Graduation Aftermath, and Related Sentiments

I am no longer a medical student! Wait, that came out wrong. Being a medic is a lifetime commitment to being a medical student. It also has the potential to be a life sentence for an unfortunate some.

What I mean to say is this- I am no longer in medical school. That is because I finally graduated! Yes, I did. First, there was the formal school ceremony. Then came the more colourful one. It was held at the ‘grass-roots’, with friends and the extended family in attendance. There was song and dance, plenty of rice, some spare goat ribs and some gifts in form of money (which I was told is fare for the much dreaded job searching activity popularly christened as tarmacking.)

Thankfully, I haven’t needed to tarmac yet. However, the ephemeral joy of having survived five long years of medical school drudgery and triumphing in the end is fast wearing off. As the dust and confetti settle, the magnitude of new adulthood responsibilities and those of facing the world as a young doctor become real with each passing day.

On a related note, I recently stumbled upon a scene in a documentary.  A wild duck, in a bid to evade predators, had perched high up an ocean facing cliff to lay her eggs. They soon hatched adding a brood of four beautiful ducklings into her new domicile. As the young ones rapidly grew, space in the lofty nest became increasingly scarce. They also got hungrier, and bringing up food from the sea became more tasking for mother duck.

She needed to come up with quick a solution to the growing problem. The ducklings were still small, weak and wingless. She intended to cajole them into plummeting, nearly forty meters down the hard face of the cliff, to a new home on the rocky beach below. The baby ducks were totally petrified of looking beyond their warm and dangerously elevated nest, yet their mother’s resolve was firm. So one cool morning, after some warm regurgitated breakfast, mother duck started moving house.

She overwhelmed their fears and stubborn resistance by gently pushing them over the nest’s embankment. One after the other they half stumbled half hurtled down, bouncing off at skull crushing speeds against the unyielding rocky cliff’s face and quacking helplessly, towards the uncertain rough landing below.

I related with the ducklings’ plight. Joining graduate medical school was, perhaps, the birth of my career as a doctor and my five years there was my period of incubation. All that came with immense growth. Graduation was just a symbolic termination of life in the nest, ushering in a new stage of life in the wild. The transition and feelings of uncertainty about the future are that treacherous free fall. Change can be head-spinning!

Suffice to say, all the four ducklings survived the fall. They got to the beach where there was more food and space to grow. They learnt to survive in the wild and adapted. They thrived.

I suppose it is natural and okay to fear uncertainty. It is better to embrace it and work with it. Change can be challenging to process, but the associated growth is always good.

With this revelation in mind, I look forward to whatever is in store for me.


On Love, a Book and Intuition

I just laid my hands on this book, A Guide for the Advanced Soul by Susan Hayward. It is a collection of quotes from an array of thinkers, titans in varied fields, writing included, who made statements so profound that they are collectively worth the book’s title.

The copy I have is a strange looking, little, hard-covered text, red in color, with a biblical consistency and that pleasant musk of aging paper. It was bestowed upon me by my girlfriend, who of late has had the pleasant sense to whet my insatiable appetite for sensible literature and all things deep and timeless.

On the first pages are instructions on how to use this book. The author notes that one should first meditate deeply on an issue they have or a decision they wish to make. In the mental stillness of their meditation they will summon their subconscious and intuitive powers before randomly opening a page in the book then reading it. There, at that very moment and on that very page, they should find what they really need to know.

Now, I am a man of science. I understand a few things about my subconscious but not that much about my intuition. In fact, I have often regarded my spooky sixth sense as some-what vestigial. As a budding scientist and an avid reader, however, I thrive on curiosity and light up at the potential experience of enlightenment. So, I gave it a try.

This is what I read on either page:
“Until one is committed, there is hesitancy, the chance to draw back, always ineffectiveness. Concerning all acts of initiative (and creation), there is one elementary truth, the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then Providence does too.
All things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision, raising in one’s favor all manner of unforeseen incidents and meetings and material assistance, which no man could have dreamed would have come his way”

“Dwell not on the past. Use it to illustrate a point, then leave it behind. Nothing really matters except what you do now in this instant of time.
From this moment onward you can be entirely a different person, filled with love and understanding, ready with an outstretched hand, uplifted and positive in every thought and deed.”

As it turns out, I really needed to read this. And, to she who gave me the book, for facilitating this serendipity, I feel warmly indebted.

