I have witnessed many deaths in my journey so far in the medical career. Right from my days as a medical student to my one year housejob at one of the federal medical centres. House job can be both exciting and frustrating. For some of us, it is our first chance to actually do things with our hands, from simple sutures to assisting at surgeries and even being allowed to carry out some minor procedures on our own.
If you are ‘lucky’ enough to be in a place where you are like the next doctor in line after a resident doctor, it means you learn faster and probably burn out more. There is really nothing like the job being passed down or across other medical officers or house officers before it gets to you. It is a preparatory ground for what lies ahead during service year which comes after house job. If you are ‘unlucky’ to be posted to a tertiary hospital where there are about 15 resident doctors and over ten other house officers with you in the unit, you may end up not doing much except errand jobs. And still burn out. That is very frustrating.
I had promised myself while in medical school to ensure that second scenario never happened to me. If I was going to burn out, I was going to do so knowing I was learning and improving on myself at the same time.
The first death to really hit me was during my service year at Kano. She was the daughter of my landlord then. A beautiful 18year old with dreams of becoming an only wife. It really was a difficult thing to be the only wife of a Hausa man, a feat none of the young girls thought possible. She believed it was though, telling me how she planned on dominating in her husband’s house and ensuring the thought of a second wife never crossed his mind. I remember trying to make her dream of getting a proper education, becoming a professional in a career apart from wifehood. She often just laughed and asked me, “what difference does it make?” I wished I could have explained but there were times I also asked myself the same question.
I was at my desk at the hospital when she was rushed in, she had been hit by a truck. I was not sure I understood the story behind why she was just being brought to the hospital, more than 2hours after the accident. She was unconscious, with a deep gash on her forehead and a wound to the lower right of her back.
“How did she get this?” I was pointing to the wound at her back.
Apparently, a pothole on the road had been filled recently with sand, which unfortunately had some glass in it. The hit from the truck threw her backwards where she landed on one of the pieces.
I knew I could try suturing the gash on her forehead but that was the least of her troubles. I had put her on supplemental oxygen, sited an intravenous line to give her fluids but she needed blood. Urgently. I also was not sure if her right kidney had been spared or hit by the glass. The urine bag was not empty but what was in it was not encouraging, despite the fluids we had given her fast. We needed to transfuse her. There was definitely no blood bank nearby and the people in her community were not keen on donating blood.
It was sad losing her. And I blamed myself even months after.
I had witnessed many others after that but I had come to take them in stride. Part of the training is to not let one death make you cause another death. Do not kill the next patient and do not kill yourself.
So, I thought I would shake off Mr. Badmus’ death just like the others. I did not.
I kept playing back every moment from when he was brought in to when he died. Something was wrong and I did not know what. It just did not seem like ‘every other death’.
Back at home the day he died, I spoke with my husband about it. Thankfully, he is not a doctor. I had to stop trying to analyse it all on my own. He told me to let it go, get proper food and rest and it would pass, just like the others. He teased me about the weird horror movies I had been watching lately.
“Maybe that’s why you think there is more to this man’s death than meets the eye. Go back to watching animations. Those seem safer…”
Maybe he was right.
A week after, I was working in the accident and emergency unit. I heard the usual commotion at the entrance signifying a new casualty. After the years spent in hospital environments, I had gotten to that point where I did not bother wondering what the case could be till it got in. Years before, I would have rushed to the door, asking questions, trying to be the first hero, wanting to be the one to spot the main problem to be tackled first. It was not that I did not care anymore, I guess there were just new and younger doctors taking up the role.
I walked to the resuscitation room and was hit by deja vu.
“She is an 18year old, 100level student of the polytechnic who was involved in a pedestrian-motor vehicle crash about two hours ago…”
The initial resuscitation was done and blood sample had been taken for packed cell volume and grouping and cross matching for blood. I moved closer to the bed; dark, smooth skin, hair looked newly relaxed, fingernails were painted black and looked well kept. And the face…
It felt like I was seeing that Hausa girl again, like she was right before me, about to die the second time. I needed air.
Stepping out to the nurses’ station, I held on to the back of the closest chair I could get my hands on. I was sweating and my palms felt very sticky. There was a standing fan working close by but I could barely feel its effect on me. I pulled off my wardcoat as it seemed air was being sucked out from where I was. I could hear my heart beating very fast and my breathing was too fast to be normal. My head was aching seriously as I tried to recall if I had breakfast that morning or not. I was feeling very dizzy and I could hear one of the nurses calling my name.
“Dr. Mina, Dr. Mina!! Attendant, get one of the other doctors here now!”
She came to where I was and held me by the waist, guiding me to a cushioned seat in the call room. She unbuttoned my shirt and removed my shoes.
“Are you okay ma? Can you hear me?”
I could hear her, like a distant whisper and even though I recognised the voice, I could not see her face clearly. Everything looked blurry.
“I’m… I’m… Fine, I think… Please can you put on the light?”
She was quiet for a while before answering, “it is on ma…”
The room was getting darker and I could not hear her again. Just before I blanked out totally, I saw him smiling and beckoning at me.