A Fitting Diagnosis

(Names and details changed for privacy)

“Doc, will you see this man tomorrow?” Nurse Kay gave me a very beseeching smile. “Please.”

“You know I normally avoid non-emergency consultation on Saturday, Kay,” I replied, unconvinced.

“But doctor, he was really disturbing me when you had to go out,” Nurse Kay grimaced as she shook her braids at the memory. “I thought he was going to bite my head off.” Her gesture conveyed a genuine sense of pain regarding the recent encounter.

“Really?”

“Yes, doctor,” she added in earnest. “I really had to talk to him a lot to get him to calm down. I promised him that you would see him tomorrow at eight o’clock.”

I realised this Friday had taken its toll on everyone’s patience, including my own. Complications and emergencies in the hospital ward, unplanned procedures, a funeral to pay homage to a fallen colleague in the medical field – the day had been a blur of activity. The frustrated, impatient frowns from the outpatient clients in the waiting room had not escaped my notice earlier.

Sensing my weakening resolve, Nurse Kay pressed home her supplication. “Please, doctor, I told him to be here promptly at eight o’clock.”

“You know I have church on Saturday, though.”

“ I told him that. He said he would be here at eight. I told him if he came late you would be gone to church.”

Nurse Kay knew she’d won her case. I sighed. “I already took the history and everything for you, doc.” She smiled with a triumphant grin and handed me the patient’s book.

I opened the green paperback notebook and peeked at the chief complaint.  I wondered what dire emergency had made this man angry when he wasn’t attended to in the clinic so promptly. I hoped that if he was seriously sick he would have consented to admission after a brief consult with our competent nursing staff. Thankfully, his vital signs were normal. He was 32 years old, I noticed. I shook my head. It usually takes a lot for an otherwise healthy adult male to see a doctor.

The next morning, Saturday, I walked over to the hospital to check on the inpatients. As expected, anytime I am in the hospital, other clients find me and I found myself completely occupied until 9:30 am. I forgot that I hadn’t even seen the mysterious impatient patient from Friday. By the time I remembered, I was already in church. I had certainly given him ample time to make it to his special appointment by 8 am. I had been around until 9:30. Perhaps he’d gone on to another hospital given the urgency of his demands?

Monday came round. Mondays have a bad habit of appearing every seven days, it seems…. Anyway, the client numbers in the outpatient clinic were above 30, so, much to half the folk’s dismay, some waited quite a while to see the doctor. At the end of the day, I noticed a familiar green medical booklet in my shelf.

“I called his name several times today,” I explained to Nurse Kay. “What happened?”

“He left, doc,” Nurse Kay shrugged. “He said he couldn’t wait.”

“He was only the second patient in line to be seen today though,” I countered. “Besides, I waited for him in the hospital on Saturday and he never showed.”

Sigh.

Tuesday came. I was hurrying to open up the clinic and get morning worship going. Several clients milled around the front door, waiting for our outpatient services to get started for the day.

“Doctor, I want to see you,” a young gentleman pressed forward as I stepped up on the porch to unlock the door.

“No problem,” I gave my automatic reply. “I will see you after we have our morning staff worship. You are welcome to join us.”

“But, doctor, I’ve been waiting. I want to see you now.”

I tried to take a step back as this gentleman was rather cramming into my personal space. (I’m not one to need a huge bubble either). I held up my hand in an attempt to keep us from bumping noses. “After worship, I will start my consults.” He was clearly not dying or in any visible pain. There was nothing externally wrong with him that gave any indication he needed to be seen more urgently in the hospital and be admitted.

“But, doctor, I’ve already paid to see you.”

“And I will see you – after worship,” I re-stated firmly. I gathered up the worship hymnals and passed them out. “Here, have a book,” I indicated a place on the bench for him to sit while I held out a book of hymns. The other staff and patients were thumbing through the pages, searching for a familiar melody. Assessing the situation, he grudgingly settled down.

~o~

“Mr. Johnson,” I looked at the now recognizable green book and name. So, he was back – again.

“Coming,” a familiar gentleman rose from the waiting room bench, pocketing his mobile phone. The gears clicked. The less-than-patient gentleman of the morning was none other than the mysterious missing patient from Friday. Interesting.

I sat down at my consult table and read over Nurse Kay’s detailed history of his main reason for consulting. Mr Johnson settled in the chair opposite.