Got Bugs in My Bed

The itchy wheal and flare on my skin right now has pushed me back to the blogosphere for an insomniac rant. The little troubles of life have an interesting way of stirring the creative juices within, I fathom. My current predicament- I am the irritated victim of a vicious bed bug attack. I can almost see all the question marks levitating from your scalp, so, sit down. We will address the matter as it is.

Yes, I said bed bugs. And, yes, I am in my bed. No, my hygene is no where near bad. I shower twice a day, clean my beddings frequently and my room just as much. And yes, I have changed beds: technically because I am no longer at home but back in the campus public hostels. And lastly, yes, I would rather be struggling to go back to sleep now because I have an early morning lecture on neonatal health. But since we are here, you would not mind reading on now, would you?

So, to reiterate- bugs are on my case. This is my third night at the hostel. Having spent the early part of last week settling my fees, cleaning up and revamping this room, moving in, and catching up with some Emergency Triage training, I rightfully deserve a peaceful weekend night in the sack, or not.

As I type this, my immune system will not let me. The viscious bug-bites are foreign to my body and an over reaction was inevitable. I am swollen on the skin focus of said attacks. I even had to wake up to confirm that I have enough face left to look like ‘me’ when sun finally graces day a few hours from now.

Ergo, why are bugs in my bed, brutally leaving me bereft of my blood? As far as I am concerned, someone refused to do their job. Common sense dictates that during long vacations, hostel rooms and furniture including mattresses should be cleaned, disinfected and sprayed by caretaking authorities. That is why accomodation fees are paid in the first place- for the maintenance of sleeping quarters.

Unfortunately, someone somewhere insists on letting go of their responsibility. This aloof and lackadaisical approach to duty is probably backed up by greed. I suppose that the funds allotted to ensure that subsequent occupants like myself have an easy time settling in when school reopens were re-channeled to service a couple of greedy guts.

This same mentality is reflected in many aspects of the Kenyan public sector today. Funds for public use are gormandized by a ‘priviledged’ few while the larger populace is left wallowing in the quagmire of a defunct society. Many projects allocated to the locals are barely ever completed due to the above. Third class, derelict and sometimes non existent utilities are the consequence of such selfish undertakings. Complaints usually fall on uninterested ears and are often batted down with callous indifference. Those who thrive are those who take matters into their own hands.

Consequently, I should probably take time to re-clean and re-disinfect my room and re-exterminate the so far resilient hemipterans. I possess neither the luxury of time nor the patience to follow up the lazy authorities on this one.

However, I must mention my dire disappointment in the fact that whereas they deserve it the most, those who sleep on their jobs are seemingly far placed from the such stinging discomfort of bloodthirsty bugs. If that were the case, they would not sleep on for too long.

Hindsight, life can be unfair sometimes, but I refuse to resign to the trivial constrains of such belief. Change beckons.

Old Age is Coming, Soon Enough

At the end of an impromptu upcountry visit, I was quite reluctant to get back to the mental drudgery of medical school. The serene countryside ambiance was naturally invigorating and enlivening, a stark contrast to city life. I had neither heard the disturbing, piercing cry of a woman who had lost her loved one nor encountered any tinge of hospital funk for the past approximately forty six hours. Two days! That was quite something.

So here I was again on a vehicle heading back to the city. I was waiting for other passengers to board so we could get moving. My mind drifted off to some obscure thoughts. The amount of mental clutter running to and fro in my cranium is sometimes enough to trigger an absence seizure. Anyway, my thought train ground to a startling halt when a boarding passenger heaved themselves on the seat right next to mine pushing me right up against the window.

I was forced to turn to get a glimpse of this person who lacked the decency to stick to the code of personal space. My stare landed on the plethoric face of a young, short and plump woman. She was panting a little. I guess the effort spent to defy gravity for a good thirty centimeters as she was hauling her body into the vehicle had left her lungs bereft of air. As I was settling from the sudden discomfort, she flung a flabby arm in my direction beckoning me to open the window a bit more. I did it reluctantly, after which she beckoned a hawker and asked for two cold Fanta Orange sodas. She then stuck her hand in a fittingly fat purse and after rummaging for several seconds, she dug out some archaic note to pay the peddler. With the drinks clamped under her arm, she proceeded to uncork one bottle, swung her head back and generously bathed her buccal cavity and throat with this cold, orange, fizzing, calorie rich liquid. I watched in bewilderment as the events unfolded almost hitting her with the cliche ‘food is not your friend!’ but I knew one better.

