Small World

The last time I visited Accra was 5 years ago. Just about everyone I met then seemed to be a not so distant relation. It may be that you have fewer degrees of connection in that city than you imagine.

I maintained the habit of an early morning walk, during my last visit to Accra five years ago. It’s refreshing, for the vigor of the exercise, the peeks at innocent, expectant faces stepping out of night into day, the serenity of the daybreak and countless other ways. Occasionally of course, I meet someone whose grumpiness, or very gait suggests he’d much rather have nothing to do with the day, except life goes on without his permission. I varied my route as often as I could, for a fresh experience.  Indeed, I took a new one on the particular morning I write about in this post.

It was six in the morning and I planned to walk south through the Police Barracks opposite the Veterinary Hospital, cross the Ring Road East at Allure Spa in The City and head westward into the Osu district. I intended to turn north eastwards there, in a circuitous route through Labone, to return to my residence. This route offered the promise of just that sort of early morning thrill.

A car drove past and stopped in front of a a familiar house, as I entered the Osu district. The house is situated along Okodan Road, behind the Veterinary Hospital. My old friend Ashitey’s father owned and lived in it. He had long since died and I wondered if Ashitey now lived there, or if any of the residents might know his whereabouts. I interrupted the lady who disembarked from the car, just as she was about to push the gate open and ask, “Good morning to you, do you know Ashitey, by any chance? He lived here with his father many years ago. He and I started school together, but I haven’t seen him since those early years.”

“Well, no, I’m a visitor here,” she answered then hesitated, “Why don’t you come with me and ask the one I’m here to see?”

“Oh, all right then.” That’s how I got to meet Ashitey’s sister at six-fifteen in the morning. The security guard ushered us into the lobby of the house and went upstairs to notify her of our arrival. She came down the spiral staircase, gorgeously clad in a colorful cotton top, white pants and white high heel sandals. The top was sewn in the Ghanaian kaba style. I thought to myself that her short hair and dangling earring hoops were just right for the outfit she’d chosen, then wondered if I’d be received with much courtesy, seeing that she was all ready to go, at that early hour. She made the final turn on the spiral staircase to face us and then it struck me that I’d met her before. I couldn’t recall where, or what her name was in that instant, but I knew the face; the bold eyes, those modestly manicured eyebrows, the well formed lips and fair complexion. She had an engaging mix of openness and modesty.

“Good morning,” she said cheery and personalized the greeting by making eye contact with us in turns. The visitor had a file with her, which they proceeded to browse, with intermittent comments from Ashitey’s sister. She concluded the review after some three minutes by giving direction on what to do next.

At that point the visitor said with some deference, “This gentleman asked about someone you may know.”

“Oh, I’m terribly sorry, I assumed you were together. How’s Dedei doing? You know of course that she and I are cousins. I heard you’d all gone to Canada.”

Oh dear, I thought, I’m more obvious than I assumed; my confusion must be showing like the day break. “Dedei’s doing very well. She expects to come back by the end of the year. Listen, I was taking a walk through the neighbourhood and stopped to ask about Ashitey. He and I started in Achimota Primary School back in 1959 and I haven’t seen him since we left there. He must be your brother, right?” She nodded, but before she had a chance to speak, I continued, “Is he in town? Can I reach him easily?”

“Ashitey’s son lives right next to us, but he himself lives in Kanda. I can give you his number, if you wish.”

“That’ll be great, thanks.”

She read Ashitey’s number to me from her phone and then asked, “So are you visiting, or have you come ahead of Dedei and the children?”

“I’m visiting. I came for the burial of my brother, in fact.”

“You mean your brother Martey’s dead? I didn’t know that. When did that happen?”

“I’m afraid so. He died on Boxing Day. We had to put off the funeral until this month, to allow sufficient time for all his children to be present during the burial.”

“I’m so sorry about your loss. Do extend my condolences to your sister too.”

“I will and you have a great day.”

So who am not I related to in this town? Only yesterday I’d walked into a supermarket in the Accra Mall, to pick up a few supplies and was star struck when I run into Mr. Justice V.C.R.A.C. Crabbe in one of the aisles. Can’t imagine how I did it, but under that toxic combination of excitement and confusion, I approached the elegantly graying, retired supreme court judge. “Sir, I think you had a very illustrious career and I’m a great fan of yours.” Good grief.

“Why, thank you and what’s your name?”

“I’m Martei, Martei Markwei.”

“Oh, might you be in some way related to G.L.M.K. Markwei, who died a few years ago?”

“He was a cousin.”

“My daughter married his son Daniel. I visited them in the US three months ago.”

“Mm, I see it’s a small world.”

The middle aged lady with the judge turned from the shelves and asked, to my surprise, “How’s Dedei? Is she back too?”

“Oh dear, it doesn’t get better. She’s doing very well and no, she isn’t back; I came alone on this visit.”

The judge leaned towards me and said with a nod, “Take it from me, the world is shrinking and very fast.” He turned to his companion, “Won’t you introduce yourself?”

“No,” she replied and muttered something to him about my mother.

I wished them well and escaped to the bakery aisle. It seemed a safe enough sanctuary for the moment, in a fast shrinking world.

Ashitey was pleasantly surprised, when I called him as I left his sister. After asking about my late mother, who he knew quite well, he mentioned that he was in the hotel business in partnership with his son and would be delighted to host me for a brunch in their hotel any day. I assured him I’d take him up on that once I’d settled my itinerary for the rest of my visit, which is exactly what I did two days later. I went north to the Madina district early in the morning to borrow my sister’s car, so I could have brunch with my old friend and make all the stops I’d scheduled for the day also. I dropped her in the University of Ghana, where she lectures and, for conscience’s sake, filled her gas tank at the next fuel station, before driving towards the Osu district to meet Ashitey.

