In my previous post on Handwriting and Cracking Eggs, I mentioned about doctors and their (in)famous handwriting. It reminded me of Dr. Njoroge.
Njoroge Mûndagĩtarĩ or Dr. Njoroge was my childhood family doctor, or more appropriately the village doctor. He was the doctor for the whole village of Shamata, in Nyandarua County. Njoroge was a huge man. It is possible that he was not a doctor, as in a holder of Bachelor of Medicine, but a Clinical Officer. Back in the days, it was rare to have a full MD attached to a public health clinic. In the village however, we make no distinction between a CO and an MD. Anyone in a white lab coat, eyeglasses and dangling a stethoscope around the neck is a doctor.
Njoroge was among three people in my village with whom it paid to be in good relationship. Unless, of course, you were planning on relocating. The other two were David, the Village Elder and Mwaniki Mûthigari, the local Administration Police officer. A village elder was and still is a powerful individual. He presides over simple civil disputes, for instance, whose cow broke into whose shamba and feasted on how many stalks of maize. He determines how much owner of the offending cow owes the maize farmer. Life is so much easier if the Village Elder has nothing against you. Unless you want yours to be the only cow with teeth that can chew a neighbour’s maize.
Mwaniki the AP was the embodiment of law enforcement. You did not want him enforcing anything against you.
Njoroge’s power base was the local Ministry of Health clinic. His second in command was Lydia, the nurse. Between Njoroge, Lydia, a woman who dispensed medication at the pharmacy and a watchie, the clinic ran like a well-oiled machine. Patients started streaming in early in the morning before the doors opened. The Watchie was responsible for ensuring that people sat in order of their arrival at the waiting area. His other equally important job was to run after boys who occasionally bolted out of the clinic once they learnt that their treatment plan included an injection. Patients who were not too sick to help often joined in the chase. It takes a village to raise a child and to keep said child healthy!
The clinic opened at 8 o’clock on the dot. That was before strikes, go-slows and rioting became a thing. Lydia would make her entry in the waiting area in her spotless white uniform, complete with ironed-in pleats running the length of the dress at the front and the back. Her stripped cap neatly pinned right on top of the mane that was her Afro. I bet she would have a blog about natural hair called Kinky Nurse had she lived in our times.
Starting with the first patient, Lydia did a triage of sorts by asking what had brought each patient to the clinic. Today, a patient’s confidentiality is a big thing. No one cared about privacy back then. You narrated your problems right there in the waiting room, including the history of how long you had suffered. If yours was the bizarre story of losing part of your finger while feeding milk to a newborn calf (true story – I have a scar to show for it), other patients would lean forward to take a better look at your finger, tied up with makeshift bandage to stem the bleeding.
I never thought about it before, but I wonder how patients with really private and confidential illnesses navigated this practice. Let’s agree, there are some conditions that even in your prayer closet you skirt around the issue, as if someone besides God, is listening in. ‘Lord, you know my needs even before I utter them. I pray for a healing touch. Forgive me Lord’. Baas.
Electronic filing systems were non-existent, so visits to the clinic were logged on a card stock bearing a number that corresponded to the patient’s medical file number. Patients coming in for prescription refills were sent to the pharmacy. Those coming for injections went to a separate room to wait for Lydia. All others were sent to Njoroge’s office.
There was something about the doctors of that era. They were men and women of few words. Very few words. You entered the doctor’s office and stood in front of his desk. He would be writing away on a file, while you stood awkwardly trying to figure out the appropriate thing to do. Should I sit down the chair, climb on to the exam table and lie down with eyes closed, or continue to stand?
When he finally did lift his head to look at you from the top of his specs, all Njoroge would say was “uga”, “say”. No good morning, or how are you feeling. Cut down to chase: say! So you said, repeating the long version of what you narrated to Lydia at the waiting area. How you have a cough and a sore throat, and a dull headache. How long has the cough lingered for? Three days, you say, hoping that that duration is within the range that calls for the pink sweet cough syrup and no injections.
Njoroge listened to your breathing. He used a flashlight to examine the throat and reached behind the ears with his fingers to feel for possible presence of inflamed lymph nodes. Finally, he pulled down both eyelids to examine the eyes. Satisfied, he scribbled quickly on a piece of paper, handed it to you and with a wave of hand dismissed you. No explanation. No mention of what he may or may not have seen in the ears or mouth. Nothing about what he heard through the stethoscope.
I do not know if anyone ever dared to ask what the diagnosis was. I never did. I would simply pick up the prescription and leave. Outside, I tried to decipher what Dr. Njoroge had written in non-legible inscriptions resembling ancient Assyrian alphabets.
Am I dying? What is ailing me and how long do I have to live? More importantly, how many injections will I get?
Those injections! They were almost inescapable. It seemed to me that the pharmacy had just about five medications that were not administered via injections. There was Aspirin of course, that was a cure for all things pain. Then there were three types of cough medicine; a pink coloured sweet viscous suspension; a red translucent liquid that was sweet but had a bitter edge to it; and, a liquid that looked like concentrated urine – deep amber – and tasted like it! Sometimes when I visited the clinic with a cold, I was lucky to get the pink or red syrup. Other times, I was not so lucky and I got the ammonia tasting liquid! Then there was GV. Do not ask what GV stood or still stands for – I have no idea. It was that deep violet/purple liquid that was dabbed on wounds. The colour generally outlived the wound. It worked great as ink in fountain pens too.
If whatever was ailing you could not be treated using one of the five medications, you were likely looking at an injection, or injections. Your fate was in Lydia’s hands. Did I mention that the hypodermic needles back then were not disposable? They had stainless steel needles that were sterilized using steam. A stainless steel pot with water boiling over a gas stove was a permanent fixture, set up in one corner of the injections’ room.
Lydia would pick out the stainless steel hypodermic needle using a pair of stainless steel tongs and fix it on the syringe. She would draw medicine from one of the many vials, flick the syringe while holding it needle pointing upwards, and give the plunger a little push. A few drops of the medication would drip down the side of the needle, while she examined it like a torturer examines an instrument of torture.
She made her way to the cubicle where you waited, eyes fixed on the wall, trying to ignore the embarrassment that naturally comes with having to strip down for an injection. She would dab whichever unlucky side it was with some alcohol, administer the medicine, dab the injection site again and leave without so much as uttering a word. You pulled up your garment from the floor or wherever it may have stopped on its downward spiral, and walked out of the cubicle. Other patients waiting for their turn would look at your facial expression as you left. Was it painful? Will they survive theirs?
The good old days!
Nowadays of course, tons of medication are administered orally. And needle free injection technology (NFIT) that drives drugs through the skin using pressure, shock waves, etc. is replacing the hypodermic needle. Eventually, I guess there will be no need to worry whether your prescriptions includes injections!2