She was a young woman, the type that are laden with volatile emotion. Such comments no matter how sincere or true have the propensity to culminate in word battles, physical exchanges, gore or even burials in unmarked graves. You may call me timid all you want to. In my defence, I chose to stand for my pacifist beliefs. World peace shalt not be compromised by things as meagre as medical students telling fierce looking obese damsels to watch what they eat. I sat tight, plugged in my earphones and got my thought train chugging away once again. It was going to be a long two hour travel to Nairobi.

Back at home three weeks later, I am now trying to enjoy my holiday and feeling happy that my junior medic years are officially over. I suddenly realize something: this is my third last holiday at home as a dependent. I have mixed emotions about it. Before I even get my mind to think it through, I am jolted back to reality. My mum has just sat next to me letting out the ‘grunt’. You know, that noise old people make when they sit down? I call it the indicative ‘noise of senescence’.

Again it hits me. My mum has indeed aged. I joke to her about it. She laughs and blushes then resolves to renew her gym membership. Her face is not wrinkled, just treaded with womanly and motherly experience. Expounding that is beyond me. A lot has changed about her. She neither even shouts as loud nor as long as she could do when my brother and I were younger. That is when we would know that we were in real trouble. The days when mothers would yell at you to go to your room, not so that you can have some time to introspect about your latest breach of the family protocol, but to have limited space to manoeuvre during the inevitable whooping.

Isn't it interesting how certain ages, men and women look pretty much the same?
Isn’t it interesting how certain ages, men and women look pretty much the same?

My father walks in at that convenient moment. His physique too has borne the brunt of time. His stifled limp, a consequence of osteoarthritis of the hip. It pains him sometimes. His demeanor, however, is that of a young man. He too sits down with the ‘grunt’ and proceeds to sip his tea slowly. He takes the remote control and flips channels hoping to catch the news. He then relaxes on his seat and strikes me with some intriguing parlance, the kind that is intellectually erotic. Politics of the day, sports, relationships, philosophy, random people on the streets: topic after topic, we wear down the clock as conversation is intermittently punctuated with humor. My dad never holds  his laugh. He takes it from deep within his diaphragmatic recesses laughing heartily like a wild lad. His somewhat large belly trembles in unison to his guffaws. I often find myself in a dilemma on whether to laugh at his jokes or to  laugh at him. It is always a good evening when he is around.

I now fathom how the youth of the physique lasts only for a while.  For different reasons and at different rates, we all age gradually. How well that happens, depends on our genes and our bodies. Both my grandfathers lived to a century plus. I am not sure how much longevity or immortal blood runs in my veins. I do, however, believe in the need for us to take care of ourselves. I admit that I probably should have found a way to talk to our ‘passenger-friend’ about her weight ‘problem’. Maybe some carefully delivered counsel on obesity predisposing to a poor quality of life, restrictive respiratory diseases and heart attacks at a young age would have worked. I wouldn’t know.

I also think that young people should not despise their friends who don’t drink as much, party as hard, and who adhere to some structured diet. There sure is a chance that, at some point in life, we could all get hit by the proverbial ‘bus’ or be a casualty statistic to some unforeseen cataclysmic event. But if such morbid things don’t come to pass, some of us may end up taking our grand children for walks in the park while the rest are restricted to their wheel chairs, passing urine via a catheter, wearing an uncomfortable adult diaper, inhaling from an oxygen mask and frequently cursing the grim reaper’s poor swing of his scythe. It’s rather obvious who falls in which category. After all, you don’t really only live once now do you?


A Tale of the Guy who feigned Malady

Like any blogger gone M.I.A, I should probably start this post by explaining my long hiatus to my imaginary audience and fans perhaps, if there are any. The frailty with which the latter statement strokes my ego tickles me I tell you. So I will just hit you with the usual ‘I am a medical student’ crass, ergo my absence is self explanatory. Bottom line, I’ve really missed posting here. Its been a while.

I have never had a brain scan done on me, but I have a feeling it would closely resemble something like this…

But here I go again…

There was this day last week, my two nerdy colleagues and I were just from sitting for the mother of all exams. The end of years for the first year of clerkship are surely no mean feat. The hardest part of junior clerkship is perhaps when you have to convince your seniors that you are of at least average reasoning even when sometimes they leave you wondering whether you have the intelligence quotient of an enema bag.

Summarily, I had walked into that exam room with caffeine in my veins and I walked out with diffuse axonal injury. That’s medic-lore for something more severe than a concussion. I actually had to grope out of the examination room. To our utter dismay the university transport available at the time wasn’t enough to ferry all students back to our campus which was half way across the city.

