teddy totimeh

When I left the operating theater at 3am that Friday, I was double-minded. I was not sure I should be going home. I wanted to stay at the hospital, sleep and then get home in the morning. But I really wanted to be somewhere else Saturday morning. I thought it would be helpful to get some sleep in my own bed for a few hours before setting out.

Last Monday I was on my way to work in the morning.  I left home, on a journey that usually takes 30 minutes through the Accra Traffic.  It took me 3 hours. I did not really understand why until I got on campus, and realised that it was because the students had come back, and we were sharing the same entrance.  No preparation had been made for the large numbers of people who would flood the place.  Everyone was using the single entrance, and single exit.  The security men milled around listlessly, trying to shepherd lost drivers unto choked roads.  It was mayhem.  And in all this, no one had thought about the fact that there was a quarternary medical centre on the University Campus, and that its staff would need access on such a day. 

 My son asked me to pray for him
To be an astronaut when he grows up
He talks about it all the time
So I stop myself thinking all the time
That he is too far away from where
The astronauts come from
To become one

The number builds. We have lost more people than we thought we would lose. Just when we have begun to fix our focus on getting back to some kind of normal, this disease seems to further deepen its trenches along the frontline. The virus is freely jumping across all the defenses we have sacrificed to put up. And seems to pick whom it pleases. It crosses class, tribal, political lines. No one is safe.

Sometimes when I am driving home, the battles of my patients continue in my head. Some are losing battles. Some are winning battles. Most of the time, the battle is the patient’s to fight. I only come in to facilitate, put a few things right so that the battle lines are in the right places. Most people will never need me to fight most of their life battles. There are only a few that I can help, and even for these, the onus is on the person to walk up to the battle line, after I have helped to draw it.

Achimota School is 90 years old. I have tried to participate as much as I can in the commemoratory activities. Sometimes I have been able to do that, and sometimes not. I owe a lot to the vision of the three men who put their minds together to dream so big, that 90 years down the line, even in a country that has not really grown, their dream stays alive.

One of the gifts of studying medicine is the privilege of looking at things from a perspective unique to the profession. The functioning human body is an intimidating lens to look through into the world. Because there is nothing in the world that can function as well as it does. No teamwork can be as intuitive as that between the body’s cells. No manufacturing process can be as efficient, lean and productive as the numerous production chains in the body. No detoxification process can even imitate the wonder of the liver and kidneys functioning at their peaks. No pump can be as persistent, maintenance free and efficient as the heart. The examples could go on and on.

During my current short course in the US, funded by a US professional body, I have been living with my uncle. He accommodates me in his home, drops me at the hospital every morning, and takes me home every evening.

In the 17^th Century, the white castle on the Osu scarp called Christiansborg, stood tall.  But very little Christian happened within its walls.  It stood for centuries, the destination of the doomed.  It became the bastion of oppression, repression and dehumanization of many who were trapped in it. 

Broad Street in Philadelphia is this wide swathe of black, running through its middle. A black big motoring vein with asphalt tributaries emptying cars, and people, milling restlessly with a tenacity that hardly ever changes. The City Hall punctuates it, splitting the broad street flow with its imposing gravity defying white columns hewn out of stone. Intricate sculpted masonry from another time, that remains beautiful in these days of glass and steel. The statue of William Penn looms blackly atop the tower, keeping perpetual watch over the city of brotherly love. The city that he, and his fellow freedom dreamers birthed.

When my father died, I had to go back to the hospital to collect a certificate indicating the cause of death. It is a single sheet with a lot of power. On losing a relative, it is the single sheet that enables everything to do with the next stage of bidding farewell. Without it, the body cannot be moved from the mortuary, cannot be embalmed, cannot be buried, legally.

The Ghanaian health situation is dire. There are 24 million people in a country the size of the UK. There are 5000 doctors for this population, with about 1500 in public service. Considering how much of a burden public hospitals bear, this is a situation that is untenable. The country’s health care machinery is running on critically low resources, in a way that makes it completely unprepared for any kind of challenges, overwhelming or not.

