Forty Days In A Trauma Ward

By Moses Obroku

I have always had an unexplained dislike for the colour red. Perhaps, it is because somewhere in my subconscious I have associated it with danger or blood. However, in the morning of Thursday, February 23, 2006, I put on an oxblood shirt and a red-brown-black blend tie over black trousers to go to work which I just resumed two days before.

Having only completed my National Youth Service in September of the previous year, I thought I was rather fortunate to have landed that job, considering I did not have to stay at home for long. So it was with great expectations that I commenced training on the job. I remembered praying that morning as I always do before setting out, for God’s protection.

After a rather hitch free commuting via public transport from Ajah to Airport road where the headquarters of the company is located, I had an exciting day at work and before the close of business that day, I was given an invitation to attend the company’s annual retreat which was holding at Nike Lake resort in Enugu that year. Things were looking great! I was excited about the retreat of the following week as I had never been to the eastern part of Nigeria before that time.

Here was I, fresh from school with a law degree, NYSC behind me, and a promising job ahead of me. Life was good! Those were my thoughts as I made my way back home. At Oshodi, I boarded a non-stop bus to Ajah.  Since I was the first to get into the vehicle, I took the front seat as it usually has more room. Soon after, a male passenger came to join me in front and I made room for him to take the inner seat while I retained my window seat. I would never know now, how that decision played out.

As the now filled bus made its way towards the third mainland bridge, the ride was smooth, things looked normal. When the driver started to ascend the bridge, at the intersection where the road forks towards Ibadan expressway to the left and Lagos Island to the right, he should move towards the right and continue on the bridge. I just started to think that the vehicle was too close to the kerb and… (I didn’t quite finish the thought) when everything happened in surreal slow motion in my mind.  The driver violently hit the kerb with the left wheel, which made the bus travelling at about 100 km/per hour careened out of balance, fell on my side and continued sliding on the concrete highway till it spent its velocity and came to an abrupt halt right in the middle of the road. Fortunately, there was no other vehicle coming behind to run us over.

The noise of the crash was deafening. The windshield had shattered to a thousand places sending pieces of glass fiber everywhere. Metal had squeezed, seats were pushed into each other and there was silence for a fraction of a second before the cries, wailings, and screams emanated from all around as if people were zoned back into the present to confront the horrors.

It has often been said that people who have had near death experiences usually see their lives flash before them. It is true!

I must have been disoriented for a few moments until the noises started and I realized I was not pinned down. I came out of the vehicle through the space where the windshield used to be and sat by the kerb of the highway. It was when I tried to assess my situation to know if I sustained injuries or not that I discovered my right palm had been badly mangled. I could see my right index finger hanging by a shred of skin, the other fingers were also broken with gaping wounds; I could see the bones, ligaments and all the stuff that flesh used to cover. And there was blood! I remember it just kept pouring from my hand wetting the pavement in front of me.

(pix: nairaland)

Then sympathizers from nearby and fellow passengers who were lucky not to have sustained injuries crowded around me, putting  their hands on their heads, screaming as they looked at my injury and generally mourning my plight better than I was doing with my shocked silence.  I couldn’t tell if other passengers sustained injuries as well, seeing I was in a critical condition which was already raising a lot of concern at the scene of the accident.

I soon realized the injury to my palm resulted when the vehicle came down on my side and I had on reflex, tried to use my hand to break my fall and prevent my head from hitting the concrete highway; even as the vehicle continued its sideways slide thereby crushing my palm to pieces. Amidst the chaos, one woman who could no longer stand the sight of my now torn bleeding palm, threw what I thought was either her headgear or her baby’s dress over my injury to cover it.

From when the accident happened till I came out of the vehicle was not up to two minutes. But it felt like a lifetime already. One sympathizer suggested I started walking to a nearby hospital. While we made our way towards the base of the bridge, the pain kicked in and it wasn’t just from my hand that it was coming from but all over my body.

