Bush Doctor in the City. Vol 24

•April 28, 2008 • 1 Comment

Bush Doctor in the city. Vol 24

 

The stale airless night was made even worse by the Bush Doctors grumpiness.

‘Now would someone tell me how black market fuel can exist in an oil producing country’ he asked between sips of the palm wine that had so far failed to bring tranquillity to his angered spirit. The Bush Nurse watched him in silence. The way a mother watched a favourite child. With a knowing smile.

‘Imagine a new born babe buying black market breast milk. Just imagine that. Can never happen’ he said

‘Can happen’ said the Bush nurse.

‘Tell me how o great beauty queen’ said the Bush Doctor angrily. It was her tone of voice. Made him feel like a little boy. The Bush nurse laughed.

‘Now, the stupid husband has bought powerful breast pumps from his foreign partners and they sucked mama dry. They have exported all the milk abroad. Stupid husband has now imported back the milk but sold it on to other babies save his own’ she said.

‘Well said. Why should his babe starve when distant mouths feed on the milk. Why o queen of mine?’

‘You are my subject, not my king’ said the Bush nurse.

They both laughed. The Bush Doctor had lost all his vaccines because the fridge had become an oven in the tropical heat of the dark forest. For three weeks the electric generator had not seen diesel due to an acute fuel shortage in the city.

The Bush nurse moved closer and began to massage the Bush Doctor’s neck.

‘Can you imagine the Witch Doctor in London with that wife of his?’ asked the Bush Doctor.

‘You like her don’t you? I see the way you look at her’ said the Bush Nurse.

‘No. I just wonder what she finds in him. She is barely twenty five’ said the Bush Doctor.

‘You lie too much’. She continued with the massage.

‘I just remembered, what is the Thyroid stimulating hormone thing. My sister says her levels are high and her Thyroid hormone is low. Confusing’ said the Bush Nurse.

‘Did you not tell her we don’t do too many blood tests in the bush. How would I know, my queen?’

‘You know everything o great Doctor’ teased the Bush Nurse.

‘You have a good point there’.

‘I see modesty is not your strong point’ said the Bush Nurse.

In a scene reminiscent of his youth, when his maternal grandma told the children in the compound tales at moonlight he proceeded to unravel the mysteries of the thyroid gland.

‘My beauty queen, I know you loved Charlton Heston; may his soul rest in peace. I also know you loved that Ben Hur film. Now picture this. Ben Hur stands on his horse drawn chariot in need of speed. When the horses run slowly he whips them a thousand lashes to get his speed back. With time, the horses get muscular, bigger and stronger. When the speed gets too severe, the whip is rested. However, hear this, when the muscular hypertrophied horses cannot run despite the whipping, a most fascinating thing happens. The unresponsive horses are replaced with powerful motorbikes which pull the chariot along’ said the Bush Doctor. He sipped slowly on his palm wine.

‘You are going mad in this Bush, my dear subject’ said the Bush Nurse.

‘Insane? No. A tropical genius? Yes. Now, I uncover the mystery. Ben Hur is the Brain. The whip is the Thyroid stimulating Hormone. The Horses are the Thyroid gland and when they get muscular they become the Goitre. Speed is the naturally produced Thyroxine and the powerful motor bikes are the supplemental Thyroxine tablets. I hope my queen is pleased’ said the Bush Doctor bowing his head.

‘Bravo, bravo! More than pleased. Light has come into my beautiful brain’ said the Bush Nurse.

 

 

 

25-04-08

 

I say and do strange things at work. Sounds alright at the time but on reflection, well that’s another matter. I talk all day and it isn’t scripted, so from time to time one does put one’s foot in it.

68 year old man with frequency of micturition which I think might be a Prostate problem. I order a PSA test and say ‘this blood test will help us get to the bottom of this problem’

87 year old with puffy legs. ‘How old are you now?’ Sounded odd. Next time will ask, ‘what is your current age?’. Not that there is anything too bad with the first question, it just sounded wrong.

60 year old man with gastroenteritis requested a home visit. I said, ‘watch your back. Diarrhoea is contagious’ to his wife

4week old baby with Millia on his face .Now this was so embarrassing. Mum and Grand mum were worried about this baby’s rash- nothing but Keratin filled cysts on the skin. So I thought , ‘why not bring up some internet images to show how common Millia is’. When I hit the search button, I felt like an earthquate should engulf the room. How was I to know there existed a Millia Rage? Some strange character who fights with her hair. How was I to know that some cartoonist with too much time on his hands had drawn a naked version of her on the web.

No more ‘live’ internet searches for me!

http://www.guardian.co.uk/world/2006/dec/27/oil.topstories3

http://news.bbc.co.uk/1/hi/business/2995108.stm

http://www.medicinenet.com/hypothyroidism/article.htm

http://www.imdb.com/video/screenplay/vi4239982873/

 

 

 

 

 

 

 

 

Bush Doctor in the City. Vol 23

•March 25, 2008 • 2 Comments

Bush Doctor in the City. Vol 23

 

The Bush nurse appeared pensive all evening. The Bush Doctor could hold back no longer.

