Your name is Toyota Corolla. You are of 1987 model. A handy little automobile I have procured years ago as a houseofficer after my Hippocratic Oath. You have ferried me from hither to tither, and wit the least tears. I have always loved you at the beginning, when I have appreciated you as my newly acquired instrument of comfort and ostentation. My uncle is wont to tell me you are my new wife, and in frank obsequiousness I pampered you even at a daily double dose bathing of your brown skin.
Then my equally mobilized friends have started making a jest of your age in our modern desirableness. To them you are one outdated piece of craft commanding of no modern-day medic’s flavor. And in my characteristic manner, not wanting to be jestered, I have resolved to replace you; to replace you with a sparkling SUV I have known I shall just purchase in a little sweated long time.
The current Hippocratic facility where I work is at the mouth of the city, and my Hippocratic boss makes ten million naira a month. I am in charge of prescribing the treatment, the medicament and the bills, but I am excluded from receiving the incoming funds; because I am only a physician. In this facility, doctors only treat patients and prepare the bills; nurses receive the money and keep for the boss. This art is straightforward and I have just learnt it all. The way I look at it, I can start off my own small Hippocratic shop, be the doctor that prescribes the treatment, the medicament, and prescribe the bill; while I get myself a nurse to dish the drugs and man the pay point.
What I know for sure is that the financial successes of the current facility where I labour, have some bearing on its city situation at the mouth of the city. The location is at the confluence of three roads, with enormous human population that mill through the frontage. This yields a handful number of patients for the facility.
I surmised: If my Hippocratic boss can make ten million naira in a month, and perchance I am privileged to secure an apartment somewhere at the other end of the city, at a mouthy area, perhaps I can establish my own Hippocratic facility there, and make even if it is five hundred thousand naira a month. With this kind of incoming funds, I can happily replace my aged jalopy, replace my worn out shoes, sport some new shirts, get myself my missing rib, and live a life of new beginning since after my graduation.
I search the other end of the city, day and night. At the mouth of that end of the city, at a confluence of five roads, I see a duplex. This apartment is owned by Mr Egbo Egbo, but I have not known that he is an Amaechi man. The rent is so irresistible, just as the human population, being the harbinger of my potential patronage, crisscrossing that confluence of five roads every moment of the day, is equally enticing. And to cap it up, there are no Hippocratic competitors within its widest perimeter.
I starve myself to save and save, to be able to pay in to Mr Egbo, before I could be beaten to this strategic business location; but that man Egbo, in one swoop of infamy, takes my whole life savings away. Yes, the apartment is dilapidated, mossed and fernned, but concededly strategically positioned. I have seen it with my own eyes. My initial payments are to be used for its structural upgrade. Little did I know that after the upgrade, Mr Egbo Egbo, would give out that same apartment to another tenant, at ten times my total agreed and made payments. He gives me an option to come and take my money back; an option my friends urge me is the best I could get from an Amaechi man. A little delay will mean that I shall be left with nothing. My friends urge me on. Take back your money back or stay in the courts of slowly grinding mills that will grind for twelve years, trying to bring Egbo to book. I bite my lip, and take back my money, because the cost of justice has become costlier than the justice.
But yet and alas, I am still left with you my handy jalopy, and with you I jostled around the city to sweat out my daily meal ticket and eke out a meagre livelihood. With you also I rallied my necessary additional programmes, and without you my biblical rib hunts would not have even begun.
In one swoop of despondency, and in an attempt not to allow the money I recovered from Egbo dissolve in my hand, I helplessly got myself a small apartment at the other remote corner of the city, situate at the terminal of a cull de sac. I have not known that the landlord is an Amaechi man too. He later turns out importunate, and demands for rent before the end of the term. The consequences of not paying according to his demands is that, one Saturday morning, when you cannot access court for redress, the landlord presents an illegally obtained court order, accompanied by a wizened court bailiff, and throw out your entire livelihood and property from his house. The slowly grinding mills of our perpetually adjourned courts, will not bring you succor when Monday comes. What the rain and sun will wreak on your discarded lifesaving, shall be better conjectured than conversed.
I have commenced my own private Hippocratic boutique. I have not calculated that my real competitors are not of the Hippocratic family. I want to run just a clinic. I am not greedy. On day one, I prescribe drugs for my patient to go and buy outside. The pharmacist tells my pregnant patient with malaria not to buy or take the quinine I prescribed for her in her first trimester and instead buy and take vitamins because, according to the pharmacist, I have prescribed an abortion drug for the patient.
On day two, I send a patient for a laboratory investigation outside. The laboratory scientist asks my patient not to do a confirmatory test I have requested which the laboratory scientist does not have the facilities to perform, telling the patient that there is no need for the test; that performing that test is waste of funds. He goes ahead to conduct another test I have not requested for and sends to me the results to attend.
My patient now lacks confidence in me, having heard from those that I referred them to, for drugs and laboratory tests, that I do not know the job. She disrespects counsel and instructions that emanate from me. The moon stories that are told to her by her neighbors make more sense to her than my laborious medical advice. Yet when she comes back with complications to the hospital after defaulting, her relatives shout on me to stop all I’m doing to attend her and save her precious life.
I’m called out from my family at odd hours to attend to her, and I’m converted into a Hippocratic magician. I have no social life. I have no life for my family. I get no vacations. I do the work meant for the doctor, the nurse and the orderly. I do a busy night, yet I’m compelled to sit the following day till evening, and in some instances, continue with another night work. When I complain, I’m reminded that my job is to save lives.
The churches have told the patient to have faith in God and disregard my art. God’s miraculous healing testimonies are all over the airwaves and the alternative medicine men, struggle to outshine the other in advertisements. Yet, I’m forbidden from advertising my work.