I realized at some point that the MP3 music device I had plugged to my ear before the accident, kept on playing. Before yanking it off, I had wondered how strange it was that my life was threatened and the music just continued playing undisturbed by the chaos surrounding me. I also realized I had left the folder containing the letter inviting me to the company’s retreat in Enugu and some other documents at the scene of the accident. It was amazing how everything was looking bright and beautiful one moment, only for hell to break lose without any warning the next.

After walking about 300 meters, we got to the hospital at Bariga where I barged in screaming ‘I need a doctor’ even as I continued down the hallway, looking for anyone who could attend to me. I remembered the lady at the reception had run after me, trying to get me to calm down even as my hand kept dripping blood all over the place. The doctor that showed up almost immediately removed the piece of cloth that lady had placed over my hand at the accident scene, took one look at my injury and declared it too severe; that I needed to see a trauma surgeon right away.  He referred me to the National Orthopedic hospital at Igbobi. I froze!

It was then I realized the magnitude of my injuries. It occurred to me then that I was encountering the Nigerian medical service issues. I started remembering all the stories I had heard regarding government owned hospitals. I became afraid. I had just survived an accident, but now I would be at the mercy the Nigerian medical system with its poor facilities and ill motivated personnel who could embark on strike action even the next day. I became very afraid, because prior to that accident I had never been an in-patient in any hospital my whole life.

As the doctor made to leave after delivering his gloomy news, I suggested to him if I could at least get some medication for the pain that was shooting all over my body. He thought about it for a second and agreed. After instructing a nurse standing by on what drugs I should be administered with, he left. The nurse made sure I paid for the medication before it was administered. I have always wondered how medical practitioners around here always insist on fees before attending to people even in emergency situations. Anyway, I paid, got my medication that gave me temporary relief from the pains; abandoned my change and returned to the reception area of the hospital to figure out how to get to the orthopedic hospital.

(pix:vconnect)

At this point, I tried to call my brother Israel with whom I lived then; but his phone just kept ringing till I remembered he was in church that evening and eventually sent him a text message. I called my friend Hycent, but he was far off too.  As I sat there wondering how I would get a taxi to Igbobi hospital, one gentleman who had just brought his daughter to the hospital came over to me and inquired what the matter was. After narrating my ordeal to him, he volunteered to ask his driver to take me to the orthopedic hospital. Before we left, he gave his driver some money to pay for whatever I may be required to and stay with me till people I had called showed up. I could not believe my fortune. Despite what anyone thinks about Nigerians, there are still a few good men around here. Even though the bible account of the Good Samaritan was only a story, I knew I had encountered an individual with a kind heart like the Samaritan in Lagos. I managed to get his phone number before the driver and I set out. I remember taking my necktie off and dumping it at the reception and parting with it and its red colour permanently.

As we arrived at Igbobi hospital, I suddenly remembered Tutu, a family friend who lived in that neighbourhood and promptly called her. She showed up almost immediately.  Upon entering the emergency section of the hospital, I was put on a bed, even as my personal data was collected.  A doctor soon emerged with a nurse and some kit, to work on my hand. They had to cut my shirt away before pouring saline over my wound to get dirt off and started to stitch what parts they could.

Just as I was beginning to think that okay, I was getting attended to quickly and efficiently, a government hospital may not be that bad after all, the power went out! Fear gripped my throat afresh. To my shock, the nurse casually whipped out her mobile phone and held it over my hand to give light to the doctor doing the suturing, even as they continued their subtle conversation under their surgical masks unfazed. I realized that, that situation must have played out so often they were now used to power going off in the middle of a procedure. Soon they were done, and swathed my hand in gauze.

It was at this point that the driver of that kind man (whose name I never got) left, sure that I was safe. By this time my friends Tutu and Hycent had arrived. Soon after, my brother arrived with some church members. In a way, I had felt sorry for them all. To get that kind of news after a long, hard day’s work must be overwhelming and frightening.