‘Come out with it then, I know there is something on your mind’ he said.

‘Who told you?’ she replied.

Silence. They sat side by side on a wooden bench in front of the Bush Doctor’s quarters staring into the night.

‘What would you say if I told you I was entering a beauty contest?’ asked the nurse. The Bush Doctor burst out laughing. He laughed so hard he fell off the bench and rolled on the ground. There were tears in his eyes. When he had regained composure he dusted himself and resumed his previous sitting position. He then noticed the silence.

‘Have you finished?’ she asked in a barely audible whisper.

She started to sob.

‘I thought you were joking’ mumbled the Bush Doctor.

‘Why must it be a joke?’

‘How could you, a professional, parade your self in your underwear on stage? What will the patients think?’ asked the Bush Doctor putting his arm round her.

She then went on to explain that there was a beauty pageant to be staged in the city to raise funds for a charity catering to the needs of Albino children and that this beauty contest will feature only albino women.

‘But you are not really contesting are you?’ asked the Bush Doctor.

It wasn’t long before they were in the middle of a full blown row. The Bush Doctor said he would not be attending her beauty contest and the Bush nurse accused him of being ashamed to associate with her in public.

‘Stupid man, so long as your city friends don’t see you, you are willing to eat Albino pie every night. You should be ashamed you two faced hypocrite!’ she shouted at him.

‘Yes, shout so that all the patients can hear. It is you who should be ashamed with your plans to expose yourself to leering vultures’ the Bush Doctor shouted bad.

‘And who is talking about vultures at this time of night?’ came a voice out of the darkness to startled them.

It was the witch Doctor. They all had a drink of palm wine in silence listening to the creatures of the night.

‘I am thinking of relocating to England with my third wife’ the witch Doctor blurted out.

‘Why?’ asked the Bush Doctor.

‘Two of my foreign based footballers want me there. You see, I have given them charms for goal scoring and beating the off side trap yet they are not satisfied. They want me there in the stadium when they play. See my trouble’ said the Witch Doctor.

‘So you will be contributing to the Brain drain’ teased the Bush Doctor.

‘Shouldn’t a job require brains to qualify for that term?’ mocked the Bush nurse. She got up to leave expecting sparks to fly from the witch Doctor.

The witch Doctor was amused. ‘You have a point. I work with the ancestral spirits’ he said.

‘I rephrase then. Ancestral spirit drain ’ said the Bush Doctor.

The Witch Doctor then went on to explain that the demand for his services in Europe has sky rocketed and he was even planning to launch a web site to sell his new powerful charm for scoring headers. He begged them not to let his first wife hear of this as he planned to inform everyone of his ‘ancestral drain’ when he had settled in London in three weeks time. The Bush Doctor felt very bitter about this. Long into the night he complained to the Bush nurse.

‘He is an illiterate and he earns my monthly pay in a day. Why did I bother with medical school then? Such injustice. This country! Our people reward quacks. What do I have to show for all my labour?’

The Bush Doctor stopped talking when he heard the Bush Nurse’s gentle snoring.

 

 

 

Bush Doctor in the City

 

19-03-08

Wonders will never end and that is what keeps this job interesting.

Was called out to visit a gentleman in his sixties with diarrhoea and vomiting. Rather than come to the surgery he jumped in a taxi and appeared at the doorstep of his sister in law to be cared for. She however is a widow and is barely coming to terms with the recent death of her husband. She was in no mood to look after anyone.

On getting there I find out that the gentleman keeps his fridge off most of the time to save on the electric bill.

His food then goes off and he eats it, thus saving money on the grocery bill. He also has no landline or mobile phone (yes, saving money) but smokes.

Some aspects of my job can be done without a medical degree.

I examined the gentleman to make sure a perforated Sigmoid Diverticulum was not masquerading as a Gastroenteritis and gave him some tablets.

I told him off for stinginess and advised he left the poor fridge on and saved money by stopping smoking instead!

At the door I advised the owner of the home not to open her door next time he eats his poison.

 

http://news.bbc.co.uk/sport1/hi/football/africa/3156332.stm

http://uk.eurosport.yahoo.com/20012008/58/african-cup-nations-fans-ghana-juju.html

http://en.wikipedia.org/wiki/Beauty_contest

 

Bush Doctor in the City. Vol 22

•July 17, 2007 • 3 Comments

n646401170_284938_30961.jpg

Bush Doctor in the City. Vol 22

The Bush Doctor, the Bush Nurse and the Witch Doctor sat around a large gourd of palm wine chatting away into the night. They all shared a secret which now bonded them together and enforced a mutual respect.

The Militia attack on the hospital benefited many. The Witch Doctor’s son in-law lamented to the press how his first son was killed in the carnage thus provoking an overwhelming degree of public support for him and his wife. The funeral for the day old baby was well attended while a few miles away the baby was cared for in a ‘Motherless babies’ home.