We decided to sketch our way to the bus station and use public means instead.

The scorching tropical sun, noise and choking fumes from the traffic did not make our early afternoon any easier. Couple that with cranky, overly sleepy minds and the colossal duress of examinations resting squarely on our aching backs and we were one glum trio. Somehow, we managed to hop into one of the commuter trains from whence the drama started…

As we waited for a few other passengers to board, some young man got into the bus. Well, there wasn’t much pomp about him until seconds after his uneventful entrance when some chesty, cut-throatish voices rent the front of the bus. Barely craning my neck, I noticed the same guy holding some banners and writhing his frame in the strangest of manner. It was a complicated blend of a drunkard’s gait, a seizure, and worm-like movements. His face was overtly bathed in big beads of sweat, his facial muscles contorted into a worrisome grimace: the portrait of a man who may have been experiencing his worst episode of constipation yet.

At this juncture, thanks to medical school, all my weariness slipped away fast as curiosity immediately sank in its place.

This fellow was passing the miniature banners around begging for money. When he got to the back of the bus where we were seated I tried to study him closely; his demeanor and behavior to figure out exactly what was wrong with him. His fliers didn’t help much either. All they had was a request for financial assistance so he may get medical help and what was supposed to create contrast and earn sympathy: a picture of a younger version of him in elementary school perhaps. Frankly, the only change this guy seemed to have gone through other than his very weird aura was physiological aging. I dug into my exhausted mind to get a fitting diagnosis but it clearly didn’t want any digging into.

Anyway after failing to get any help, the young man shuffled back to the passenger exit. Then something even more strange happened. He just totally snapped out of it. He straightened up and slapped the door vehemently asking the driver to slow down so he could alight. And all about him were clearly amazed and very perturbed by his act. Who really does that?

What do you even make of such a man?

I’ll tell you this. Other than the fact that his performance could earn him a place in a good drama school and probably be a sturdy foundation to a stellar acting career, I will choose to overlook the fact that his moral compass blatantly points to the true South. My diagnosis for such a man is nothing more than severe mental myopia.

Healthy and seemingly talented, he yet chooses to live in the paucity of fleecing plenty of hardworking others off their change. Maybe I am missing something. But for the larger part, I think it shows what happens when we refuse to recognize the profoundness of our natural abilities and hence fail to exploit them in vigor, beneficence and sincere gratitude.

As such this should not merely pass as an experience, but be ingrained as the important lesson that it is. Pulling weird acts in buses makes other people really uncomfortable. It doesn’t pay that well either. Okay, here is the real lesson- If there are better things you can do with your life, never settle for less.

An open Letter to my unborn Son

My dear son,

Many, many moons from now you will be born. I cannot precisely quantify it in terms of years as yet but truth be told, that ‘many moons’ phrase sounds really medievally chic. On the day of your birth however I will be an elated man.

More so because you will not be the outcome of a dubious encounter between a reckless man and an enstranged ‘campus diva’. You will be borne of a loving mother and a caring father. You will be the seed of my loins and your handsome features an uncanny reflection of your mothers beauty. I will be proud of you, so much that if pride swapped places with helium for just that one day,  I would be halfway into the stratosphere and probably croaking like Donald Duck.

When you transit from the comfort of your mother’s womb and gasp for your first breath, I will be there. You will be a slimy mess son, I know, but I will be there. It will be a perilous time for you. The warmth and cushioning that her uterus provided, the nourishing she gave you and the peace, calm and quiet that homely chamber posesses will be suddenly gone. In their place will be a bright and cold pandemonium, noise everywhere and large hands holding your minute frame. At some point, you will even have to cry. Ironically as this will be for you, I will welcome you home.

I promise not to give you a name you cannot pronounce.

As you grow, your mother and I will nurture you. You will learn the value of honesty, hardwork and mental stubborness from your mother. When the epiphany of right versus wrong overtakes you, I will be there to guide you. I will show you how to be a free thinker son just as your grandfather taught me. I will let you follow the path that the flames of your ambition clear for you. You will never be wrong. You will only learn.

You have to realize that my letter to you is written with the ink of optimism on the parchment of hope. These are trying times son. The government scorns its workforce while favoring the upper ranks. It soils the healthcare system and takes education for granted. It puts the rich on a pedestal and leaves the poor alienated and desolate. Such is life as per now. But there’s hope, there is always hope.