“Doctor, I’m tired,” he frowned and turned his palms upward with a dramatic sigh. “I have a lot of responsibilities. I can’t wait.”

“Ashia,” I let him continue.

“Thank you, doctor,” he automatically replied. “Doctor, I came here on Friday and you were not. They told me you were at a funeral.”

I nodded in confirmation.

“I couldn’t wait until you came back.”

“I looked for you on Saturday,” I replied. “I waited for you until I went to church.”

“I came, doc, and you were not,” he insisted.

“Didn’t the nurse tell you to come at 8 am?”

“Yes, but doctor, you were not.”

“I waited for you until I went to church at 9:30 am.”

“But, doc, I came.”

“You came after I’d already left for church.”

He conceded the fact with a nod. “But, doc, when I came you were not.”

“I was at church.” Since church is generally considered a legitimate reason to abscond from the hospital, I knew Mr Johnson had little recourse to argue now. As I expected, my pronouncement silenced his complaints for a few moments.

“I’m here now,” I attempted to clear away the past and re-focus our meeting on the present. I gave him my full attention. “Now tell me about your problem. What brought you here to consult?”

Mr Johnson gathered his thoughts for a few moments and let them sort. He took a breath and released it slowly. Then he began. “Doctor, my girlfriend,” he paused, “my girlfriend’s not happy. When we make love my stamina is not too strong. I weaken too fast.”

“You mean that when you have an erection, you climax too quickly?” I clarified.

He nodded.

Diagnosis: Premature Ejaculation

Rather fitting, given the circumstances?

 ~o~

“We can rejoice, too, when we run into problems and trials, for we know that they are good for us—they help us learn to be patient. And patience develops strength of character in us and helps us trust God more each time we use it until finally our hope and faith are strong and steady.”

Romans 5:3,4

Universal Male Sporting Rituals

“Guys care about sports teams. I'm not talking about simply rooting; I'm talking about a relationship that guys develop, a commitment to a sport team that guys take way more seriously than, for example, wedding vows.”

― Dave Barry, Dave Barry's Complete Guide to Guys

I am not a ‘sporty’ person. I can count the number of sporting incidents like baseball games and American football matches that I’ve attended on one hand, I think. The last time I watched a football match was the world cup in 2010.

~o~

“So they left the subject and played croquet, which is a very good game for people who are annoyed with one another, giving many opportunities for venting rancour.”

― Rose Macaulay

“There will be traditional wrestling up at the Pala-pala field today,” our Cameroonian friend informed us one Sunday.

“What time?”

“Four O’clock but you can come at five,” he replied.

“We should go.” I turned to Bill next to me. “Something different. Might be interesting for a while. I’ve never seen traditional Cameroonian wrestling.”

So the three of us found ourselves up at the Pala-pala field that Sunday. Curiosity about the sport took precedence over my usual reservations on watching male testosterone-touting athletic feats.

The wrestling field is a natural amphitheatre. The grassy slopes surround a more or less level circular playing arena below. Wooden pickets with white crosshatches that have the village name painted on them and look like the white crosses of marking graves dotted the edges of the field. Villages grouped themselves accordingly to show support for their wrestling representatives. A gigantic oak-like tree that appeared as if it had had witnessed many hundreds of events on the field loftily stretched its thick branches over the upper corner of open expanse. Perched on the wooden supports fastened to the tree’s branches were three enthusiastic ‘sport’s announcers’. They pounded tirelessly on their traditional drums in an upbeat, intoxicating rhythm that added spice and vibrancy to the atmosphere of expectation that permeated the jostling, talking crowds. Women and children wove through with snacks balanced perfectly on their heads – peanuts, chin-chin, plantain chips, fruit slices. The perfect sport’s event – crowds, sweat, shouts, laughter, music, and food.

“One, two, three…” the referee counted down on his fingers and on the count of three the two young boys hunched over and eyed their opponent. They looked to be about ten years. Small. Sturdy. Muscular. Slender.  Apparently the young boys start before the adults kick-off the game officially. The two young boys waved their arms over their head in a pawing manner as if they were getting ready to pounce on their prey. They concentrated on every move their opponent made trying to anticipate and outmanoeuvre. As they each reached forward toward the other, they circled within the confines of the white wrestling circle.

“The goal is to get the other person on their back,” our Cameroonian friend leaned over and informed Bill and I. “As soon as the back of one touches the ground, the other person wins.”