Nature never stops. Nature rests, lulls, and then keeps going. Nature self sustains by not stopping. Life is that miracle kept going by not stopping. The human body is designed to keep moving, keep innovating, keep changing its environment. There is a certain paradigm that I have grown up with, that needs to change. 

I was watching a documentary on Henry Ford, when one of my children asked me a question that set me thinking. He was looking at the Model T Ford, that iconic forebear of anything we know now as an affordable car, and he wondered why cars were not made that way anymore. He wondered why most of the cars that we use now looked so different. Then he asked if we built any cars in Ghana, and then he wondered why we did not.

There is a certain luxury I enjoy as a doctor. The ability to walk out of the hospital into a world outside the battleground of pain and disease. There is a spring in the step sometimes, when there is enough energy, walking into a sunny afternoon, when I am blessed to close early enough to meet it. Sometimes I carry the battles home with me… sometimes I am sitting at the table, looking into a plate of food, but what I see is not exactly what I am looking at. I have learnt not to take for granted, the simple things of life. Walking out to a car, without pain, without falling, sitting inside, driving it unto a busy street and not being afraid.

It’s been 3 defining days in sunny Malaga, Picasso’s birthplace. For 3 days Eisenhower fellows from 49 countries huddled in this hidden treasure of a sunny paradise, one glittering diamond in the Coast of Sand. My mind was blown every day, whether it was awestruck admiration of the stately accessorizing of the Gran Miranmar Hotel, or amazing forays to the philosophic crevices of brilliant minds. 

My drive to work every morning usually takes 45 minutes, depending on how disciplined I am. If I get out of bed, resist the temptation to persist in recumbence… and get on the road before 7 am. If I don’t, it is another story… except for the first 15 minutes.

When I was told that the man had come to look for me, I was not surprised. I thought he was just asking after the doctor who had seen him a month previously, after being seen by the one I had referred him to.

We were doing a morning round in a hospital far away from mine when I first saw it. Well, I heard it first, an electronic female voice warning me that it was coming. Then we almost run into it, but it stopped, a red light blinking. It waited for us to pass, bleeping green and red, and then once we passed I heard the quiet whir as it went its way down the beautifully lit hospital corridor.

It had been quite some time since I visited the fish market at Tema New Town. I had forgotten how stiffly the presence of fish hangs in the air. It’s like a curtain you cannot get to the end of, once you get out of the car. And there are no escape routes, once you step in, you have to keep breathing until you step out. And it’s the whiffs of fish from yesterday’s catch, swirling with today’s and you know tomorrow it will be there. Sometimes, there are parts of the market where one encounters the smell from last month. Remnants of stinkfish delicacies brewed in putrefaction’s pot.

Four students have died. One after the other over a ten day period. And the diagnosis is only certain now, after they died. In a country with 5000 doctors, multiple teaching hospitals, a Ministry of Health, and a Health Service, this is not acceptable. Especially if the country has had 60 years to build a system. It is not right. If there was a war going on, it would be excusable. If there was famine, civil unrest, natural disaster… maybe, this would be easy ignore. Not in this Ghana. Not in this time.

I know something of the helplessness of severe illness. I have memories from childhood. I have also had some experiences in my adulthood. It is not a good thing to be ill. The fact that an illness has a cure, takes nothing away from the naked terror of its journey through the body. Sometimes, I have been ill, and have known exactly what to do. I suffer nonetheless.

My birthday just passed. I am learning to treasure each year. Learning to count my blessings, and to be grateful for health, for strength, and the opportunity to make something of the abilities I have been blessed with. I work in an environment where those opportunities and blessings are wrestled from people’s hands regularly... And sometimes they come to me with the question: why…

I have two friends in ICU now. One has been on a ventilator for the last 2 weeks, and one is not. Their faces are always on my mind. Every day, I make that call that apprises me on their clinical numbers. I say a prayer. I trust that they both get better. I look forward to seeing them someday soon. There is always my doctor’s mind that never loses sight of the worst case scenario. But I have got to keep pushing the harsh reality of the swelling limbs, the worsening numbers, and how the last CT scan looked. I need to push that reality away, and believe. I have lost a few friends since January. I have to believe I will not lose more. 

