Bond of Affection

 

“The last segment of the functioning lung has cracked. We cannot reach the doctor now. I am afraid she is going to die.”

A staff member was explaining to the patients’ families who crowded the scene at the emergency room. They tried my line several times, but was unsuccessful. The patients’ families watched helplessly the lives of their loved ones slip away.

Clipped to the hoop of my trousers was an electronic message-receiving device. When I felt vibrations, I knew someone was trying to reach me. I groped round my side and pulled out the gadget.

I looked at the beeper’s screen. My heart beat aggressively. The information staff had sent a message as a last resort to circumventing the network failure.

Two patients were brought to the hospital few minutes after I arrived Kaduna, and were admitted to Cardiac Unit straightaway.

On returning home from academic sojourn abroad, sad news hit them unexpectedly. Their respiratory tracts and the blood circulation vessels had blocked.

On learning the situation, I recommended cardiopulmonary resuscitation should be administered to Laila, a girl in her twenties, who was in more critical condition than the boy. In this procedure of mouth-to-mouth breathing, the girl was laid face-up, her neck lifted and the head tilted as far back as possible to enhance enough passage of air into her stomach. Her nose was then nipped shut, a nurse’s mouth covered Laila’s tightly and the nurse gave four deep successive breaths.

I was dreaded when staff in the operation room (OR) called back to tell me that Laila’s breathing did not come back. I quickly pushed out my gadget from the bag and set up a webcam facility. Direct view of the OR popped up on my screen. As the condition persisted, even getting escalated, I suggested Laila be immediately wheeled to electrocardiography.

Instantly, she was taken to the machine. Everyone gazed at the screen, reading.  Our physicians were able to get the tracing of her heart electrical activity, the irregularities and disorders in her muscle, blood supply, and neural control.

Laila was having tight situation in her chest.

I told the staff to put her on a respirator. Some distressed couple of nurses frantically searched around Laila’ arms. No trace of her veins with which to slit the breathing tube into her trachea.

In the absence of veins, the tubing system was immediately connected to her nose and was quickly whisked to a mechanical ventilator. With only Laila’s head out, she was swallowed in the belly of the large cylinder apparatus. With an airtight seal, the ventilator forced air into her lungs to provide her lifesaving support.

I held my breath, watching the scene live on my screen. One hour, two hours, up to four hour’s period, the situation seemed unabated. The worst had happened; Laila stopped any movement. Her eyes fixed and diluted and showed no sign of neural function.

The other guy, Habib, although unconscious, showed some signs of hope.  As I could read from my mini screen, he was having fragile breathing. Despite the situation, both the victims’ parents were trading abuses.

           

 “I will file a lawsuit if my daughter dies.” The father exploded, vividly loved and cared for his only daughter. Enraged, he began divesting off his babbariga and rolled up his sleeve to engage the boy’s father.

 “Who is that your daughter?” The other man burst out angrily. “Can’t you see the damage she inflicts on my son? You will get to know who I am if my son dies.”

          

“Didn’t I warn you to stop your son from seeing my daughter?” As he just concluded, Laila’s father made a violent surge forward and nearly blew off the other Alhaji’s mouth.

The nurses intervened. As the two parties went on verbal assault, doing anything possible to save the lives of the patients and at the same time forestalling the worst that loomed ahead.

The couple fell in love during their school days in London. They struck a warmth relationship the first instance they met. When many couples have crisis over power and roles, fortunate enough, they have had a beautiful shot. They never argued, such terrible one. If they got married, there would be no discomfort and struggle.

I was frightened; chances of their recovery were very slim. I began debating ways to overcome the situation.

I did away with my struggles in minutes and asked my colleagues in the hospital to send me the patients’ medical records.

Shortly, my email blinked to life.  Radiologists sent in the results. Images on my computer screen. I began reading the cross-sectional images of their body formed through a computerized axial tomography.

In the previous years, researchers from across the world began a process of creating a new technology that would   alleviate the cost of time and distance between doctors and patients. This process involved the developing of three-dimensional imaging system in which surgeons could examine cases and conduct operation on patients – all in absentia -- from their computer workstations.

“We have 3-D glasses in our lab that allows physicians to stare into a small reflective display which then projects the image into space so that doctors could virtually see the inside body of the patient who is actually lying on the hospital bed on  another continent. The physician could move the image in space, rotate it or zoom it in order to see the different complex cross-section and the smallest details of the inner structure of human anatomy.” Dr. Solomon was explaining at a medical conference I attended lately.

When I communicated the procedure I was going to use, the grim faces inside the emergency room broke into joyous smiles. On second thought, I realized I could not do the operation. Power uncertain.

The communication staff advised that I should fly to the hospital. I checked my watch. I had less than twenty-five minutes in all, with all the delays and preparations, if only to get them alive.

I expressed doubts, I could not make it within the stipulated time. I didn’t have any booked flight and besides, all the flights bound for Kano had already gone. If I attempted buying a ticket for the next flight, the game would be over.

When the staff in the hospital communicated my fears to the patients’ families, realizing the danger of the situation, they stopped trading abuses.

Alhaji Dikko, the girl’s father, garnered enormous influence in Abuja. A power broker and kingmaker from northern aristocratic family, and a protégé to the successive regimes including to the incumbent.  

General Sada, the father of the son, was a former Army General who made it to the top thorough the rank and file. As ex-security adviser and a former defense minister, he still wielded control years after he left the service. He maintained his power by ensuring to install people who could command his order in every strategic foothole of the security cadre. The retired Army General was now a petrodollar oil magnet and always at the helm in government contract, military hardware and technology.

