I went through the preliminary part of the consultation; just confirming the name, age and so forth. It was a very young couple, the man was eighteen (was able to determine that) while the lady was nineteen. They had with them a three year old girl but from the woman's earlier relationship. Married only for a few months, they were now expecting their first fruit of love together, the lady being about two months heavy with child. I had initially thought it was the child who was sick but the card read the mother. Then I had inquired what the problem was. Silence. Fidgeting. More silence.
We have been taught never to speak for a patient; a patient has to state his case in his or her own words and it's your duty to figure out with precision what they mean. However you may paraphrase or ask with tact to establish what they have said. So here we were. Checking my demeanor I asked again in the gentlest of tones what it was that had brought them to the facility. Furtive glances and some half attempts at speaking up. Then the man had eventually surmounted the difficulty by imploring the wife to state the issue.
Not able to maintain eye contact at first and fidgeting some more she had eventually explained that the previous night somebody had attempted to rape her. Damn! Where? In their house. What time? Around 0200hrs. How? The intruder had told her he wanted to see her husband and so she had believed he was friends with hubby.
Now the problem was this: the husband was not at home at that time and they being new in the place he expected no night visit from any friend of his. He was doing night duty at his place of work that week. Intruder had however insisted on being admitted saying he had a message for the husband. Well on entering he had cut to the chase and threatened her with a dagger. She had not seen his face for he had moved like the devil himself. This is where it gets twisted. He had not been able to manage intercourse due to a defensive manoeuvre she had adopted and so defeated in his evil designs he had quietly slunk away into the dark night. Real Creepy.
No hair touched, no bruise sustained, no blow given, no alarm raised, nothing but a lone shaken woman at a ghostly hour of the night. Believable? The hubby hardly believed a thing and seemed very riled though he appeared one of those meekly indisposed, gentle characters. It's here that he wanted me to come in. To establish if at all there had been penetration; he had heard that it's possible to examine and know if someone has been raped. Damn, Mungu Baba, saidia hapa!
I went over the details slowly and meticulously. The lady now confident and with a reassuring telling was however adamant that nothing happened, no penetration, no intercourse, no sex, no rape. Nothing. In my own assessment her tale had a ring of honesty to it. The husband however persistent with his hows just could not buy it. I understood his cynicism and so tried to reassure him by pointing out that it made no sense for her having even told him a thing if she was a willing accomplice in the business. She had tried calling him after the scary ordeal but he was apparently sound asleep on duty.
He had never doubted her trust before and nothing so far had occurred that made him have doubts on her fidelity. Same to her. I went through the paces of detailing the post rape protocols and everything that had to be done, explained what risks there were to her and the fetus and that if any intervention needed to be made then we still had time but she stuck to her word. Nothing had happened. At that point I chose to fully believe her.
A private session with the husband and I was able to make him understand that though it was hard for any man to come to terms with anything like that we had to believe her all the same. They had however to report the matter to the police because criminals always left an unmistakable scent or two. Trust Sherlock Holmes to unravel a mystery of this nature and nab the ghost-like, faceless, night time prankster. And who knows, he might have wanted to part hubby's neck from his head. It went like one phantom tale, but true it was. I became more afraid of the dark some more and for some days slept with the lights on..
The hilly terrains of Iten and Cherangany and Kapsabet have bequeathed us with generations upon generations of nimble sure footed gifted track athletes, world beaters who have represented us well on the very competitive global stage. It's also true that many of business magnates and captains of industry spent their childhoods braving the morning chill of The Aberdares and Mount Kenya. Now there is in this country one county famed for it's very decent professor-per-village ratio. With many sons of the land well settled in many notable research and academic entities the world over it easily occupies the enviable position as the undisputed hotbed of scholars in the country. It is here that we now go.
Any clinician or nurse or physician or any of the health professional for that matter will tell you they have met some very confounding cases in the course of their work. But it has to be noted that many of these confine themselves to the medical or scientific aspect of things. Any social dimension taking the centre stage in a case and we beat a hasty retreat into our nauseating doctor or nurse cocoons and refer to the counselors, psychologists, pyschiatrists or even the police and the administrators. This state of affairs is however to be understood and the medics are not to be begrudged, they already have much going for them already and almost all training curricula are so deficient in this aspect.
So in the land of scholars one Saturday morning at the OPD/A&E of one of the county referral hospitals, the outpatient crowd sat patiently and orderly waiting in turn at the waiting area. The departments were still very sluggish, what with some of us preoccupied with the usual silly extra-hospital banter and gossip; but the patients and their relatives waited with unbearable patience all the same. Then waves of guilt hit us like the dry heat of The December. Were we really doing justice to whatever it was that paid the bills albeit belatedly? Was this how we repaid back the government after gifting us a hefty extraneous allowance! So one by one we had trooped to our stations and settled down to work. And work we did for in no time the crowd had been conquered!