One of the boys lunged forward. His opponent skipped sideways and dodged the outstretched arms of the other. They circled around each other for another round. Suddenly, the shorter of the two reached out and caught the shoulders of the other. Instantly, the two locked into battle. Muscles bulged and ligaments strained. The boys danced left, right, and all around each leveraging to get the other one to fall over. The grimaces on their small faces matched the effort they were expending to try and win this match.

“Do they have to hold their opponent on the ground for three seconds in order to win?”

“No, any touch of the back to the ground constitutes a win for the other person.”

I watched as the two boys used all their strength to try and unbalance their opponent and get him to flip over. Each crouched low and kept a wide stance. They were equally matched.

The referee blew his whistle. One of the boys had pushed the other outside the white line. Instantly the boys regrouped in the middle and returned to a their former locked-limb configuration. One boy stumbled and almost fell. The crowd cheered and shouted. The referee’s helper in a red-knit hat watched the boys closely for any sign of foul play.

“What are they doing over there?” I turned to my friend and indicated a group of young men kneeling on the ground in front of a table under a canopy. The young men with traditional cloth wrappers knotted around their loins formed a semi-organised half-circle in front of the elderly gentleman writing names down on a sheet of paper.

“They’re registering their names for the match,” he answered. “They have to show their respect by bowing before their elders when they ask to participate in the wrestling.”

“Oh,” I said. Now that is something different from American sports events that I’ve attended. Respectfully kneeling before one’s elders/leaders. Not a bad concept. It was interesting to watch these same young men, after paying their respects to the presiding elder, later mingle in their groups. They were otherwise your typical free-spirited young male species boasting big male egos, loud laughter, beer, and cigarettes – not to mention the sagging jeans that always look as if they’re going to fall off and give a full view of the underlying colourful boxers/underwear.

“Any game becomes important when you know and love the players.”

― W.P. Kinsella, Shoeless Joe

As the men registered, the young women did what young women typically do at athletic events. They strutted and giggled. High-heels, sparkling dresses, and flirting laughter punctuated the crowd as the ladies threaded their way among the crowds in pairs of two or three – sometimes five or six. Male and female eyed each other from a distance. Yes, I thought, a rather universal activity at sporting events – testosterone meets oestrogen.

I turned my attention back to the youngsters in the ring. Each boy fought with all his might. A fierce determination registered on each of the their faces. Back and forth they gyrated locked in their wrestling. The drummers thumped out an encouraging beat. The crowds cheered. Eventually, the one boy was momentarily thrust off balance so that his left shoulder touched the muddy surface. The whistle blew. The other boy had won.

A group of mature women in matching cabas danced enthusiastically onto the field and trampled all across the boundaries of the wrestling circle. The referee blew his whistle and waved his arms to redirect them elsewhere in vain. He was absolutely hopeless in his efforts against these solid and joyful dancing women. No itty-bitty young pom-pom waving cheerleaders here. Mothers and grandmothers of solid-build and genuine enthusiasm danced a congratulatory, winner’s dance for the boy. A man, perhaps a coach, with greying hairs and strong muscles, rushed out and hoisted the winning boy onto his shoulders. The boy punched the air with a big smile on his face.

People cheered. The women yodelled. It was a big moment for the small boy. All around the field, the papa figure carried him. Clearly, he was proud of the child as he raised his own hands in a gesture to generate more cheers and clapping from the crowds. The younger men in his village that had registered to wrestle in the match gave the kid high-fives and backslaps. Some of them, in their excitement over the win, gave each other hugs and chest thumps. Very male bonding-ish. The same behaviour is observed everywhere among the masculine species at sport events.  I smiled. The enthusiasm was infectious. It was very uplifting to see a village come out and show such sincere support.

And what about the boy that lost? He was picked up by his village papa and given a big hug. Although he didn’t get a winner’s congratulatory stroll around the field, he was walked back to his waiting teammates with a comforting hand supporting his shoulder ensuring him that he was still part of the team and his mates were not disappointed in him. He pulled up his traditional cloth wrapper around his waist and strutted back with his chin up – perhaps a little disappointed he hadn’t won but not discouraged. Next time… One could see it in his posture and face. He was a determined chap.

“In the dust of defeat as well as the laurels of victory there is a glory to be found if one has done his best.”

― Eric Liddell

The adult-version of the traditional wrestling was much the same as the kids. Suddenly an extra-excited hum of chatter filtered round the watching fans.

“The white-man is up next,” my friend answered my unspoken question.

