There were no doctors in her family tree. None. Just hunters and gatherers, teachers and masons, farmers and small scale traders, an engineer and a handful of lawyers. [What’s the collective noun for a group of lawyers, anyway? A boil of lawyers?] There might have been a relative or two who may have worked in a hospital, but that’s not exactly the same as practising medicine is it? The whole goddamn family tree, no doctor. No medicine men or women. So she decided to do something about it. You know, save the family the embarrassment. Set a precedent. Besides, she was also a salmon, built to swim upstream.
She did what people who turn out to be doctors do; burn the midnight oil, walk about with tons of dog-eared books, mumbling under their breath. Forget to comb their hair. Because she’s smart and she didn’t ‘fear blood’, her efforts saw her join medical school. Finally, medicine. The family’s trajectory was finally getting corrected.
Most of us have never been to medical school, but word is that there is a lot of reading involved. A lot of creased-brow conversations amongst medical students. Such that by the end of the week, a good number of them would want to blow off some steam. We don’t know the geography of this particular University but word has it that the medical students campus is sequestered in a bush, with the very cold, dark nights marked by moaning of owls. [A group of owls is called a parliament] Frequently, students went to the nearest town to reacquaint themselves with civilization.
She and her friends were no exception. Leave Friday for a weekend in town. One of those Fridays when she was in first year she and her girls made a plan to hit the nearby town and do it justice. A plan was quickly hatched. Bags were packed.
So they gathered to leave; she and three of her friends. They walked down a long stretch to hostel gates, past faculty and there they ran into this chap, a medical lab technologist. Young fella who had just started that job. He was an OK guy, friendly with everyone. He had a small car, a fifth Generation Toyota Starlet. His first, and you know how it is with your first; you think there will never be another again. He brought the car to a crawl and stuck his head out the window and said hello to her. “Where are you all headed?” He asked the group of girls. [A group of girls is called a Giggle].
“To town,” she told him.
“I can give you guys a ride,” he said, “I’m also going to Eldy.”
Cool. They got to save some money for drinks and food.
There was a guy – one of his mates – riding shotgun. If you know the Toyota Starlet you know it’s not exactly a car with tons of space. It’s a tiny little thing with a soprano engine. It’s the rat of cars.
Anyway, the babes bundled at the back. It was a very clean car, smelled of fragrance. This guy was a neat guy, besides since it was his first car he probably slept in it some nights like one should in their first car. I loved my first car so much, I thought I’d make it official, you know, marry it.
They somehow all fit at the back, the four of them, mainly because in university, especially if you are studying medicine, you tend to be thin.
The guy introduced his shotgun riding pal and he turned in his seat and growled, “hey.” He had thick lips and a short chin which meant that when he smiled he looked like was blowing a kiss. They drove out. At the gate the lab guy stopped the car and said, “let me grab something here for a minute” and jumped out of the car. He was gone for maybe ten minutes.
A little context. This was in 2011, Emmy Kosgei was hot. The song ‘Taunet Nelel’ was all the rage, playing everywhere. Taunet Nelel means ‘a new beginning.’ Or new dawn. As they waited for him to get back they agreed, as an act of gratitude, they would all changa and buy him that album because he was Kale and what Kale doesn’t like Emmy Kosgei? Actually, who doesn’t? When he got back in the car they left.
The road was scenic. The Starlet climbed and dropped down hills like a toy car with its own engine. On one hill, and this is the proverbial hill people die on, he started overtaking a matatu but realised that he didn’t have enough throttle to complete the task, besides a lorry was hurtling down towards them. So he slowed down and tried getting back in line, only he went back too fast and hit the flank of the matatu. The car did a complete spin and stopped, it’s whole right side now facing the oncoming lorry that rammed into it at full speed.
This is a story about scars. Visible scars, but also invisible scars. The lady who narrated this story has a scar running across her throat.
When she speaks she sounds like half-machine, half human. Like she has a bad throat infection. Her voice and her face are as alike as a pineapple and a wheel spanner. Good thing is that she doesn’t remember how she used to sound before 2011. All she knows is that she didn’t sound like this. I told her I liked her voice, though. It’s a radio voice; grainy, scratchy. It has character. You wouldn’t forget it if she told you, ‘pass the salt, please.’
But before the sound, before everything else, there was that accident. She doesn’t recall anything at all from the moment the guy got back in the car at the gate. Nothing. All this is stuff she pieced together through years of talking to people who remember the accident.
Without being graphic, here is what happened.
