Doc recalls his encounter with a strong-willed cancer patient

The cancer patient complained of abdominal pains, which made her survival difficult. PHOTO|FILE

What you need to know:

  • Upon arrival, the patient received a warm welcome from nurses, doctors and whoever was around.
  • As a junior doctor, I approached her for history taking. I was well equipped with all medical gadgets. Soon after a lengthy conversation, she handed in her important documents to me.

It was in the wee hours one day, before hospital routines in the wards kicked off at the medical centre I was interning at, a 19-year-old lady was brought in, accompanied by her father. This was about two years ago.

Upon arrival, the patient received a warm welcome from nurses, doctors and whoever was around.

As a junior doctor, I approached her for history taking. I was well equipped with all medical gadgets. Soon after a lengthy conversation, she handed in her important documents to me.

She was already a known patient diagnosed with ‘Leukaemia,’ a cancer that affects blood and the bone marrow. In a doctors’ language, the disease is known as ALL, which stands for ‘Acute Lymphoblastic Leukaemia.’ Tough words, though even tougher is the condition.

I was captivated by the way she was so well versed about her condition and the way she thoughtfully explained her problems to me. It was as if she was teaching me about leukaemia.

After getting her medical reports from the laboratory, I presented the findings to my senior doctors and the patient was put on treatment immediately after other lab results came out.

But my eyes remained glued on her hands. She was severely pale—doctors call it, ‘severe palmar pallor.’ When I looked at her lab results, her haemoglobin level was at 4. She was severely anaemic and that meant that she needed blood. Her father was the first to donate.

But the young cancer patient remained optimistic, despite her condition was scary. She had slim chances of survival. I guess she had strong faith in the medical team.

On the next day, before she had her breakfast, her father arrived.

After we exchanged greetings, he asked, “Doctor, when will my daughter be transfused with blood? I remember to have donated my blood!” But one nurse who was in the vicinity interrupted, “We will check with the blood bank people today.”

But the father kept posing questions. He asked “How is my daughter keeping today?”

Before his question found an answer, a voice from her daughter interrupted, “Daddy, today I am doing better than yesterday.” As a doctor, her response meant a certain thing to me.

You see, it was not strange that she was so pale and severely anaemic. Mind you, leukaemia destroys the tissues where red blood cells are made—so, the patient becomes natually anaemic.

After all this, some sort of a love story ensued. The young lady spoke highly of me—day by day. Whenever she experienced any pain, we could hear her voice, though in agony.

She would yell, “Doctor! Doctor! At times she would say in Swahili, “Niitie daktari wangu.” (Call for me my doctor).

Of course I wholeheartedly took care of her; she also reciprocated by being appreciative of my service in the full view of the medical staff.

Some of my colleagues thought that I had fallen in love with the beautiful, insightful and intelligent lady that she was—perhaps they were wrong!

I didn’t know why they came to think so because our faces didn’t even communicate romance; we often stared at each other; enthusiastically and compassionately—a day never went by without seeing her off and giving her words of encouragement and reassurance.

My service to her was first-rate. I had to, because she was the most serious patient in the ward. At times she looked stable and she could ask me, “Dokta nitapona kweli?” (Doctor, am I going to recover?). However, life moved on.

One day I replied, “All is well and you will be well as you keep your focus squarely in having faith and in God.” And since I knew she was a Catholic, I brought her a rosary.

Then another issue made my life hectic. Despite being so concerned about the patient, I was at one point pissed off by the to-and-fro movements to the blood bank.

It was an arduous task, since the patient belonged to group O- negative. You know, when you belong to this blood group, your blood can be given to any one else, they call you “a universal donor” but you can only receive blood from your fellow group ‘O-negative’. Bad enough, the blood group (o-negative) was seldom available at our hospital.

On the third day, as usual, doctors were carrying out what we call ward rounds—seeing patients from bed to bed.

The ailing lady was complaining of abdominal pains when the team arrived at her bedside. Doctors decided that an Ultra Sound test be done on her abdomen. She continued to complain of abdominal pain.

Doctors wanted to establish what was causing the pain. But, alas! Fate arrived!

No sooner did the results of her ultra sound arrived, it was too late and she took her last breath.

We later realised that she had died of anther condition—appendicitis. This is a condition that results from the swelling of one of the body organs called the appendix. In fact, it killed her “silently.”

On seeing this scenario, tears flooded my eyes. I could not stand the emotional pain but, ethics call me to just remain empathetic—not to go beyond. But it was not easy.

When I met her relatives I just uttered the words, “poleni sana”, I said that twice.

Who breaks the news to relatives?

I was also hesitant to break the news owing to the sympathetic and empathetic connection to that family. When her father arrived, he found an undefined gloomy atmosphere. Then, his eyes stumbled on his daughter—not breathing!

He became “furious”. “I want to know how my daughter died,” he fumed.

“What made her die whilst I donated blood for her?” he further asked. “I want clear explanations”.

A senior resident doctor, who is always humble, stormed the ward. He explained to him and responded to all he asked but the father insisted the daughter died of anaemia. He was insistent on why the daughter died while he had donated blood.

He threatened to smash the doctor who was trying to explain to him. The doctor couldn’t fight back—it’s unethical.

Since the father held me in high esteem, I decided to intervene.

I explained to him how difficult it was to rescue her daughter’s life. He understood me in no time and he thanked me for the service that I offered to her daughter.

Then, I came to realise that what actually made him calm down again were not my explanations per se. It was the trust he had built in me as I attended her daughter in the due process.

The author is medical doctor, young scientist and a researcher.