Donations poured in from mainly private companies for the emergency fund the Commissioner for health set up for the re-construction of the Bush Hospital. He had personally re-opened the hospital which now boasted of separate male and female wards and a new paediatric ward.

The commissioner came to the Bush with over ten pressmen in tow as he had promised historic announcements. In a speech lasting close to an hour he thanked his wife’s Egunje ventures construction for the marvellous work they did on the hospital.

He then announced that Egunje Ventures Electronics had imported 20,000 solar panels and medical fridges for use in all health care establishments. A few eye brows were raised since only four hundred health establishments existed. Once again the state statistician was called upon. Road accidents was old new. Sex was the new killer. HIV was a priority.

‘It is not enough to say don’t smoke and don’t speed. We must now say don’t sex! Sex is the killer. Some die during the act and others after the act from sexually transmitted diseases. The honourable commissioner has ratified the No to the three S strategy’ he announced.

The commissioner returned to announce the launch of the first made in the City condom; the Egunje Ventures condom. The state help board had ordered 10 million of these to wage war on HIV. Those awake clapped.

The Bush Doctor could now read for his USLME exams with power supplied by Solar energy. He also drank cold palm wine out of the medical fridge.

The peace was broken was cries. Young men rushed out of nowhere holding a bed in the air. A white bed sheet covered whoever was on the bed.

‘We heard you were here’ said the Bush King’s son to the Witch Doctor.

‘The great Eagle has left the mountain side’ said another of the Bush Princes.

‘Shut up! That cannot be’ screamed the Witch Doctor. He sprang to his feet and pulled the bed sheet away to reveal the Bush King naked on top a young girl who had both knees touching her shoulders.

‘Get him off the woman’ the Witch Doctor screamed.

‘We tried but they are both death and glued together’ said one of the Bush Princes. The Witch Doctor got all excited and began to say some incantations.

‘Help me’ he said to the Bush Doctor. They lifted off the Bush King and laid him on his back. The sight man the Princes and their helpers to flee into the darkness.

‘Risus Sardonicus!’ exclaimed the Bush Doctor

‘Even in death the royal tower stands erect!’ exclaimed the Witch Doctor.

The Bush Nurse flinched as she looked into dead kings face that bored a devilish smile. She then lowered her gaze. ‘Priapism it is called’ she said.

‘Priapism is for the living. This is Angel’s lust. The City Prison Doctor told me that the men he witnessed being hung developed erections sustained after death.

‘Is nothing not sacred. How dare you discuss the royal tower?’ asked the Witch Doctor looking at the Bush Nurse.

‘More like the leaning tower if you asked me’ she answered. The Witch Doctor remembered their secret; his first grand son of Black parents who came out White and held his peace’.

‘How will that girl fit into a coffin with legs in the air?’ asked the Bush nurse.

‘She’s alive!’ exclaimed the Bush Doctor. He had seen her blink. He checked her pulse then asked his Bush Nurse to get some Diazepam which he promptly gave. Her rigid muscles went floppy and she soon came to herself. She was completely hysterical. The Bush Nurse led her into the female ward and she spoke like she was in a trance, ‘ I have killed the royal father, I have killed the royal father’.

‘I warned that man about these young girls’ said the Witch Doctor.

‘Too much excitement or his seventy five year old heart’ said the Bush Doctor.

‘His wives will soon be here. I will say he died alone and that is what happened. We cannot afford to be the laughing stock of our neighbours’ said the Witch Doctor.

‘You have a point’ said the Bush Doctor.

‘I cannot let them see him like this; dead with an erection. The ancestors forbid it’ said the Witch Doctor. In one deft movement he grabbed the royal phallus and fractured it at base. Blood spurted out of the urethra accompanied by a squelching sound. Most astonishingly, the Bush King let out a most agonizing scream.

‘He must have been in shock only’ whispered the Bush Doctor just realising he had not even felt for the Royal pulse all this time.

‘Let us just say I bought him back from the dead’ said the Witch Doctor.

‘I better get a morphine injection for the Royal bottom’ said the Bush Doctor

A nice and quiet day for the Bush Doctor in the City.

13-7-07. 11am. Speaking to a 25 old man about a musculoskeletal problems when he mentioned his other problem; large prolapsed pile.

‘I’ve got it on my phone’ he said and showed me the pictures. Quite good pictures actually. He had actually been examined and referred to a Surgeon already.

I began to think of other people who might make my life easier by coming with pictures.

1. Rashes and lumps that disappear when the patient walks into the surgery.

2. Coughing babies that settle as soon as they walk into the surgery.

3. Lumps and peristalsis visible after feeds (Pyloric stenosis). The abdomen can be videoed.

4. Women with lumps ‘down below’ who want a female Doctor when I am on duty.

5. Swollen knees that have disappeared.

6. Assaulted people with huge bruises that have disappeared.

7. Those requesting medication I have no record of and whose name cannot be remembered can photograph the box (showing dose and strenght).

