Thursday, October 16, 2014

X-Rays: a la Cameroon Style!

Medical care in Cameroon can be a little different as it is delivered in a culturally unique manner. Getting an x-ray in a foreign country can push one out of their comfort zone and yield surprising results.


I hate doctors.
Yes, I know. I am a doctor. That doesn’t mean I like being sick, being a patient, being on the “other side” per se. When the roles are reversed, my stomach churns with anxiety and my palms sweat with fear. I make a very good doctor. I make a lousy patient.

But, pain is an unremitting taskmaster.  Funny how convincing she can be?!

The receptionist smiled at me as I approached the radiology suite along the main road in Buea. I often walked past with my dog for our afternoon walks. Most of our client-patients utilized their radiology services for x-rays. The staff knew me well.

“Good afternoon,” I greeted the receptionist. I looked around the front room of the office. Only a couple of other young men, I couldn’t tell if they were supposed to be working or potential clients, lounged against the wall in conversation.

“I want to make an x-ray,” I addressed the receptionist.

“For you?” Her eyes startled open a centimeter.

I nodded. “Yes.” (So much for an incognito entrance).

The receptionist turned and walked into the back. I had no idea why she’d left so abruptly but I wanted an x-ray, preferably now, so I stood at the counter, waiting, exchanging uneasy glances at the young men in the waiting area. Both of us probably wondering what the other was thinking.

“The doctor says it is ok,” the receptionist reappeared abruptly to my left.

I turned to face her. “Oh, good.”

Just then, a very enthusiastic French-speaking radiology technician appeared from the back hallway.

“Vien, vien,” she motioned with her hands to follow her.

“X-ray?” I hoped that the doctor had translated the instructions for which x-rays to obtain. I had serious doubts that she would otherwise know what to do.

“Please, God,” I breathed silently as I followed her to a small room in the back with an army-grade x-ray machine. It looked as if it had survived a few wars.

“Chest,” I pantomimed as my whirling dervish technician briefly paused in her swirling activity to contemplate her next move.

She nodded excitedly. A bit too enthusiastic for my comfort, I’m afraid. How could anyone be so enthused over a black and white photograph of someone’s insides? But, what else could I do. Hope for the best.

The technician’s face lighted up and suddenly she made up her mind. With rapid hand gestures she motioned for me to strip off my shirt and hang it on the hook on the door of the room.

“Now?” like right now in front of her with an open door and curious young black gentlemen just around the corner? I hesitated.

“Now,” she nodded impatiently with a look that said she couldn’t understand why in the world I’d dawdle to take off my shirt.

So, off came the shirt, and bra. I hung them on the door. She smiled happily and quickly scooted me over to the wall and the x-ray’s photo plate board. I turned one way. She frowned and turned me the other way.

We were like a mismatched dancing pair for a few awkward moments. She’d step one way and mumble French directions that I couldn’t understand. Perhaps they were French insults but I’ll never know. She was smiling the entire time so who could tell.

She tried to direct my inept steps toward the correct arrangement. Left, no right but not that much right. Shift forward but not quite so far. She pushed and prodded me inches one way and another way. Finally, she seemed satisfied that her subject matter, me, was properly posed.

“Stay,” she motioned with her palm with a big grin, clearly pleased at her success in posing me properly for her film. I swallowed and tried to be the compliant client in spite of my misgivings. I really didn’t want to repeat this tango again.

“Should I take a deep breath?” I figured somewhere in this process, lungs should be inflated for a proper film.

The technician nodded her head earnestly. I wondered if there was anything she’d not agree to by this time. All the time she chattered away in rapid fire French. Whatever I thought she might be saying was truly a guess.

Somewhere within my asking if I should take a deep breath and hold it and her enthusiastic chatting, she took the x-ray. I still cannot pinpoint the precise moment, but she effortlessly came round from the back of the machine and indicated that I could shift from my nose-to-wall position. Not that the wall was so bad to stare at but it was a little monotonous. All white and all. The wall was probably bored by staring at me too.

Another round of tango ensued in which the French technician tilted and bent my body to her tastes, cheerfully giving out instructions in French that could have been in Klingon for as much as I could understand. In spite of my foibles at anticipating her instructions, her smile never wavered. As I practiced being a human Gumby – remaining stationary after she shifted my limbs into the correct position – she clucked encouragingly. She was pleasant, at least. Our communication abilities were less than ideal but at least she was friendly.

For the second picture, I didn’t try to coordinate the whole breathing thing. I focused on the other wall and basically tried to not stir. She stepped behind her machine, fussed over the knobs a bit, and finally re-emerged, still smiling.

“Done?” I asked hopefully. She took the correct number of films. I decided that was a promising sign that she’d also taken the correct views.

“Yes, yes,” she answered. She walked briskly off to develop the films. I re-clothed myself, thankful the place didn’t have any other clients waiting. I’m not as modest as when I was a teenager, mind you. Still, I have noticed that white-man skin tends to attract an unwanted curiosity on the part of my darker skinned community. Not the kind of attention I crave.

At the counter, I paid the customary 5000 XAF ($10) for the x-ray. Turns out one of the young men lounging against the wall was supposed to be the cashier. X-rays in Cameroon are probably a bit cheaper than those in America. Granted, of course, there was no electronic data file available. And, although the radiology technician was happy with her work, the quality of the black and white film was a bit fuzzy in areas with some developing fluid drips staining the lower portion. The good news, the pictures were adequate. I didn’t have to repeat them.

And the other good news?

The electricity went off just AFTER my x-rays, not to return until the next day.

And the x-ray pictures results?

Well… the radiologist’s interpretation is at least unique. I doubt I’ll ever get another read on a chest x-ray that says, ‘…small heart!!!’. Not sure if the triple exclamation marks were necessary…


 “Suffering has been stronger than all other teaching, and has taught me to understand what your heart used to be. I have been bent and broken, but - I hope - into a better shape.”
― Charles Dickens, Great Expectations