I strained on tiptoe to see. A very white man with an even paler white chest strolled out to the middle of the wrestling circle, Cameroon wrapper around his waist and all. His opponent was a very black Cameroonian. They appeared to be about the same size – same height and general build.

The two opponents faced each other and shook hands. The referee checked their mouth and hands for any foreign objects. Satisfied, he blew his whistle. Black and white men circled and quickly locked arms.

“How long do you think he’ll last?” I asked my husband, referring to the white volunteer.

“Not long,” he answered knowingly. My husband had once tried to toss a small five-year old boy up in his arms at the orphanage during playtime. The boy was slender and appeared lightweight. Not at all! My husband almost sprained his back! The youngster was solid muscle. Much heavier than he looked.

My husband’s predictions were barely out of his mouth before the white man’s opponent lifted him up and almost gently flipped him onto his back. Oh well… kudos to the white guy for trying. The crowds cheered and laughed. No one really lost on this match. The Cameroonian proved his strength and the foreigner had an unforgettable experience. Everyone was happy.

Cultural curiosity satisfied I headed home as the sun was setting. “Interesting,” I commented to Bill. “It seems to be rather universal that at sporting events there is an unspoken code of manly display. Enthusiasm, joy, mutual encouragement is shown through certain physical bonding rituals rarely witnessed any other time – hugging, chest thumping, fist pumping, back slapping, and high-fives. Perhaps it is part of the global language of testosterone brought about by the atmosphere of adrenaline-charged sporting competitions?

~o~

“It seems that soccer tournaments create those relationships: people gathered together in pubs and living rooms, a whole country suddenly caring about the same event. A World Cup is the sort of common project that otherwise barely exists in modern societies.”

― Simon Kuper, Soccernomics: Why England Loses, Why Germany and Brazil Win, and Why the U.S., Japan, Australia, Turkey--and Even Iraq--Are Destined to Become the Kings of the World's Most Popular Sport

Humour

Local Public Toilets in Buea. Only cost 50 francs to relieve oneself inside!

Church service.

Long church service.

Very very long church service…

-- Comedy break --

“Time for something to spice things up a bit since we are all falling asleep,” the speaker announced.

A young man strutted to the podium and held the microphone confidently in both hands. He flashed a smile and launched into his comedic interlude.

“In this life we live there are two things involved

Either you are a man or a woman.

If you are a woman you are saved,

If you are a man there are two things involved,

Either you are a civilian or you are in the military.

If you are a civilian you are saved

If you are in the military there are two things involved

Either you are in the office or you are at the war front.

If you are in the office you are safe

If you are at the war front there are two things involved.

Either you kill somebody or somebody kills you.

If you kill somebody you are saved,

If somebody kills you there are two things involved.

Either you are buried or your body is used for manure.

If you are buried you are saved

If your body is used for manure there are two things involved.

Either you are used to grow flowers or you are used for trees.

If you are used to grow flowers you are saved

If you are used for trees there are two things involved.

Either you are used to make tissue paper or you are used to make furniture.

If you are used for furniture you are saved

If you are used for tissue paper there are two things involved.

Either you are being used by a man or a woman

If you are being used by a man you are saved

If you are being used by a woman there are two things involved.

Either she uses you from the back or she use you from the front,

If she uses you from the back you are saved

If she uses you from the front there are two things involved.

Either you contract gonorrhoea or HIV.

If you contract gonorrhoea you are safe

If you contract HIV there is only one thing involved

YOU ARE DEAD!”

The young comedian up front flashed his a huge white grin. The church members all roared with laughter. The white man sat there and smiled, amused. More because of everyone else’s laughter and the situation than anything. She wasn’t sure she understood the underlying humour. Apparently everyone else did though. Even the children giggled.

~o~

Some weeks are tough. Horrible tragedies. Unfair deaths. Pain. Misery. Tears. In the midst of it all, a person has to step out, alienate themselves from the day-to-day struggles, and laugh. A few moments of relief – something to distract the mind -- from the harsh realities around. If one doesn’t laugh; one would cry.

~o~

Jordan, our dog, and I are out strolling the neighbourhood. Her fluffy curled tail and jaunty step attract all sorts of enthusiastic shouts of ‘white man dog’ from the children playing in the grass. As Jordan enthusiastically stiffs out her favourite doggy smells, she glaringly ignores the shouts. Not even a nod of her muzzle in the direction of her noisy fan club. Dogs… We pass by a small Call Box – a booth where a woman sits and sells mobile phone credit. Her little toddler rummages around under her skirts; playing with some article of hers he’s filched from her purse.