I decided to make a detour through Cantonments, as I came to the 37th Military Hospital intersection, in the hope that I might avoid the snail paced morning traffic and while at it, evade the taxi drivers and mini-bus operators who operate from the hub there. They’re a law unto themselves and a pain I didn’t want to inflict on myself that early in the day. So, I turned east onto the dual carriageway Giffard Road and then south onto the single carriageway Second Circular Road. There was a long and static queue of cars in the opposite lane, as is usual at ten in the morning.

KONICA MINOLTA DIGITAL CAMERA

As I drove past the policeman directing traffic in the junction where the Cantonments Post Office stands, I heard a decidedly offensive sound which has become all too common in the city these days. It was the blare of a siren, or bully-horn, as I like to call it. The offending party appeared in a moment. It was a garbage truck heading directly towards me in my lane and against the flow of traffic, presumably because the evacuation of garbage requires emergency response these days. Flailing arms protruded from the truck and directed me to yield by turning onto the road’s shoulder. I stopped in my track and slid the gear shift lever into parking position. The driver of the garbage truck was furious. He blared his horn, put out his head and, in concert with his crew of three, gave me … well in Accra we don’t give the finger, we give all five fingers, together with choice words which aren’t admissible in polite company. The cursing continued for perhaps a minute, or two. I didn’t hear the words themselves thankfully, because I’d rolled up the windows, turned the air conditioner on and had the radio tuned in to a local FM station. I really couldn’t make much of the broadcast on the radio. The exchanges didn’t exactly qualify for a discussion, but rather, a trading of insults. Still, it served a useful purpose in the instant. I was comfortable, distracted and could wait the road rage out. I was in no rush. There was a policeman within walking distance behind me; a peace officer whose business that morning included resolving problems which impede traffic flow. Let’s see how he’d earn his keep in this circumstance.

The queue in the opposite lane started rolling along again and one of the drivers stalled to let the garbage truck ease back into it. That was disappointing to me, to put it mildly. I’d hoped for somewhat more drama. I noticed that the obliging driver too had taken offence at my conduct. He gave me the fingers, as he drove bye. Knowing attitudes in the city, I imagined him thinking, “Why are you being so difficult? How unreasonable can people be? Garbage collectors are trying to do their job and you want to put them in trouble? Some people are just too-know.”* I was delighted to be an aggravation to him too.

I looked in the rearview mirror at the garbage gang bullies and noticed one of the crew members holding his clenched fist to his mouth, the way one does to restrain a cough; except he wasn’t coughing. It was an expression of regret, or embarrassment. He appeared to have directed his rage at someone familiar; someone he might be deferential towards, in the normal course of life. Don’t rage at me in Accra; you may embarrass yourself. ©

 


*   Too-know: Ghanaian slang for a smart alec.

I’m in a relationship … 5 of 5

Its a relationship which makes the difference.

[Continued from 4 of 5]

Epilogue

I met Dr. Sandra Yong again in the early hours of January 23rd, 2018 by which date my eyesight had improved enough for me to drive to her clinic in Vancouver, without using my old prescription glasses.

“Good,” she said, drawing out the word for emphasis. “The wounds have healed and while there are some scars left on your right eye, they won’t interfere with your vision. I’m going to send you back to Dr. Dubois for future visits, OK?”

“I’d much rather return to Dr. Richard Caldwell for those. He’s been my regular ophthalmologist hitherto. I met Dr. Dubois because of the emergency last month.”

“That sounds right to me. Do give this slip to my assistant as you go and she’ll arrange that for you.”

“There’s one thing also; is there any indication of the pathogens’ serogroup on my record?”

“Let me see … no, it simply notes that it was neisseria meningitidis.”

“I’m curious about its source.”

“In that case, remember to ask Dr. Cadwell about it. He can access the lab record, for additional information.”

“You have a good morning.”

“You too.”

I’d learnt from my niece that serogroup B of this pathogen is not uncommon in North America. About one in ten persons carry the pathogen in their nasal and throat cavities, without manifest symptoms. My niece should know, since for many years, she’d made a career of getting people across the globe pricked and poked to immunize them against various pathogens. Serogroup A wreaked havoc through deadly epidemics at regular intervals, in the so-called Meningitis Belt; the Sahel of Sub-Sahara, until it was reined in by effective immunization drives between 2010 and 2015. Serogroups C, W-135, X, Y, etc. appear to be less concentrated regionally. The pathogenic serogroups are spread through contact with respiratory secretions; such as through coughing, sneezing and kissing, rather than through casual contact, or air dispersal. As a result, its not as contagious as say, the flu virus.

In any case, here is peace, peace at last; thank God this insanity is over. Hostilities have indeed ceased and I’ve returned to where I stood on December 8th, prior to the Pearl Habour-like strike on my eyes. I should visit my optometrist soon, to learn if and what corrective lenses I’ll need, following the surgery four months ago.

So, What Relationship?

The alliance of healthcare service providers sustained by the province of British Columbia’s Medical Service Plan (MSP) offered the urgent and comprehensive response I needed, when neisseria meningitidis threatened my eyes with grievous damage and my body with worse. Its members acted with dispatch and in a manner which made economic sense to me. Other healthcare professionals may second guess the steps taken, after reading this narrative and that too makes sense to me, because techniques and technologies improve incrementally through such reviews. And yes, I love to be annoying too. More specifically, I love to visit the neighbourhood pharmacy just when I’m about to run out of long-term medication and ask sweetly that they fax a request to my family doctor, for renewal of my prescription. Its such a convenience that I’ve no intentions of mending my ways anytime soon.