Their actions boasted of their influence. A simple phone call to the Presidential Villa and the Ship House, was enough. They sat, waiting, silent, in rumination. The whole process exuded power and command.

A jet from NDA Kaduna bound for the job was flown to deliver me to the airport in Kano. At airport, I would be connected with a driver who would just be arriving to whisk me down to the hospital.

I went headlong to the OR when I arrived. The guy was less severe and ordered to undergo coronary by-pass surgery. The Deputy Chair of the Cardiovascular Unit was to supervise the operation while I would be working on the girl that up till now didn’t even lift her finger.

The team of nurses, anesthesiologists and a host of other medical staff went on to perform the operation under the leadership of Dr. Zakariyya, a renowned cardiovascular physician who was leaving the hospital when the patients just arrived.

The guy was immediately prepped, anaesthetized and draped on the electronic operation table. The state-of-the-art invention was the new facility that few health institutions across the world were able to provide. It was invented by the graduating students from the Department of Computer Science and Medical Engineering in partnership with experts bioelectrical, biomechanical and biochemical engineers from Kano State University of Science and Technology. The invention was comprehensive and multifunctional. It doubled as operation table and by-pass surgery machine, coming along with a host other devices.

From one end of the table, an endotracheal tube was situated, stethoscope and two bulbs standing for red and green light. The beaming green light was the only consolation that gave us hope.

We have had two electronic operation tables placed opposite each other. I was simultaneously working on the girl and the boy. Although coronary by-pass surgery  become a well-known procedure in treating heart disease in medical circle, the complexities of the situation could give a headache to even most renowned physicians around the world. Thanks to the students for their invention. The machine had internet facility, webcam and camcorder that allowed communication while operation in progress. I transmitted pictures and live coverage of the procedure to my colleagues at the other end. New problems kept rising throughout the operation.

Anesthesiologists concentrated on their machine, hands cupped in cheeks, looking grim and serious, monitoring the patients’ health through wireless connection that fed their screen. Another flat screen hung from the far wall was streaming updates from a desk-lamp-like camera reclined downward to the operation table which was as well feeding another screen to the viewers in the waiting room. Patient’s families would not be so tense. The technology recorded all the processes and procedures which could be retrieved after the operation to prove against a lawsuit in the event of the death of a patient. Since we acquired it, the machine offered us fascinating ease in mentoring medical residents.

Laila had to undergo an open-heart surgery. A procedure that required the replacement of her damaged valves. The heart defects could be seen much better in this procedure in addition to the easier way of correcting congenital defects in her septum, and repairing of leakage in her mitral valve. We needed to put her cardiac arrest in order to avoid damaging her neurologically.

The couple was transferred to ICU after the operation. The guy had come back alive. The tension subsided but there were gloom and anxieties still in the air. The girl was yet to come back.  The only indication that she was alive was the green light. 

Some of the staff members gave up any hope. They recommended we should remove her off life-support. But I suggested we should give her one more chance, one more day, with a vague hope in my mind. When I told my colleagues this, they looked me in agreement but their eyes communicated something else.

When we came out, our staff briefed Laila’s father. I didn’t wait to hear the announcement of the end of the story. I cast one last glance to their side, dabbed my eyes and walked to my office. Buckled at the knees.

           

 “Alhaji,” my assistant was speaking, “we did everything we could to save her life. When she arrived hospital, she was already devastated.”

Alhaji was visible distressed for the loss of his only daughter.

“Dr. is there anything you can do now?” Her father asked pleadingly, desperate and depleted. His words carried the bearings in his heart.

“There is no any hope actually.”

“Please Dr. any slightest chance?” He entreated again already feeling weak.

Three days, Laila did not come back. Let’s give her one more chance, I always entreated my colleagues. Until we reached one week. She did not come back.

Finally, I threw in the towel, to ease the buckles, fastens and drapings off her, to die with dignity. My eyes moistened by the sight of the ICU. Weakly, I sauntered through. There were tears and wailing and weeping in the room.

My fingers trembled as I moved them to the tubes. When I grabbed the connections, Laila’s chest gave a light move and exhaled casually. Instantly, the weeping and wailing were replaced with spontaneous joys.

Later in the day, the boy came to see Laila despite his fragile condition. That was when it hit me Laila and Habib were deeply connected biologically.

The tension ahead was hardening, neither of the parents was willing to make concession. All entreaties failed to reconcile them.

What my assistant told me after his briefings with the parents accentuated their determination.

“I swear by God,” they each determined firmly and conclusively, “if they will all die I won’t allow their relation to continue.” 

I knew I had gotten to do something to the historical vendetta between farmers and herdsmen. I organized a meeting with the parents in my office and briefed them about the threat they posed to the health of their children.

           

“Your children are still suffering from other diseases. We need to transplant their organs. We allowed them to recuperate before we begin the kidney surgery.”

They were frightened. Their fears summed up in the awkward silence that descended the room, so clean and clear.

“Your organs are needed.”

           

 “Dr, would there be any hope they could live again?” They chorused, full of expectation. 

We went to the lab directly from my office for medical examination. Moments later, we headed to the operation room.

They were draped, the team of surgeons hovering over them. We navigated through their hearts using microscope to detect the valves we believed to be poisoned by hostile hormone. We excised the dirty tissues and replaced them with the good ones from their children. We then sifted through their bloodstream and removed a mass tissue of endocrinal poison off them.

We then moved up to their brains and opened the portion that was responsible for feeling, worked on it and detected a growing hostility tumor. The operation was timely; they were nearing a level where they could kill each other without compunction. We stitched up the skulls and dropped the last flap successfully.