breaking the news.

Exhilaration, elation, sprightliness...these are some of the words that describe the emotional states that engulf many an applicant when they receive that admission letter to pursue any of the medical related courses. I bet it must be true with all the other courses too. It's however believed by many that the medical professions have a higher premium to them.. This is may be attributable to their employability. Who wants to tarmac after college? So competition to pursue these courses is always tougher and which brings me to where i started off; the states that many find themselves in when they get this chance. It however is true that many are motivated only by the prestige, employability, family pressure, and other superficial motivators. We all know of colleagues who struggle hard to get in but once in lose all interest. At that point few truly comprehend what they are getting themselves into. It is the reason why some fellows with mellow constitutions fail the ultimate aptitude test by repeatedly fainting at the sight of a cadaver or worse still blood. Then they realise that this is not what they desired after all and many have jumped ship at this early stage. But some have overcome these initial frights and went on to make excellent practitioners.
Amwayi-that's Mose's surname, had gotten past this stage and went on to complete his college coursework. He liked Amwayi because he said it fitted him properly in his skin, but people found Mose easy. He was now settling down in his internship and the medical rotation was just fine. Dr Akhungu was one very agreeable fellow and so you can say Amwayi was enjoying himself immensely. In the evenings, he would listen to his friends' tales of tribulations in their rotations and laugh himself silly! Not that in any way he was disposed to revel in the miseries of others but as he put it himself, 'why cry now and cry again later', what an apt philosophy. That was his nature. But he too was having knock-abouts.
 There was in the private medical ward a special patient. Yes, special. There was at any particular time a bed reserved for him in the room next to the nursing office. He was an elderly longstanding diabetic and hypertensive. The number of times he'd been admitted here were innumerable. Dr Akhungu had been managing him for so long that he was now openly referred to as Dr Akhungu's patient or 'number one'. His two conditions had been under good control but as he aged more they became erratic and hence his frequent admissions. Any time he felt unwell Akhungu would be amongst the first persons to know and he would make adequate arrangements at the hospital. On some instances the hospital ambulance had been deployed to get him to hospital. Akhungu would be on hand to personally supervise as the blood pressure, sugar measurements and other vital sign readings were taken. This was the one patient that was never managed from the comfort of the couch!
A chronic hypertensive and diabetic, the family had come to honestly trust that he would add so many more years to his life. It therefore should not startle one that they had never considered his demise even as he became more frail. The bet is even if they had they had not imagined that it would come to him the way it did. They had an astounding confidence that he would surmount any small setback and live on to a ripe old age. Such was the expectation one evening as he was brought in with pneumonia. Dr Akhungu had promptly set to work to fix it and managed to stabilise him. For several days he was in a state of recuperation and evident restoration back to health. Then the day before he was due for discharge home it happened.
Amwayi had been on his usual evening lap around the hospital and for some inexplicable reason sauntered into the private wing. The sight of nurses in a frenzy met him-one busy dialing numbers, another with a tray and yet another in the hallowed room one frantically doing chest compressions. Naturally he joined in the resuscitation efforts. Thirty minutes, nothing. Well they had tried. Dr Akhungu could still not be found on phone, having gone off in his usual evening ride. Till that point the daunting task they faced had not fully registered itself. It however did immediately the daughter to the late walked in through the door and in an uncharacteristic manner handed the nurse a 'small' package, ''sister i brought you some kuku''. The small team quickly retreated to the nursing office. Who would break the news? Who? This couldn't wait for Akhungu.
Amwayi; sister you do it..
Sister; No you do it you are the clinician here..
Amwayi; sister, i have never done this before..
Sister; just tell her we tried but failed..
Amwayi; no sister..

All this tugging was interrupted by the daughter who alarmingly inquired what was going on and if all was well. The nurse pointed to Amwayi and directed her to talk to him.
''Hmm...ok mzee's condition is not so good''. Big mistake.
''What do you mean mzee's condition is not so good? Is he breathing really?''
"Ok, what i meant is his condition just drastically deteriorated and all our efforts to revive him came to naught".
"What do you mean drastically deteriorated? Is he dead? But what happened between morning and now? Where is Dr Akhungu?" The lady in a climaxing emotional torrent and agitation came down hard on him. He was in the thick of a situation here and he was alone, the nurses had busied themselves in some activity or the other which in all honesty was pretentious, they were keenly following the proceedings from a safe distance!
His okays and hmms lost all meaning and he was on the verge of losing all cool. And where on earth was Akhungu? As if on cue in he walked and making a quick assessment of the situation went straight to the bedside.
As Amwayi had recounted the incident to his friends after wards it struck him as rather ironical. That the primary aim in in every patient's care was the making hale again. And yet they had always been taught that to be expected as an eventuality even remotely was death. Cases abound of the slightest of infections or a minor operation leading to death. It was a common joke that if you were asked the complications to any condition and you ran out of responses sooner that you imagined the was the time to throw in death.
Any one in the medical profession will confess that the practice of his or her line of earning a living brings him or her into closer proximity with the 'distressed man'. Is this frequency one of the reasons responsible for the aloofness that some of them display towards patients or their relatives in these states? They have seen it all and nothing new will shake them out of their thick skins. But how ironical.. He recalled an incident in his final year at college. A nephew of his had been brought in the hospital with bad pneumonia. It's only after he had been stabilised and admitted that he had rested easy confident that the child would live. Then he had gone back to his duties in the casualty. You can only imagine his state when one of the sisters walked in and bluntly told him that the child had died. Then she had walked out again. The image of a sniper on a mission had never been stark.
Breaking bad news,,,