Thoughts Of A Doctor

It was a few years ago at the then Central Regional (now Cape Coast Teaching) Hospital. We were grossly understaffed those years. There was no opening or closing time. You worked as long as there were cases, day or night. I remember often being called two to three times in a single night to perform emergency surgeries.

It was so frustrating; I opted to sleep in the hospital at night so as to give myself a few extra minutes of sleep which I was wasting in transit from the hospital to the hospital flat which I shared with two other doctors.

I remember walking in the middle of the night along the road surrounded by bushes infested with snakes and robbers in the name of “saving lives”. I walked with fear in my heart and a prayer on my lips. If I was attacked or bitten by a snake and survived it, I would still have to bear the cost of any treatment. That makes no sense does it?

I remember being called frantically at night because of mass casualty road traffic accidents on the ever-dangerous Accra – Cape Coast – Takoradi road and ALL doctors including pediatricians coming in at night just to save lives of total strangers… all this while our friends and families slept totally oblivious to the reality of our job. I remember seeing so much blood and gore. So much death!!! More death than you will see in many lifetimes!

It was about 7pm on a totally random day and we were very tired as always. The referrals from the surrounding health centers were pouring in. We had a number of women in labor. Patient X was probably late 30s or early 40s.

She delivered a healthy baby and all seemed well except she seemed to bleed a bit heavier than normal… and she bled and bled!!! Everything that could be done had been done. My whole (rather small) O&G team comprising 1 specialist, 1 registrar and two house officers was there. We had no option but to prepare her for an emergency hysterectomy (remove her uterus) to save her life.

Sound simple right? Ok, let me complicate further. She has bled so much and we have given so much IV fluids, her blood is now very dilute and she is drifting in and out of consciousness, she’s on high flow oxygen and we need blood to transfuse URGENTLY. After several calls, we realize there’s no blood in any hospital in Cape Coast. Now we’re in a fix. Don’t operate because there’s no blood available and she will be dead in a few minutes. Take her to theatre and open her up to save her and she will probably die on the operating table. What do we do?

My Boss says “Jonathan, let’s go to theatre and hope for the best”. The midwives are very stressed & hurriedly tear off the rest of her clothes with a pair of scissors & rush her to theatre. We scrub and we’re about to start when on a whim, I ask my colleague house officer to assist my boss in my place. My boss is surprised but lets it go and I tell him “Boss, I’m more use to you at the lab”. I run like a maniac to meet my friends in the lab who calmly opened ALL their fridges for me, one after another. All empty. No blood anywhere. I am in a quandary. How do we save this woman’s life? A cleaner comes to me and says: “Oh doc, if they sort me out, I can donate 1 unit of blood”. I ask how much & he says “40 cedis”. This was quite a bit of money back in the days particularly considering the government of Ghana of course had not started paying me though I had worked for over 8 months and had submitted all documentation… but I digress. I paid him, they screened his blood, he was clean and a match. Thank you Lord, 1 unit received but I need an absolute minimum of 2 units of blood. What do I do?

I suddenly thought, what’s the lady’s blood group? They say “O positive”. Then I say: “but I am O positive, please take one unit from me now!” They look at me like I’ve totally taken leave of my senses. I bully them and get them to take the one unit of blood and they put me to lie on a couch and bring me a drink. They say “doc, relax because you’ll be very dizzy when you stand”. I stand slowly, waiting for the dizziness to come, but I’m fine, so I grab the blood and run out heading to theatre with everyone looking at me like I’m a crazy person. I arrive in theatre to find a barely alive lady with a very stressed medical team around her. When I bring the blood out, my boss shouts in relief and everyone is so happy. After the surgery is complete, he comes out and gives me a big hug. We have just saved her life. My colleague pulls me aside and asks me how I got the blood and I quietly let him know. He just laughs. This is the life of a doctor. We make things happen and make our miracles. I stay behind to do another caesarean section that evening. I made it home probably about 11pm.

The following morning, my team is assembled for ward rounds and I when asked again by my bosses, I was forced to disclose how I got the blood. Their comments were “You did well, but this man, you’re mad oh!!” We get to our star patient and she is complaining bitterly. We ask “Madam, what’s the problem” and she replies “Why did you people tear my clothes yesterday?!!!” All the doctors erupt in laughter and we have a good laugh. We couldn’t bring ourselves to tell her what we did to save her life. She probably is out there calling us names. She has no clue. Just a routine day at work.

I believe in very hard work, but I also believe in being well remunerated. My reward should not only be in heaven. Why is accommodation in government flats or bungalows only an issue for doctors? Do the armed forces not stay in government accommodation? It’s never an issue because they have guns and can topple the government if pushed too far. Is it not shameful that a consultant in Korle Bu Teaching Hospital falls ill, is brought to his own hospital and ends up paying bills with his wife’s insurance because she works with a bank? Why do you say doctors are an essential service but you do not treat them like they are truly essential? Why does the military have clear conditions of service COS but they have been working on the doctors’ document for over 10 years? Should the conditions of service for all essential personnel not be fairly similar with allowances made for individual circumstances and risk? Are they not all “Essential Services”?

I chose to leave a job I truly enjoyed helping the poor and destitute and moved to the private sector. I work in probably, the foremost private medical facility in the country. I have very decent conditions of service. I take care of wealthy people, politicians and senior staff of various firms who have excellent conditions of service including top level medical cover as they are the only ones that can afford my services. The strike does not affect them at all. They have me to take care of their children. They are free to call me at ungodly hours because they have back pain or their children are crying too much and are confident I will sort out their problems.

They can turn around to insult doctors in the government sector. They go into propaganda overdrive to confuse the average citizen and distract from the core issues. They say doctors are killers, evil people, greedy bastards, nation-wreckers etc.

The politicians say they want to serve, but we permit them to give themselves wonderful conditions of service in order for them to live comfortably and focus on their work. Their Ex-gratia alone for 4 years of “service” is more than 12 years total net pay and more than 65 years pension for the average medical doctor!! That does not destroy the economy but doctors who watch over your wife and child during childbirth on the other hand are the ones expected to sacrifice.

I am sure you reading this, are reasonable or you probably would not be my friend. Friendship entails some responsibility and action. Spread the word and use your influence to make your friends and family understand that a society without motivated health personnel (doctors, nurses, pharmacists etc.) is one that is destined to fail.

I leave you once again with a few words from people much wiser than me. Archbishop Desmond Tutu’s (The anti-apartheid fighter) once said:

“If you are neutral in situations of injustice, you have chosen the side of the oppressor. If the elephant has its foot on the tail of a mouse and you say that you are neutral, the mouse will not appreciate your neutrality.”

Dante Alighieri also famously said:
“The darkest places in hell are reserved for those who maintain their neutrality in times of moral crisis”.

God bless you all.