Brave cancer patient who started a crucial campaign on death bed

Knowing how familiar, Jill was with medicine and surgery as a medical stenographer, I did not hide anything from the devastated couple. ILLUSTRATION| JOHN NYAGAH

What you need to know:

  • I asked for ultra-sound and MRI of the abdomen and they confirmed my worst fears; It was cancer of the pancreas.
  • More dismal was the fact that both investigations showed metastasis – spread – in the liver, making it a terminal case.
  • Knowing how familiar, Jill was with medicine and surgery as a medical stenographer, I did not hide anything from the devastated couple.

“Is that Mr K?” Asked the caller whose voice I could easily recognise. It was the secretary allotted to me by the hospital, to do my dictation, typing and other secretarial work. The mode of address, the explanation of which though digressing, my readers might find interesting.

It is an abbreviation of my surname, both difficult to pronounce and spell. In the past, I have described it as a cross, which I have carried all my life. It arose from the fact that my father was born in a village in India by the name of Kodwav and everybody from there is known as Kodwavwala. Little did I realise when I inherited the surname that it had V immediately next to a W, which made it more awkward, a fact brought to my attention more pointedly when I went to the UK to qualify as a surgeon.

The abbreviation was a result of Irish ingenuity possessed by Sister Robinson, the operating theatre sister, who had an occasion to call me for an emergency appendicectomy on the day I joined the hospital as a Resident Surgeon. After a few unsuccessful attempts at pronouncing the surname of the newly arrived surgeon, during which time she distorted it beyond recognition by me, she gave up and said. “Do you mind if I just call you Mr K?” That was it and the hospital staff caught on to the easy version.

I felt proud because Mzee Jomo Kenyatta was very much in the news, John Kennedy was the US president and Krushchev was in power in Russia and when the press was pushed for space in their headlines, K was often used as an abbreviation of these famous people and I felt very honoured to be in such distinguished company! I must add, however, that when it came to find a pseudonym for my writing, I shed it for a much simpler name, which has caught on too, though I have to use the difficult version as a surgeon because all my academic documents are under that name.

Reverting to the phone call, from my secretary, who except for urgent work, took dictations from me on Mondays and Fridays, she said: “I need to see you urgently on a personal matter. When would it be convenient for you to see me?”

Since I was doing desk work and noticing the urgency in her voice, I replied: “Come now if you are free.”

As I was waiting for her to walk from the secretarial bureau to my office, I recalled that along with two other ladies, I had interviewed Jill about ten years back. With me sat the head of the secretarial bureau and the Human Resource manager. There were four applicants, all women, who had done their ‘O’ levels, followed by shorthand, typing and specialised medical stenographer’s course to make them familiar with medical terms. At the interview I asked every candidate. “Medical stenography is a very narrow specialty. What made you take it up?”

I was impressed by Jill’s reply which was. “I wanted to work in a hospital because I knew that there I would be exposed to different specialists and  learn medical terms used in all specialties. Also, I wanted to be with patients, because initially I wanted to be a nurse but my family could not afford to pay for my training.”

'BACKDOOR ENTRY'

“So this is your backdoor entry into a hospital!” I remarked, making them all laugh.

Jill was unanimously voted the best candidate by the interviewing committee and bagged the job. I was very pleased with our choice when she started working. She was fast at taking dictation, typing and carried a filing cabinet in her head, which could easily recall medical facts of all my patients. As I was wondering what it was she wanted to see me for, there was a knock on the door and I said, “Come in.”  I could sense that Jill felt uneasy about whatever she had come to see me about, so I put a couple of minutes to make her comfortable and then set the ball rolling by asking. “What is it you want to see me for?”

“It’s about my husband.” She came straight to the point.”For the last couple of weeks, Pascall has been feeling unwell and has now developed indigestion and has lost some weight.”

“Who is looking after him?” I inquired.

“Our family doctor.” replied Jill. “He is very good, but he doesn’t seem to know what is wrong with Pascali.”

“Has he done any investigations?”

“Only the basic like blood, urine and stool,” Jill replied. “He says that my husband’s complaints are so vague, he doesn’t know where to start.”

I decided to cut the cackle and asked.”How can I help?”

“I was wondering if I could bring him to see you.” Jill said.

“You know, your doctor is right about your husband’s symptoms being vague. I will be very happy to see Pascall but he might benefit more by seeing a physician rather than a surgeon like me.” Then to clear any doubts in Jill’s mind that I was passing the buck, I added.”Let us leave the final decision to your doctor.”

The next day, I received a phone call from the GP and he added a little more information and then said that he thought that his patient better come under my care. A week later, Jill brought her husband to see me. Fortunately for me, Pascall’s symptoms had become more specific and he had developed obvious signs which pointed to a clinical diagnosis. Amongst the many questions I asked him, one was.”Have you any pain in your tummy?”

SILENT KILLER

“Yes here,” he said pointing to his upper abdomen and added. “It has recently appeared and goes deep into my back.” As he said that, I looked in his eyes and found a trace of jaundice, yellowness of the conjunctiva.”How is your appetite?” I asked.

“I have no appetite.”

“Bowels normal?”

“Recently I suffered from diarrhoea and my stools are smelly,” Pascall replied.

I had a provisional diagnosis in my mind and the lack of any additional physical findings did not put me off, because the diagnosis, I had provisionally made is known as a ‘silent killer’. I asked for ultra-sound and MRI of the abdomen and they confirmed my worst fears; It was cancer of the pancreas. More dismal was the fact that both investigations showed metastasis – spread – in the liver, making it a terminal case. Knowing how familiar, Jill was with medicine and surgery as a medical stenographer, I did not hide anything from the devastated couple. “How long do you give him?” Jill asked when we were alone.

“As you know, this is one of the worst cancers to have.” I replied. “Difficult to set the time frame but all I can say is that we have to think in terms of weeks rather than months. I presume, you have told your husband everything.” I went on.

“Yes, I did,” replied Jill.

“What was his reaction?” I asked.

“Bit strange,” Jill replied. “He just hugged me warmly and said. ‘We have had 20 years of married bliss and it’s a pity that I have to leave you so soon.’ Then he turned philosophical and urged me to start a campaign to make people aware of cancer.”

After consulting Pascall, Jill decided to take him home.

“Though we have no children, we both have large extended families and they all would like me  home,” Pascall said.

On the day Pascall was going home, I went to see him, give him a prescription of drugs to take home to make life comfortable.

He sat me on the chair near his bed and said to the Sister who had accompanied me, “Please carry on with your work because I want to discuss certain personal issues with Mr K.” As she made herself scarce, he asked his wife to sit beside him and said. “You want this surgeon to assist you in your mission.”

Pointing at me, he added. “He has tried to create breast cancer awareness amongst women of our country.” Then turning to me, he continued. “We have been busy talking about communicable diseases in Kenya like TB, Malaria and lately HIV and Aids. Now with change of lifestyle and diet, the disease pattern is changing and the incidence of cancer is set to escalate. We need to educate our people in cancer awareness.”

Then he turned philosophical, as he had done with his when she gave him the details of his illness and prognosis and added. “I read somewhere that medical science is closing gaps like malnutrition and communicable diseases on the bridge of life and so we all fall in the abyss of cancer at the end of the bridge and it is important that our people are made more cancer conscious. It is too late to create a rainbow in my own sky but by Jill starting this campaign, I could create one in someone else’s cloud!”