The lockdown continues. An increase in children’s appetite has gone viral, driving down domestic food storage levels everywhere. Even our dog, has been cleaning up her plate on a much more regular basis.

I was walking along the bank of the river Volta with my son, when he noticed that the green patches in the river were moving. I had described them to him as islands, so he shouted that the islands were moving! The one he pointed out was a big ‘island’… so I did not believe him at first, but lo and behold, it was really moving.

There is a village in Ada Foah that bears my name. It is nestled between many small villages along a beautiful beach between Tema and the Volta region. It is a 3 hour drive from Accra. It is all good road, and pleasant driving. But one has to drive by big towns, expansive salt ponds, beautiful chalets with private piers, the Chinese built district hospital, an FM station, a teacher training college, and then when it seems like there is nothing left, Totimekope.

There is a harsh reality about trying to succeed in an environment rigged for failure. It always catches up. There is a certain inevitability about the attitude that births failure: no matter how hidden the rot remains, it is just a question of time. The fruits emerge, just as surely as a mango will fall from the tree in its season.

In some countries, it is unlawful to have the hazard lights flashing whilst driving.  Any such lights should be on a stationary parked car, off the road.  If it is an emergency, there are institutions tasked to take care of it.  They are allowed to move with their hazards on.  Such countries are usually either developed, or disciplined, or both. 

I have spent my last few weeks settling down. Getting back into the groove of all things Ghana. Not much has changed in one year. A few new buildings here, another road there, same people, same challenges.

I have come home. At the end of an eventful seven weeks. Things run to a climax very quickly in the end. Final stories, report writing, debriefs, conversations with distinguished leaders, graduation ceremony, final words… and it was done. And we had been let go to continue the journeys that brought us this way in the first place. Plunged back into the reality to muscle out the facets of our dreams, and make the missions that we had announced true.

I stepped across the door sill into a room last week. It was not an ordinary room. It was the lobby of a centuries old house. The dream house of a man who had taught himself to be a refrigerator technician, so he could set up with family in this town. With his wife, he would raise six boys in this home. He became the first accredited refrigerator technician in his family. His boys would become leaders, each of them. One of them would become president of the United States. His name was Eisenhower.

I have recently gone back home. To Tel Aviv. It is one of the ironies of life, that going for a conference of pediatric neurosurgeons in Israel, was like going home. Life has mountains, valleys and plains. Sometimes one gets the chance to fly to a peak quickly enough to take in a perspective of the past, and snippets of the future. Tel Aviv was a chance like that for me last week.

When I saw the word hotspot on the front page of the daily last Friday, my heart lifted. I thought it meant that suddenly, the COVID pandemic was going to be attacked strategically like was promised. I thought that suddenly 25 hotspots had been identified and were going to be shut down. And that the promise that was made long ago, was going to be kept.

On Independence Day, I was sitting in an Uber being driven by a (now) Dutch Nigerian Ibo man, stuck in Central London traffic. He was excited to meet someone he could freely call Charley, and be hailed Oga kpata kpata in response. In what ended up being a 3 hour ride, we talked about many things. He had a sense of humor that kept me laughing, and almost forgetting about my diminishing bank balance as the pound denominated tariff massacred my poor Cedis.

When I heard the voice on the phone I did not recognize him. I assumed he was one more person wishing me a happy new year, until he mentioned his name. I stopped everything I was doing at the time and just sat down, and savored the experience of hearing him speak. His name was singed into my memory. I had looked after him, on the same bed, every day, for a 3 month period.

Last Saturday, there was a deep sense of peace as I sat with my family, in front of a screen awash with color. The kids had been playing outside, I pulled them in. This was something special. This was not any other day. This was easily a day that might not have happened. This was a day that was yearned for, by other countries in our subregion. This was a day that people not different from us, wanted on their calendar, but could not get. Sometimes just because of the fear of a day like this, countries have been torn apart. People have become refugees, just because a day like last Saturday was postponed indefinitely.

