Resuming into the department of Medicine, I knew I had twelve weeks of hard work, moving stuff and watching people die or at least taking a long time to recover if they ever did. I also knew i was to share the twelve weeks between two units.
Dear God, please not neurology.
This was not a prayer born out of knowledge. I did not yet know what units were tough and full of work. I did not yet know which units had ‘interesting’ consultants. Those ones we all just prayed not to have close contact with. I did not yet know which units had the weird schedules that had everyone sleeping in the hospital or the interesting rituals that had to be done to keep the unit running.
But I knew my ignorance. I knew I did not know nada in Neurology. Or the things I may have known would not be enough to uphold my shine as an Ibadan product.
So, when I was told I’d be starting with Pulmonology, imagine the joy and ecstacy!!!
What could they bring in that unit that I would be clueless about? Asthma? TB? Lung cancer? Pleural effusion? Come on, what do you take me for? Bring it on!
I took the first day to find out how many patients were in the unit and know their locations. Second day, we had a ward round.
But before the second day was over, I got the shocker of my life.
“Dr. Eunice, you’d be moving to neurology tomorrow.”
Somebody call 911!
There was no negotiating or contesting it. It was an order from above.
Before I left work that day, I was already hearing about the numerous patients in the unit, the consultant that would take hours on his round and move stuff and move stuff.
It was sealed, I was either going to go and disgrace my village or some miracle would happen to stop the impending transfer, all depending on my Saint Obi.
Fourteen patients. Well, we were like four houseofficers, not too much for us to handle.
There were two consultants and the way things worked, one consultant was in charge for one week while the other was in charge for the next. I found myself resuming in the week meant for the ‘stuff moving’ consultant.
I think I need to explain something here.
Both consultants moved stuff. Both of them knew their neurology. Both of them could give spot diagnosis. However, one of them could spend two hours on one patient, moving from one differential diagnosis to the other, explaining symptoms and signs based on MRI findings and why, talking about prognosis and outcomes and in between, urging us all not to end up as ‘typhoid and malaria doctors’.
By the way, most of us were trained with the ideology of hierarchy in answering questions. That is, the consultant usually starts asking questions from the medical students (if available), on to the Houseofficers, then registrars and senior registrars. Once your level is left behind, you have no right to speak again even if you know the answer.
Not so with this consultant. He starts with and continues with anyone and expects you to answer.
This was what me I did not want. I mean, I already said I’m not knowing neurology stuff. You’re now robbing me of the immunity of hiding behind my seniors. ???
Ladies and gentlemen, surprisingly, I started answering questions as if they were meant for me ever since. The one that surprised even me was when I could identify the aqueduct of sylvius on MRI. (I am sure some of my doctor colleagues would be thinking what’s the big deal in that. Well, for me, it was). Of course, I had first started with “I don’t know, sir” but the consultant urged me to look again. I then said, “I’m not sure, sir”.
When I finally said it and found out I was right, it reminded me of my oral exam in my part 2 medical exam. One of the external examiners said, “young lady, you really need to learn to push yourself more. You know these things but you give up easily.”
Lol, I thought I had changed.
Anyway, in my seven weeks of neurology, I actually learnt a lot.
1. As much as possible, hear from the horses’ mouth first before making your conclusions. The fear of the consultant had been put in me before getting to the unit. I got there and found out, this doctor is actually a cool one.
2. If you don’t know much or anything about something (good and valuable) and you are presented with the opportunity to know, don’t shy away from it. Don’t let your fear of being exposed stop you from getting exposure. (I think I have a future in motivational speaking?).
3. Try not to shoot yourself down even before the war begins.
4. When you’re doing well, take heed. Else, that is when you’d be talking about ptosis in Bell’s palsy. ?♀️
This one pained me sha. How could I have done such a mistake?
5. In all thine doings, put in your best. The world may not always appreciate this but you’d be able to tell yourself you did your best.
6. Work on your people skills. It makes a lot of difference in the world.
7. Every consultant that thinks you’ve done well will want you to specialize in that same field????
(Honestly, I am not sure if they have not won me over. I mean, consultant neurologist doesn’t sound so bad you know.??)
With all of the above, it would be safe to say I enjoyed my posting in the neurology unit.
There were other things.
1. It was during this posting I saw terrible things. Young people coming with strokes. People coming in after spending a lot of money elsewhere being treated for Malaria and God knows what when they had actually had strokes.
2. People not having money for neuroimaging, thus, making all care based on assumptions and best guesses.
3. People having to travel to Lagos or Ibadan to get neuroimaging done and then traveling back to Abeokuta… On these our terrible roads????
Healthcare in Nigeria needs help… Preventive and curative wise.
4. In the moving of stuff and learning of all sorts, there were days we just had to sleep in the hospital, without being on call. By the time we were done seeing patients, writing pre consultant round summaries and updating patients charts, there was no point attempting to go home again. And we picked up again the next day.
5. The way things are, if one dies as a medical personnel in Nigeria, sometimes, the best that can be done in honor of you is a black armband worn by the others still alive. We could not even declare an all black. We could not even uphold the no surgeries for the day/week. We could not even be sincere about the failures in the system.
Work just goes on.
I still don’t know much about neurology. But, at least now, I won’t be praying against it again.
It took some of my weight and time, energy and health. But it sure gave back more.