The list is endless. NHS direct should encourage patients to text pictures of rashes etc to them at night. Free phones for those without proper high quality ……..

14-7-07. 12pm- 6pm. Mansag (Medical association of Nigerian specialists and GPs) West Midland Branch had a weight management awareness day at the Firs & Bromford Sports and Community Centre.

Members of the public were weight and height measurements and Body Mass index calculated. Weight circumferences were measured, as were blood pressure and Blood sugar estimations. Various health risks were discussed.

A very rewarding day. Good turn out from the Nigerian GPs and Specialists in West Midlands. Well done

http://www.usaid.gov/stories/uganda/fp_uganda_solar.html

http://en.wikipedia.org/wiki/Death_erection

http://www.mansag.org/

Bush Doctor in the City. Vol 21

•July 14, 2007 • 3 Comments

Bush Doctor in the City. Vol. 21

The Bush Doctor had taken to reading in the evenings before it got dark. The late afternoon rounds had been done and nothing exciting was going on. He had been reading for thirty minutes when the hurried sounds of footsteps towards his door made him say aloud, ‘what could it be this time’.

‘You have a VIP patient. The Witch Doctor’s daughter’ said the Bush Nurse.

He followed his nurse back to the ward. The new patient was pregnant and distressed.

He examined her quickly and said, ‘I am afraid, you cannot go back to the city. I need to operate now’.

‘Oh no. Not in this dump. No way. I would have my baby with my specialist in the city. Moreover, if my husband hears I came here, he will kill me’ the Witch Doctor’s daughter said.

The Bush Doctor knew her husband; a volatile army major who loved his beer. Most of the well to do city folk were wary of coming to the Bush for fear of being kidnapped for a ransom. The old militia leader had suddenly disappeared with all the cash and the new leader, a really angry youth, had unleashed a reign of terror. He was known as ‘cash and bury’, for he sometimes shot dead his hostages but still demanded payment for collection of corpses for burial. He horrified the whole Bush and City when he announced that ‘ dead hostages represented savings on food expenses, and the clients of dead hostages always paid up quickly before the corpse began to rot’.

The Witch Doctor has complained about the ban his son in law had placed on his daughter visiting his Bush shrine on a few occasions during his night time visits to the Bush Doctor.

‘No one of those militia boys is bold enough to come near my house’ he had boasted, beating his chest as he spoke.

The Bush Doctor prevailed and the operation was about to start. The two end legs of the operating table were raised on stones to effect a head down position. This tipped the baby away from the cervix thereby relieving pressure on the prolapsed umbilical cord.

He had been blunt, ‘ you will end up in the City with a dead baby if you leave now’ he had warned. That utterance had the Witch Doctor’s wife screaming out, ‘God forbid!’

He explained that at 38 weeks old the baby was ready to be delivered. The waters have broken and more importantly, the umbilical cord had prolapsed through the cervix into the vagina. The Witch Doctor was hurriedly summoned. Both parents insisted on watching the Caesarean section but the Bush Doctor would only allow one of them in, so the Witch Doctor’s wife took the only seat.

The Bush Doctor worked very fast. He gave intravenous Metoclopramide to aid the emptying of the stomach and hence avoid the dreaded Mendelson syndrome which occurs when vomit finds its way into the lungs. Diazepam was given to relax the patient.

The Bush Nurse passed a urinary catheter and put up a drip of Normal saline to inflate the bladder. This also helped to put the baby away from the umbilical cord.

‘One rule for some’ said the Bush Nurse.

‘The ancestral spirits forbade it. An eagle was perched on a palm tree the morning I gave birth to her’ said the Witch Doctor’s wife.

‘Where were ancestral spirits when I needed them?’ said the Bush nurse with a sigh. The Bush doctor was keeping out of this female circumcision riddle.

‘With due respect, the ancestors are against albinos’ said the Witch Doctor’s wife.

The Bush Doctor saw a flash of fire spread across his nurse’s face for a few second before she laughed and made a face at the old woman now almost blinded by her cataracts.

The Bush auxillary nurse was to assist during an operation for the first time. Two auxillaries had been trained by the French volunteer Doctor before her sudden departure but the Bush Nurse got rid of the female auxillary. She didn’t like the way the Bush Doctor’s eyes gazed on her waist line every time she walked past.

‘Hope you washed your hands like I taught you?’ the Bush Doctor asked as he painted the mountainous abdomen with iodine.

‘Yes sir’ came the reply.

The Bush Doctor started to incise the skin across the lower abdomen, where he had infiltrated with local anaesthesia a few minutes before.

‘I am down to peritoneum. This baby must not drown in Ketamine’ he said

‘Say when’ said the Bush Nurse.

A wall gecko scuttled across the roof and stopped directly over the operative field.

‘I don’t want that ulgy thing falling into the wound, kill it’ said the Bush Doctor to his assistant.

‘In my family, we are forbidden to kill these animals’ said the Bush auxillary.

‘Then I suggest you take off those gloves and go find another job!’ screamed the Bush Doctor making his patient jump. The wall gecko was dead in a few seconds.