This brief, if unlikely war over my eyes gave me renewed appreciation of the value of British Columbia’s single payer healthcare system. I’m in a relationship with other partners in the MSP. They include the Ministry of Health, a hierarchy of Health Authorities across BC, Colleges, Boards and Commissions which regulate and oversee healthcare delivery practices, vendors of healthcare goods and services, other patients and Health Insurance BC. If a subscriber is assessed as capable of affording it, based on his preceding year’s tax returns, he pays a regular premium to Health Insurance BC, to pool his risk of healthcare costs with all other subscribers. Therefore, he doesn’t shoulder the full cost of the care he receives when he needs it. We cover each other’s back, by that means. Premiums have been reduced by 50% for all, this year. Besides that, the threshold of income which qualify subscribers to pay full, or reduced premiums have been adjusted favourably, to offer financial relief to more subscribers.

All of this makes economic sense to me, not to talk of the moral imperative for universal access to healthcare. While a resident of BC is healthy, he remains an asset in full bloom, in the pool of talent which the Province can look to, to address any challenges it faces. Why throw part of that talent pool away by excluding it from BC’s healthcare system? The rich in any society don’t have a corner on the best ideas for addressing the challenges which confront them, or all of humanity. Sometimes the best ideas have humble origins.

  • The much acclaimed Apple II computer emerged from Steve Wozniak’s garage and translated the personal computer in the workplace, home and school from concept to reality; a reality we now take for granted. Steve Wozniak didn’t have much to his name, when he developed the remarkable circuitry of the Apple II.
  • The unscholarly Wright brothers blessed humanity with the first aeroplane, from their mechanics’ workshop and on a shoestring budget. Flying to a distant, or remote city seems the natural thing to do today.

If for their potential alone, everyone in the talent pool deserves to live, not just the rich, the famous, the privileged.

The sudden assault on my eyes in the wee hours of December 9th terrified me initially, as an unexpected encounter with the unfamiliar tends to with most persons. By morning though, I’d settled into my educated attitude of, “Yeah, so …,” which my son says he found puzzling. I chose that attitude over every other, because of a relationship:

  1. Jesus of Nazareth affirmed some two thousand years ago that I’m of such value to His and my Father in heaven, that He even numbers the strands of hair on my head. Put another way, every detail of my life is of interest to God. Nothing has happened since that affirmation which undermines my faith in it. On the contrary, much has happened to strengthen my faith; such as the details of His death and ressurrection (which was predicted before His time) and the testimony of His contemporaries;
  2. Since I’m of such worth to my Creator, the Sovereign of the universe, when I pray as I did on December 3rd for better eyesight, He hears and invests in the outcome of my prayer. Sometimes it gets worse before it gets better, when He intervenes in our lives. Jesus put it pithily when He said, “… unless a grain of wheat falls into the ground and dies, it remains alone; but if it dies, it produces much grain.” (John 12:24; NKJV);
  3. God’s calculation of when and how to intervene in my life must be infinitely more complicated than I can comprehend, since He knows every possible outcome before the event. Mind you, He created and moderates the time, space and matter of the universe to fulfill purposes which are far weightier than my immediate fixation.

Therefore I’ve no need to be anxious about the urgency of the immediate. He intervenes on my behalf for the best possible outcome, in the most opportune moment. Now, some dismiss such reflections as pie in the sky thinking, or belief in fairy tales, without bothering to examine the historical evidence* of the authority of Jesus of Nazareth to pronounce on these matters. Some speculate that the universe is infact, self perpetuating and doesn’t have a creator.

center-universe

What evidence you pay attention to is yours to choose. Nevertheless, here’s the end of the matter. Consider the vastness of the universe; I’ll assume you’re well informed enough about its size. Compare that expanse with the size of the earth, just to gain some comprehension of the enormity of eternity, when compared with our lifespans on earth. If I happen to be wrong about Jesus of Nazareth, I will have:

  • spent my organic lifespan for more than me, myself and I;
  • laboured to reign in my urgings and appetites, rather than be ruled by them and
  • laboured to manage my personal relationships in response to what Jesus taught and did for me, as my expression of appreciation towards someone I adore.

I can live and die with that error, without regret. If you happen to be wrong about Him, do you have a contingency for living with your error throughout the endlessness of eternity? ©


*   The first five books of the New Testament.

I’m in a relationship … 4 of 5

Ceasation of hostilities and reconstruction

[Continued from 3 of 5]

Tactical Nuclear Weapons Replace WMD

“Hello, I’m Dr. Sandra Yong. How are you today?”

“Certainly better than I was over the weekend. This eye infection started in the early hours of Saturday morning. The pain I was experiencing has subsided, thankfully. The profuse tearing up has too and while I can now see your facial features, my vision is still blurred in both eyes, which wasn’t the case prior to the infection. My eyes have become hypersensitive to light too.”

“OK, let’s see what they look like through the microscope,” she said and then after the examination, “Well, here’s the good news; while you do have some lesions on your right eye cornea, there are none on your left eye. I’ll prescribe some eye drops to help you combat the infection and to stop further development of the lesions, lest they become perforations.”

“And the bad news?”