“Hey, stop that!” she suddenly notices the forbidden object and wrestles it out of his dusty hands.

“Wahhhhh!” he screams angrily, clearly upset at having his “plaything” taken away.

“Shush… quiet!” his mother warns the boy.

“Wahhhh,” he continues to cry and reaches toward mommy’s purse again.

“No, no,” she scolds.

Jordan and I begin passing the Call Box. Mom notices our approach out of the corner of her eye. “Look, dog,” she says to the crying boy and points in our direction.

He stops crying momentarily to take note of the white man and dog. His eyes blink back tears as his gaze latches onto Jordan.

“Dog,” mommy points again. Her boy watches warily from behind the safety of his mommy. Suddenly she pushes him forward toward the path Jordan and I are walking.

“Argghhh,” the boy screams in terror. He’s fascinated and yet terrified by the fluffy dog that’s as big as he is.

Mommy laughs. “Dog,” she repeats and pushes him closer to Jordan. “The dog go chop you.”

The boy tries to twist out her grasp but she only holds him in position as he squirms in fear and begins to cry again.

She laughs and points to the dog as we pass.

Behind me I can still hear the echoing laughter. I turn partially and catch sight of a relieved little boy scuttling for the safety of the Call Box table, wiping away his tears. I don’t always get the humour here. I shake my head, amused and confused.

~o~

Still strolling around in our neighbourhood, Jordan and I pass the relatively “new” public toilets. It’s a freshly constructed, cement structure with painted diagrams to depict exactly what functions are appropriate to conduct within a public toilet. The illustrations are clear – very clear in their depictions!

Cutting across the football field behind the toilets, I can’t avoid noticing a young man easing himself next to public toilet. In almost perfect imitation of the painted peeing man on the wall, the man casually empties his bladder. His posture and urine stream perfectly mimic the picture. Insignificant detail that he should be urinating inside the building rather than against the back wall!

~o~

Cameroon has two official languages. English and French. (Not to mention the 240+ tribal languages and Pidgin). Buea is a town in the Southwest region of the country. One of the Anglophone regions. There is still a heavy predominance of French in the official written communication even within Anglophone Buea.

I find it amusing to read some of the French translations in our pharmacy orders. I know what the real meanings of the words are but the English equivalents are somewhat ironic. For example:

Medications that might be termed “delayed-release” or “long-acting” are termed “retard”. Nifedipine, a blood pressure medication comes in two forms. Normal Nifedipine and Nifedipine-Retard. Ironically enough, the retard version is usually a better choice.

Recently we received some medications from a pharmacy in Douala. Laborex. Sadly, very few of the medications we ordered were actually available. In the margin next to the column of listed missing medications were the fateful words, “RUPTURE DE STOCK”. I always imagine that the missing medications have somehow exploded upon the storage shelves...

~o~

Let me bring to a close this short expose on humorous fragments of life in a foreign culture with a couple of fun Pidgin translations. Pidgin is a language unto itself. It’s a combination of English, Portuguese, smidgeon of Arabic, and some French nuances all blended together and morphed into a common language suitable for traders all over West Africa to conduct business with each other. As such, the vocabulary may be limited. The limitations in the number of different words is more than made up by the colourful descriptions of things without a name and the hand gestures and facial expressions to clarify and emphasise.

Children are lovingly called “mama” and “papa”.

“Papa, come here,” spoken by a young mother in an effort to get her two-year-old toddler to follow her was a bit confusing until I understood this terminology.

Most mother’s breastfeed here and soothe their crying youngster by giving “booby to suck”. Pacifiers are therefore rare but they are aptly referred to as “baby-shut-ups”.

~o~

“A merry heart doeth good like a medicine…” Proverbs 17:22

Prayers you find those small oases of humour amidst the sorrows and toils of life.

To end, a prayer of Christ’s in Pidgin:

“Papa, A want sei meik de pipul weh yu don giv-am fo mi, dem bi fo wusaid weh A bi, meik dem si hau weh yu don ono mi. Yu don giv me de ono foseika yu bin laik mi bifo heven an grong begin… A bin meik dem fo sabi yu an A go go bifo fo di meik dem fo sabi yu, so dat dem go laik pipul hau weh yu laik mi an A go bi wan wit idem.” John 17: 24 & 26