God Knew His Name

There was a loud banging on the gate to my tiny flat on the hospital premises. It was just after one o'clock in the morning. My boyfriend awoke and shook me, your call. When he was on call, we'd sleep in his flat next door and I believe he had a weekend call coming up. Anyway, I got up to see who it was. I stepped outside the room and leaned on the protectors. The orderly passed me a note through the iron bars while explaining: doc, it get serious case for casualty [there's a serious case in Casualty]. Unfolding the note I said, make una dey go - I fit walka [you may go, I'll walk up]. She left with the ambulance driver. I rushed in and pulled on my simple and casual, yet lovely, Arab kaftan (in the Middle East we called it a galabiyah). Stethoscope in hand, I hurried out as my boyfriend shut the door behind me. I loved the Hamartan season which typically runs from November until March or April. In spite of its dry hot days, the nights are so cool. It was into this coolness that I stepped and thoughts of a break at Christmas cheered my heart. I'd be traveling to my father's village with my family and I could not wait. Excitement filled me as I made the relatively short trek to the emergency room.

Upon getting there, I saw quite a few patients. There had been an RTA [road traffic accident] on the Umuahia-Aba expressway. The small Casualty room could not contain them all and so some were out in the corridor on make-shift beds. It was always a blessing to work with the male Casualty head nurse. He was the epitome of efficiency. I'll never forget my very first casualty call as an intern. In the middle of a doctors' meeting, I had been called out for a case of mass casualties. I entered the ER to see bleeding, dying and dead people all over the place. The casualties overflowed into the corridor where additional beds had been provided. I froze and could not move. I just stood there and stared. The male head nurse had said, doc, I'm taking care of it. Just follow me and write up your notes accordingly. Like a robot, I did as told. By the time I came to myself, he'd stabilized all the patients by working fast, telling me what to do, and enlisting the help of student and other nurses. We were nearly done when doctors poured in from the meeting to assist. My notes were complete. I had survived my first call. Years later when I had returned to visit the hospital, I met him on duty and was greeted with an enthusiastic and excited “Eya (oh wow) ... doctor, I never forgot you”.

I snapped back to the present. Doctor, most of the patients are stable. I have one bad case ... he went on to brief me on the situation so far. I took the folder he held out, and tears came to my eyes instantly. The name on the front cover read "Unknown". Our young man, college-age, was unconscious. He was in deep coma. Even now, I see his face albeit more faintly than some years back. He was tall, slender and had shiny dark skin. Clean shaven with a baby face. Eyes closed as if in sleep. I read the case notes and took over from where the nurses had stopped. He continued bleeding from the mouth and we continued suction. Intravenous lines were inserted and drips started. Medications were given straight into the vein and his vital signs continued to be monitored. A bladder catheter was put in too, connected to a uribag. Tubes all over him, we were sending out further lab requests for blood work and x-rays while waiting for blood to be grouped and cross-matched. I was overwhelmed. I had invited specialist consults from both surgery and orthopedics, waking up my chiefs for help at that predawn hour. They came, as a courtesy no doubt, and later I knew that they had known that only God could wake the chap up. It was a long night. An exhausting battle. Periodic assessments yielded no improvement. I could feel him slipping away. I prayed but felt utterly hopeless. I coaxed and bargained with God for his life. Eventually, I heard a cock crow somewhere in the distance and realized that it was past six o'clock and I had to take a break. I needed to go prepare myself for early morning ward rounds: I had a few new patients (children) to present to the unit so I wanted to glance at their case notes before the senior chief arrived. I left my patient in the care of the nurses and hurried back to the flat to take a shower and change for the new work day. In my heart I begged my head injury case to be awake by the time I returned.

While in my room I couldn't concentrate. My boyfriend tried to cheer me up and wanted to fix me breakfast, reminding me that it would be a long day. I hurried through my morning routine and denied myself a moment to de-stress. There was no time to waste. I was not hungry. I received no further call and for the first time felt hopeful that my patient had stabilized. I retraced my footstep to Casualty. Doc, make you check am oh; it be like say he don go [doctor, please check your patient; it seems like he has passed]. They knew he had passed away and I later learned that it had happened soon after I had departed for my flat. Literally it had been a battle to the death. I sat down on a stool by the bedside and stared at the handsome face of this stranger, distorted by edema (swelling) and lacerations with dried blood all over. “Unknown”. Lord, why? why? You could have woken him up. The accident wasn't his fault. He had a life ... maybe brothers, sisters, parents still living. He must have been in college ... trying to better his life. Lord God, why? What did I miss? What did I forget to do? How could I have managed him better? I stayed a while, lost in my own sorrow. Colleagues came by having heard of "last night's tragic case". They offered me condolences. I felt a part of him. My classmates from medical school knew how I was feeling. They tried to cheer me up and told me that I had done my best; that it was a bad case from the start. All I could think about was, so why didn't he die at the scene? Why did God bring him here if he was going to die anyway? Why was it my shift, my call? At that moment, I blocked everything out in search of only my own solitude. It was time for rounds.