“There’s a lesion sitting right smack in your right eye’s line of vision, where it can cause the most damage. Its going to take weeks to heal, I’m afraid and even then, you may need a cornea transplant in that eye. Not every one does in a situation like this though, but I won’t be able to tell until your eyes have healed completely. Either way, we will make progress from where things stand now, alright?”

“Mmm hmm.” Well, just what on God’s earth happened?

“What medications are you using for your eyes at the moment?”

“None. I used to apply a drop of Symbrinza to my left eye twice a day prior to the infection. It was prescribed to help me regulate the pressure in that eye after I’d had surgery to ameliorate the exfoliation syndrome in it, but I stopped using Symbrinza after Saturday morning, because it aggravated the pain.”

“I see. I doubt that it’ll cause you any more pain, so you can start using it again. Here,” she said, pushing the completed prescription form into my hand, “You need to purchase and apply these three drops immediately. They include a broadspectrum antibiotic which is compounded by a particular pharmacy in the next block, so you’re better off going to them first. I’ll have you booked to see me again on Friday, the fifteenth, so I can assess how well you’re responding to the drops. Will that work for you?”

“You bet it will.”

“Good, if you give this slip to my assistant, she’ll appoint a time for you to come back on the fifteenth. See you then.”

“Do I need to continue on the intravenous therapy started by the Burnaby Hospital’s ER?”

“No, absolutely not.”

A Decoy

My son and I walked over to the pharmacy Dr. Yong had directed us to and after purchasing the prescribed drops, drove to the ER at Burnaby Hospital. I presented my Care Card to the receptionist on arrival there and started to explain that I’d just seen the ophthalmologist and her opinion was that I wouldn’t need additional intravenous therapy, but I was interrupted by a young doctor standing nearby.

“What’s your name again?” She asked.

I introduced myself and related Dr. Yong’s opinion to her, knowing as I did, that her colleague Dr. Morton had indicated the previous day that the therapy sessions would be repeated for up to five days, depending on the opinion of the ophthlamologist.

“Do come in, so we don’t have to discuss this matter out here.” She led us to an isolation chamber, offered me the seat there and said, “I’ll be back shortly.”

After quite a few minutes had passed, Dr. Morton joined us in the chamber, all suited up to attend to a patient in quarantine, which I found odd, since my son was standing in the same chamber without any protection, but whatsoever.

“Hi, you’re somewhat early today,” he said.

“I know,” I responded. “We drove here after seeing Dr. Dubois this morning and, by his referral, Dr. Sandra Yong, who’s a cornea specialist. She prescribed three different eye drops for me, including two antibiotics. She says I don’t need to continue the intravenous therapy.”

“Really? Do you have a followup appointment with her?”

“Indeed, I do. I’m due to see her again at a quarter to twelve on Friday the fifteenth.”

“Oh? Well in that case, I’ll have to remove the peripheral line on your arm,” which is exactly what he proceeded to do after pulling off his face mask. “When did you say you’re due to see Dr. Yong again?”

“About noon on Friday.”

“Well, there’s no point detaining you any further then. You have a good one,” he said, as he walked us out of the isolation chamber.

“And you,” I replied.

“Are you letting them go this soon?” the young female colleague asked him, as we made our exit from ER.

“They know what they’re doing,” Dr. Morton replied.

There’s a book-long young medic, I thought. It appeared to me, by her inflexible adherence to the rule book, that she may be a newbie to a vocation she’d chosen, but may lack the flair for. On the other hand, I just may have succumbed to a bit of uninformed conceit, as I sometimes do.

De-escalation

My eyesight had improved significantly by Friday and I could feel little pain in the eyes, though they remained hypersensitive to light. We arrived in the block where Dr. Yong’s clinic is somewhat early, on my request. As a result, we had time to scout for a cheaper street parking slot. It was worth our while. I directed my son to a lane where parking slots cost five Dollars an hour; a bargain which felt good to gain at the cost of the walk past two blocks.

Dr. Yong thought I was responding satisfactorily to the medications she’d prescribed, when she examined my eyes in the microscope. “Let me see you again next week, OK? Do give this slip to my assistant and she’ll let you know the date and time for your next visit. Enjoy your weekend.”

“And you.”

Our next visit was during the morning of December 19th, by which time my eyesight had improved some more and our anxiety over the vicious neisseria meningitidis had subsided. In large part, the war against the pathogen was over, with just a few holdouts left to be mopped up. To our surprise, Dr. Yong’s clinic was virtually empty when we arrived. It turned out that in preparation for the Christmas break, they’d retained only the most urgent cases on their calendar for that week. She again examined my eyes under the microscope after dilating the pupils, as they always do prior to such scrutinies.

“Your eyes are looking much better now. The lesion in the bull’s eye of your right cornea is healing. Now, as I mentioned earlier, some people experience a complete regeneration of tissue after such damage, but that isn’t always the case. If you do experience full regeneration, there’ll be no need for further intervention from us. Otherwise, you may need a cornea transplant. So, I’m going to have my assistant set up an appointment for you to see Dr. Morrison early next year, for a possible cornea transplant. In the mean time, the progress you’ve made so far means we can begin to tapper off your use of the medications.

“Here’s how I want you to proceed for the next month. Continue using the antibiotic eye drops twice a day for the next week and then cease using them altogether. Use the steroid drops four times a day during the same period, then three times a day during the ensuing week. Reduce it further to twice a day in the third week, once a day in the fourth and cease using it altogether in the fifth week. Let me write it all out for you.” She wrote and handed me three slips for the routine she’d just described, for notifying her assistant of my next appointment in January 2018 and for the ensuing appointment with Dr. Morrison. “Merry Christmas to you both.”

