II

  Hand-over

  Light streaming in through the windows at either end, the L-shaped ward was quiet (if you ignored the beep of the machine hooked up to Ebuka, and the wall fans); the calm before the storm. On my left, at the doctors’ station, Dr. Ugo sat poring over folders while Dr. Adaobi (a classmate and one of the HOs on call last night) completed the hand-over note.

  Dr. James, the other HO, was seated beside her, his chair facing the opposite direction. He alerted her I’d arrived. She turned, waved, and I waved back.

  However, prior to this, my eyes had sought someone else first. The patient occupying the bed nearest the door. In nothing but his boxer shorts, propping himself up a bit on his elbows, Ebuka seemed to be in the same state as two nights ago. More or less. This was a relief. His grandmother’s attempts to spoon feed him tiny bite-sized pieces of Okpa could fare better. His uncle was nowhere in sight.

  Try as my mind might, it was difficult to take seriously the images it conjured of this boy, his grandmother, and his uncle as the beasts we’d fought then.

  A boy who’d presented with multiple seizure episodes occupied the bed directly across them, on the other side of the doctor’s station. The girl on one bed behind the doctors’ station was being managed for nephrotic syndrome. The bed next to her was a case of sickle cell crises; bone pain and acute chest syndrome, to be specific. He’d presented during my second night shift. Three other patients on the arm of the L brought the total number of patients on admission to seven. Although one of them (the child with AGE which Chisom and I had set a line for two days ago) was on no IV medications and was to be discharged today. They communicated this during the hand-over.

  Presently, I returned the key to the top drawer of the table at the nurses’ station, greeting the nurse seated there with a smile. “Good morning ma.”

  Short, fat, and coal dark, she was going through the write up in a long, hard-cover note book. “Ehe doc. good morning,” she replied, glancing up with a smile of her own. “Happy Sunday.”

  “Same to you,” I replied, then headed… I wasn’t sure whether to check on Ebuka first or greet my colleagues. I ended up doing the latter. My interaction with them was brief.

  I got a “GIG how far? Hope your off went well,” from Adaobi and a “God is Good the most punctual HO,” from Dr. James.

  The guy wouldn’t stop tormenting me with my name in full ever since I’d shared it with him during the ground ward round on Wednesday, or that I try to arrive on time for things. Asides the jokes about my punctuality, he asked me if I was on call with Chisom and if she’d arrived yet.

  At the same time, Adaobi was saying: “Happy Sunday. I would have finished this since but this your colleague here…” she pointed at Dr. James, a mock frown on her dark face “…has been distracting me. Let me just complete the last patient.”

  “Me or…?” he said, eyeing the patient who’d presented with fits while gripping her pen.

  “Dr. James…”

  While they bickered, I turned my attention to Ebuka. I could find out about their call during the hand-over.

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  I don’t remember who greeted who first, but Ebuka’s grandmother and I exchanged pleasantries first. She said she hadn’t seen me the day before. I explained to her I was off duty. Complaints followed before I could even utter another word. Igbo added flavour to her parts of the conversation, but I’ll translate directly.

  “Doctor see,” she said, tilting the bowl of Okpa towards me. “Doc. please tell Ebuka to be eating actual food. Let him be eating actual food—”

  I glanced down at the boy with skin as hard as stone. Innocent…suffer…guilty. He’d gone back to lying down before I came. The white rubber rosary she’d been praying with two days ago lay beside him. Same as on Friday, it called out to the Catholic in me today. Also reminded me I still needed to complete my rosary. I promised myself that I’d pray for them at Mass in the evening. Meanwhile, I said, “Mama what have you been giving him?”

  “Just water and juice. Since yesterday. Tell me, how can he get… get energy to sit up, how will his drugs work…? They said he…he should not be lying flat on the bed throughout the day. How will… will… how will he be moving if he doesn’t eat?” Her flabby, dark face was a mask of pain. “Even the kind water, nurse said he should drink a lot, that the urine she measured this morning had a strong odour and wasn’t enough.”

  His urine bag was empty.

  “Has he drunk water this morning?”

  She pointed to an iron cup and an open sachet of water in an expanding puddle of water next to it on the overbed table. “Yes. He drank small.”

  “Give him more,” I said, dabbing the puddle with my handkerchief— a third face, different from the two I’d used earlier. The more daring, least intelligent solutions come to the head first. “He should drink plenty of water o. The nurse told you.”

  She nodded, elevating him slightly so he could sip the water from the cup in her hands. Were this a murder investigation, the old woman a suspect, I would have ruled her out then and there, I swear. So, you can imagine what happened to my actual suspicions about her.

  Words failed me. Likely, the body was shunting blood from less important organs to more important ones. I felt his hands after he’d tired of drinking and she’d taken the cup away. They were still warm; thank God. His forehead was burning, though nowhere near the levels of that first night. I asked if he’d gotten his paracetamol. Yes, the nurse on night had given it. She’d also said to expose and tepid sponge.

  How did I explain Ebuka’s condition was something neither she nor her grandson could control? I wondered while she spoke.

  Dr. James and Dr. Adaobi saved the day. Actually, they came to hand-over, but Dr. James had grandma laughing in no time. First he made fun of her, dis Mama sef, always complaining, was this how she disturbed “Papa”. Next he pointed to the vitals on the monitor. PR: 80b/min RR: 26c/min BP: 120/76mmHg SpO2: 92% HR: 140b/min. That the body was compensating, so Ebuka was fine, for now. That didn’t she see how everyone was working round the clock to ensure he got a new line and blood? (I hoped Dr. Aliozor, wherever he was, was part of the everyone.) The dermatology team collected skin scrapings yesterday and said to send a consult to rheumatology. She and that her son should just try to provide all the things needed. Where was that Peter sef?

  She laughed a bit at this. He went to see about… money. She sounded unconfident.

  I smiled as Adaobi snorted in my ear.

  “But Doc, I don’t want this child to die. You people should do so that he will have the strength to eat. He needs to join his mates in school.” One could see her grumbles now were only half-hearted at best.

  “It will be fine,” James said. “Ebuka won’t die. He will return to school and claim the first position in his class.” To his credit, he handled the entire thing in Igbo.

  Moving clockwise, the hand-over continued until we reached the last patient at the other arm of the ward.

  Dr. Chisom joined us at patient number four. Sorry she hadn’t arrived on time. She was spending the weekend at her parent’s place in town. (This made me feel guilty that I hadn’t at least called my parents since moving here in January). Coming all the way from town, she’d had to wait until the bus was full before the driver moved. Weekends are slow like that.

  The hand-over ended around 8:35 or so.

  The hand-over note summarizes important details of each patient on admission: diagnoses, outstanding tests, IV drugs: dosages, rate of administration, next due dose.