The attending doctor on duty that night came to assess my injuries and told me frankly that my hand would not be the same again. He confessed to not guaranteeing what fingers they would be able to save. But he was sure the index finger on my right hand was gone seeing it was barely hanging by a slice of skin and I had left part of its bones at the scene of the accident. The ring finger next to it was so severely damaged too, he could only hope it would survive. As I looked at him blankly, he asked if I understood what he was saying. I merely asked him if I would be able to write again. He gave me his optimism and left.

Prof Onyebuchi Chukwu
Until recently, Nigeria's Minister of Health 
(pix: Nigeria.gov)

With nothing left to do afterwards, the family and friends who had responded to my distress call, called it a night and agreed to be with me the next day. I spent that night at the emergency ward, surrounded by accident victims of varying magnitude. Sleep would finally put me out of my misery even as I hoped the whole surreal event of the day was a bad dream from which I would wake up.  That was how I spent my first night ever on a hospital bed. 

It was the pains that woke me up the next morning, dragging me back to my shocking, painful reality. It wasn’t a dream after all. The day began with the doctor from the previous night coming to check on me. When he removed the gauze covering my injury, my index finger still hanging by the shred of skin had lost colour and turned a deathly grey. The ring finger next to it which was declared critical the previous day seemed to smile at me with a fuchsia colour promising to stay with me.

As the second day of my stay at the hospital went by, efforts were made to get me admitted. I would later see the clinical summary of my injury which said ‘crush- Avulsion injury of right hand D3-D5’

When I was finally admitted to the Mobolaji Bank-Anthony (MBA) ward 5, I was told I needed to supply my own water for immediate usage as the facility was lacking water at the time. My mouth dropped. How can a hospital not have water running for one moment? I asked no one in particular. Anyway, Tutu my angelic family friend came to the rescue. She sent Muyiwa her steward to bring a gallon of water to me at the ward. This Muyiwa, (God bless his heart) would later faithfully and tirelessly bring meals and provision from Tutu to me at different times in a day for most of the duration of my stay at the hospital.

While the no water situation at the ward did not last long to my relief, I remember the power going off again during my first night at MBA5 and lanterns were lit as  the nurses came around to tuck in our bed nets properly.  As time went by, I would later admire the dedication with which the medical personnel of the National Orthopedic Hospital Igbobi carried out their duties regardless of the huge institutional and infrastructural challenges they face daily.

As I lay on the hospital bed, the grimness of my situation started to set in, and with it heavy depression.  It was either the second or third day of my stay in the hospital that the consultant in charge of MBA5, came around with a group of young doctors I believed were on internship to do a ward round. When they got to me, the consultant discussed my injury with his group and promptly scheduled me for two surgeries- debridement and skin graft.

After some days at the ward, I fell into the rhythm of things there. Wake up, do personal hygiene/ clean up, the nurses administer drugs, meals get served, injuries get cleaned up and redressed, sleep or interact with other patients or nurses/ receive visitors, lunch gets served, more medication is administered, dinner is served, medication, bed time and the cycle begins all over again the next day. I felt imprisoned by my body. My hand which was heavily bandaged and put in a cast slab was required to be elevated to reduce the swelling. I sunk deeper into depression from the surreal situation my existence had become. Each day my injury was opened up to be cleaned before my surgeries, I looked at the horrors my palm was becoming, and the sight must have added to the weight of the depression I was having.

Friends and family ensured I was not lacking anything to make my stay at the hospital comfortable. Israel, my brother would call me at intervals during working hours to ensure I was fine and dutifully drive down after work all the way from Ikoyi to the Mainland to see me, amid the traffic before heading home in the other far flung part of town. I had to tell him to space his visits since I wasn’t leaving the hospital soon. Tutu  would increase the quality and quantity of meals and provisions she was sending to me through my man Friday-Muyiwa,( which no doubt ensured I ate less of the hospital served meals that I surprisingly found decent, and gladly offered my ward mates). My dear friend Christy Nwachi would demonstrate a high degree of selflessness, care and devotion to me during those trying days. I can never repay her for her true kindness. They say it is when you are down you will know who your true friends are. It is partly true! The people who stood by me all that time are too many to be enumerated. They know who they are, and I will be eternally grateful to them.