The lorry was something of a 3-axle, which weighed at least 25,000kgs but it was carrying some goods, so it was heavy. At a speed of about 80 km/hr because it was coming downhill, it was basically a meteorite of death. At the back of the Starlet, behind the driver was her Indian friend, then another pal who we will call X, then her and then lastly another pal Y at the door. When the car swung, the driver and the Indian friend were facing the oncoming lorry. They didn’t stand a chance. Death was instantaneous. His legs were found inside the lorry’s engine. She was pancaked against the engine. Lady X, next to her was also killed when the roof collapsed on her, crashing her head.
She was next.
Her ankle got crushed. She had an open leg fracture on her left leg along the shaft of the tibia. Her left collar bone was shattered. Her left ankle had an open fracture with most of the talus crushed and left in the car. Her two upper ribs snapped in two. She suffered a deep cut on the outer edge of her right eye and an abrasion next to the left eye halfway down her cheek. There was a lock of hair from her occiput and a skull fracture. [An occiput, I’m sure you are wondering, is the back of the head but doctors would rather die than call it “back of the head.” It would be a waste of their time in medical school.] Her friend, seated on her left, survived, so did the guy riding on the passenger seat.
“I was hugging my laptop and when they retrieved it, it had folded in two from the force of the collision,” she said, “ quite possibly that laptop, an Acer, saved my life because it saved my organs from extensive and, possibly, fatal injuries by cushioning the crash.”
People from the matatu that they were trying to overtake rushed to the accident site as soon as it happened. There was a river of blood and petrol under the cars, debris of metal and wires, all twisted and gnarled in this final art of death. They left the ones who were obviously dead and pulled out the shotgun friend and the girl to her left. “I’m told they had one look at me and assumed I was dead too, so they focused on saving those who were at least alive.”
An ambulance came with lights flashing. She must have twitched and someone said, this one is still alive. The dying were rushed to the nearest hospital. At the hospital they left her in the emergency waiting bay trying to figure out who she was and who would pay the bill – the usual big hospital charm. She was broken and bleeding on the floor. When her lecturer from uni arrived and made a stink, they checked her into the ICU. Meanwhile, her mother got those calls parents dread to get.
“Your daughter has been involved in an accident.”
“Accident?” She asked, “my daughter is in school.”
“She was involved in a road accident.”
“A road? What…what road?”
“You need to come immediately.”
She gasped and flopped down, the mobile phone shook in her hands.
“How bad is it?” she whispered.
“You need to come.”
There is something called the Glasgow Coma Scale. It’s a score used to assess the depth and duration of a coma, and impaired consciousness. It’s based on motor responsiveness: eye opening to appropriate stimuli. That kind of thing. It’s scored between 3 and 15. Three being you are basically brain dead, I suppose, and 15 being the highest. A 5 is associated with an 80% chance of being in a lasting vegetative state or death. A score of 8 or less is severe brain injury. [I had to Google this shit].
“I scored an 8,” she said. “Severe head injury.”
If you are intubated in the ICU for 14 days you develop something they call tracheal stenosis. Basically your windpipe narrows and it restricts your ability to breathe normally. It’s the body figuring, ‘oh, it seems you aren’t using your windpipe, so we shall just take that away from you, try using your ass. Thank you.’
She was in the ICU for two weeks, but it screwed up her throat.
On day eight she woke up from the coma. She looked up at the ceiling and thought, ‘what the f*k? What ceiling is this?’ It was unfamiliar. She could hear cars and wonder, why am I hearing cars? We didn’t live anywhere near a road. Or did we? And wasn’t there a river near our school? I was in school, wasn’t I? Why is this ceiling made of stone? She was on Synchronised intermittent mandatory ventilation. [OK, also do your part and Google some of these things. I can’t do everything here.] She couldn’t recall who or where she was. “I tried to sit up but I couldn’t, so I reached out and touched my leg and I realised that I had massive casts on both legs, how did I get casts on my legs? I was later told that I used to throw my legs around when in a coma, so they had to make my casts very heavy.”
She had amnesia and as weeks went by she realised she recognised no one apart from her mom. Nurses would come and ask her, do you know where you are? What is your name? What year is this? When she said her name the nurse was so happy she ran off immediately and called the surgeon who asked her again, “What is your name?” When she said her name she could see the happiness in their eyes, the nurses looked gleeful. ‘Why are they so happy I know my name?’ She wondered.
“It was strange, I would not know you or your name but when you spoke I somehow had some unconscious recollection, an unspoken sense of context between you and I, a context I couldn’t describe,” she said, “I would call someone my brother’s name. I mixed up genders. I devised a way of assigning visitors numbers. You are number one and you are number three and four like that. But when I slept and woke up I would have forgotten everything. It’s almost like my mind would reboot each time I slept. It kept cleaning up my memory and I’d have to start afresh.”