I have part Fante ancestry. Maybe it is the reason why I love good bread, and cannot let delectable pastry pass by unappreciated. And this morning, I was on my way to visit my Mother, who is the genetic channel for this part of me. All the more reason I could not just pass by the bakery shop at the filling station along the road.

I went back to Battor Catholic Hospital last week. It had been a long time. I walked through the main gates with my family, and for the first time in 14 years retraced my steps from the consulting rooms, through theatre across imaging and to the living area. As a newly minted medical officer, right after my internship, I was privileged to start my growth in these walls. I made that trip hundreds of times during 2 years. And with each trip I grew. With each surgical case, each person I would talk to in the consulting room, each wound I sutured, every incision, every mistake… I slowly matured. I was pampered, in retrospect. There was a family of dedicated doctors, who would not let me face a problem alone. Coming back, and meeting some members of that family, still working away more than a decade later was humbling. The hospital has continued to flourish.

Lockdown begins. I thought, going to work that I would see a ghost town. I did not. The traffic has definitely reduced, but there are still people on the streets. The shops are closed, or closing. The police stops are increasing. The first day, I was underwhelmed. I did not meet a single police man on my way to work. Today, I was stopped more times. The grip is tightening slowly, but maybe not fast enough.

Lockdown ends. The streets are already beginning to fill again. There is a new item of colour on the landscape of faces now: masks. I am learning to recognize people by the pattern on the masks they wear. It is a different world now. I don’t think things will ever be the same again. This virus has ravaged through the very fabric of our societies. We are living through historic times. This is a transition nobody could have seen coming. The syllabus for life’s textbook has undergone a major revision.

As the year began, a group of us sat out on a cool Spintex evening. The children milled around, bursting the red and green balloons we had put on each of the gates in our close to herald our local street party. We sat around a plastic table, with khebabs, light soup and other delectables, reflecting on the year that had passed, and the coming months. 

There was enough laughter to go round. Most times it was at ourselves and the country we find ourself in. Sometimes it was about the people who lead, and how they got there. We talked for hours, in the way only old friends can. The hours passed, the music played and the plentiful food slowly diminished. We were welcoming the new year in grand style. 

One of the laughing points for the evening was the discovery that the owner of a black SUV who had been passing by each of us on the frequently traffic choked Spintex road, hazards on and siren blaring, was actually a nonGhanaian businessman. I rued the many times I had hurriedly parked by the road side, as that black SUV had whizzed by, red and blue leds ablaze. 

I felt cheapened by that single revelation. We did laugh quite a bit about it, but it was painful laughter. It was like pointing fingers, with most of them pointing back ourselves. And it did not matter that the khebab tasted so good. The bitter taste of being taken advantage of, by one who had no place in leadership in a country whose citizens had just changed its captain, did not go away.  

We talked about the election that had just passed. We sang the refrain of the newest political hit in town. We took our country system on an imaginary tour around the world. We lambasted banks, clinics, libraries, the works. Here we were at the beginning of another year, with some hope for the coming months. And it did not seem like we were alone, not with all the talk about prices coming down in key industries, treasury bill rates depreciating, and businesses restarting. 

We all looked into the future with hope. Keen expectation that the change that was coming would galvanize the people, to do more. We accepted that the change that was coming would not really change people, but give the platform for changed behaviour. We accepted that our neighbor would most likely continue whizzing by with his hazards blazing, as long as he did not see any change in the people. As long as he did not experience a culture that he needed to conform to. 

We hoped the change could mean that one day the police along the road would actually stop him, and give him a reprimand, and not collect anything for torchlight battery maintenance. And that there would be more of a focus on widening the road and fixing the tributaries, than on buying V8s which could conquer potholed horrid back roads, and whiz by mere mortals on the good roads with their sirens. 

Of course, because I was there, we also hoped that the change would mean that we the people would invest less into freezing bodies, and more into freeing souls. Freeing souls from the shackles of ill health and illiteracy. That there would be more family meetings to discuss education and payment of hospital bills, than those for funeral planning. That more money would be spent on libraries, schools and hospitals, than on mortuary fees, coffin finery and tombstones. 