At my private clinic, I’m questioned about my consultation fee. In the teaching hospitals, the doctor’s services are accessed free of charge. The patient only pays when he goes for laboratory investigations or when they purchase drugs. Patients are therefore made to believe that only laboratory tests and pharmacy drugs that deserve payment, and not doctors consultations.
The payment after hospital admissions are only attributed to hospital stay and use of hospital facilities. My contribution to hospital services to the patient is only seen as supervisory and incapable of recompense. This mentality has so much pervaded and eroded the society that the doctors services are also demanded on phone, and consultation fees in private hospitals are seen as exploitation by the doctors. Patients would rather go to laboratories and pharmacy shops where they don’t pay consultation fees than come to my clinic. After all, in this country, the laboratory scientist can use stethoscope and transfuse blood like me.
The work of a doctor has been so gratuitously conceived that pregnant girls, without fear or respect, obtain phone numbers of doctors and call them up in the middle of night to demand for abortion drug that they could go over and purchase and swallow.
When the power goes off in my neighborhood, the mechanic next door puts on his generator, and I melancholically listen to the noise in my dark apartment. A roaside mechanic can fuel his generator but I cannot. The exhaust fumes from his noisy generator has become my nightly companion. In the morning I put on my tie and board my jalopy. I also receive his well-intentioned “good morning, doc”.
I’m called up in the middle of the night to attend an emergency, and in the end when the patient recovers and wakes the following morning, I’m paid with hated remonstrance as to a hospital bill I have applied all modesty in its computation.
The pharmacists and laboratory scientists are busy raking in the money that I am instrumental to its acquisition, yet, when things go wrong, I’m the person that is litigated by the patients and relatives. It is I that am litigated, even though it is I that am least recompensed. How then do I replace my ailing jalopy? I have now seen it all. I just live a life of an empty respect, cashless gratitude and vain glory.
Nobody must die in my clinic. Lest I am tagged an incompetent killer. Those that they have given tickets to Armageddon, have no resting place in my shop. I quickly refer them to the teaching hospitals because they must not be seen to have died in my shop. I can also refer them to my Hippocratic boss, at the mouth of the city. He is a specialist, and thus he has the licence to attend their deaths. That is the difference between him and me.
The only people that are left for me are in two groups. The first group are those who have known me at the other facility where I have worked, as a good Hippocratic officer. They come to me because of my humane attention to their worries and fears. Yet, and yet, I won’t see them in my new facility because it will amount to patient diversion. The other group have a design to ruin my business. They only come at nights in critical condition. They promise to pay the following day, as they do not go to the bank because it is night. I will revive the patient, but the following morning, the relatives will resist to pay. The cost of continuously keeping them in my facility, will usually be costlier than their bills. So they are allowed home, with an empty promice to pay from home.
They come in droves. Yes, the complicated cases. They come from the chemist shops, churches, laboratories and pharmacy shops, patent medicine dealers and other alternative healers. They come as post abortal sepsis, diabetic coma, stroke, ruptured uterus, shock , kidney failure, heart failure, any in other hues. They come for me to supervise their deaths or do some Hippocratic magic. Our people still queue up in those uncanny patent shops for their turns to Armageddon, while there are many young doctors trained to do the proper things roaming the streets. The young doctors cannot statutorily advertise themselves like the patent medicine dealers do; yet Medical and Dental Council of Nigeria cannot protect their art.
My Hippocratic boss nods me a welcome. My failed Hippocratic misadventures at the other end of the city has become known to him, and my trying moments are written all over my haggard body . Why not get yourself a residency job, he advises me. Private medical practice, for a young doctor, in Nigeria, can be very troublesome. It took me twenty years to be where I am, he admonishes me. I started seeing the light after my specialization, he reveals to me. When those quacks FINISH the patients, you can come in to attend their last office at death, only as a specialist, he enlightens me. The relatives also pay your bills, because they must as of culture, and in the bid to protect their bogus integrity, pay any amount so as to take their dead home and bury their dead, he baptizes me.
My little jalopy, I have been baptized, although after a hard lesson, harder than that experienced at the Calvary. I have felt so insignificant on you, because I have acclaimed that I sure deserved a better and befitting mode to ply my trade. I see your make in many models, in their 2014 models, and in 2015 models. They were navigated by chauffeurs, they are sported by little lads and lasses that have yet to know the pains of a hustle. But you in your 1987 glory, have trudged the roads under me, sometimes with that uncomfortably loud attention-drawing exhaust noise that notoriously attracts my neighbourhood and beckons to them, ‘Hey, thats Dr Fred’s jalopy has come!’.
My little jalopy is now gone bad! and that is when i have need of her most. Do I even know you are worth more, when on you I have ridden the roads and streets of Coal City, from one private infirmary to another, mustering halfpenny here and halfpence there that have become the Doctor’s worth. You have betrayed me now my small jalopy. You have disembarked me without second thoughts. You have just hissed the last hiss, and not even my drooling mechanic can pull your anatomy together again. You make me operate on sore-foot tentoes.
I gawk at your immobile skeleton every morning as I pass by your cadaver. And when these negligent chauffeurs, spotting your various make and garbs, in different sparkling hues and of proximate years, mindlessly spray me with dust and puddles, they do that with reckless abandon, and with little regard to me or whatever I feel I medically represent. And as i walk the streets in laboured brisk efforts to overtake scheduled hospital duty and appointments, I long with unmitigated nostalgia, to be magnanimously blessed one more time with one more jalopy of your kind, even of a model a little much more aged than that which you are; than to saunter medical duty on melancholic worn-foot tentoes, or search for hospital residency job in ragged outfit.
©Mr Ikenna Awkadigwe
First written 2010
Re-written 19th November, 2016.