IN THE WAKE OF THE NGONG PLANE CRASH

When I heard the story of the Ngong’ plane crash earlier yesterday, I was quite shocked. Perhaps it was because it was an unexpected occurrence. That is how death works. A cold master, a hunter out on a prowl out in a creek where there is a plethora of prey. Even when we think we expect it, we are left aghast in its wake. Some fear it, others convince themselves that they can face it. Fact is we all revere it. It is what makes you, me and people like Kim Jong’ Il stand on level ground, the only difference- time. A few people however commented that it wasn’t such a huge loss. Considering role models like the late Wangari Maathai and the late Michuki, I very much concur. But first, I would like to talk about how my late grandfather knew one George Muthengi Kinuthia Saitoti.

My grandfather was born in the late nineteenth century. A short bio of him- he was a son of the soil, raised an orphan, nurtured by hardship and matured in life. He had lived through the birth and making of this country and been under all the three regimes. He was a humble man, not well traveled albeit he was revered amongst his equals. I did not know him much as a person, but I got to spend quite some time with the man during his last days. I liked his opinions though. They were seldom well informed (I don’t blame him), but I found them rather interesting.

In the current government for instance, he knew three personalities- Kibaki, Raila and Saitoti (or Toitoti as he used to call him). The first two were familiar to him due to their positions in government, and their tribal affiliations. The man was born in the era of Gikuyu and Mumbi and the half a dozen or so clans so again: I don’t blame him. Toitoti- well let’s just say it was one familiar name and face. This, of course, is from the time Toitoti took the lime light on KBC radio news as ‘Makamu wa Rais’, always taking the second headline (as per traditions at the time). Anyhow, the television era didn’t make much sense to my grandfather.

Once in a while as we were sitted in the living room watching nine o’clock news; my grandfather would wonder how Toitoti could appear twice on national television within a period of two hours. He couldn’t conceive the idea of that being even possible. He would ask me whether this guy had any idea that normal people would be hanging around their families at that time of day in readiness to retire rather than moving around hell knows where with throngs of people tagging along. He concluded that this Tiototi fellow (and the others around him) were indeed quite peculiar.    

Another time, while Toitoti was being questioned vehemently by the first lady over the laxity of his ministry in managing disasters such as the Sachangwan fire, my grandfather could not help but notice Toitoti’s face on telly. In the background of his portrait was the footage from the scene of the fire, flames and all. My grandfather kept wondering whether he was burning for real. His worries were however allayed when footage of Toitoti making comments over the same was played later. The mzee could not however let it slide just yet. He went on to remark, as he watched, that it was no wonder he was smelling smoke in the ambience.

My grandfather aside (God rest his soul), my deep condolences go to the families of all the bereaved. Those who passed on had people who depended on them. I especially feel for the relatives of the young pilots and the security detail. The late Orwa Ojode was still young in the rings of leadership, his passing was untimely. Perhaps there was still some potential in him to take the country places.

Lastly, I do understand that ours is a setting where we are obliged by culture to exalt the deceased by sometimes unrealistic proportions. However, the media’s protracted story about the late Saitoti’s impact in this country and the gap his sudden absence creates leaves a lot to be desired. The truth always stands astute. As we come to terms with his demise, perhaps it is good for all to introspect on how we would want to be remembered once the inevitable happens. As far as I am concerned, I know I am nothing close to a saint. But if I live my whole life like a turd, and without apologies or regrets; I hope someone at my funeral will have the honesty and the balls to throw a roll of cheap toilet paper in my pit right after my casket.

May God bless Kenya.

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ISN'T IT FUNNY HOW SOME DOCTORS REACT

The deputy director of this hospital wanted to communicate major changes in policy to all the consultants on call. He summoned them all to a meeting in the board room. Having facilitated the building of the new trauma theater, the orthopedic surgery team was on his side. They even told him to break a leg. After the meeting was over, this is how the other consultants responded.

The ophthalmologists pondered over it. They could see the deputy director’s point of view, but they concluded that his ideologies were myopic. The radiologists on the other hand thought it was all in black and white. They could see right through the whole thing.

The immunologists knew that the idea favored some departments more than others. They got quite defensive over its implementation. The dermatologists however wanted more time to think it through. They didn’t want to make any rash decisions.

The gynecologists felt that the deputy director was a crafty man. In trying to put a finger into the matter, they concluded that his ideas were rather slippery. The obstetrics team on the other hand found the newly communicated policy hard to conceive. However, they agreed to labor over it before airing their final take.

The urologists were annoyed that the deputy director didn’t look well into their affairs. They pissed over the whole idea. The pharmacists were just as aggrieved. They inwardly hoped that someday soon the deputy director would get a dose of his own medicine. The pediatric physicians however thought urologists and pharmacists were acting rather childish: they even asked them to ‘grow up.’

The cardiologists thought that the deputy director’s concerns were heartfelt. They were all for the new policy. The ENT specialists however could hear none of it. They hoped the deputy director would swallow his words sooner than later.

The gastroenterologists had a gut feeling that some things did not quite add up. They had found the new policy hard to digest. The proctologists felt that the deputy director's ideas were rather constipated. In fact, something didn’t quite smell right.

The neurosurgeons could not wrap their minds around the issue. The neurologists thought the director had a lot of nerve. On consulting the psychiatric team however, they unanimously agreed that the new policy was insane. The chest medicine specialists concurred with this view, after all: the deputy director was asking too much of them. They really needed a breather.
 

While plastic surgeons felt that the new policy could use a facelift, their general surgeon counterparts had already dissected the idea into a simplified version. They were all for it. The worst reaction however came from the pathologists. After the deputy director finished his speech, the head of the pathology department stood up and started marching out in protest. Just as he got to the front door, he turned around facing the deputy director and said, “Over my dead body!"

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IN THE ANNALS OF INTERNAL MEDICINE

After moments of analyzing my routine activities in internal medicine rotations, I have come to a conclusive pattern that briefly describes my view of what happens. Imagine someone suffering from chronic constipation, so bad that he spends a week without ever having to flush a toilet. Then he has nightmares on Sundays about how his week is going to start all because Monday morning is going to be literally crappy: I’m talking excruciating, rectum-wrenching crappy. That, my friends is what my internal medicine rotation has been like so far. That should explain my use of the word ‘annals’ whose homophone, ‘anals’, is (appropriately) the plural of anus. Moving on…

So last Monday my colleagues and I make it to the ward early in the morning, just in time to (very uncomfortably) ‘void’ our ‘constipated bowels.’ Half-way into the session, while doing our best, the consultant responsible for overseeing the entire process gets so pissed off that he walks out on us. From his side of the view, we totally lacked initiative hence he felt had wasted his precious time coming to teach us. From my side, things looked way different.

For starters, me thinks that raising enough money to pay school fees and showing up for classes and ward rounds on time counts for at least 30% initiative. Complement that with risking your health while in the wards clerking patients, reading volumes of jargon for your examinations and being daring enough to stand and talk to people who salivate at any opportunity to demean you and you have 90% initiative. The 10% on top technically makes you a nerdy medical zombie. Back to the Monday saga, I think his demeanor was uncalled for. Maybe our dear consultant was just having a bad day: I suppose it was that time of the… I’ll shut up now.

In retrospect, it appears that internal medicine is an entirely different faction of medicine altogether. For starters, while surgeons walk around tall, canoodling their even taller egos, the ‘shorter’ physicians prefer to consistently rub in the fact that they really use their brains. That brings me to lesson number one of Internal Medicine: Forget all you learnt in surgery, and (preferably) put your thinking caps on. If you don’t have one, please borrow.