There then; the UN’s Secretary General, acting on behalf of the Security Council, had issued the predictable statement calling for an immediate ceasation of hostilities, the return of all parties to pre-existing borders and the commencement of talks leading to the exchange of prisoners, the safe evacuation of wounded combatants and a lasting peace, with regard to the brief war over my eyes. Christmas would still be possible, howbeit I’d missed deadlines for the dispatch of greeting cards, etc because of the unseasonable outbreak of war.

I walked to the neighbourhood pharmacy that afternoon for two purposes. “I’d like to return these reading glasses which I purchased four days ago.”

“Ow, is there anything wrong with them?” the Sales Associate asked.

“Nothing whatsover, but my eyesight has been changing progressively, so I no longer find these suitable.”

After that transaction was completed, I stepped up to the prescriptions counter, presented my identifying Care Card and asked the assistant, “Could you send a fax to my family doctor to ask for a renewal of the prescription for my blood pressure medication? I’ve a day’s supply only at the moment and I can’t get an appointment to see him before December 22nd, which is, you know, three days away.”

“We will and we’ll give you a call as soon as we hear from him,” she replied.

“Thanks and Merry Christmas.”

It was cold but sunny that afternoon. I took off my sunglasses momentarily and looked up at the leaves of one of the trees which shade the walkway, as I made my way home. Thank God I can see the yellow leaves fluttering in the gentle afternoon breeze again. maxresdefault

Its a simple pleasure I treasure, because of an association and more. One of my cherished childhood memories is of warm afternoons spent outdoors, sitting under a tree as we listened to our first grade teacher read, or tell us stories about heroic figures. The fluttering leaves mean much more to me these days, because I also view them through the prism of just what it took to build a planet which supports organic life in this vast expanse we call the Universe; an expanse in which our solar system hardly qualifies as a speck of dust, let alone its planet which serves as our home. Yet this delicate, infinitesimal Earth presents us with such stunning glimpses of beauty and always, in the offhanded manner of a masterpiece.

[To be continued …]

I’m in a relationship … 3 of 5

The war effort against neisseria meningitidis

[Continued from 2 of 5]

Going Nuclear with a WMD

A nurse turned up, dutifully took my temperature and announced, “Thirty-seven degrees.” It took a bit of effort on her part to identify a suitable vein for installing a peripheral line on my arm, though. The line would serve as a gateway for feeding antibiotics into my bloodstream. “I guess your veins don’t protrude as much, because you’re somewhat slender,” she said, after she’d settled on a spot about six inches above my left wrist.

I could hear another patient, an adult lady, crying in the next tent, which wasn’t very comforting. Anyhow, I simply clenched my fist as instructed and turned away till the nurse would get it over with. No point witnessing acts of savagery.

“I wonder why they’ve chosen not to admit you to the hospital, if they’re going to repeat this for five days,” my son remarked in the course of the intravenous therapy session.

“Well, there are a number of reasons why that makes sense. First, hospital beds and attendant resources, including nurses, are a very limited resource everywhere. So, doctors will normally admit patients on an absolute need plus resource available basis only. Second, many patients tend to respond better to therapy when they aren’t resident in the hospital. Thirdly, patients sometimes contact secondary infections which are traceable to the hospitals they were detained in and finally, it makes economic sense to minimise the cost of care for each patient in this and other ways, to conserve economic resources and so, maximize our access to healthcare services. There may be other reasons why they do this, but its common practice in most countries. It offers benefits to all sides,” I replied. “By the way, you’re going to have to use the rubbing alcohol in the bathroom cabinet to disinfect the door knobs in the apartment and the car. Make certain you vacuum the car also and disinfect any other things I may have handled since Saturday.”

When the therapy session ended about an hour later, by my reckoning, the nurse taped the peripheral line in place, explaining that it is preferable to keep it there and reuse it, than repeat the installation process during each visit. It was imperative that I keep it dry at all times though, which seemed reasonable and doable to me.

Dr. Khorenian returned to inspect the peripheral line and to reassure my son again that he didn’t have to worry about the pathogen, so long as he washed his hands after every contact and followed the commonsense rules of hygiene.

400px-nmeningitidis827975656.jpgI slept much better that night, didn’t have any hallucinations, didn’t experience as much pain as I had in the previous days and by morning, could see marginally better than the night before. Kudos to the ER of Burnaby Hospital for going nuclear on neisseria meningitidis by using intravenous therapy, I thought. The pathogen may have a good strategy in forming basic clusters of two bacilli each, to maximize impact on the tissue it invades, but it obviously was no match for this WMD.

We returned to the ER in the afternoon of Tuesday, December 12th for a second intravenous therapy session. Dr. Byron Morton introduced himself and after some forgettable small talk, stepped aside for a nurse to take my temperature; which routine was again followed by the proclaimation, “Thirty-seven degrees.”

“I haven’t heard from the ophthalmologist this far. Do you have any indication as to when I may see him? My own ophthalmologist is Dr. Richard Cadwell.”

“I’ll find out once we get you started,” Dr. Morton replied. The therapy session itself went on uneventful, but somewhere in the middle of it, my son broke the silence with news from the US.

“Oh, Roy Moore lost the Alabama Senate race to the Democrat.”

“Well, isn’t that good news? Steve Bannon can go back to his home state with his tail between his legs and leave the people of Alabama alone.”

Dr. Morton chuckled.

“You didn’t hear that.”