When the day for my first surgery came, it was an open and shut matter. The surgical teams at Igbobi hospital are quite knowledgeable.  I was put under general anesthetics so that by the time I woke up, the surgery was done.

With my right hand banged up, I resorted to doing everything with my left hand. Now that I think of it, it’s amazing what we can achieve when our survival depends on it. I realized that it is not true that you cannot learn the use of the left hand at old age. I even began to scribble with my left hand but soon gave up when my writing looked worse than that of a two-year old.

Soon after, the day for the skin graft surgery came. I was prepped and wheeled into the theatre again. I remember the anesthetician asking me to count down from ten with her. I cannot remember going beyond eight before losing consciousness. The next thing I knew was nurse Orugbo calling my name with her deep firm voice. Only in my drowsiness, it sounded like a call from the supernatural. When I woke up, as before the surgery was done. Only the pain from my left foot where skin had been taken to close up the extensive injury on my palm, shot to my head. Now I had my right hand and left foot in heavy plasters. It looked like things had to get worse first before they got better.

Back in the ward, I was given a crutch to aid my movement since I couldn’t put pressure on my left foot. My depression increased. Here was I, hitherto never admitted to any hospital but going through the whole works now. I began to reflect on the things we take for granted- safety, good health, mobility, sight, sound, two hands, two legs, sunshine, bird songs, family, friends and all the other excellent things about life.  If it was possible, I could have given up every material thing I possessed in exchange for my health and that hospital experience and those ordinary things of life. There was a partial eclipse of the sun that year. I experienced it at the hospital!

In retrospect, I think I fared better than most of my ward mates. Some had only hospital meals to rely upon, less visitors and worse still, most had debilitating aggravated injuries that made mine looked like a scratch. One of such individual was Kayode, the fellow whose bed was just beside mine. Kayode had been on that bed for about six months before I was admitted. In all of that time, he had never left the bed, never set foot on the ground. His injuries, which were extensive burns from his neck down to his toes, resulted when he was attending to a fuel tanker discharging the product which had caught fire just as he was trying to turn the engine off, bathing him in a fiery liquid. He was lucky to have survived it.

(pix:electives)

When I was admitted to MBA5 ward, I found him bandaged from neck down. Cleaning and redressing his wounds was always such an ordeal as he was always screaming.  And when the physiotherapist came to exercise his limbs to ensure his muscles don’t atrophy or his bone stiff from disuse, his screams were louder and heart rending. There is no human that would not be moved by the sight and screams of Kayode. I remember one afternoon after the physiotherapist was done with him. He had screamed so loudly from the pains that, after the session was over Kayode continued to sob aloud and asking/praying at the same time in Yoruba language ‘ha you God, what did I do wrong? Please have mercy on me, have mercy on me, have mercy on me….’

It had been nearly three weeks since I had been by Kayode’s side seeing him go through that ordeal daily. From when I was involved in that accident till that afternoon of Kayode’s  sobbing aloud, never for once did I have a soft moment to feel any sorrow other than anger and frustration my depression had left me with. I did not have the patience to shed a tear in sorrow for my condition or anyone else around me. In my mind, it was a war on recovery I was determined to win, determined to stay tough to win. But as Kayode continued to sob that afternoon, and kept on with the rhetoric question/prayer, that element that makes us humans, that enables us to recognize our shared humanity, common pains and sufferings (the burden and ordeal of the other person) gave way in me as I felt the tears I had held back for many days begin to flow for a long time.  There is no one that would see Kayode and hear him scream and not be moved.