When you work in the accident and emergency department of any hospital you are always putting out critical situation fires. Serious injuries, shocks, comas, grave complications of all sorts. You are literally in the firing line of things. Speed, sound judgement, experience, patience are all of utmost importance. Then can you hone your competence. But you also get to meet some of the most baffling real life situations that only highlight how deep a well human nature truly is.
And so as we had gone about our work on this particular Saturday morning, a commotion outside had drawn all our attention. A sobbing lady of about twenty two was hustled into the area. She was disheveled and in such a sorry state emotionally and physically. Hot on her heels was the mother, apparently. Also in tow were several relations most likely siblings to the young lady. Mother was fuming, agitated and in no moods to display any etiquette of following the laid down regulations. She headed straight to the nearest consultation room which happened to be mine! They half pulled, half supported the daughter inside and she slumped into the seat. Then the rest of that no nonsense entourage followed, all evidently ruffled and using some of the choicest not-so-nice English words. I let them vent and ventilate for a minute or two before I cracked the whip demanding order and decency. As a condition for anything to proceed I requested they all leave the room except the young lady. The mother insisted on remaining. I grabbed some writing material and dug into it.
"She has been raped" bursts the mother.
I calmly ask to let the lady speak for herself.
"Can't you see how distraught she is?".
I however insist and kindly request the mother to leave the room. Then she beats me to it, rapidly launching into how the suspect waylaid the daughter the previous night and sexually abused her the whole night. She had only been able to make her escape in the wee hours of the morning after the satiated and worn out beast had slumbered off.
I asked the lady to corroborate the narrative but all I got were sobs and more sobs. I sat back and quietly regarded everything. Then out of idle curiosity asked if they knew the suspect. She told me he had been apprehended by the police. However as if on cue another commotion outside revealed that the suspect had been brought to the hospital. Badly beaten, he was bleeding from many scores.
I requested the lady to lie on the couch so I could examine her. She complied and I completed the assessment noting down my findings. After establishing she had not changed her clothing nor had taken a shower I explained to them that we needed to get some samples for lab investigations. It's like the mother had been waiting for this important piece of information. Urging me with uncommon vigor to speedily get done with it. They needed to lock away the unfortunate, worthless and mannerless mongrel.
Then the daughter snapped.
"Mum, why are you doing this to me, how far will you go to achieve your mean objectives? Denounce me but kindly let Kevin go, he is just a poor innocent boy, please mum, I beg you", young lady had hysterically broken down, inviting some alarmed colleagues and even patients into the room.
"You shut up, disgraceful scoundrel, you are a total embarrassment to my person and the entire family. Messing around with poor, pathetic scumbags, is that what is expected of you?".
I was by that time stupefied by the unfolding drama and remained rooted to my feet, I have seen some melodramatic Nigerian movies but only believed them to be sweetened tales. Now here I was!
"Daktari, can you kindly proceed?". the mother roused me from my incomprehension.
I asked to be told what exactly was going on because it looked to me some stinking fishy bit of business.
"Which part of 'she has been raped' don't you understand?".
I inquired from the lady what had then happened. She tells me Kevin was just her boyfriend and she had willingly spent the previous night with him. She was stopped midway by two well aimed slaps from the mother amidst a torrent of unprintables.
That being the case I tried to explain that there really was nothing much to be done here. In fact nothing at all. Wasting valuable daktari and genuine patient's time in this manner was not so cool. Complicated matters of rejected choices were best handled privately and civilly in chief's courts or behind their palatial residences.
"Test her for HIV", barked the mother, evidently smarting from her temporary setback.
The daughter saved me the trouble by flatly declining to have anything to do with a forced HIV test. Out went the mother cursing and wailing and making such a scene that you would certainly believe the greatest calamity had struck home.
Compelling the young lady to compose herself I was itching to get to the bottom of this trifling matter. It turned out to be nothing but a rich girl, poor boy antagonistic family story. She was from a very well-off family from the neighborhood. The mother was a college lecturer, the father a university don. She was herself at the university pursuing a degree in fine arts. Her boyfriend who she confessed to love dearly was in another campus pursuing actuarial science. He was however from an underprivileged background and thus her parents would have none of that social tomfoolery. Only that? Yes. They are despicable egotistical maniacs who have gone to very laughable lengths to achieve their objectives. They have bribed the police and the chief to fabricate and backup this rape story. But they will not succeed. I need to see him daktari.
It would be expected that in any community with a significantly big proportion of well read people would also boast of a corresponding social advancement with scant prejudices and full of understanding and that elusive erudite pity. Wrong.
I can't clearly recall how those Nigerian movies ended. I can't say how this one ended either. The family left the hospital in a huff, young lady remained behind with her boyfriend who was still under police custody though undergoing treatment for his injuries. I asked a police friend of mine how they felt being in such farcical and ridiculous situations and being used thus and he just laughed.
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