In your time my son, our lives will be different. Condoning impunity will be a thing of the past. Exploitation of the masses by a powerful, selfish handful will be non existent. The thwarting of efforts gunning towards fulfillment of basic needs and empowerment for all will be history. Intolerance to societal views and beliefs will have dissipated and our opinions will be open and unifying. Our country and humanity as a whole will perhaps be slowly gravitating towards utopia. When such times are upon us, you will flourish son. We will all flourish.

There’s always hope…

Meanwhile, I strive in my own meager ways to prepare for such a future. After all change begins with self. Needless to say, I would like only the best for you my son; just like any good father would.

P.S. On the day of your birth, the doctor may inflict pain on you so that you can breath. Fear not son for on another occasion  their progeny will come to birth and a doctor will again smack the bejesus out of their behind. Then and only then son will we have our revenge.

Signing off.

With love,
Your prospective father.

Mission No Slavery: The Plight of Registrars

It’s an early Thursday morning, 6.50am to be precise. The mid June weather is unforgivingly cold. I am out already, to meet my colleagues for group discussion. Mid year exams are fast approaching. I find a sheltered spot in the Com-care restaurant of KNH and huddle to my notes waiting for my friends to arrive. As I pour on the myriad of drugs and their pharmacological properties, my attention momentarily delves into an approaching trio- two gentlemen and a lady, all dressed in scrubs, golden badges and lab coats, clinging to the latter for warmth. I steal glances at them watching as they select yet another sheltered corner, sit down and order breakfast.

They looked thoroughly spent. Once the coffee and other accompaniments were delivered, they dug in- almost ravenously, the pride that comes with being a doctor was perhaps their only restraint. They refrained from making any exchanges amongst themselves for a while. I became more curious.

As soon as the caffeine and glucose kicked in however, they started conversing in low tones. It is from eavesdropping their exchanges where I would learn that they had been up since mid night in theater. I did not hear the intricate details but whatever procedure it was that they had been doing must have been complicated. What seemed to bother them more was not their obvious fatigue, rather a task they were supposed to accomplish: a major write up to some department that, according to them, took so much time and effort to compile yet was only worth a mere percentage of course work. As they wrapped up their brief breakfast and headed out, I slowly fathomed just how complicated a doctors and more specifically a registrar’s morning can be.

Later on in the day (and in many other days before and after that) I brushed shoulders with similar doctors- registrars. From the minor theater of the casualty in KNH to the dissecting table of the morgue’s autopsy room. These older sisters and brothers in the profession conduct clinics and offer medical services to the larger Kenyan citizenry, majority of whom are poor, on behalf of the hospital. They man the wards, run the Operating Rooms, ensure the smooth running of the entire hospital and also mentor medical students: all this, unfortunately, without any returns.

All work and no pay

Being a doctor has never been simple. Serving in a ‘noble profession’ puts one in an awkward position as far as bargaining for rights is concerned. Being a registrar is something else. A majority have to raise their own fees in the background of an unpaid study leave. As aforementioned, they offer medical services around the clock to the hospital and teaching to medics for no enumeration. Most have families to care and be there for, a hard feat to pull since they also has to lo-cam to make ends meet. All this happens under the umbrella of a bureaucratic education system and to top it all off- one has to excel so as to graduate. In essence, being a registrar is an insurmountable affair. It therefore follows that sentiments by the government in view of their demands for payment as ‘unnecessary’ and ‘unusual’ are complete crass.

A government that cares for its people should have in mind the imperative nature of a proper healthcare system. The backbone of the latter is a country’s doctors. It is rather disturbing that the government would choose to dump mud and dirt on the on going quagmire with medical registrars instead of encouraging positive negotiation. In the light that a well funded health care system and motivated doctors directly culminates to Kenyans benefiting immensely from better health care, the way the government has been handling the frequent fall outs with its doctors is a big shame. After all, most of those who run the government seek healthcare from outside the country. Indeed, by literally enslaving its doctors, the government is showing blatant lack of concern to the needs of its people.

Keep keeping on

As a medical student, I support the stand that the registrars and KMPDU have taken. While fighting for their own rights, the rights of a majority of Kenyans and paving way for the younger medics, it goes further to show that the seemingly feeble voice of reason shall in the end be heard and heard out loud. I hope other doctors and Kenyans at large will join in in solidarity with you, surfing bravely on that long awaited wave of change. Finally, the far we have come should serve to fuel your current efforts. For as long as the stream of doctors’ power runs persistently, the rock of slavery and exploitation will gradually but surely wear out. The struggle continues.