As I reflect upon my experiences following that accident many years ago, I realized the magnitude of institutional failures in Nigeria. The Nigerian Medical Association (NMA) has always locked horns with the Government over welfare of its personnel and provision of infrastructures. As this annual cat and mouse game between the NMA and Government continues, patients are usually at the receiving end emergency situations or not. Critically injured or sick patients have had to resort to private Medicare during those doctor’s strike days. My greatest fear when I was hospitalized was doctors embarking on one of such strike actions. Mercifully, they did not.

In other climes, their medical institutions and response to medical emergencies are just amazing. All you need to do is dial some short magic numbers. In a few moments, a response ambulance of paramedics would just show up. Where the location is not accessible by road or traffic is heavy, they would resort to air ambulance and lift the person to save the life. We have seen it on television how choppers hover over the sea or rocky terrain just to rescue one person even in dangerous weather conditions. The regard those developed countries have for human life in putting all those measures in place and ensuring the services are available to everyone is amazing. I am aware of the Flying Doctors in Nigeria who run air ambulance services. But the cost to run that kind of privately owned outfit in Nigeria is also reflected in the fees they charge patients.

During my hospitalization, in my depression and delirium I had nursed a mad thought as I wondered if Nigeria will ever have a functioning dedicated line that I could have dialed and waited for a few minutes to be rescued as I sat bleeding on Third Mainland bridge on Thursday 23^rd February, 2006.

On April 2^nd after over one month of being hospitalized, I was able to hold a pen with great difficulty with my injured hand, opened the bible I had with me and wrote ‘great is your faithfulness oh God my father…’ After forty days of being hospitalized, my hand had healed enough for me to be discharged. My left foot healed nicely too, and I had dropped the crutch. I left the hospital with mixed feelings, but I was grateful I walked out of there on my feet. I would later relate the forty days I spent at the ward as my own wilderness experience when I reflect on my name, the ironic period hospitalized, the story of Moses in the Bible and the series of ‘forties’ in his experience vis-à-vis the biblical significance of the number ‘forty’.

While I was glad to leave the hospital, I saw too many amputations among ward mates to leave me depressed for a long time afterwards. Some of the people I met at the ward, I sadly left there. Many months after I left the hospital I stayed in touch with Kayode. I called him one day and he was excited to tell me he had also left the hospital, and could walk again. I was ecstatic with relief! I also called the number that good Nigerian who sent his driver to take me to the hospital gave me. I spoke with a lady I supposed is his wife, narrated my encounter with him to her and asked her to please convey my message of gratitude to the kind hearted fellow. Sadly enough, I lost the number eventually. While our paths may never cross again, he sure had made a lifesaving impact to me that God will reward him for.

On February 14, 2007, a few days before the anniversary of my life changing accident, I paid a visit to MBA5, the ward I occupied when I was hospitalized to renew hope to the patients there. One boy was depressed just as I was during my stay there. When I finished sharing my story, the countenances of all the patients glowed with hope as I assured them they would all eventually go home. That visit, was one of the most fulfilling things I have ever done my whole life! While I was hoping to make that anniversary visit a continuous one, to my shame I have not been able to do so.

Over the years, I have had cause to remember that lone vehicle accident I was involved in every day. I still feel some pains in my right palm from time to time. It must be the strung out nerves and misaligned bones.  I have now become ambidextrous as I can effectively utilize my left hand as much as my right. And the only driver I completely trust is me. But then, I also thank God daily for allowing me to live through it all.

Accidents don’t just happen. People make them happen. Seeing most accidents and resultant complications in Nigeria are caused by a combination of the recklessness of unqualified drivers, bad roads, poor implementation of regulations by the authorities and failing medical institutions in Nigeria; if it is not too much trouble, can the government please look into these issues and prevent continued needless deaths and maiming around the country?

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Obroku, a Lawyer, Migration Management & Document Forensics Expert contributed this piece to SCRUPLES  from Lagos. mosesobroku@gmail.com