“No, of course not,” he replied.

He walked us to the hospital’s reception and there, obtained details of the ophthalmologist’s address and the time for my appointment with him the next morning, which he recorded on a prescription slip and handed to us. As we parted company, he said, “Just a heads up; you may receive a call from another agency, because of public health concerns about this pathogen. Its standard procedure.”

“Thanks and you have a good evening.”

“You too.”

Redeployed

We drove to Dr. Philip Dubois’ the next morning, Wednesday December 13th, for the appointment arranged by the ER. The doctor had me try the standard chart reading test to assess my visual acuity, but it was hopeless. Then he took a look at my eyes through his microscope and became settled in his mind.

“I’m going to arrange for you to see Dr. Yong as soon as possible. She’s a cornea specialist and is better qualified to deal with the lesions which have developed on your right eye, as a result of the infection.”

“But that’s crazy, it used to be my good eye.”

“Then you must see her immediately.”

Immediately was in fact, the same day. We went to see Dr. Yong in Vancouver, after leaving Dr. Dubois in Burnaby. This would of course, be the sixth doctor I’d seen since the neisseria meningitidis invasion four days earlier. Yet, counting by consultations consequential to my relief and allowing for the fact that the second ER doctor substitutes for the first in that case, the number would stand at four.

We found a roadside parking slot close to our destination and thought to take advantage of it, but discovered we’d have to pay fourteen Dollars for an hour there. “No, that’s a rip off,” I said, so we drove off to the car park beneath a building nearby. That turned out to be a classic big mistake made by motorists visiting Vancouver city. How could I have forgotten? We ended up paying sixteen Dollars, instead of fourteen.

There were quite a number of patients waiting to see one, or other of the doctors who work together at this clinic in Vancouver, so we had to wait quite a bit before I could see Dr. Yong.

Incidental Intel

Some things about the neisseria meningitis invasion will remain with me for quite a while.

  • We’d agreed beforehand to visit my elder daughter on the very day the invasion started. This would be the first time her mother had seen her new apartment and she was keen to have all four of us visit for a family reunion. She was very disappointed to learn that I wouldn’t be coming, because I was unwell and pleaded with her mother to convince me to at least come and rest there for the afternoon. At the time of course, we none of us had any idea about the nature of my ailment. We wrongly assumed that it had something to do with the surgery I’d had twelve weeks earlier. Nevertheless, I declined to attend the event, knowing full well that her plea meant that it was very important to her. The intense pain I was experiencing on that first day made even the 23 km drive to Richmond seem frivolous. When I did learn about the nature of the pathogen, I was especially grateful that I’d limited the exposure of others to it by refusing to keep the prior engagement.
  • When I was informed that the pathogen was neisseria meningitidis, I remembered a close friend of mine who died of meningitis some thirty-seven years earlier. The thought of him left me on guard against possibilities of spreading the pathogen, but also appreciative of the attention I was receiving under the province of British Columbia’s single payer Medical Services Plan.
  • I missed the online community I’d assembled. I interacted with its members frequently through WhatsApp and less frequently, by email. They included high school year mates and others from more junior years, college mates, friends I’d made in other settings and close relations. They are of diverse nationalities and reside in different countries, but I’ve had offline interactions with majority of them, in times past. As happens in social media groupings these days, much of the time we exchange light hearted satirical materials on different aspects of life between us. Sometimes though, more serious materials like links to important reports, blog posts and other published material come to our attention through these exchanges. The pathogen’s invasion so deteriorated my eyesight from the first day, that I couldn’t read. It left me feeling cut off from what had become an important part of my social life and I grieved for that loss. While I’d taken the online community seriously, I was for the most part unaware of its contribution to my wellbeing, until the invasion prevented me from interacting with it.

[To be continued …]

I’m in a relationship … 2 of 5

Escalation to Red Alert, in the Emergency Room

[Continued from 1 of 5]

The Hacker

Dr. Khorenian returned just as the nurse was completing the vampire-like act of drawing blood from my left arm. He proceeded to collect a sample of puss from my left eye,  using a cotton swab and with profuse apologies. “I must refer you to an ophthalmologist at this stage, so I’m going to try to speak to the one nearby who can be reached on Sundays. I’ll be right back.”

Sometime after he left, the same, or perhaps a different nurse turned up with a little plastic cup in either hand and offered me the content of the one in her left hand. “You must swallow this,” she said.

“What is it?”

“Its a combination of Percocet and Tylenol. They’re painkillers to relieve your distress for the time being.”

“Is Percocet bitter?”

“I’m afraid my job at this stage is to see you swallow it, nothing more.”

I gathered as much saliva in my mouth as I could in my condition, reclined my head and threw the composite pills as far behind the pool of saliva as I could, so that it might go down without touching any of my alert taste buds. Then I reached for the cup of water in her right hand. She chuckled and surrendered it.

“Shall I get you more water?”

“Oh, absolutely, thanks.”

Dr. Khorenian reappeared with news, “I did reach the ophthalmologist by phone and he’s promised to have his office call you tomorrow morning for an appointment. In the meantime, I’ll give you more painkillers and dressings to keep you comfortable till he sees you.”

I heard him instruct my son on how to applying gauze soaked in warm brine on my eyes periodically, to keep them from becoming sealed again and with that, we were dispatched home with a booty of a few Percocet and Tylenol pills, some gauze dressings and a bottle of brine.