Some of us had to go to work the next day, so we did not sit out as long as we could have. But it was a really good night to start the year with. And the optimism was not just because of the good food, and excellent drinks. It was also because of the privilege of minds gathering around the table freely and spewing good thoughts for mutual consumption. 

But I still think of the goat light soup, and the spicy khebabs.

Every November I remember my family in the diaspora. I have been really blessed with love in different places along my journey of life. My love line runs through West Africa, through East Africa, to South Africa, and then through the Middle East, right across Europe, and into North America. In special homes in each of these regions, I have the privilege of being loved by family that only God blesses with.

I have been around long enough to finally be sure about something. We were created to dominate the earth. The actualisation of our humanity is the triumph of mind over matter. It is not the default status. It is the fight of life. It is a fight that we are designed to win. But we just can’t win it walking in the park. It is a fight that never ends. These victories are meant to be built on so growth is exponential. Defeats take away even the little that the battle started with. When matter rules, the mind dissipates. And the society degenerates into an abnormal state of stagnation, growth and implosion.

Some Saturdays, when I am strong and wise enough to listen to my wife, we climb the Aburi Hill. We drive to the Ayi Mensah toll booth, park among the many cars that have converted the roadside to parking lots, and join the crowd climbing up to Peduase Lodge. It is not a difficult climb, but it does take getting used to. It is a twisting route up. Most of the gradient begins the trip, so by the time the midpoint is reached the muscles complain and the lungs hunger. And there are people who stop. That climb is an interesting microcosm of life. It is the place to meet a cross section of Ghana in one hour.

A week ago, I entered a hotel on Broad Street in the city of Philadelphia. It is a double lane, always busy, lined on its sides by beautiful buildings of varying heights…. all seeming to pay obeisance to that one building at the apex of the road. A majestic, concrete behemoth from another time, topped by a metal man frozen in time - William Penn.

The brain is made up of up to a 100 billion neurons. A neuron is a nerve cell, dedicated to one thing only: processing electric signal and delivering it to another. Each neuron has multiple inputs, and a single output. It is a recurring theme in the nervous system, that it does not matter how many inputs there are, there is usually a single output. Sometimes a single neuron may have hundreds of thousands of inputs, microscopic tendrils of nanometric dimensions gathering signal from hundreds of thousands of other nerve cells, and handing the processed information to one nerve cell in networks that are complex beyond imagination.

Our family dog and I have a special relationship, forged by years of her being the only awake being in my house many nights a month, when I return from work. I can always count on the wagging tail behind the gate as I unlock it, as I totter closer to sleep after a long day. And there are quite a few long days in a month. It does not matter that the health care system is subpar. One must do what one has to do.

I have been in Kigali the last 3 days, in the presence of movers and shakers that only the EIsenhower Fellows can pull together. It has been an insightful 3 days in a city that proves that Africa can have a future, if we choose.

There are times when humanity scares me. Not as much its presence as its absence. It is intriguing, what dehumanization does. We are human beings, and without humanity there is a certain state of being that is difficult to describe. There are some days when we are reminded suddenly of how completely humanity can disappear, and what capacity for evil resides within. Then we have to look directly in the chasm of this absence, and yet live on. There are the days when we have to remember, that the fact that humanity has dissipated from some people, does not mean that the world has lost its entire plot. These past few days have been like that for me.

A couple of years ago, I was walking on the street in the capital city of a country not my own… when a middle aged man grabbed me by the arm. Before I could react, he grabbed me by the other arm, feeling my biceps and facing me, and then asked me if I needed a job. I shrugged his hands off and told him no, but I still feel his hands on me once in a while. I still remember the look in his eyes. I see his gaze bypassing any humanity that I have, peering purely to seek out function. Any function that this non-person could fulfil in his machine. I still feel the defilement of that moment. Because I know where I come from. I know I am not just a mass of muscle and skin walking aimlessly on streets looking for jobs. And even if I was, my humanity should be considered before my functionality.

