The evening was calm, like most Saturdays. That was until a loud scream swept across the ward, bringing to attention the surrounding low-toned voices in mourning. “So you have gone like this? What am I going to with my life now?”, the husband of the recent bereaved woman cried out. All this was going on outside the ward where his beloved wife spent her last days. Suddenly, his tone changed to
something different, a mix of anger and disappointment. This happened as the doctor was making his way out of the ward. “You people have killed my wife! She was fine when I left her this morning! You people have killed her for me oo!”. The doctor kept walking on, walked past the mourning crowd, quietly and soberly, and soon he was out of sight.
As he walked back to his house, he was so saddened in his heart. Someone shouted “Dr. Mark!” from a distance and he slowly gave a tired-looking wave. What in the world had just happened? He kept replaying the events of the day in his head. It was his fifth month as a medical doctor, he was currently working at a federal hospital. He was scheduled for call duty for most of Saturday. Arriving early in the morning, he quickly did his rounds. All the patients in the ward he was assigned to were stable, including Mrs O, a 38-yr old being managed for chronic kidney failure. Everything was looking calm, so he went to rest for a while.
Not long after, a nurse called him. Apparently Mrs O was breathing faster than usual, and it concerned her. He quickly came to examine her. Few minutes later he confirmed that she had pulmonary oedema, or a ‘wet lung’. The fluid in her lungs was making it hard for her to breathe. He immediately started giving drugs to clear the fluid and went to make immediate provision for her dialysis (for my non-medical readers, a dialysis machine basically does what a normal kidney is meant to do, and she needed it urgently to help remove the fluid in her lungs). He got to the dialysis room, the hospital only had two, one was currently undergoing maintenance (it got spoilt 3 months ago, and they just assigned someone to fix it two days ago) and the other one was in use. The head nurse said the most shocking thing. “Your patient wasn’t registered for dialysis today o, so she can’t use it”. He kept explaining that it was an emergency, that if she didn’t have the dialysis she would die, nurse still held her stand. He called his superiors, “if that’s what the nurse said then there’s nothing we can do”. NOTHING WE CAN DO?!! He ran back to his patient, the drugs weren’t helping much, she was coughing, had developed chest pain and was gasping for air. He changed medication, still not much improvement. She was doing down really fast, and dialysis was the most assured way to help her. He immediately contacted the ambulance service to arrange for her to be taken to another centre for dialysis. Guess what? The driver on duty went to buy fuel as there was none in the bus, and was still on the queue.
Mrs O. deteriorated really fast, and at 3pm she had gotten so much worse. He kept giving drugs that he knew were not going to help. He had never felt so powerless in his life. Unfortunately she passed around 6pm, the first patient he managed that died. The sadness he felt was indescribable. He managed to maintain his composure to tell the family, but as he walked away tears just started to slowly fall. This was a day he wished he could forget.
A number of Nigerians have the misconception that Nigerian doctors generally are not good, and many who can afford it are flocking to other countries in search of treatment because of this distrust. I’m not saying that there aren’t a few bad eggs here and there, but I promise you this: a lot of Nigerian doctors know their onions. After the intense medical school training they come out filled to their hair strands with knowledge. These doctors now enter into a health system that is not working, and are expected to perform miracles. If doctors here truly were bad, how come they always excel when they go to a country with a competent health system? Granted, mistakes could be a doctor’s fault, but so many more people die needless deaths which could have been prevented if things were working the way they should. No matter how amazing a doctor is, they can be crippled by a defective healthcare system. This is the more pressing issue at hand.
So, help me to judge here. Who might have inadvertently killed Mrs O in this case? The young doctor, or the system?