‘When!’ said the Bush Doctor to his nurse. As she injected in the Ketamine, the Bush Doctor moved like lightening. Through the peritoneum, then through the womb and next thing the baby was out. The assistant by now was on the floor having passed out in shock and the Bush Nurse ran over to cut the cord. The baby screamed and a cheer rose out side.

‘We have company, please give the Ergotamine now’ said the Bush Doctor as he began to stitch the womb shut.

‘With which hand?’ said the Bush Nurse holding up the baby.

‘Drop the baby for a second would you. I need this womb contracted. Its bleeding!’

A big head appeared through the door. ‘Boy or girl?’ he asked.

‘Boy’ replied the Bush Nurse. The major disappeared. Celebratory machine gun fired followed.

‘I am so proud. My daughter is such a great woman. Do you know she has built an estate for the white oil workers in the city. She even supplies them with cars for hire. All down to the powerful Juju my husband made’ said the Witch Doctor’s wife.

As he put in the final stitches to the abdominal wound, the Bush Doctor began to ramble. He did that when there was something particularly difficult to say. He spoke out loud of how the Caesarean section was the way of entry into the world of great men. Great men like Julius Caesar and Robert the Second of Scotland. He spoke of how the great Ugandan Witch Doctors had been performing Caesarian sections long before the white man arrived in Africa with a mortality rate close to zero for mother and child; a feat witnessed by RW Felkin in 1879. The Witch Doctor’s wife swelled with pride and rocked from side to side smiling. The Bush Doctor looked at his Nurse for help.

‘Madam, we have bad news. The baby..er .. his complexion..’ her voice trailed off. The noise of soldiers celebrating outside intensified.

‘Don’t tell me its albino!’ screamed the Witch Doctor’s wife.

‘Worse ma. The baby is White’ said the Bush Nurse.

Before the news could settle in there was an almighty bang. The room shook. The Bush auxillary nurse on the floor jumped up and ran out screaming ‘earthquake, earthquake!’

The operating room suddenly was full of soldiers screaming ‘evacuate! We are under mortar attack from the militia! Cash and bury is coming!’

They carried the patient and the baby off. In five minutes the Bush Hospital was devoid of staff, patients or visitors.

No such excitement for the Bush Doctor in the City.10-7-07. 9.30am. 30year old lady comes in complaining of being stressed, having headaches, poor sleep, anxious and having a flushed face.

‘Is it the menopause?’ she asked.

‘Probably not’ I say. ‘Do you drink or smoke? I inquire’

‘No, I just drink 20 cups of coffee a day. Hardly a vice’ she says.

‘Caffeine can give you headaches and nervousness’ I say.

I think of the cancer causing chemical acrylamide which is contained in coffee. How some researchers gave poor laboratory animals ton loads of this wicked chemical and how the poor animals developed Cancer. Too much of a good thing might harm anybody. Who is to say small doses in humans is dangerous? Fried chips and crisps also contain acrylamide.

‘Why don’t you cut down on coffee and lets see what happens’ I say.

I feel a song coming on. Brasil defeated Ghana, 3-0 on the 27-6-06 at the World Cup. Reason for defeat? Must be the coffee says Osibisa!10-07-98. 9.30am (Travelled back in time to a London hospital where I am a junior doctor in obstetrics). I go to see a new- born. Dad’s cradles baby with pride and mum’s exhausted.

I examined baby and leave. Dad catches up with me on the corridor. I felt a thank you coming up.

‘Please, can you tell me how I can go about getting a DNA test. I don’t think that baby is mine’ he whispered. I am still in shock!

http://fn.bmj.com/cgi/content/full/80/3/F250

http://www.foodproductiondaily.com/news/ng.asp?id=58525-crisps-and-coffee

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http://profile.myspace.com/index.cfm?fuseaction=user.viewprofile&friendID=168799421

Bush Doctor in the City. Vol 20

•July 13, 2007 • 1 Comment

cowlegedis-benz.jpgBush Doctor in the City. Vol 20. 

