THE UNPLEASANT SURPRISE

I paced through the wards frantically trying to adapt to the new ballgame at hand. In this case, I was no longer that medical student jumping from one patient to the other, but the doctor to whom a patient’s life would be entrusted to. As usual my white lab coat was neatly ironed. Did I say as usual? I mean it’s because it’s the first day. With your first day at work, impressions matter. I smiled to every patient as I was being introduced to them, intently taking notes.

To my right was the Senior Resident of the team; dictating our schedules for the week, and to my left, were my colleagues who were co- house officers, Dr. Akpaloo and Dr. Adu Poku. The work seemed to submerge us because we did not know what to do a particular time. Belinda would ask, “When are we taking blood samples?”, “Where are we retrieving the patient’s labs from?”, “Which drugs are covered by the Health Insurance?”, “Should I wait for the relatives to come over so I discuss the prognosis or should I call them over the phone?” The work was a lot but we knew we would definitely come through. It was all a matter of time.

Making things worse, we met the lead clinician and team head who taunted us with a few of the medical school questions. “What are the complications of a thyroidectomy?”, “For clean cases and contaminated cases, which one would you operate first and why?”. The why part thrust me into dandelions of wonder because I knew this was common sense. You obviously bath your face first before your feet but I couldn’t look askance. I was as cool as a cold cucumber. I tried so hard to rhyme.

The patients on the ward had cases ranging from appendicitis through hemorrhoids to gastric and rectal malignancies. There were lots of distended abdomens which rendered the wards not a pleasing sight to behold. I then thought to myself “These were all ‘normal’ people. What could have possibly gone wrong? This situation would not last forever.”

I came to work the next day, noticing two empty beds which were occupied the previous day. Empty beds signaled good news. The patient has been discharged. The question then would be discharged where? Home? Or the other side of town? In that sense, Doctors tried all they could but the patient just couldn’t survive. It was just their time.

The first patient on the male ward I encountered was a 36 year old man diagnosed with rectal carcinoma a year ago. I used carcinoma? I mean cancer. He was “in his usual state of health” until he noticed a bulge emerge in his perineum as he passed stools. Making things worse, He also noticed his faeces were stained with bright red blood.

These red lights brought him to the hospital in a swift. He looked so energetic and well at that time. He was just a worried man concerned about his health. Laboratory investigations confirmed he had a rectal carcinoma in situ.

Rectal carcinoma in situ means the cancer was just in the bud. Just like a caterpillar growing in a cocoon. Being in its early stages indicated the cancer had not grown beyond the inner layer of the rectum.

Chest X- rays and CT scans excluded the possibility of metastasis (spread of the cancer). Risk factors for rectal cancer include old age, drinking three or more alcoholic drinks per day, smoking cigarettes, and being obese. However his risk factor could not be determined. He was just 36 years, had a health weight, had never smoked cigarettes nor drank alcohol. It was idiopathic.

Then he began to lose weight. The scare. His workplace was thrown into a frenzy. Everyone thought he had AIDS because he kept wasting. He had his own shop where he sold and repaired computers and according to his friends, he was so good at it but they were bad at sympathizing with him.  At this rate, He could not wear his clothes any longer and continued to spew out anything he ate.

He was brought to the emergency department one day when he suddenly lost consciousness on his way to work. All his laboratory values checked were deranged. Notably, was his hemoglobin level which was 1.7g/dl. Normal ranges are 13.0 -18.0 g/dl. He had bled out.

He was given 8 units of blood and further tests revealed the cancer had spread to a large area of his large intestine. His forebodings were now justified and he cringed on the bed, weeping like a baby. Why him? At this crucial stage of his life? He was just married 6 months ago to a beautiful lady and there was no way he was starting life this way.

He was counselled for surgery to limit the spread of the cancer. The surgery involved resection (removal) of the part of the large intestine affected, together with the rectum. In order for this to be possible, a permanent colostomy had to be done.

A permanent colostomy meant the healthy end of the large intestine had to be brought to his abdomen, creating a channel for the passage of feces on his skin. This was heavy news! But that was the only feasible way to save his life. It took 3 days with the clinical psychologist before He budged on his decision. “The rapture that was associated with being alive, was what mattered.” His wife told him.

He had his surgery done and started chemotherapy a week afterwards. This was the state I had met him – A week after his first shot of chemotherapy. He always lay in bed because he did not have the strength to get up and walk. Amazingly, his wife never left his side despite the state he was in. He had all the love and support he needed. He was aware of his prognosis and he gave up most of the time, but his wife always stood by him when he faltered.

A week after the surgery, He was rushed back to the operating theatre because the surgical intervention failed. It took a lot of steady hands which worked tirelessly, quick feet which rushed for blood, and a miracle before He made it out of the operating room alive.

Fast forward to 4 weeks later in the consulting room, I can’t help but stare at a young man taking strides confidently into the room. I couldn’t hide my joy. “Kweku!! You look good!” Surprisingly,  He had no complaints just a headache which resolved upon taking a tablet of paracetamol in the morning. He smiled and said a big thank you to the team for saving his life, and left the consulting room exactly as He came.

Grace has the power to give beauty for ashes, strength for fear, gladness for mourning and peace for despair.  It is true tough times never last but tough people do. Two men may have the same affliction but to one it shall be as gall and wormwood, yet it shall be wine and honey to another. So hold on!

God has a thousand ways to turn your situation around that you’ve never even thought of. Just because you don’t see a way doesn’t mean God doesn’t have a way – Joel Osteen

Thanks for reading.

Eliezer

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