Second lesson I have learnt since I started rotating there is that your sole duty as a medic is to make your consultant happy. When he shows you how to do something, DO NOT let your creativity get the better of you. Mind you, I hold the opinion that creativity is for surgeons- refer to lesson number one. Learn to repeat what they say, verbatim. When they yell jump, hell; find your way to Pluto if you have to. That is the only way you will have a smooth ride in the wards.

Third lesson: this, in reference to the answering of questions. When in doubt, mumble. When standing close to a person who is in doubt and you think you know the right answer (and you are daring enough), mumble the wrong thing and try not to laugh while you are at it (yeah, I said it). It should help the one in the line of fire to think in the opposite direction faster (ideally). This is if they have sufficient info. Otherwise, they may repeat the bull you just whispered leaving them to take one (or more) for the team, and you are officially branded 'mean'. This brings me to lesson number four.

Your ego can take much more than you think, unless of course you are an Emo. If, for whatever reason, you go against lesson number two, brace your ego (and your nuts too, if you have them) for a good bashing. The consultants can and will come at you with an arsenal of insults, from something equivalent to a slap from an army sergeant, to a Scud missile. Protect your ego with your all. Otherwise, you can picture yourself rushing your emaciated and now traumatized ego to the casualty after it has suffered severe embarrassment. 

Lastly, lesson number five: it’s never that serious. After all is said and done, bottom line is that you are there to learn. It is said that sarcasm is a good teaching tool and that it actually reinforces memory. How true that is, I do not know. Bashing or no bashing however, do your best and try and take it all in your stride. After all, what's the worst that can happen? 


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BEFORE YOU DRINK YOURSELF INTO A DITCH…

How I have missed the blogosphere. The things I have been through lately in the medical realm have been immensely preoccupying. If the persistent haunt of incoming examinations severely obliterating the posterior sphincters of my intelligence, physiology and anatomy (in that order) are anything to go by, my day lasts at least eighteen hours. Oh, add my ward rotations to that. That leaves six hours for social life and other activities. Paradoxically enough, sometimes I feel like I have overslept when I wake up before the alarm clock. I think I need to see my Shaman.

Talking of alarm clocks, lately, I hardly even use mine. Thanks to the numerous sirens, courtesy of living in the vicinity of two major hospitals and right next to a major road, I can wake up any time other than the designated time. Here is how the situation plays out; I fall asleep after a tiring day. Next thing I know, Siren! Siren! SIREN! First thought: maybe it’s a VIP (Very Idiotic Person) maneuvering their way to be on time for a breakfast that’s on my tax or, an ambulance transporting unauthorized morons or contraband to some location. Either way, this calls for Plan A:

 *Gets out of bed, calmly screws the silencer onto the muzzle of his Dragunov and pivots it on the window sill before aiming and squeezing the trigger, sending a single round flying in the cold morning air and watching it sharply connect with the siren- obliterating it on impact. Silence*

Take that you Banshee.

But then again, it may be an ambulance desperate to reach the A&E before the victim inside gives up in which case Plan B comes into play:

*Sinks deeper into bed covering his head with a pillow hoping its sound proofing qualities suffice the current scenario*

Not a very good idea, but at least I gave the victim a fighting chance. I can live with that. I resign to dragging myself to the freezing shower. I’ll skip all the uninteresting details until the part where I walk into the hospital gate [slow motion effects] clothes neatly pressed, groomed as per protocol, tie tethering my thyroid, stethoscope and all in place… Then a weaver bird flies by and offloads on me the products of what I later diagnosed as a transient constipation… [Remove slow motion.] Needless to say, my ‘matrix’ skills are not word worthy. I hold on to the idea that being shelled on by avians is considered a blessing by some tribes to keep up with my so far crappy day.

Later, when a few accomplices and I are at the A&E looking to learn a thing or two about clinical practice, a stretcher comes in. Guy on board: an Unknown African Male in stupor smelling of urine, the mud stains on him suggestive of a night of one-too-many ending in an unpremeditated swim in some ditch. After some shaking he finally wakes up with the ‘I’m-I-in-heaven?’ look in his face. A few cheeky questions follow all to establish his state in the time, space and person orientation. At least he remembered that he was over-indulging and that his ‘friends’ are all turds for letting him go home on his own. We can work with that.

First thing to do: fluid therapy. After efforts that almost culminated in us calling a bouncer, the guy calmed down so we could set a drip. Amidst all that, we had brushed off some of our English into his wasted brain and he kept yelling ‘What’s up!’ then staring at us like a retarded goblin. He was then wheeled out to recuperate.

Another U.A.M. is wheeled in and his stretcher parked right next to where we are standing. Other than being schizophrenic, this fellow was either too sleepy or had also partaken of the bottle, the latter more likely. Simple math: ‘The-crazies + Alcohol = Comedy. No?’ *Slaps knee* ‘As you were.’ He pointed at us and said that we had colluded with his wife to steal his land, his beloved goat and his wife while he was asleep. For these charges, he condemned us to a HIV infection, a sentence that would be in effect starting the next week. *Gavel-knock* Case closed.

We try not to laugh as we leave for lunch break. Hardly three paces on, we see Mr. Alcohol, blood dripping from his forearm as he stares at it blankly. He had ripped off the drip that we’d taken forever to fix. When he notices our presence, he stares at us and shouts ‘What’s up!’, then smiles sheepishly. *In my mind* [thick Irish accent] ‘Waiting for a round applause ey?’… We quickly patch him up, recommend close monitoring and walk away. As it all sinks in, I remember a sticker I saw someplace: ‘If you must drink and drive, drink milk.’ My take; if you must drink and take yourself home, at least drink something that won’t make you 'confuse' some culvert for your bed. In related news, any one up for a glass milk?

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ON BLASTS AND SAFETY

Dear Kenyan,

I am blogging this on behalf of those more honorable before me and my colleagues helping out at the Kenyatta National Hospital Accident and Emergency department right now. For the three years I have been in medical school, I have come to realize that there is nothing as gruesome to the eye as the sight of human suffering. Health professionals never get used to seeing casualties and the loss of human life. Safety cannot be overemphasized. By the look of things, we are living in perilous times. The year has hardly hit its half mark and several have lost their lives in the unacceptably high number of explosions and terror attacks that have since occurred. Many others have been maimed loosing the ability to live a normal life.

It is unfortunate however, that authorities both local and otherwise seem to be lax on this matter. Many Kenyans are also seemingly unwilling to learn lessons that could help them live another day or help their afflicted colleagues better cope with such unexpected situations. Most of these things can however be avoided by proper enlightenment of the greater population and, by individual and collective responsibility. I take this opportunity therefore to emphasize a few important measures that could help you, esteemed citizen, survive or help out in the event you find yourself in such a situation.

Be vigilant. Scan your environment and ensure that all volatile or explosive utilities are kept in designated areas far from meddlers and other potential triggers. Ensure all faulty sockets and bare wires are repaired. After using cooking gas, ensure that the taps are well closed. Keep an eye out for suspicious looking people when in crowded places.

When the unexpected happens, don’t panic. Act fast and decisively. Find cover, preferably a sturdy non flammable structure. If you can find none, get down: your head between your knees using your hands to cover your head. Do the latter as close to a corner as possible. In case it’s a grenade attack, do it with your head away from the grenade. This will minimize your exposed surface area and keep you safe from any projectiles that come with the blast.

Usually, two waves emanate from blasts; a shock wave and a thermal wave. The latter leaves those around confused and sometimes concussed. Internal bleeding can also occur. Thermal waves can cause burns of varying degrees including inhalational ones. These effects are supplementary to those caused by falling debris and projectiles secondary to the blast.