The Bush Doctor was so glad to have a day away from the Bush. He had been invited to yet another meeting by the Commissioner of Health; this time in a very plush hotel.He was surprised to find many Traditional healers and policemen among the invitees and even more surprised to see the Witch Doctor sitting on the high table next to the commissioner’s wife.He sat around his usual friends and they made light conversation, nibbling at snacks and eyeing up the crowd. The wine flowed freely.The commissioner was introduced and he rose to reveal to all that his abdomen had grown since the last conference.‘Welcome to this historic event. I know you must be all wondering why I have assembled busy people like you here without an agenda. Sorry about that. We are here to launch the City Laser speed camera programme! I hand you over to the City chief Statistician to explain why’ said the commissioner.The assembled Doctors all looked puzzled while the policemen nodded knowingly.The statistician gave a presentation on the findings of his specially commissioned team who had been looking into the death rate in the City in the last six months.‘In conclusion, the Death rate was 25 per 100,000 and the life expectancy stands at 44 years. 30% of the deaths in the last 6 months have all come from road traffic accidents directly as a result of over speeding on our roads. You all advise your patients to stop smoking. I think you might save even more lives if you advise them to stop speeding’ was how the statistician ended.‘None of my patients have cars’ said the Bush Doctor. ‘Well, tell them to stop running, climbing trees and having so many children’ joked Dr Arugbo; the oldest practicing physician in the City.The commissioner now returned to put everyone out of their misery.‘We shall be equipping our police officers with the tools to cut speed. Speed guns! Now for a demonstration I call on my wife, eh, I mean the CEO of Egunje Ventures to demonstrate the speed gun’A motor cycle began to rev at the fire exit before flying across the room. The commissioner’s wife held up the gun and registered its speed.‘At this stage, the Police officer can arrest this Okada and give him an instant fine’ she said. The Policemen rubbed their hands in glee at the prospect of all those fines.Dr Arugbo rose to ask a question.‘How many of these guns have you bought?‘Ten thousand’ replied the CEO.A murmur swept through the crowd gathered.‘But we do not have that many good roads on which to speed on. And by the way, have you tested these guns out?’ asked Dr Arugbo‘Oh yes. We have been running a pilot on the Malu road. I can tell you that there has been no accident there for 3 months’ replied the CEO.‘That is because no one actually drives on that road to avoid these blood sucking police men!’ someone shouted to general applause. The policemen looked hard in the direction of the speaker.‘No insults please. The Police are doing a very good job’ shouted the commissioner from his seat.‘Yes. Guarding you and taking bribes. Now you have made them worse by equipping them with Laser speed guns!’ someone else shouted  The commissioner was soon back on the microphone.‘We are only trying to elevate the life expectancy. From next week, all roads in the City will have signs clearly stating the Maximum speed of travel. Egunje ventures will be handing that contract also’ he said.Dr Arugbo was up with another question. ‘I wonder how speeding is possible on congested roads. My question is this, when are we going to have a state run ambulance service? Surely that will improve life expectancy’.‘Ah, you are indeed the oldest and may I add wisest Doctor around. We were not going to mention it today but I..er..I mean we are working on it.  My wife, no the CEO of Egunje Ventures has been in London studying the Ambulance service there with a team of experts’‘You and your cronies abi!?  shouted someone to general laughter. A small debate arose around the Bush Doctor. The rumour doing the rounds was that the CEO had spent more time having breast implants and a tummy tuck than studying ambulance services in London. ‘Her waist line definitely looks smaller’ one said‘Could be a diet’ aid the Bush Doctor.‘There’s no diet that can make the breast grow you know. Not even in London’ said another.The commissioner allowed time for the murmuring to settle. ‘Please, let us be civil. There is no need to re-invent the wheel and that is way a fact- finding mission was approved. We need to learn from those who have experience in these things. The London ambulance service has been going since 1897 and in 1948, the NHS service act made it a law for every citizen who needed an ambulance in the whole of England to have access to one. I shall be implementing that in 8 weeks. Yet again Egunje Ventures have kindly agreed to import 600 ambulances and radio equipment to kick start the City Ambulance service. The future is looking bright for this city’ said the Commissioner.By now no one was listening as the wines were being served.Dr Arugbo raised his hand. He was the only one bordering to ask questions. ‘Why don’t we just tie stretchers or wheel barrows to the back of Okada?’ A few chants of ‘Okada Ambulance’ rent the air.The Bush Doctor met the Witch Doctor in the loo. ‘You didn’t mention this yesterday’ said the Bush Doctor.‘I didn’t even know I was coming. They sent a car for me this morning. I am the commissioner’s spiritual adviser. She fears all these government contracts she is handling will make people jealous so I am here for her spiritual protection’ said the Witch Doctor.‘It is the people that need the protection from their leaders’ said the now drunk and despondent Bush Doctor. No Alcohol for the Bush Doctor in the City. Have to travel on the motor- way to do a Locum.12-07-07. 7.30AM. Enter the destination on my Satellite Navigation and turn the ignition on. It’s raining but Black beauty (my car) has beautiful wipers. Problems on the M6. No movement. I am stationary in the rain till 9am.  Rang the Agency who in turn informed the Practice I was running late. (Wasn’t really running anywhere). I hate lateness. Really unprofessional. I switch on the Radio and hear two lorries have been involved in an accident about three hours ago and there was chaos ahead. I was trapped. I had my Fountain of Praise CD playing. The agency rain back and told me not to bother.‘You can go home’ he said. Oh no I can’t!So, I am burning fuel, wasting time, not getting paid and shedding tears of frustration. Why should an accident wreck my day?It was now 9.30am. I truly was going mad trapped in a stationary car. Getting depressed. Recounting all my woes. Then it happened. A white guy could take it no longer and he jumped out of his car to pee on the road side. I started laughing to myself. Now that was a Lagos scenario.I was hungry. Looked around for the lads selling pure water and Gala. Found none. No street hawkers on England’s motor- ways!Finally I could turn around and head back home. I drove for miles looking at people on the other side in the long queues where I had been; looking frustrated.I wasn’t the only one, so what was all that feeling sorry for myself? (Feeling you are the only one suffering really magnifies problems). The world has millions going through the same thing. That’s life. This morning was worse for others. The lorry driver who died. His family. His friends.I need to stop my whinging. Really.                   cowlegedis-benz.jpg                

