Readjusting to medical practice in America

I write these words in a bit of a mental fog. Lying in my own bed in the early morning stillness, I unable to say with any degree of certainty whether our recent 16-day medical mission to Africa was a conjurer’s dream, or if this American life with its mundane worries and cares might actually be the illusion.

Yesterday, belatedly I flipped the page of the calendar that hangs on my bedroom closet door. The month of August bears a reproduction of Gauguin’s “Dog Before Straw-Covered Huts, 1892.” Although Gauguin painted in Tahiti, this scene could well be African; the colors certainly are. In any case the Gauguin print offers a magical window to the events of the past two weeks.

I am still on Nigerian time, five hours ahead of schedule. I become sleepy at 4 o’clock in the afternoon. Last night I forced myself to stay awake until 9:00 PM, then slept soundly until 2:30 AM. Shortly, I drifted back to sleep until 4:00 AM, when agitated, I arose, unable to endure the confines of the bed any longer.

Yesterday at the office I saw 18 patients, a mere pittance compared to the usual daily roster of 75 to 90 in Obudu and Ogoja. Yesterday my American patients came to me with their slates of worries and anxieties, for which I silently forgave each one of them on the spot, because they had no understanding, really no concept of what it means to face suffering truly every day without hope.

The one exception was the father whose young son failed his routine vision screening in the right eye. Instead of the usual red reflex, a grayish white pupil greeted my light. Over the course of the past two years this man’s wife had been diagnosed with breast cancer and his daughter developed insulin-dependent diabetes. I referred the boy to an ophthalmologist for further evaluation. This family has suffered much, and there will be more suffering to come; but at the very least there will be treatment available and the means to access it.

As yet I have not left Nigeria in my mind. I am still haunted by the faces of the suffering children I saw, children for whom I could do little from a medical standpoint. As a clinician practicing in the African bush, I could not cure dislocated hips, disfiguring keloid scars, congenital hernias the size of eggplants, hemolytic anemias, and scarred corneas. Moreover, my Nigerian patients didn’t have the resources to travel 5 hours to the nearest university hospital, let alone bear the cost of care. (In Nigeria, medical care must be paid for out-of-pocket prior to treatment.)

Although I have left Nigeria, Nigeria has not left me. She is like a child crying in the night, waiting to be comforted; rooting for a mother’s breast nowhere to be found.


One comment on “Readjusting to medical practice in America

  1. td says:

    Beautiful imagery, illustrated by a “linguistics” master ….

    “Perception is Reality, yet seldom the Truth”.

    “To Live is to Suffer”.

    Brian, you’ve described the Human condition, born Melania ago; and suffered collectively every day through generations of our species.

    Thanks for selflessly sharing your gifts (and life) with the rest of us … and courageously helping the least among us …

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