After a blast, try and re-orientate yourself to assess whether you are trapped or not. Perform a quick self-assessment for any injuries then call for help. If you are ambulant, try and clear from the site as fast as possible. If you are a passer-by, steer clear of the scene. Avoid the temptation to help, collect your property or even loot. Your life, health and safety are worth a lot more. If you must help, do so when you are sure that the worst has passed. Preferably though, let the professionals handle the aftermath. There is always the possibility of a secondary explosion soon after the first.

In case you are called upon to assist, try and stay calm. Knowing that the victims need immediate attention is necessary but being calm and collected while doing can help avert secondary injuries. In transporting the injured to the paramedics, stability of the head neck and spine is vital. A neck brace can be modified from soft cloth as padding with carton paper as reinforcement. If a stretcher is not available, carry the casualties using a hard board or a folded blanket to keep the whole body level. Don’t rush. As mentioned earlier, let the paramedics handle the rest.  

In summary, stay vigilant. When it happens, stay calm, act fast, help if you must and be safe. Lastly, be your brother’s keeper; pass this information to everyone you know.

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OF SEX… AND ITS BATTLES

I think cartoons depict our sickest thoughts: the kind we'd get crucified for if we ever thought out loud. And what’s on our gallery today? She wouldn’t kiss him if she was under anesthesia. Ouch! If a lady ever told any guy that, my guess is she may be having issues, is downright jealous, or the guy is a 'Voldemort'. The last is the worst case scenario. To deal with that, one may need a team of surgeons, a good anesthetist, a psychiatrist and a masseur for their injured ego. *A cheaper alternative would be an appointment with a mortician*

In retrospect to other gender based scripts, I choose to start this by referring to the good book. Just so you know good people, I regard the writings therein as sometimes metaphorical. Let me explain. Adam came first, then Eve was created from his rib. The act of fashioning someone from a rib is not quite feasible. Unless of course one day your sleepy son came to you with a rib ache, and you affirmed his suspicion that it means he is about to have a wife. The good book claims that Eve was the weaker one. The snake therefore tempted her with an apple and she fell for it. So the question lingers: of either sexes, which is fairer?

I must say that the X chromosome is pivotal for the propagation of life while the Y chromosome is abberant. In fact, according to the shrinking theory, the Y chromosome may completely lose function in the next ten million years! *I suppose our gene pool could use a little chlorine?* Life starts with ova and sperms- a pair of them. Both are geared up for the run of their lives when copulation is at hand. The male sperm is the faster runner. It is an epic journey equivalent to a hundred meters' sprint. The distance in real life parameters however stretches from the horn of Africa to some slave town in Guinea Bissau. And the male sperm usually gets there first, but because the Y chromosome is weaker, it's less viable. That’s one for the XX and nil for the XY.

Birth and survival is next. The ratio of male to female births is almost equal. Females are on the higher side. More birth complications are however associated with the males than the females. Male neonates are more predisposed to complications such as respiratory distress than their female equivalents. Other neonatal infections are also likely to affect males more than females. It’s like the world doesn’t want them here or something *whatever they did!?*.

Later in life, the females always seem to thrive better than us. This is due to three major factors. Survival for males is not guaranteed. Competition is mandatory. Secondly, females have to distribute their attention to a myriad other things they ought to care for (males included). Lastly, menses: that time of the month when everything else slows down for the woman so that nature can take its course. Some in fact use it to wreck havoc on the universe; ranging from a few tantrums here and there to catastrophes of tsunami-esque proportions. I give one for the XY here for their ability to deal with such despite their dwindling numbers *vuvuzela*.

On a scale of one to... say, Kelly Rowland, most men rank high up on motivation for their activities. This makes them prone to illness and injury. The number of beds occupied by male patients is always way more than females. This makes me wonder what pick-up line the snake used on Eve: An apple a day keeps the doctor away perhaps? I wouldn’t know. Whatever the case, Eve still ate the damn fruit and we are all screwed!

The most intriguing detail is how women get men to do anything for them. Men vehemently refuse to admit it but that’s the truth. You can even ask Akuku Danger *if you have access to Hades*. My assumption is if it were a world with men only, nothing would ever get done. That’s one more for the XX. Ergo, the person who said ‘it’s a man’s world’ must have been a chauvinist, an alien or a Neanderthal Homo habilis. I think the last one is more likely.

It is said that women are crazy and men are stupid: that women are crazy because men are stupid. However true this is, I'm yet to fathom. The battle of the sexes never wanes. We all want different things; women want men and men want women. Still, me thinks whatever broth we keep brewing in the pot of gender tastes more like fun. Don't you agree?

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EASTER WITH THE FAMILY

Yesterday was an epic family gathering. One of our beautiful sisters is jumping the broom soon; we had to be there for moral support. The interesting bit for me started with my rather dramatic arrival. These wedding things are quite unpredictable at times. I was accosted at the gate by my other sisters, no greetings or anything: just subtle hints to get me to pay for a badge that would act as my entrance key to that event. Something similar to being coerced to purchase an insurance policy: a brother of mine remarked. And after the tension of rattling my pockets and taking one for the team, things were settled. The usual ‘hugs’ and ‘umepotea sana’ commence.

The first good thing about family gatherings is the food. So after a bit of small talk; I took to the buffet. And I must remark, my mothers and sisters do have a way with the kitchen. The servings were tantalizing, nothing I had eaten in a while could equate. Once my tummy issues were sorted, the mingling and fundraising was next.

The ambience was just what I expected. The sturdy Ngong’ hills in the background, cool winds sweeping down their slopes to amply grace the occasion. The sun above, some fuzzy could cover around it… a picturesque scene. The bark of a country mongrel, a few cackles by the chicken in the farm beyond, the muffled ‘moo’ of a distant heifer and cheerful talks punctuated by bouts of laughter were the sound effects to the occasion.

The master of ceremony rolled in to conduct the fundraising. Like most brothers in my family, he was a juggernaut of a man. I don’t get how these people get to gain that much weight while I don’t. Not that I'm jealous or anything, but I guess that it’s my own way of standing out. I smile at myself as this thought dissipates in my mind. Back to reality now, our sister is getting married. This MC guy is good, real good. I bet he would get the devil to give an offering at his own exorcism. I chuckle at the thought.

Afterwards, my mothers (aunts) summon me to their corner. It’s the usual family drill. ‘Are you ever going to put some meat on those bones?’ ‘How is your very tall brother?’ ‘Why didn’t you bring your pretty girl today?’ e.t.c… I love their concern. I defend myself with the usual wild card, being a medic doesn’t allow me to put on weight anywhere else except in my brain. We laugh about it; they have so much hope in their son, in all their children actually. You never get that elsewhere except in family.

As the evening staggers in, we huddle around to talk about this, that and the other. First is wedding stuff, then the other things. This is my first wedding committee. I put my naivety in the background and listen to the experts as they talk. I have a lot to learn I realize. Despite the creeping cold around, the family company is ever so warm.

Stories come next, with them, a bottle or two of alcohol. Meat is in abundance. We are in Maasai territory. Here infants get weaned on roasted ribs. The mutura is awesome too. Next thing I know, I am being referred to as ‘Daktari wa Wafu’ (doctor of the dead); something to do with how I usually talk about postmortems. I give a different story this time to defend my position as a doctor of the living. The alcohol starts kicking in. You know, those moments when people start confessing their love for each other. Then we pour some alcohol for a fallen brother: R.I.P Leimayan.

Stories go on and on. The laughter is too much. Maybe it’s the euphoria of family. Everyone is elated. It’s a no-holds-barred talk. Everything from Thwathinigga (with lotsa love to uncle) and Maranatha (don’t ask), to some good brotherly advice. At one point, the biggest ‘mzito’ pinches the dog’s ears. He does that twice. That’s officially the funniest moment of the evening. I'm asked to update it on face book and make it official. As we gear up to part, one thing rings again and again in my mind. We always have each others’ backs. These are the moments to remember, times we all live for. I truly love my big family.