Her history was wiped. And nobody was willing to tell her what happened. The months she was in hospital were gruesome and torturous; kidneys crashing, blood infections, malaria, whatever. They washed through her body one after the other. “There were hallucinations. Oh the hallucinations. ICU delirium of a horrible monster, this huge person is trying to steal her phone. I’d tell the nurses, ‘please, don’t let them steal my phone, please. Be careful with my phone.’ I didn’t even have a phone at that time.”
“When I was told I was in an accident with my friends I kept asking them what happened to my friends, are they okay and they never gave me any answers.” She said, “It’s only some doctor, my mentor, who one day told me the truth. But how could I grieve when I couldn’t remember these friends of mine?”
The brain is a weird organ. It germinates. It selects what you need to recall and what you don’t. Over time her memory came back, some of it. “If I met you a few months before the accident, I would not remember you. I don’t recall the accident or a lot of the events preceding it. When I left the hospital, months later, I was in a wheelchair and I wanted answers but most people had moved on from that experience. They didn’t want to go back to it and I spent three years trying to talk to my friends to tell me what happened. I felt like I had lost a chunk of my life, like the file was missing.”
Healing was very painful and soul crushing. “I’d fall off the wheelchair. I couldn’t live with my mum because of the mobility situation, we lived in a neighbourhood that wasn’t friendly to people in wheelchairs so I would live with people, relatives and later a friend’s mum and I was a burden to people because of that condition. People get tired of you. They want to live their lives.”
She had to re-learn virtually everything; brushing her teeth, reading, writing, showering, wearing a belt, combing her hair. She couldn’t recall her mother tongue or Swahili so she started learning, reading books, and watching the 7pm news. “I would go to a supermarket and wonder why one picked one soap over the other. I called the attendant and asked them how someone chose one soap over the other; who said this soap is bad? How does one rationalise a decision? He explained to me stuff to do with personal preferences, packaging, and price. Basically I was relearning everything, even the most mundane of human interactions. For instance,” she said, her voice scratching the air between us. “When someone told me ‘ I will come see you at 11am,’ I never imagined that they were lying. I had implicit faith and trust in humans and my emotions. I didn’t understand the nuances of emotions, and they only just started making sense to me gradually over time.”
She wanted to go back to school and study medicine but the university said, ‘come on, now, you have amnesia, medicine is difficult enough for people of sound mind, imagine how difficult it can be for you.’ Before the accident she was in the top ten percentile of her class.
“But I persisted. I had a very good and understanding dean and he said, ‘ok, go study anatomy and sit for a test, if you pass you will gain admission.’ I love bones, fascinated by them, so it seemed like a good challenge. So I bought anatomy books and I read and read and the thing with the brain is the more you use it the better it gets. And I realised that I could remember some stuff from the anatomy class, so I was basically pulling this information from a different part of my brain.”
She passed the exams and got readmitted into medical school.
The next journey in school wasn’t easy either. She was on crutches. Everything hurt. “I had to start leaving for class thirty minutes before everybody did because it would take me twice as long to get to the lecture halls. I lost friends, of course. I felt like a burden and I’m sure I was.” She studied harder than everybody else and then she passed. “Many people had to resit classes, I didn’t.”
Internship also came with its own set of challenges because patients didn’t trust her. She looked sick and battered. “I had a tracheostomy done, which is this opening created at the front of my neck so that a tube could be inserted into my windpipe to make me breathe. That scared patients. They used to prefer my colleagues to handle them, they would call me daktari mgonjwa.”
She was on a cocktail of drugs and painkillers. She would constantly develop acidity because of her sensitivity to foods. She couldn’t process proteins at some point. She developed asthma. It was problem after problem but it’s been 12 years now since she got into that Starlet and is now a doctor at AAR Health Services.
“I think the greatest battle I have had to fight from the accident is amnesia. For the first three years all I wanted was to know what happened, who I was before the accident. It dominated my life. I considered hypnosis but at some point I gave up trying to find out about the past. I mean, I figured maybe the brain was doing me a favour by blocking what I didn’t need to know and allowing only what I needed to know.”
She still has pain in her ankle joint, walks with a limp and has back pains. “It’s difficult to get the right kind of shoes.” She also still has stenosis in her throat, so she’s short of breath with any physical exertion. Flus really knocks her out. She plans to go back to school and study orthopaedic surgery.
She keeps moving.
Do you have a great story about a scar? Kindly email me the photo of the scar and a synopsis about it to bikoz[email protected] [Trick to photography; don’t take it in darkness]
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