage and devotion of doctors and other medical personnel who give so much under extremely difficult – and even hostile – conditions to save lives.

In a society like ours where soldiers are sent to war with bare hands and teachers are deployed in schools without roofs or tables, doctors and medical personnel who save lives in spite of the odds are miracle workers.

But three times in about two months, I have heard stories of medical personnel whose negligence could have complicated matters, and cost lives. I also recently encountered a doctor at a high-brow private hospital in Abuja, who, for a moment, I thought may have entered the consulting room that night with a loaded gun, in a manner of speaking.

Each story reminds me that when all is said and done, sometimes – and they may well be the most crucial times in your life – what you know beforehand, and not what the man in the white coat does or prescribes, may well be the difference between life and death.

Let me share two of the other stories first, and then mine later. A friend told me last month, before the doctors’ strike, that she had taken her son who was diagnosed with malaria to the hospital for the second of a three-day treatment which consisted of a prescription of three doses of different injections on each day.

Because her son, who is a teenager, had also been diagnosed with urinary tract infection, antibiotics were also prescribed along with the three daily doses of anti-malarial injections.

Things went off pretty smoothly on the first day. On the second day, it was the father who took the boy for the injection, and she assumed that all went well. On the third day, however, she discovered that one of the two antibiotics that should have been administered on the second day was not. Rather than giving the boy the 2mg prescribed by the doctor, he was given only 1mg.

On getting to the hospital, she requested to see the nurse and demanded to know how such an error could occur. The nurse replied offhandedly that she didn’t figure out what the doctor wrote.

“I thought he wrote 1mg!”, the nurse said. “But it doesn’t matter. Madam, she can take it another day.” Not on the day the doctor prescribed or on the day that the patient needs the correct dose, no. The patient gets the treatment if he is lucky to be alive, on the day and time convenient for the nurse. That’s how we roll.

Her second encounter was the same day at the medical records department to retrieve her son’s folder. After a long, anxious wait, with patients groaning and discharging a slew of hisses that would shame a python, my friend went to the head of the queue to find out what was happening.

She was told that the officer who was supposed to attend to the patients had gone to pray. They waited, shuffled about and grumbled but nothing happened – until she staged a mild scene.

That was when a kind-hearted senior medical staff weighed in and admonished the head of the unit who finally dragged herself up to attend to the crowd of agitated and distressed patients and visitors. At the time my friend and her son left, the prayer warrior officer had still not returned to his station and his prayer had obviously not helped the crowd of distressed patients.

On another occasion, an elderly friend of mine recovering from malaria recently shared the story of how the tardiness of the medical staff nearly complicated his recovery, and potentially, his life.

After three days of injection, he was supposed to have closed out with oral therapy, as follow up treatment. Unfortunately, the staff responsible “forgot” to tell him, and later “apologised profusely” for the omission. He had to start his treatment all over again!

Mine was an encounter of a different kind. After a shoddy attempt at self-help, I turned up at a private hospital on Monday evening with a worsening bout of malaria.

In the past few years whenever I have had early signs of malaria, which is perhaps once or twice in a year, I have managed to overcome it with a normal dose of any of two commonly used anti-malarial drugs – Lonart or Coartem – usually, the latter more than the former.

I tried it this time, but it failed. As I was driving back from work on Monday, I was feeling as if I had been apprenticed to one of the numerous construction sites in Abuja, under a foreman from Julius Berger. I drove straight to the hospital, with hurting joints.

After my vitals were taken a nurse asked me to wait for the doctor. I didn’t wait long before a smallish looking, light-complexioned man, flying a checkered long sleeve shirt over a pair of faded blue jeans and black slippers, walked into the “consulting room.”

As soon as the door closed behind him, the nurse asked me to enter.

That was when I experienced suspended misery, even before I opened my mouth.

“I’m just coming in!”, he hollered. “You have not allowed me to settle down!”

I froze.

“The nurse asked me to come”, I replied.

Then he relented and motioned me to a seat. There were two chairs, not facing him, but to the right of his something like a seven-by-four feet cubicle of an office. I sat on the chair farther away from him as he struggled with the glare in his eyes.

“What is the problem”, he asked, at last, without looking at me.

I rattled off, starting with my Coartem misadventure to my aches and pain, blah, blah, blah.

“Any cough, fever or sore throat,” he murmured all the while punching, with considerable effort, at his HP desktop computer with his right forefinger.

“None,” I replied as if speaking to myself.

He continued, ta…ta…ta…ta…with his forefinger.

And then I added, as if to myself, “I stopped using my multivitamins before I started the Coartem because one of the capsules contains Vitamin C, which I understand tends to propagate free radicals….”

“That is nonsense!”, he roared, looking at me for the first time since I entered the cubicle. I thought he would pull a gun.

“It is not nonsense”, I replied.

“You may disagree but you don’t have to say it is nonsense. What I have said is based on studies which I have read.”

He stood his ground, repeating that such notions have no basis in science and then, ta…ta…ta….

Apart from writing out a laboratory test and a three-day injection of artesunate and diclofenac, he prescribed antibiotics, sleeping pills and folic acid. I didn’t complain of poor sleep, but ta…ta…ta…the blue pill was right there!

The next day, by some stroke of good fortune, Dr. ta…ta…ta…was not consulting when I turned up for my test result and medication. A young doctor next door took a look at my case file and without a word, asked why I had been placed on folic acid along with my prescriptions.

I told him it was Dr. ta…ta…ta….and he smiled. He also asked, in a most friendly way, if I had been having any sleeping problems. I said no, after which he then said I should immediately discontinue the folic acid and blue pill.

According to some accounts, medical errors are the third leading cause of death in the US, after cancer and heart diseases. A John Hopkins University study said medical mistakes kill more than 250,000 people, every year – and that is in the US where they have and keep records.

A June 2017 study by Gabriel Uche Pascal and others on medical errors in Nigeria with a specific interest in Abia State said of the three most common medical errors reported 95.2 per cent is linked to medical prescription, while radio laboratory test follows with 83.9 per cent.

As I left the young doctor’s office after what was for me a redeeming encounter, I was relieved. Not because he provided a miracle cure, but because he listened, showed interest, and most of all demonstrated that he cared for his patient.

It confirmed to me what I always suspected about many things in life, especially matters of health: always seek a second opinion, and possibly, a third.

In the end, it’s your life.

Ishiekwene is the Editor-In-Chief of LEADERSHIP.

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