Todo para la familia- everything for the family.

TWO THREE STORIES, AND EASTER WISHES

It’s crystal clear that April is finally here, and with it, presumably the longest weekend of the year- Easter. Before I disclose my thoughts on April, let me recap a bit on March. March was the month of new things: a new rotation, new medical information, new experimentation… and a demonstration. As you might have picked from the last blog, surgery was the new rotation,. The rest is blah blah blah until the moment to remember; the new demonstration.

Well, a couple of our older brothers and sisters in the medics fraternity were unsatisfied by the terms and conditions offered by a health ministry crippled with rickets and severe cretinism. The precipitating factor for the demonstration was perhaps acute deafness from those who manage it. So the family had to get together and act, for our rights, and more for the rights of the Kenyan patient. The whole affair was a great success. It is what happened during and after that got me in kicks.

For some, it was the fun of walking along the major streets of the city in solidarity with the other aggrieved. The songs that were sung, the slogans that were written on the hand held boards: one even asking an individual from the health ministry whether medics should go on a diet of rats or something. The highlight of all was the response from the school’s administration after most students abandoned ship for a day. They alluded to an African proverb, something about medicine being a noble profession; a bath which we have already stripped for and we are too far in it to start complaining. I choose not to comment over the matter. Far as I'm concerned though, if the bath is too cold: you don’t quietly bath yourself into hypothermia or pneumonia while you can easily turn up the heat. That was my march with March ergo; I’ll digress to April.

Fools day was rather boring. It was on a Sunday, the foolish-sphere was under heavy heavenly surveillance I presume. I hope it lands on a Monday next year. I'm already imagining a patient playing a sick joke on an unsuspecting doctor. Oh, the irony. Then there is the April cold. This sudden change of weather got me thinking that the global thermostat had broken down or something. A week down the line and I think the cold means business. In fact, I’m barely able to type this.

Well, the cold carries with it some implications. Other than the fact that respiratory infections are on an all time high already, it marks the start of the mating season. I will give you the reasons in an order of most to least importance. One is the need for warmth; that’s where the bachelor envies the married man. The latter has someone to keep his lair warm. Secondly, people would rather stay indoors and avoid the cold outside. They will try and figure out several ways of having fun indoors and guess what will be at the top of the list (pervert’s trap). Last, the rate of spermatogenesis increases exponentially with the cold. If you don’t believe me, stay observant till late August to early December and notice the abrupt rise in the number of abdominally inflated females.

Last is Easter. The good book says that one man subjected himself to severe trauma and death for all to be forgiven. Whether it happened around this time or not, that is still under question. The main lesson here is that of sacrifice and forgiveness. On that note, thank you for sacrificing your time for reading this blog. I hope you forgive all your haters and love everyone else during this season and after. Take good care of thyself as you go about your celebrations.

As for me, ideally; I would be scrubbing into my kitchen in readiness for the debridement of my Good Friday chicken. In related news, someone please turn up the thermostat, it’s taking too damn long to boil them Easter eggs.

A SURGICAL APPROACH TO THE KENYAN POLITICIAN

My general surgery rotations in med school are so far quite something. This is one field of medicine that I piously revere. See, the job here is straight forward; see a patient, deliberate their fate with other intelligent colleagues, open them up and fix whatever is wrong and hope nature will handle the rest. Sounds pretty simple doesn’t it? Well, even with my meager background of medicine, I can tell you; it’s not all that simple. That’s why surgeons are revered as demi-gods by laymen and envied by their other less daring counterparts. One thing that I have learnt though is that surgical patients need to be overly analyzed if treatment is to work. And to put my newly acquired skills into action, I will present to you a very familiar surgical case: the Kenyan politician.

Typically, this patient is a geriatric male presenting with an overly distended abdomen, verbal diarrhea and mild kleptomaniac tendencies. This clinical condition is called politicsitis. All cases have a history of election to parliament as the predisposing factor. The onset of these symptoms is insidious, with the acute phase coming soon after election and chronicity kicking in as little as four months later. The disease escalates from a mere infection to a premalignant condition known as a politicytoma about four years later. This may graduate to a malignant condition that will be illustrated below.

The pathophysiology of this condition is as intriguing as the politician himself. I will therefore try to illustrate each symptom according to the latest medical findings. The distended abdomen is usually the earliest symptom. Due to exposure to the ‘greed atmosphere’ of parliamentary quarters, the average politician tends to gormandize on public funds. This directly impacts on their gastrointestinal system culminating to constipation. The adynamism of their intestines culminates into an infective process: politicsitis.

Acute politicsitis rapidly turns into a chronic systemic complication. While the politician seems healthy to the ordinary mwananchi, he is suffering inside. Consequently, the incumbent becomes rare to the electorate to nurse a disease process that is now a vicious cycle. This phase of the disease is the longest, lasting from the sixth month to the fourth year of the electoral term. During its active phase, it is a vicious cycle that presents with kleptomaniac tendencies and hypersomnia especially in parliamentary proceedings. Absconding of duties is also observed and when the politician makes a show, verbal diarrhea is very evident. The three symptoms i.e. kleptomania, absconding and verbal diarrhea are collectively known as the Vulture’s Triad. If they are not well monitored (as happens in most cases) the premalignant phase is imminent.

The premalignant condition, politicytoma, is a benign tumor that affects the frontal and temporal lobes of the brain. Its cause is unknown though Evidence Based Medicine suggests that tribalism, greed for re-election and corruption are predisposing factors. It starts late in the electoral term. The gross presentation of its onset includes holding irrelevant prayer gatherings and paranoia with formation and disbandment party and tribal alliances. This phase is also characterized by a lot of verbal diarrhea secondary to severe cognitive embarrassment. It is no wonder that a brain biopsy analyzed microscopically reveals very few normal neurons strangulated by large tumor cells; the Cells of Idiot. This is a pathognomonic feature of this stage. Where a biopsy test is unavailable, one can conduct an easy ‘Lame Joke Test’ where in his attempt to please everyone in exchange for votes; the politician will blatantly laugh at the lamest of jokes. This characteristic howling laughter is known as the Howling Hyena Syndrome abbreviated as HHS.

Its prognosis is poor as it turns into a malignant condition (Politicytosarcoma) just before elections. The chief site of metastasis is the electorate via 'pouring of money', cheap liquor and false promises. The symptoms of metastases may range from mild e.g. nominating the politician as a ‘tribal figure head’; moderate e.g. soliciting for signatures to postpone Hague trials; to severe ones like the post election violence (how fast we forget).

Unfortunately (very unfortunately indeed), this nagging condition is rarely fatal. Its management is also challenging due to poor compliance and high recurrence rates. In an ideal situation however, radical management is prime. Patients should be exterminated from the larger society and completely forgotten about. Those in advanced disease stages should be deprived of palliative sympathy and any vote treatment. The latter drug is known to aggravate the disease. Prevention is by isolating and electing leaders with a strong immunity and a will to work with relevant stakeholders to cure society of this disease. Otherwise, I know I would be speaking on your behalf by saying that we are all getting sick of this, wouldn't I?

ON CLERKSHIP AND DRY BONES

The epitome of a medical student’s life is clerkship: that’s before graduating from med school of course. My clerkship started on a rather interesting note. My first rotation was in Orthopedic Surgery. Orthopedics is basically the medicine of the musculoskeletal system; at least in theory it is. Where I was, things roll a little bit differently.