I certified my patient dead and walked out without looking back. Behind me I could "feel" the nurses removing the infusions and i.v. catheters and Foley catheter and blood bag and ... I passed the doctors' lounge and meeting room. It was located next to some administrative offices which were to the left. I walked by the Male Surgical ward where someone greeted me from inside. I responded automatically. More hellos and good mornings were exchanged as I crossed Female Surgical and Obstetric/Gynaecological. I was almost at the end of the long corridor that went beyond the operating theatre [OR, Operating Room] and XRAY Department. I was turning into the Paediatrics wing and could still "feel" the nurses moving the stands, and the oxygen machine out of the way. I could "feel" them unfolding a white sheet and laying it over this unknown stranger. I saw his face covered with that white cloth, in my mind's eye. He had no name. Without a single tear, I began to weep.

After rounds I hovered around Casualty. It was bustling with activity this morning. There she is. Doc, please help this couple. I turned to face a young man and woman who were clearly nervous. I asked how I could help and then sighed when they told me. The fatal crash had been “breaking news” all morning and Dr. Eze had his little radio on ... “if anyone recognizes any of the names that will be announced at the end of this broadcast, they are asked to immediately contact the police department at Umuahia. Also, if anyone knows of any one who might have been traveling to Aba late last night, they should please verify their safe arrival or contact the police otherwise. There has been a fatal accident and some unidentified victims. We need your help …” My sorrow deepened and I returned my attention to the couple.

They were friends who had heard the name of another friend on that broadcast. They had had a bad feeling about it because the newscaster had used his proper name, Maculay Princewill Ndukwe Obasi. So what? I wondered. They explained that it meant that his school I.D. card had been found. If he were alive he would have given his name as Maculay Ndu Obasi; he never ever gave his full name. Wow … I said nothing for a while. The place was so busy with the usual emergencies arriving in addition to anxious loved ones looking for the survivors of the crash. We were directing all relatives to the Surgical and Orthopedic wards to enquire after the survivors there. I knew that we had no one by the name of Maculay Princewill Ndukwe Obasi admitted the previous night. Finally I mustered up the courage and explained: many people died at the scene so we never saw them. They were taken to the central mortuary. Some survivors were sent to other nearby hospitals so perhaps the police can give you a list of the other hospitals. I am not sure why the news had implied that all the cases were brought to our center. Lastly, I told this young couple of my “unknown” patient who passed early that morning. I can permit you to go and view the body at the mortuary across there, I said pointing to the low building close to the main gate. The man was shaken. The lady was calm. They stepped away from me and I knew he was crying.

Maculay was his best friend. They lady comforted him. She insisted that they see the body. They had traveled all the way from their university campus in Port Harcourt (about an hour’s journey by bus) as soon as they heard the news. How could they leave without confirming? The man was numb. He needed to know but he was afraid of what they might find out. A long time passed and then he turned to say, we’ll be back. I watched them walk towards the morgue feeling sick in my stomach … sick with dread. I waited. I helped out in the Casualty room – they were ever in need of a free hand. Twenty minutes later, the couple came back to me. It wasn’t him. Praise God! Simultaneously we all let out a deep long sigh of relief. Still, he could be in another morgue? I told them to go speak with the police. They departed and I prayed earnestly that they would find their friend alive in one of the smaller hospitals in the area. My heart was so heavy and I wanted to go lie down. I cried for my “unknown” patient and then for Maculay. Why ever did I choose medicine? What did God have in store for me in this field?

As I write this post ten years after the incident, I struggle with the thought that, had this all happened in a top Trauma Center in America or Europe or Australia, my patient would have recovered. That contributed to my decision to return to America to chase up residency and specialist training that I could use to improve the facilities available back home. I wonder whether Maculay was ever found by his friends, alive or dead? And I wonder if my unknown patient was ever identified? Of some comfort is the knowledge that God knew his name.

To God be the praise for everything that happens in our lives!