There is this Fanyogo seller who has been a friend for the past 20 years. I met him when I was in medical school. Some days, as I stepped out to decompress from the ravages of diminishing my ignorance, I would meet him. He would ride in with a honk, hoping I would be tempted by the yoghurt in the pink plastic. And usually I was, and if I had cash in my pocket, I yielded. We would engage in the kind of banter that a harassed medical student and a hassling entrepreneur would have. It usually never got much deeper than banter, and we still meet each other now. He still rides the Fanyogo bike, comes unto the medical campus with a honk. He has aged very little, and he still has all his hair… I lost mine. 

When I was in primary school, the Children’s library was one trotro ride away from home. We would walk to the main Korle Bu Station, sit in the Bishop trotro, get down at the Bishop Station in central Accra, and walk the rest of the way. Sometimes, we would walk the whole way back home. 10 year old kids, crossing the Korle lagoon in all its polluted glory.

On Christmas day I was with family. Tucked away in a toasty room away from the grey chill outside. It’s turned out to be a much sunnier day than was forecast. It was my first Christmas day in the United Kingdom.

It has been a memorable Christmas. Hot. And now the harmattan rears its head, like a forgotten belated guest. Suddenly I am reminded of how Christmas was supposed to feel like, with its special morning chill, dry lips, ‘white’ faces, clothes quickly drying on the line. I am not sure how long this will last. The weather has a mind of its own these days. After all, it was raining in November… flooding, even.

I find myself in the UK at a time of change. It is an experience that gives me again another chance at perspective. Around me I see what dedication to community, and public exhortation of communal responsibility does.

Two weeks ago, I sat in a club house in Kolkata, with a special group of people. They were neurosurgeons from 4 continents, hosted by a generous colleague in a special place.

It was my younger brother who introduced me to ‘Football made in Germany’ on GBC TV when we were children.  He never missed the show on the black and white TV which was our GBC TV portal at the time.  It seemed artificial to me at first.  I just could not imagine how the ball always ended up with someone when it was passed.  No one seemed to run to the ball, or run after it.  The ball just seemed to find targets, and moved round the field.  It was something that did not happen on our own football field after school.  It was definitely not what I would see on Sports Highlights Ghana league section, where the commentator would ecstatically whoop: ‘top striker dribble one, dribble 2, dribble 3… and it is a goal!!!!’ No tidy triangles of coordinated human arrow heads navigating effortlessly there. 

I visited Denmark for the first time about 20 years ago. I have since gone back once again, and have deep friendships there that will last for the rest of my life. There were impressions that have seared themselves deep into my consciousness. And every time I have had the privilege to return to Scandinavia, I have been struck by the divide between a culture of progress and that of retrogression.

It’s minus 4 degrees outside. The sun is shining brilliantly. It is a beautiful morning. The grass still sparkles with the left over snow from 3 days ago. Persisting in whiteness, because the cold claws of the winter freeze will not let it go.

When I stopped at the traffic signal, I noticed him immediately. He was waiting for the light to turn green, on a motor bike, like all of us. Waiting while other riders just whizzed by nonchalantly. He was in a helmet, unlike other riders. I wondered whether he could withstand the pressure of everybody just passing by and making the most of the time. He did. He moved just ahead of me as the light turned green, leaving me with something to think about.

I was 12 years when I went to Achimota School. The New Hope pupil from Korle bu, became an Achimotan. By the time I left the school 7 years later, the ideals of the school formed the superstructure into which a lot of my life would fit.

Two weeks ago I was walking along a Spintex dirt road which has a name… Aviation Road. Looking at it now, one can tell that it was planned to be a major road. It is as wide as a major road should be.

I was walking a few steps in front of my teacher one Saturday morning in between rounds when I passed by the ice cream wrapper. It had been blown into my path by one of those gusts of wind that just happen. I saw it, I passed it. Just one of those things that litter a path. Just one of those things to overlook. I paused a bit when I sensed my teacher stop behind me. When I turned and realized he was picking the ice-cream wrapper, my heart sank.