The wards:

I learnt to locate these by my sense of smell, which (I must say) was bad for most of the rotation owing to the weekly visits to the Ear Nose and Throat clinics. Most of the cases there are trauma. Unfortunately, trauma cases are on the increase. In fact, road traffic accident victims occupy most of the beds. The rest are victims of burglar attacks, ‘Nyerification’, survivors of a ‘Wanjiru episode’ or those who believed they could fly, actually tried it and lived to tell the story. And after the trauma of natural and not so natural causes, they are all bundled up in the ward (that explains the stench). Their fate: a simple recovery or, being victims of malpractice, a long uncomfortable and complicated hospital stay and an even longer hospital bill.

The consultant:

My admiration of our consultant knows no bounds. A simple hulk of a man, a frame built well enough to break a bone and fix it. He has this gorilla-esque demeanor, an ever twisted neck-tie and an uncanny sense of sarcasm that only ages of practice can justify. And he knows his stuff too. His teaching techniques, rather unorthodox I must say. He keeps pinging very open ended questions: like telling you something about a fracture and asking you what you should tell the anesthetist (like it’s him who broke a bone). He likes concise answers, very military of him I should add. In fact, all he needs is a stolen war medal to make a fool proof alibi of his being a veteran war medic.

The practice:

You know those moments when you are about to do something then your friends tell you to break a leg? Well, it’s not that easy. Neither is fixing a broken one. Actually it depends. The simple ones just need a cast, but when surgery is required the game changes. A chisel, a hammer, some screws and plates, nails, tape measure and other things to measure angles, bolts to mention but a few… those are the essential tools of carpentry, erm, sorry: orthopedic surgery. So similar are these two that one famous orthopedic surgeon wrote, “To operate on the bone requires the tools of a carpenter, yet orthopedic surgery is not carpentry; the biological imperatives ensure that it can never be.”

The lessons:

Other than the simple straight forward concepts, there are a few other bizarre ones I have to mention. First, the indications for limb amputation of are better known as the 3 ‘D’s : Dead /Dying, Dangerous, or Damn nuisance (that’s how they wrote it I swear). Secondly, a boner is not a bone: just plenty of blood in erectile soft tissue. The hydrostatics behind it is plain to the eye. The paradox is that one can get a fracture of the penis. Let’s leave the cause of that to doctor-patient confidentiality and its management to your imagination.

What next?

Next on my plate is general surgery. Before that, I hope none of my friends will ever say that they have a bone to chew with me because from then onwards, I will assume they are talking hyenas. As for my new rotation, I'm mostly looking forward to it. I must say though that I associate it with a lot of alliteration: Surgery, Surgeon, Scalpel, Sear, Suction, Scaffold, Suture, Strap… Sigh; let me display my ignorance no further.

HIGH SCHOOL NONSENSE: THE REWRITE

My high school days were nothing short of hilarious. Where I went to high school, form one students were called ‘nyani’. That’s Swahili for baboon - though in high school context it generally referred to any non human primate (with a tail preferably). Legend has it that in some past era, a form one student climbed a tree right outside my former dorm in search of some distasteful fruit. This boyish escapade ended up in him falling and breaking his arm. From then onwards, all form ones were labeled 'nyani'.

Other characteristics of this primate species of students included; high speed darting to the dining hall at mealtimes (we are talking Kapsabet Express, Rudisha and Usain Bolt kind of speeds), mortal fear of prefects and seniors, an invisible tail and a very retarded reasoning capacity. Class time took less than a meager percentage of their time. They spent most of the day running, scrubbing floors, kneeling and doing other punishments.


Higher up the evolutionary chain were form two students. This lot was often referred to as 'Nyati', Swahili for buffalo. Students in this stage of learning exhibited defiance and some improvement in reasoning. The reasoning bit is best captured by an incident I forever hold funny in my chest of gags. On that day the deputy principal was doing his usual patrols snooping for 'crime'. He happened to stumble upon this 'culprit' ogling at pictures of lingerie models on an old newspaper during prep time. Here is how the situation went down:

Deputy: Kijana (young man), give me that.

Student: {obviously shocked that he has been caught red handed, hands the paper to the deputy}

Deputy: {acting deeply perturbed} What is this you are looking at young man? Why are you reading 'pornographic' material during class time? (FYI, those were pictures from a national newspaper)

Student: {strongly fighting the urge to giggle, then looks up and replies simply}actually sir, I was wondering how such profane material found its way into such a prestigious learning environment…

Rest of the class: {dead!}

Form twos however wore shorts, ditto for Form ones(I hated shorts!). They therefore had an affinity to ‘harvest’ clothes belonging to the Nyani’s from the hanging lines. Save for the geeks, this lot also had an immense loss of focus and a tendency to read for tests at the very last minute - if they ever read at all.

As for the senior students, I don’t recall any alternative names given to them except the common 'Fisi' (Hyena). In credence to the name, all the girls that attended school functions rightfully belonged to this lot. Wearing trousers implied you had taken a quantum leap up the 'evolution ladder'. A senior was regarded as a higher level primate; a Homo sapien to be precise.

Indeed, some form of sanity had fully kicked in amongst most members of this species. This special lot had access to the senior route. Worth mentioning were their rights to solicit for ‘favours’ from juniors ranging from unlimited laundry services to errands like shopping at the canteen (at the juniors' expense of course). Being a senior also meant that running to and fro was no longer compulsory. Members therefore adopted a new way to locomote; walking, or a type of sluggish running which fell more on the extremes of brisk walking whenever required.

There were some other interesting entities who I have to mention to complete this high school story. These are

The principal

INTEL
Alias: Raich, Yao Ming

Height: pygmies are taller

Nationality: Kenyan

Language: English and Meru… a lot of Meru

Famous quotes: "some people ave to mbe protected against themselves", "we ave to ngo out of our way…" (And boy, all talks on sacrifices had so many 'ways' to 'ngo' out of)

Motives: Lead the school, Command fear, Make money… lots of money


The deputy principal

INTEL
Alias: Nyastu

Height: tall enough to slap the 'evil Knievel' out of you

Nationality: (Origins rather unclear) Snake Park, maybe hells gate? No. Hell is a tad bit more precise

Language: Swahili (he was out to give the language a bad name), English

Famous quotes: "usilibughudhi jike lipitalo" (whatever that’s supposed to mean), "hamjambo" (an ice breaker), "student of goodwill" (read snitch)

Motive: Find ass, slap ass, whoop ass, kick ass, suspend or expel ass….. jack ass!

The discipline master

INTEL
Alias: Thendex, JW, Jesus Walks, Jonny Walker, Waithaka e.t.c

Height: towering, tall enough to arrest lightening

Nationality: Murang'a

Language: Kikuyu, English-kikuyu… did I mention Kikuyu?

Famous quotes: “bring a squizer, a broom, a pairo (pail) and a bakett (bucket)” (and my personal favourite) “crass monta, I can see three-quota of the crass is hia, where is the other haf?” etc

Special Adaptations: tall for a larger radius of surveillance, large strides and slightly leaning forward when walking for speed. This dude was always on top gear. Massive memory: from biometrics recognition, to easy Intel retrieval including culprits full name (with abbreviations), admission number, crime time and site, evidence, both parents' addresses and any other previous encounters. He was a walking forensics lab. Others adaptations are athleticism and insomnia (whoever said we needed a bell ringer to wake us up in the wee hours of the morning).

Motive: You can run young man, but you can't hide

Conclusion: High school had its moments, but I NEVER wish to go back there.

A BEAUTIFUL TALE ON THE PARCHMENT OF INSOMNIA

Once upon a time, the Creator needed a hand. After a thought, He conjured a man. He wove around him a weakness for writing, a longing for curing, an eye for the arts and an ear for music and poetry. Within him, He placed a deep, resilient soul. Around him, were simplicity, subtlety and flaw. He then let him out into the world and set him on the path of life. As time went by, the Creator noticed a vast and troubled emptiness within this man. This 'flaw' was taking its toll on the man. There was a need to make an antidote for this flaw lest the man veered off on his path of life. After thoughtful consideration, He decided to make a painting.