The evening and early hours of the night were mostly quiet, but not the later hours. I woke up, or in the first instance wasn’t quite sure I had, to find myself trapped in a maze. In that instance, I was surrounded by a kaleidoscope of moving shapes with different colours, which effectively obscured the door of the bedroom. Oh dear, I thought, if only I can just open my eyes. They were held shut at that time by dried tears and puss, I suppose. When I did manage to open my left eye, I was able to differentiate between parts the wall and my bed, from the moving shapes. That’s how I managed to get out of bed, though it didn’t prevent me from first walking into the wall opposite the door, as I tried to exit to the bathroom.

The next time I needed to use the bathroom, I seemed trapped in a maze of pipes; the galvanized steel type used for erecting scaffolding on construction sites. Again, I managed to escape after opening my eyes and this time, I knew not to turn right as I walked past the bed. I woke up a third time without a need to get out of bed. I appeared to be in a glass-walled room with stained glass shapes for furniture, but no doorway. I was certain I wasn’t dreaming, because I could also make out parts of the bedroom, as I struggled to open my eyes.

Oh hell, what’s hacking my brain? I blamed it on the strangely named painkiller the ER nurse had insisted I swallow. Just keep things simple; if anything changes, its the fault of the new guy who entered your gut. If that indeed is the hacker, then this breach can’t last very much longer. I’ll reload and be back to the real world soon and will definitely deport the new guy into the toilet in the morning, which is exactly what I did, after my wife confirmed that she’d read about the side effects of using Percocet and yes, it rarely, but sometimes induces hallucinations.

I called my optometrist’s office as soon as I could that morning, which was Monday, December 11th. My eyes were in no condition for taking the sort of measurements she’d need to prescribe glasses, so there’d be no point holding the slot reserved for me during the afternoon of December 12th.

“If your eyes are swollen, then its the more reason why you ought to come and see Dr. Prentice.”

“You’re sure about that? I can hardly make out the details of objects around me.”

“Absolutely. Can you come at 2:30pm today?”

“I will.”

When I turned up at the optometrist’s at 2:30pm that day, her assistant mysteriously couldn’t find my appointment in her digital records, which I found altogether silly, since she’d insisted that it would be in my interest to keep the appointment. I simply took a seat and asked her to search more diligently, because she had confirmed the appointment on the phone.

“Ah yes, you’re right. I was looking at the wrong records. Dr. Prentice will see you shortly.”

The Doctor took a close look at my eyes through the microscope and didn’t like what she saw. “Look, I’m going to prescribe three different eye drops for you. I want you to buy and apply them immediately. I’ll have you booked to see me again on Wednesday, December 13th. However, if you don’t get any relief from using them by tomorrow, I want you go back to the ER with the drops and let them know for how long you’ve been using them and what you’re experiencing.”

“That sounds doable to me.”

Valued Intel

My son received a phone call from Burnaby Hospital just as we arrived at our neighbourhood pharmacy to buy the eye drops. “The ER Doctor wants me to bring you back immediately. The lab tested the sample from your eye and reported that the pathogen is a dangerous one. He says we’re to inform the receptionist that your case has to be fasttracked.”

“Well, let’s race to Burnaby Hospital, then.”

The ride to the hospital was uneventful and our entry into ER was without drama. “Oh, there you are, we’ve been expecting you,” Dr. Khorenian said, after my son introduced himself as the next of kin who had received his call a few minutes earlier. He ushered me into one of the comfortable, high back chairs in their tents and asked me, “I notice on your record that you have an allergy to penicillin. What happens when you get a shot of it, or something?”

“I collapsed the last time I encountered that wonder drug some forty-five years ago.”

“Oh OK. We got the lab results on the sample I took from your eye. It shows that the pathogen growing on your eyes need urgent attention to contain and eliminate it. Let’s see now, try to relax your neck muscles. I’m going to tilt your head back a bit, as I examine you.” He tilted my head backwards and then released it. “Thankfully, there’s no evidence this far that the infection is otherwise than topical, which is a good thing. Neisseria meningitidis can cause meningitis too, which is why we’re going to give you antibiotics intravenously for up to five consecutive days as a precaution, beginning now. That means you’ll have to keep coming back about this time for the next four days, depending on what the ophthalmologist says when you see him.”

“I haven’t heard from him all day, contrary to what you indicated yesterday, but what about the exposure of my wife and son to this pathogen?”

“You’ll be alright, if you take the precaution of washing your hands thoroughly each time you handle things you use in common,” He said to my son, who had driven me to the hospital alone.

[To be continued …]

I’m in a relationship … 1 of 5

No, not the kind evoked by the idiom, but no less intense, for that matter.

Last year was a notable one for many reasons, but I’ll recount a series of related experiences to illustrate the theme of this blog post. The names of persons included in my narrative are fictionalized, to respect their privacy.

Pearl Harbour Type

I was woken up in the early hours of December 9th by an excruciating pain in my left eye. The pain was hard enough to deal with at that time of the night, but my thoughts were even more disorienting. I’d had surgery in that eye 12 weeks earlier, to remove excess cataract scar tissue, in a bid to help me obviate the exfoliation syndrome. The condition caused periodic blurred vision, as loose pigment tissue floated into my line of sight. I’d been experiencing associated spikes in the eye’s internal pressure too, with attendant headaches which for many years, I’d attributed to migraine, tension headaches and any other demon I could name.

The surgery on September 15th had gone well, although it took longer than expected. The lens implant in the eye did become unstable, once the offending scar tissue had been removed, but that was not unexpected. Dr. Levesque had removed the wobbly implant and stitched a new one into place, while I totally ignored them and listened to my favorite music playlist, using the ear plugs attached to my phone. He’d been sufficiently satisfied with my post-surgery recovery and in response to my question during my last visit, had confirmed that it was indeed time to see my optometrist, for a review of my needs with regard to prescription glasses.

