Ilorin, Nigeria
17th October
I DIDN’T GET enough sleep last night so I contemplated making myself a cup of coffee before heading to the hospital. Coffee doesn’t mix well with the antidepressants I’m on; it can make me very agitated, but I still needed to perk up a little. I was cutting it close by waking up at half past six for Morning Review in the Internal Medicine department by 8 a.m. The Academic Staff Union of Universities (ASUU) had just called off their eight-month strike, and today was their official first day back. We hadn’t yet been informed of the faculty’s decision regarding the final year’s calendar. My days here are numbered, but I needed to see the certainty in print.
As in many departments in core clinical specialties, the number of consultants and other senior members is in decline, and the empty chairs in the Morning Review this morning were a testament to the japa wave rocking the nation. I made it here early enough to understand what the presenter was saying. He’d been unable to answer some of the questions he’d received regarding the management of his team’s patients, so his senior registrar helped him out. All in all, quite uneventful. Nine a.m. and still no calendar out.
I am rotating through Pulmonology/Infectious Disease for my senior medicine posting, and the activity today was Lentiviral Clinic. As much as I enjoy the teaching of our unit consultant, especially during clinics—he goes the extra step of teaching us ethics, the need for documentation and communication—I needed to get some procedures signed in my logbook so I headed toward the endoscopy suite. Thankfully, my friend (who is also named Maryam) was with me so it was less of a hassle. Until I realised I needed a pair of scrubs in order to be allowed into the suite. I begged the unit nurses for help. And my incessant pleading pierced through and one of them got someone to bring me out a clean though oversized pair.
The Senior Registrar in Gastroenterology, the unit in charge of endoscopy, was just scoping the first patient when I finished changing. He was also rattling on about the indications for the procedure, the process, and the need for anaesthesia in some patients to reduce gagging and discomfort. The suite was packed full of students, most of them from other units, like me, who’d come to observe the procedure, so many that the AC was working overtime to disperse the hot air in the room, and the assisting nurse was growing more uncomfortable by the minute.
After the second patient had been wheeled out, we were dismissed and our logbooks signed. Time to go to the clinic I’d avoided earlier on.
The University’s new Vice Chancellor was visiting the College of Health Sciences today. I’d missed his entourage, but the unit consultant gave us the day off in honour of the celebration. Not about to waste the opportunity, I looked down the list of my unsigned procedures and decided to head for the Renal Care Center, so that I could observe and get hemodialysis signed.
While waiting for the Renal Care nurses to let us in, I got a notification and immediately clicked, hoping it was the new calendar. No such luck, just another work email to shelve for later. After waving us in, one of the nurses took us through the five-bed facility. There were two patients getting dialysis, and I let my mind wander thinking about how much this session must have cost them and their families.
“A jugular tunneling access route could often go as high as N170,000 for the first few sessions, and N27000 per session subsequently,” said the nurse, interrupting my thoughts.
A colleague beside me sighed, and I knew she was thinking of the cost implications on the patients too.
“Ideally, they should have at least two sessions per week, but the cost of it makes people sometimes stick to a session per week, or alternate weeks in some cases,” the nurse continued.
She went on to explain the constituents of dialysate, the signs of some kidney conditions, and indications for dialysis. After getting my logbook signed, I decided to join another clinic, a neurology clinic, which went on for longer than I had hoped. There had been public holidays for the past two Mondays—one for the celebration of the country’s independence, and the second for an Islamic holiday, so the number of patients here for follow-up had tripled. After taking a break to go pray and get lunch, I contemplated going home but decided to stick it out, since neurology gets a lot of the most interesting cases, and there’s a lot of learning to be had.
My coffee + antidepressants combo was working so wonderfully well that at 4:40 p.m. as I was heading back home, I felt restless enough to not want to go back to my apartment. I texted a friend I hadn’t seen in almost three months, and invited myself over to his place.
“Sure thing. You are always welcome,” his text read back.
Another mutual friend was at his place as well, and we spent the rest of the evening catching up and swapping stories. While having dinner and relaxing with a movie, I marveled at how productive and relaxing this Monday had been.
As my friend dropped me home afterwards, I recalled my earlier mail and realized it was going to be a long night. I had edits to get back to… and the calendar was still not out.