So on a designated day, He set out before sunrise to the windward of the heavenly hill side. This place had the most exquisite view in the entire universe. With Him was a priceless canvas, a unique set of brushes and a collection of the rarest of pigments. He found the ideal spot on the hill side, settled on a rostrum and waited. At the first ray of dawn, He struck his first mark on the canvas with his brush. And for twelve painstaking hours, he struck his brush gently and carefully umpteen more times until the last ray of the sun. For with the sunset came his completing stroke. He stood back and looked at the painting. It was ideal, so perfect was it to his eyes, it deserved to be brought to life He thought. This would be the best gift to the ailing man. So the Creator set back to his premises, this time satisfaction welling within him. He was eager to summon the man in the morrow.

The next day, the man found himself in the dark of the heavenly hill side, the creator astute by His side. A little puzzled, the man inquired why he had been brought back to heaven on such short notice. The Creator explained to him that he had a special gift, one that was intended to change his life for the better. Within that moment, the night gave in to dawn. The sun, with all its majesty, cut slowly through the morning chill. In its aura was the silhouette of stunning beauty. So unique was this astounding image that the plethora of God's creation paused momentarily in its recognition. The man's heart bubbled with bliss, as his emptiness faded. In that instant, he found his feet carrying him towards this sight-to-behold, his eager steps gradually transforming into flight. His hands reached out this newly found treasured gift. His speech failed him, but his eyes glowed in awe. She was the most exquisite thing he could never describe. Her gentle eyes, dainty nose, soft smooth skin, stunning smile, perfect curves and her breathtaking ambience amalgamated into pristine beauty. She was flagrantly fragrant. He embraced her warm frame; it was his first ever serendipity.

Having witnessed this magical moment, the creator wished them well, let them back into the world and retired to his premise; a satisfied being. Together, they were united in life. They walk the same path, but in different shoes. The man had never felt as complete before. She laughs at his stupidity; her giggle is magical, more so how she lifts her foot when laughing. He likes their random kisses; her petal soft lips, how they evoke a rush within him. He smiles at her naivety, her deep sense of keenness, her feminine strength and her prowess in culinary. She has a thing for music, often depicted in her graceful gyrations. She is a kindred spirit, one he admires in awe; a fragile heart he will ever hold so close.

She is his patient; contagiously love sick. He is her doctor, somewhat addicted to her contagion. Between them is a sense of uncanny ambivalence, a Utopian reality, joyful hurt, dry tears, a confusing epiphany and most importantly an everlasting moment: sweet and treasured. Emotional alteration is their subtle tuner, and life's turbulence serves as a constant polisher to what they have. The man embraces it all with thanksgiving, as a priceless present, which he strives to set on a pedestal despite his misgivings. And everyday, he sends a silent prayer to the Creator; that in her deepest insecurity, He may so often so softly remind her, that she was specially and specifically made for him, and he will always be there.

THE SCARE THAT IS 2012, OR NOT

The Hippocratic Oath requires medics to recognize the frailty of human life; and as such act to save life, not pose as gods. Sometimes however, I ask my self whether human life is really that frail. I mean different people are caught up in similar situations all the time. While some - rather most - brace themselves and walk out of it; others insist on pegging their lives around the worst possible outcomes. The former lot takes life by the horns, while the latter are like naïve matadors in the ring, devoid of the red flag. The out come is rather obvious don’t you think? So what am I drawing at? The fact that the modern world is consistently bombarded with unnecessary and sometimes disturbing information about the world ending.

It all started with one Reverend Harold Camping's first prediction in 1994. Well, maybe there were earlier predictions by other characters prior. Since I wasn’t around yet as they were happening, I presume it safe to announce that the world never ended. Now, let's get back to Mr. Camping. This man announced the end of the world on September 6th that year, later postponing it to May 21st 2011. He then postponed it, again, to October 21st, same year. The reason for changing the dates according to him was a 'miscalculation'. The irony is that the fellow has a degree in engineering. Miscalculation should therefore not exactly be his specialty. Somehow, the old man still managed to pull a hat trick on the scare contest (applause). If the 'good' reverend still has a following, I wonder what his flock thinks of him.

Then there was Y2K at the turn of the century. It started as a potential logistical scare in the computing and business world. Computers back then were programmed to date up to 1999 and therefore the aforementioned stakeholders risked distorting huge amounts of data. This would rather be disadvantageous. Somehow, the media and some pessimistic isolates in the public extrapolated the scare into a full blown potential disaster. I clearly remember the 31st night of December 1999. I stayed up late that day. Picture a scared kid waiting for the trumpets and heavenly escalators to materialize in the skies at night. Midnight kicks in, and the crossover is just as usual; fireworks, disturbed barking dogs, then the night retires to a few cricket chirps here and there. Oh brother!

It is even more disappointing that some of the most famous civilizations had to join in this scaring game. Case in point: the Mayans and the Aztecs. I think whoever they decided to designate the role of 'chronologist' to suffered from a severe case of Pessimismosis - not a real disease, though I believe you get the idea. It is for that particular reason, in my opinion, that somehow the Aztec and the Mayan calendars' had to end at December 24th this year and December 23rd next year respectively. As I wait for Christmas this year, I am hardly surprised why these civilizations are almost non existent.

Lastly, there is this fellow Nostradamus. If there is one policy in life I live by, it is not to trust any information contained in someone's autobiography. To prove this, I will digress to Hitler and his book Mein Kampf (My struggle). I will not divulge into its contents, but just from the title, you are left wondering what sort of struggle this man was writing about. Whether it was liberating Germany from western influences, or 'cleansing' the Arian race off Jewish infiltration, this guy was pure evil; I give not a tad about his struggle.

Nostradamus had an autobiography and a book, Les Propheties (The prophecies). Last time I checked, prophecies emphasized on three things; time, manner, place. His book however makes no tangible sense in the named aspects. In fact, while some people try hard to interpret its contents according to modern day events, a segment of his critics describe his quatrain poetic writings as 'vague', 'inaccurate' and 'baseless'. A school of thought even argues that Nostradamus was expelled from University of Montpellier Medical School, after which he took to being a quack in the French countryside. In his own record, he took to studying astrology using cosmologic reflections from a bowl of water and interpreting them in a state of 'trance'. As with autobiographers, I have a deep seated mistrust for quacks. Then the mention of trance brings two things to mind, cannabis and methamphetamine (crystal meth). No further comments honorable readers.

In concluding, I tend to think that the outstanding feature about the human race is its consistent sense of optimism. A few characters are usually out to preach the worst about everything. Some of us believe it and react by selling all our property, buying gas masks, building bunkers, 'cleansing' ourselves with fire, worshiping guys who just landed in our locale using parachutes, to mention but a few. The rest of us however coolly trudge on into the future with special motives, faith in the Creator and a resilient sense of optimism. It is for the latter that I do not listen to propaganda, nor lend an ear to sad music. In fact, you can play all that after my funeral for all I care. For now, 2012 is another year for us to prove ourselves as human beings; the best and strongest species the universe has yet.

SUPPOSE SANTA WAS A KIKUYU...

Well, it's Christmas again, that short time of the year when the usual activities are replaced by traveling, eating (even while traveling), drinking and making merry. I don’t want to go on about what happens during Christmas lest you start accusing me of having a firm grasp of the obvious. Lets talk about something eccentric instead. Something like; what if Santa Claus was a Kikuyu?

Ditch the white guy, the red clothing, black boots and the hat. In their place, put a hefty middle aged Kikuyu man in a blue Savco jean, a yellow 'Ng'ombe' T shirt, Safari Boots and a beige 'Blue Triangle Cement' flat face as a hat. You could switch the latter with a cowboy hat or a turban if you like. That’s your average Kikuyu Santa.