That was only two days ago and my appointment to see the optometrist was due in three days, on December 12th. So, what on earth had suddenly gone wrong in the eye which had hitherto recovered so satisfactorily from the surgery? Could it be that some of the stitches which hold the lens implant in place had snapped for whatever reason? Why was the eye tearing so profusely, all of a sudden? I was nothing short of terrified, in my ignorance, yet somehow, I drifted back to sleep after agonizing over my condition for a bit.

When I did wake up again, it was to the urgent call for attention through pain, but of a different sort this time. I felt a burning sensation in both eyes, accompanied by a profusion of tears and an exaggerated sensitivity to the daylight seeping through the closed venetian blinds. Now the fight was on and it was a Pearl Harbour sort of engagement, not the tame Israel – Philistine type which was settled by David and Goliath, no. I could hardly make out the details of any objects I’d look at in the well lit bathroom, after struggling to open my tear sealed eyes enough to stumble there. My vision in both eyes were that blurred and my eyelids looked, well somewhat puffy. I did manage to redial Dr. Levesque’s surgery when I returned to the bedroom though, thanks to the saved history of recent calls which is standard on mobile phones. While the surgery was open that Saturday, its gatekeeper wouldn’t let me speak to the designated assistant on this occassion. The interactive voice response system of the modern office left me on hold long enough for me to drop the phone and recline again on my pillows in despair. Should I, should I, should I … I took some Tylenol pills in the hope they’d numb the pain, but by the next day, I was sufficiently distressed to ask that my son drive me to a nearby walk-in clinic for whatever assistance they could offer me and my wife was distraught enough to accompany us and make certain I didn’t miss a step in my faltering walk. I went with sunglasses to shield my now hypersensitive eyes and dragged a box of tissues along to keep the generous flow of tears from adding more drama.

The young doctor assigned to my case took a look at both eyes through a portable contraption, while I tried to give her a run on the history of my left eye. The narrative started forty years ago and ended with the third successful surgery, now thirteen weeks past. Of course, I mentioned the post surgery eye drops I was using and included some description of the beginning of my current distress.

“I’ll be right back,” she said and when she did return after a while, “I’m going to refer you to the Emergency Room of the Burnaby Hospital for immediate assistance. Just describe your current symptoms to them and they’ll know how to proceed.” Right, no stories in ER; not even the boring one about my surgeries. They’re serious out there.

Emergency Room

The drive to Burnaby Hospital was frustrating to me, perhaps because I could only tell it involved multiple left and right turns, by the swerves of my body in the car, yet it seemed unending. When it did come to an end eventually, I shuffled into the hospital on my wife’s arm and with my son in tow. “Yes, we just received notice of your referral,” the receptionist said after I presented my Care Card; the identification which both entitles me to insured health services in the province of British Columbia and offers service providers a single gateway to my health records. “Follow the directional signs to my right and you’ll come presently to ER.”

ER was at the end of a maze; at least that’s what I thought, but the directional signs did bring us first time visitors to it and I was relieved to be deposited onto a comfortable chair with a high back rest, in the midst of curtains and a bustle of nurses, at least one doctor and a number of patients. Some of the latter didn’t sound patient at all really, so I asked my son, “You think I’m better off going back home, for all these sounds I’m hearing?” He chuckled.

“Hi, I’m Dr. Vladileu Khorenian. I’ll be attending to you today. Let’s see now,” he said to me, “What the hell happened to you? When and how did this start?”

“I woke up in the early hours of the morning yesterday with an excruciating pain in my left eye. I took two tablets of Tylenol then and later drifted back to sleep. When I woke up in the late morning though, both eyes were sealed with drying tears, I felt a burning sensation in them and noticed the puffiness you now see. In the course of the morning, I applied the Symbrinza eye drops prescribed for me after surgery on the left eye thirteen weeks ago, but my eyes hurt so much more after that that I haven’t repeated the dosage since yesterday.”

“Why did you need surgery?”

“I’d been experiencing a frequent buildup of pressure in the eye and blurred vision from time to time. The ophthalmologists thought it was caused by excess scar tissue from a cataract removal operation forty years ago. The surgeon removed the offending tissue and inserted a new lens implant, because the old one became unstable, once the scar tissue had been removed.”

“OK. Was the pain you felt on Saturday morning sharp, or dull?”

“Good grief. It was a terrible pain, for sure. Ok, let’s try this for specifics. It started as a sharp pain in my left eye, but by the time I woke up in the late morning, it had become a burning sensation in both eyes; which is how it feels like now.”

“Do you have any allergies?”

“To penicillin, yes.”

“Well, for now, I’m going to give you a pain killer and take a swab of the puss in your eye; just for the records, together with a blood sample, oK?”

“Sounds good.” While he was gone, a nurse turned up and asked to insert a thermometer in my mouth.

“Its my eyes which hurt you know, not my mouth.”

“I know, but my job right now is to insert this thermometer beneath your tongue and record your body temperature. So, I need you to stop using your tongue for the moment and just open your mouth … good, now don’t you bite on that thing.”

“Hmm, thirty-seven degrees.”

“So can I go home?”

“No, we’re just warming up here. I need to draw a sample of your blood from your forearm. Which of your arms shall I use?”

“Draw it from the left arm; that’s the less critical one.”

[To be continued …]