Bush Doctor in the City. Vol 19

•July 9, 2007 • Leave a Comment

Bush Doctor in the City. Vol 19

The Bush Doctor had settled things with his Nurse during the early hours of the morning. Enough was enough with this French volunteer Doctor. The Bush Nurse had said she knew her Oil worker ex boyfriend was a foreign government spy and that she had see a look of recognition in his eyes when he saw the French Doctor. She too must be a spy.

The ward round went very quickly. Everyone was doing well except the construction worker from East Africa. He had initially improved on the intravenous Suramin but had now relapsed. He slept all day on account of the dreaded sleeping sickness. His step mum had taken her younger son to the city for Chemotherapy on his now shrinking jaw tumour (Burkitt’s Lymphoma) and was expected back that afternoon. The volunteer Doctor was in tears after they left his bed side. The Bush Doctor’s compassion had failed him.

Later that day when they all assembled in his office he went straight to the point.

‘Sorry to bring this up, being such a personal matter and seeing you are so upset about this man with Trypa..Trypan..sleeping sickness’ he coughed and paused.

‘We are worried about your closeness to the young man’ said the Bush Doctor.

They all sat in awkward silence.

‘I don’t really think you believe this talk about them being marine scientists with a grant from the UN. No woman is that stupid’ said the Bush Nurse. The Bush Doctor was taken aback by his Nurse’s rudeness.

The volunteer Doctor began to sob louder.

They sat in more silence.

‘OK. Go take a rest. We can discuss this some other time’ said the Bush Doctor. The volunteer Doctor hurried out of the room. The Bush Nurse gave him a dirty look.

‘What? She was upset. There is no rush’ he said.

They went off on a walking round to the Leper colony without their French visitor and stayed till late in the evening.

Early the next morning the Bush Doctor was startled by the noise of a jeep. He scrambled for his hurricane lamp and hurried out. The jeep was gone. So was the volunteer Doctor with all her belongings.

It wasn’t long before the machine gun fire broke the calmness of the morning.

Trypanosomiasis struck a cruel that morning. The young man lay motionless in his bed while his step-mother wept for him. ‘Where is our oyibo Doctor wey been dey help us o’ she cried.

The Bush Nurse kept on saying ‘I knew it. I knew it. That woman was so suspicious’.

Suddenly the Militia leader ran into the ward very frightened.

‘The federal troops are coming! Save me!’ he screamed.

He dropped his ruck sack on the floor. The Bush Doctor remembered his American dream fund. He wondered what might happen if the federal troops came in, dragged out this frightened young man and shoot him.

‘No one else would know there was money in that rucksack’ he thought.

The idea was from the bereaved woman. The Bush Doctor feared for his mother. Bush Nurse was not sure why he agreed to such a strange plan. Surely now they were all accomplices.

The Federal troops rushed in and saw the body dressed in bullet belts and army fatigue. They saw a ruck sack containing Dollar bills lying next to the bed on the floor.

One of the soldiers walked up to the body and laughed. Suddenly he brandished a huge knife with which he disembowelled the corpse.

‘Where the Cobra head he hides in his belly?’ he laughed. The soldiers dragged the corpse outside and set it alight.

When they had gone the Militia leader took off the bandages from his face, got out of the hospital bed and hugged the bereaved woman. He then grabbed the black bag into which housed the rest of his money and ran back into the bushes.

‘Someone has betrayed us’ he said as he ran off. He didn’t ask where the French Volunteer Doctor was.

It was the bereaved woman’s idea to have the militia leader’s clothes put on her dead step son and then have his face riddled with bullets, making it unrecognisable.

‘At least I have a burnt corpse to bury. When his father died we had no corpse’ she cried.

The rest of the patients on the ward acted like nothing happened

The Bush Doctor in the City was off to do a Locum.

6-07-07. 3.30pm. Arrived at the Surgery. Looked shut. Knocked on window as no one answered the door.

‘We do not need you. There are three Doctors here tonight’ the Practice manager said. I wondered if I had heard wrong. Could this be a wasted journey? I had left my diary at home so didn’t have the agency’s telephone number. We all groped in the darkness for a while till when in a flash of inspiration the Practice Manager checked the computer.

‘Oh. You are booked at the branch Surgery and the first three patients are waiting already’ she said

‘And where is this branch Surgery?’

‘Oh, just ten minutes down the road’ she said.

Thirty minutes later I pulled up in front of a health centre and wondered why someone was locking up.

‘Ah, you need the Surgery down the road’ he told me.