Santa Claus Village would be Gatunguru village in Murang'a County. I hear that is where all enterprising Kikuyus hail from.

The guy would roll in a Toyota Probox or a hand cart depending on how much a liter of petrol is going for on Christmas Eve. These are trying economic times remember? Either way, the vehicle would be pulled by donkeys.

The elves would be four to six standard three boys from Mushatha Primary School (probably Santa's sons or nephews).

Carols such as 'Njingo Mbews' and 'We Wich You A Melly Krithimath' would be remixed by John De Mathew and the likes to more conversant 'Mugithi' tunes.

Gifts would be wrapped in banana leaves. They would definitely be for sale.

The Probox would work as a Taxi on Christmas day. Hakuna kuregarega!

Christmas bells would be replaced by the 'Coro' horn.

The 'Merry Christmas' greeting is a little hard for the average Kiuk Santa to repeat all day. After all, 'Engrish' came into this land via a 'Chip' (read ship). How about something simpler like 'Mujiejoyy! Ho Ho Ho!' Its a good thing Kikuyus do not shrub 'H' sounds.

Finally, Luo's, Kalenjins and Luhya's would be 'Claus'trophobic

That said, I am now gearing up to celebrate Kwanza this time round. To all loved ones, friends, followers and readers of this blog, have Happy Holidays. Try not to eat yourself to constipation, drink yourself to a comma, or drive yourself into a ditch. In case you do, you know where to find me. J.K. Mujiejoyy!!

MEDICAL SPECIALIZATIONS AND THEIR DAFYNITIONS

Being a medical student is a 'jack of all trades and master of none' affair. It really leaves me at a loss of where I would like to go after the next three years of clerkship and hard labor. But that’s far off, for now; let me share what I sometimes think of some of these professions whenever my mind wanders:

Mortician/ Pathologist
Male: Either you are a weirdo, or you just get the kicks out of telling people, 'OK, we'll still meet: sooner or later'.
Female: Seriously lady, get a life. (I mean that literally too)

Proctologist
The ass kissing you did in med school, it wasn’t meant to be a profession.

Psychiatrist
Me: Hey, so what is your job like?
Answer: Well, I just sit all day, listen to people say their problems, observe their behavior and confirm they are insane
Me: Really, that’s all?
Answer: Yes, that’s all I do.
Me: Erm, I think you need to see a psychiatrist.

Gynecologist
Young male gynecologist: You pervert!
Older male gynecologist: Yeah, I know you have saved many damsels in distress. Still, you pervert!
Female gynecologist: Girl power; way to go lady, way to go!

Urologist
Male urologist (age regardless): Bro dude, you either have balls of titanium (three balls to be exact) or I am asking questions about your position on the sexual fence.
Female urologist: Well, well, well, what have we here? For one reason or another, I am cocksure (that's an English phrase) you never lack patients. In other news, way to go ma'am, way to go!

Orthopedics
You sadist, all you do is wait for accidents to happen.

Geriatrics
Roses are red, violets are blue, the patients are old, the job is too.

Obstetrics
I bet you never have Monday blues; all you do is witness and facilitate miracles for a living.

Neurologist/ Neurosurgeon
Until the day you find the cure for stupidity, whatever your job entails will never really equate the number of years you spend in medical school.

Cardiologist
We mend broken hearts; hearts full of cholesterol to be precise.

Cosmetic surgeon
The barbie doll industry is at last alive. Using a blade to draw curves and conjure smiles, totally awesome job. Yeah, even the part you ensure ladies stop seeing their feet whenever they glance down.

Oncologist
Either your sense of optimism is enough to move mountains (read tumors), or you and the hearse driver have a lot in common.

Lastly, Kenyan General Practitioner
The Game to Dr. Dre: 'Yo Dre, I see debt people.'

FATHER FORGETS by W. Livingston Larned

Listen, son: I am saying this as you lie asleep, one little paw crumpled under your cheek and the blond curls stickily wet on your damp forehead. I have stolen into your room alone. Just a few minutes ago, as I sat reading my paper in the library, a stifling wave of remorse swept over me. Guiltily I came to your bedside.

There are the things I was thinking, son: I had been cross to you. I scolded you as you were dressing for school because you gave your face merely a dab with a towel. I took you to task for not cleaning your shoes. I called out angrily when you threw some of your things on the floor.

At breakfast I found fault, too. You spilled things. You gulped down your food. You put your elbows on the table. You spread butter too thick on your bread. And as you started off to play and I made for my train, you turned and waved a hand and called, "Goodbye, Daddy!" and I frowned, and said in reply, "Hold your shoulders back!"

Then it began all over again in the late afternoon. As I came up the road I spied you, down on your knees, playing marbles. There were holes in your stockings. I humiliated you before your boyfriends by marching you ahead of me to the house. Stockings were expensive-and if you had to buy them you would be more careful! Imagine that, son, from a father!

Do you remember, later, when I was reading in the library, how you came in timidly, with a sort of hurt look in your eyes? When I glanced up over my paper, impatient at the interruption, you hesitated at the door. "What is it you want?" I snapped. You said nothing, but ran across in one tempestuous plunge, and threw your arms
around my neck and kissed me, and your small arms tightened with an affection that God had set blooming in your heart and which even neglect could not wither. And then you were gone, pattering up the stairs.

Well, son, it was shortly after wards that my paper slipped from my hands and a terrible sickening fear came over me. What has habit been doing to me? The habit of finding fault, of reprimanding-this was my reward to you for being a boy. It was not that I did not love you; it was that I expected too much of youth. I was measuring you by the yardstick of my own years.

And there was so much that was good and fine and true in your character. The little heart of you was as big as the dawn itself over the wide hills. This was shown by your spontaneous impulse to rush in and kiss me good night. Nothing else matters tonight, son. I have come to your bedside in the darkness, and I have knelt there, ashamed!

It is feeble atonement; I know you would not understand these things if I told them to you during your waking hours. But tomorrow I will be a real daddy! I will chum with you, and suffer when you suffer, and laugh when you laugh. I will bite my tongue when impatient words come. I will keep saying as if it were a ritual: "He is nothing but a boy-a little boy!"

I am afraid I have visualized you as a man. Yet as I see you now, son, crumpled and weary in your cot, I see that you are still a baby. Yesterday you were in your mother's arms, your head on her shoulder. I have asked too much, too much, yet given too little of myself. Promise me, as I teach you to have the manners of a man, that you will remind me how to have the loving spirit of a child.

LETTER FROM A CLERK TO THE ALMIGHTY

Dear Almighty,

It's been quite a long while since we talked. I know it is entirely my fault. I hereby ask for your never ending forgiveness. I think I should start by saying a big THANK YOU for all your great works. And indeed, they are numerous. On the sixth day for instance, all the credit goes to you for creating employment for all medical personnel. Other works include helping us to get by medical school much as studying there sometimes practically translates to student + dying. My gratitude to you is immeasurable. Today however, I have several issues I need to bring to your attention.

Now that the pre clinical years are gone, the climb uphill just got steeper. This means I no longer deal with books only, but now more directly with those you require of me to help, and those who you have put to teach me. I therefore ask four things from you as I embark on my clerkship next year onwards.

Keep me safe from all nosocomial infections. I know the system I am placed in does not provide as much safety as would be required. I also know you work under different terms. Your protective cover is universal, and is always available for those who ask for it. Sometimes we do not even have to ask for it, yet it is still there. That is written in all the good books. So here I am again asking for your protective care.

Enable me to have mental clarity. What good is a doctor if they cannot maintain their cool? I have experienced some of the tough things the system puts my mind through. How easy it is to forget important terms, how limited my mental capacity is and even how my body lets me down at times. Only you are in the position to give constant renewal, only you can fix what is beyond me. For all its worth, I ask for lucidity.

