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Just another day at the ER


It was barely 7 am and I had the energy of a boa constrictor that had just swallowed a goat. I was 7 months pregnant, seated in a courtroom on a cold hard wooden bench. My back supported by nothing but the cold wind that blew in through the pin sized windows. My feet were swollen and I could barely breathe. I didn’t want to be here but I had no choice. They said I was an expert witness and my testimony was needed. A testimony of a patient I saw almost a year prior who I could barely remember thanks to the amnesia that accompanies pregnancy and the passing of time.


Nights were created for sleep. That’s why God gave us melatonin — The Dracula hormone. It’s so named because it is produced in the dark. It makes you feel less alert and sleep becomes more inviting. Night shifts are therefore a law against nature; one that illnesses refuse to obey. Think about it. Why do most women go into labor at night? Or toothaches start at night? And even the worst of food poisoning hits in the dark. It’s a conspiracy I tell you.


During the night in question, I got to the ER shortly before 8pm when the twelve hour shift was set to start. It didn’t look busy. The start of a shift rarely does. It’s a fallacy, a con. A way for the universe to draw you in. Keep you happy and strong and then — the storm.


First patient was a lady in handcuffs — HC. She was escorted into the consultation room by law enforcement officers. She and another lady were fighting over a newborn baby in the postnatal ward. They were both claiming the baby was theirs. HC was later arrested because there was no record of her ever giving birth at the hospital. No record of admission either. Yet she was in a hospital gown and had been around the ward for 7 days undetected.


Since the advent of free maternal care, the postnatal ward resembled a crowd in a political rally. And the turnover was equally high. Sometimes, some patients got discharged but because their babies remained ill in the newborn unit, they could not go home. And they were not few. So they got mixed up with active inpatients that you never knew who was coming or going. It’s just a room full of women in green. And equally numerous babies. Back to HC.


The guards needed me to examine her and establish whether she could have delivered in the last 7 days. So I asked them to excuse us and uncuff her. What’s she going to do to me anyway? They left one cuff sensing I was as naive as I looked. As soon as they left she smiled with masked neutrality and started rumbling.


“I didn’t do it. You can ask my husband and my sister. They are right outside. They saw me pregnant and brought me here when labour pains began.”


I called them in. They each gave an account. Her sister saw her twice during the pregnancy. Before she began to show. Her husband who seemed confused reported she never allowed him to see her bare belly — but he saw it grow. When they brought her in labour, they escorted her to the ward and left. It was then that everything became mixed up. After delivery, no one ever saw the baby. When her husband came to visit, she told him the baby was in nursery and no one — except her — was allowed in. He didn’t know that spouses were not no one. So he complied.

The lack of records worked grossly against her. No hospital card, no inpatient file. Nothing. No one understands how she had been in the ward for seven days; or even how she had acquired the inpatient gown. She had no clinic attendance card or ultrasound scan for the pregnancy but she insisted she had been pregnant and that was her child. So I examined her.


I checked her breasts for milk — dry. Her abdomen — flat as the heartbeat of a dead man. And she had no bleeding or even the hint of a discharge. I called in a second set of eyes and hands and my colleague agreed with my findings. Because we are not investigating officers, our work was to document our findings and leave the rest to the cops to investigate. After several other blood and ultrasound investigations, they took her away. The test results did not help her case.

It was later discovered that she had a phantom pregnancy. It has a name : Pseudocyesis. An uncommon condition that leads a woman to believe that she is pregnant to the extent that she exhibits classic symptoms of pregnancy. The symptoms can last long enough to convince the woman — and those around her — that she is pregnant. They may actually have a distended abdomen similar to a baby bump but with no baby. The distension is usually due to flatus, fluid, feces or fat. Go figure!


I never saw her again. Not until the court house. It was packed to the rafters and I kept looking around for her face. Surely pregnant amnesia couldn’t be this bad. The proceedings had began and the judge kept referring to her but I couldn’t trace her in the room. It was only until they asked her to stand for identification that I understood why I couldn’t recognise her.


She was pregnant.



 

Men who fight over money do it during the day. It could be in a boardroom or in the parking lot but it’s usually accompanied by daylight. Not so the ones who fight over a girl. Those ones wait for dusk or dawn. Maybe it’s the element of surprise or just the privacy of the fight. Who knows? Once, a patient landed in my consultation room at the crack of dawn with a knife sticking from his forehead. A human unicorn.


He was a guard at a renowned garage in the leafy suburbs minding his own business when his old pal paid him a visit. He saw him and he knew that he wasn’t there for a hug. Not the loving kind anyway. Words were exchanged and a fight broke out. His pal came ready. To break, destroy or kill him. As they fought, he brought out the knife and plunged forward landing on him as the knife went straight through his forehead.


As fate would have it, the knife plunged deep into his skull, missing every vital organ and coming within inches of his brain. He was a walking, talking unicorn. When he got to casualty — brought in by his attacker no less — everyone stared at him in awe and disbelief. Some wanted to touch him. I asked him to take a seat but he was too restless. He kept pacing up and down wanting to pull out the knife. He was feeling odd having something sticking out from his forehead. Imagine that. He didn’t use the word pain. He said odd. His buddy did most of the talking. He admitted to attacking him because he had stolen his girl — but he didn’t intend it to get this far. Or maybe he did. The guy looked so mean; like he would steal flowers off his grandmother’s grave.


When I called the neurosurgeon on call, he had a hard time believing me.

“Morning Doc. I have a guy with a knife in his head.”


“What do you mean?”


“Exactly that. He was in a fight and someone stabbed his err… head.”


“Where is the knife?”


“In his head.”


“I heard that. I meant what anatomical area?”


“His frontal bone. It’s just sticking out.”


“Is he conscious?”


“Like you and me.” I chuckled.


“Coming.”

With his consent, I took a pic. Several. They took him to theatre and uneventfully took out the unicorns horn. Three days later, the guy walked home.


Lucky guy.

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