I was tired by the time I finally sat down in the consulting new. There is something about that chair though. It might be a strange room with a strange computer system and maybe even stranger receptionists, but one thing is certain.

Sit in that chair and you are in the mood.

Bush Doctor in the City. Vol 18

•July 6, 2007 • Leave a Comment

Bush Doctor in the City. Vol 18

The Bush Doctor was getting worried. His intuition, without which practicing medicine without the luxury of a fully equipped laboratory became an impossibility, was declining.His French volunteer Doctor had astonished everyone and settled in quickly. Too quickly. She was now having a passionate love affair with the leader of the local militia, whose almost presence at the hospital was becoming a cause for concern. However, he always brought with him valuable diesel and chocolates!The love birds would then disappear into the creeks for hours.The mother of the child with the Burkitt’s Lymphoma was now back. The response of the high grade tumour to chemotherapy in the city had been good but he now had intractable diarrhoea. As if that wasn’t enough, her step son who worked in construction somewhere in East African was back home ill. Doctors in the city thought it was HIV but he refused a blood test opting to see the witch Doctor who in turn referred him to the Bush Doctor. The poor mother was beside herself with worry.In between periods of staring at the walls smiling, the volunteer Doctor had developed a deep interest in the ill man from East Africa.The noise of singing brought everyone out to the front of the hospital. The Bush Doctor was surprised to find a large group of militia youths and two foreign men in tow. Their leader was passing and had come to drop a gift for his French lover.The Bush Nurse went berserk when he saw the captured white men; oil workers.The militia boys thought it funny.‘African European say make we no hostage oyinbo European. You still love am? I think this oyinbo na your ex. No bi Doctor be your new boyfriend?’ they teased.    The Bush Doctor signalled for the Militia leader to follow him. Once in his office, he begged for an end to these visits. People had started talking. ‘And what ever you do, don’t take this French Doctor hostage. They would say it was me who organised her abduction. Please’ he begged.The Militia leader suddenly broke own in tears. He was in love and would be eloping to France with his new love. They would be getting married. He had already saved $30,000. The Bush Doctor had an idea.‘I too, will be going to America for studies. Why not give me $10,000. I can transfer it to you in Paris when I am settled in the States’ he said tentatively.The militia leader took off his rucksack and counted the money out in clean bills in silence.‘You mother is a good woman. We eat at her place regularly up in the creeks’ said the Militia leader.‘Oh yes, she is so kind’ said the Bush Doctor. He mum had just become the collateral in this deal. Two hours later the volunteer Doctor was screamed excitedly while she sat with her eye over the microscope. She had been looking at the cerebro-spinal fluid she obtained from doing a lumbar puncture on the construction worker from Uganda.‘I have cracked it! Trypanosomiasis! Just like the French  hero Eugene Jamot!The Bush Doctor and his nurse both took turns looking at the parasites .‘This Eugene whatever. Who is he?’ asked the Bush Doctor.His French visitor looked at him as if she could not believe her ears. She motioned for him to drag a chair over.‘That man did so much for Africa. This may take some time’ she said. No such diagnosis for the Bush Doctor in the city. He hasn’t looked down a microscope in fifteen whole years. 4-7-07. MI a 40 year old man comes with rashes. ‘What do you think?’ he asks.‘Chicken Pox’ I offer.‘No. I had this 10 years ago. Was told it came from a bug in the carpet’ he says.‘And how was it treated?’ I asked‘Cream’ he says.‘Well it looks like Chicken Pox. But it may be Scabies. Here is some cream’ I said, struggling to maintain an air of confidence.In medicine, the customer is always right.                    5-7-07. 60 year old lady comes with a belly lump. Had been for Ultrasound scan which showed nothing. No surprise there as it was in her anterior abdominal wall.As she gets on the examination couch I notice how frail she has become.‘Lost any weight?’ I asked‘Yes. 2 stones’ she answers.Maybe hernia or maybe secondary deposit from her Beast Cancer (Did my thinking in my head as I didn’t want to cause sleepless nights on mere speculation). I dictated a letter to her Surgeon there and then.She asked for a repeat prescription of her Zopiclone which I printed off. She said good bye, made for the door and then turned back. ‘Is this tablet good for Cancer?’ she asked.‘No, it’s a sleeping tablet’ I replied. She looked horrified.‘Don’t tell me I have been taking the wrong tablets for Breast Cancer’ she said.I rushed to get her notes.‘You should be on Cyclophosphamide. You were given some 4 weeks ago in the hospital’ I said and printed out a new prescription..She rang an hour later.‘Found my tablets. They had fallen behind the sofa and I got mixed up. Thank you very much and God bless you’ she said.‘Amen’ I replied. I didn’t really do anything to deserve her thanks though. It was a good thing she asked that question.          ‘Is this tablet good for cancer?’ 

http://www.asnom.org/en/441_trypanosomiase.html

http://tmcr.usuhs.mil/tmcr/chapter41/clinical.htm

http://www.frtomskids.org/kidswithburkitts.htm

 
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