Clear my path of all nurse's, resident's or attending's malice. Yes, you are aware of how bureaucratic the medical system gets. Everyone can be edgy sometimes. For reasons best known to them and perhaps Satan himself, they lose all benevolence and get on a dreaded medic-annihilation rampage. It is for this reason that I pray for the safety of my neck.

Lastly, I ask you to take good care of all who I am in this journey with. Lecturers, fellow medics, friends and those I love. You know what they fear, all that drives them forward and everything that keeps them on course. It is said that you are omniscient and much as I am a man of science, I do believe that. So as you walk with me, I ask you to hold their hands too so we all move together.

When all is said and done, you are the sole reason for all this. Hence again, I thank you. It is said you work in mysterious ways, I believe that too. I will be waiting for a response, a sign, e-mail, text or maybe just a small inner voice: whatever it is, I will be waiting.

Yours sincerely,
The Bush Doctor

15 MEDICS ON A DEAD MAN’S CHEST

If you believe that dead men tell no tales then stop reading this for just a sec. Yes, I am talking to you: STOP. Now that I have your attention, laugh at yourself: laugh real hard. You might as well believe in a black Santa Claus, wildebeests pulling his cart on the dunes of the Kalahari Desert and pigmies helping him dish out kola nuts. Now that you have laughed at yourself let me get to the point. The only way we get to learn human anatomy is by keenly listening to dead men. Enter the rendezvous point (the morgue). I may have been high on formalin half the time I was there, but I do have a tale or two from the dead to share. So sit back, read on and enjoy these stories.

Tale #1: Muscles sure are a piece of work!
From their Latinised names, to knowing their relations, attachments, nerves and blood supply; these were some of the hardest tales to master from the dead. The paradox is that most of the large muscles have short names (example gluteus maximus) while the most of the small ones have hyper-extended names (talk of levator labii superioris alequi nasi). The latter muscle, by the way, is a facial muscle which when in bilateral use makes one resemble a beaver or something.

Tale #2: Breasts aren’t all they seem to be.
And I quote, ‘let’s talk about this beautiful structure called the breast.’ Breasts are a vital component of the human being. From nurturing young ones, to being a focal point of feminine aesthetics and playing a major role once lights are off: they are central to the completeness of female anatomy. (For guys reading this, take a moment of silence and think how the world would be without breasts) But did you know that breasts are modified sweat glands? For the record, I am talking about natural breasts here. Anything after a visit to a cosmetic surgeon is, well: just a modified……balloon..?

Tale #3: Hips do lie
The truth, at last! You see those well crafted parts of feminine anatomy that men ogle at, they are all an illusion. Let me expound. Hips are bony protrusions of the proximal femur (thigh bone) that are accentuated by a wide feminine pelvic girdle. What makes them look supple and rounded is the skin and the ample padding of fat underneath. I bet the Maker looked at this part of His creation and said, ‘Now that my friends, is how to keep that guy Adam staring.’

All these and more stories we hear from the dead help us later to cure the living. So for all those who ask me why I am still a medic yet we frequently deal with the dead, now you have your answer. It is an interesting experience (no weirdo). Were it not for the putrid formalin, 'communications' with the dead would be next to impossible. Just so we are clear, ‘putrid’ here translates to the smell of a well blended cocktail of a kg of crushed onions and about a liter of stale urine. In the end however, one thing stands astute: God’s creations are supremely exquisite.

BIZARRE THOUGHTS FROM A MAN'S HEART

It is said that men and women will never get along. Maybe it is because we all want different things. Men definately want women; but what women want, that is hard to tell. However, one thing that all normal men and women should agree on is that some chauvinistic jokes can be funny. I stumbled upon a few gags which I think you would want to check out:

Thought 1
When we are born, our mothers get the complements and the flowers
When we are married, our brides get the presents and the publicity
When we die, our widows get the life insurance
What do women want to be liberated from?

Thought 2
The average man’s life consists of:
Twenty years of having his mother ask him where he is going
Forty years of having his wife ask him the same question
And at the end, mourners wondering too where he is going

Thought 3
Everyone in the wedding ceremony was watching the radiant bride as her father escorted her down the aisle to give her away to the groom. Once they reached the alter, the bride kissed her father and placed something in his hand as the groom waited. Everyone in the room was wondering what the bride had given her father.

The father could feel the cloud of curiosity in the air as all eyes were on him; prodding him to divulge the secret and say something. So he announced, ‘Ladies and gentlemen, today is the luckiest day of my life…’ He then went on to raise his hand and that of his daughter and continued, ‘My daughter finally…, finallyyy returned my credit card to me!’

The whole audience, the priest inclusive, burst into hysterical bouts of laughter: all save for the poor groom!

Thought 4
A man was walking down the street when he heard a voice from behind, ’if you take another step, a brick will fall on your head and kill you.’ So he stopped and the brick fell right in front of him. The man was astounded. He went on and after a while he was about to cross the road when the same voice shouted, ‘Stop! Stand still! If you take another step a car will run you over and you will die.’

So the man stopped and a car came careening around the corner barely missing him. Overwhelmed with curiosity, the man asked, ‘who are you?’ ‘I am your guardian angel’, the voice replied.

‘Oh yeah?’ said the man, ‘and where the hell were you when I got married?'

THREE WEEKS, FOUR EXAMS AND A COUPLE OF SENTIMENTS

I must admit that I have just had the longest three weeks this year. Somehow, the gods want to prolong the three week streak by adding a fourth week! In fact, I am still negotiating with them for a hiatus. I thought it would be prudent to jot down a few remarks from the three-week experience as I wait for their reply:

1. I officially accept that medicine is a grey area. For starters, any medical experiences (like exams) that turn you from a ‘doctor hopeful’ to a ‘pessimistic-optimist’ are proof of this. Other grey things include the 2.5kg grey's anatomy textbook, grey stethoscopes, and the plenty of grey I have been seeing lately every time I open my closet!

2. This goes to all medical students. If you have an oral exam and an inner voice tells you that an Egyptian lecturer might to oral you, please turn around and scurry for your life as fast as your distal appendages can carry you. An exception is if this Egyptian lecturer is one Prof. Malek of Embryology. You see, Romans crucified wrong doers; Egyptians on the other hand have a thing for medical students. After they crucify you mentally, they might mummify your brains just because they can. (yes, I had an Egyptian examiner for my orals)

3. I think I have a case of mild egyptiophobia. (Refer to sentiment no. 2)

4. ........Screw fear. (now that’s what I call a fast recovery)

5. The way to a man’s heart is through his stomach. I am still working on the physiological and anatomical explanation to this theory. In the meantime, it is safe to assume that men with dysgeusia, esophageal stenosis, GERD and other intestinal pathologies DO NOT conform.

6. The line between straight and gay is getting thinner by the day. I partly blame Kenyan TV stations and all the soaps they have been airing lately.

7. The only person who can solve your problems is you. Other people only serve to guide you, or help you realize how stupid you are. From me to you, this is so true.

8. ‘A bro leaves the toilet seat up for his bros’. Ref: Article 81 of Barney Stinson and Michael Kuhn’s Bro Code. That book is a must read for all the bros!

9. Many writers suffer from depression or a bipolar disorder at one time in their lives. This is bad news and it gets worse:

10. ‘He who lives by the sword dies by the sword!’ That’s the writing on the wall in my former hostel room. I caught a glimpse of it amidst a heated argument with this angry halls custodian. Well, since I’d still like to become a surgeon someday and live by ‘the scalpel’, a little part of me wonders how all that will end. But alas, I digress from the main reason I am here. That regardless where life takes me, I’m bent on living great so I can die free.