The Spintex road has this long, straight stretch from one round-about to another. In some respects it's like a dash of black fastened unto red earth, and then painted on. The white midline strip runs gaudily along its length, with corresponding lines along its two edges. The drainage must be effective, I usually do not see much of it, but I have not seen it flood yet. There is no pavement for most of its length. It must have been missed somewhere in the planning. I do believe it still exists on the drawing board, awaiting implementation.

On father’s day, my Dad was unwell. I am far away from home and praying. These are not good times to be ill in my country. I am sure this has been a day for him to think about his children. I have been thinking about mine. I am separated from my kids too. Along a journey that has gifted me with good fathers at every step.

On father’s day, I was in my father’s house. Looking back into time, and looking into the future at the same time. I had been wished happy Father’s day, and it was just right that I wished him that too… and personally. We sat in the balcony of his home, surrounded by shouting kids, jumping dogs, and some good food. And there was nothing that really needed to be said. We shared a bottle of his favorite drink, and shared some of the joys of the past, insecurities of the future and realities of the present. 

I recently went to the cemetery for a function. We stood together, one family remembering a departed member. All of us with memories, some fleeting, some vivid, all united in commemorating the absence of one who was once with us. It was while leaving the cemetery, stepping over tombstones seemingly strewn in our paths, that it struck me how disordered the memorial ground was.

About 20 years ago, I was on the Cape Coast bus from the Kaneshie station to Wesley Girls High School to visit my younger sister. I happened to sit next to this middle aged man I found out later was American. Now I don’t remember who initiated the conversation, but we talked all the way from Accra to Cape Coast, until he got off at the Kakum Rural Bank. He pointed to his apartment above the stately building, and we both promised to keep in touch. Over the next few months, we did keep in touch. I got to know he was a Peace Corps volunteer with machine making skills. He had been teaching in the US, and now offered his services at a vocational school in Cape Coast.

In medicine growth is taken for granted. I think we have become so used to the notion that a ball of human cells can ultimately become a breathing, achieving, human being that we treat growth as common place. Growth is expected.

It was an interesting day. Some days are like that. Offering a breadth of experience that one treasures. I had ended up chasing an accident victim to the hospital to find out what happened. I found a rundown hospital with two doctors seeing patients on a Saturday afternoon, assisted by nurses. A medical team who would want to be anywhere rather than in the dilapidation named after a prominent person in our history.

It was the cloth that caught my eye. We were on the last curve of the 15 minute 1st stage of our ride to school. On the road the children used to call Gbolomgbolom - an onomatopoeic articulation of their early morning car bounce to school.  After doing this road for years, every pothole was etched into the muscle memory of their growing bodies. Every delayed contract, every postponed roadwork, translated into gboloms of an old car creaking at its joints as it lumbered from one hole to another. 

I was driving to work on a bright Saturday morning when I met her at the mud island at the junction created by the road construction in my area. There was only enough space for one car at a time, to turn.

We were walking along one of the many green parks of Adelaide when we met him. He gestured to my friend, pointing first to his own arm and then pointing to my friend from Nigeria.

Where I come from, it is a big complement to call another person a human being. Sometimes, it is just summing up the good, to say that a person is a real human being, so there is nothing better to add. It was a strange thing to hear, when I was young. Because it was supposed to be a no brainer. After all, we are all supposed to be human beings. It is what we were brought here to be. It is the way we find purpose. It is not an easy way, it is just the way. Life is not rewarded by doing the easy things, and any rewards for being inhuman are transient, and temporal.

The Christmas trees have come down. The lights that brightened my morning drive to work are off. Slowly but steadily the Christmas luminosity has diminished, the carols silenced, and life moves on. People are back at work. There are still a few Christmas trees surviving, but it is already almost as if Christmas never was.

I entered the barber shop not knowing about the increase. I noticed it on the wall, in the middle of the cut. Time has flown, my hair is gone, but there is still some stubble to be trimmed. It’s just that the price had gone up by a whole 50%. Overnight. There were no reasons. There had been a two day notice, and I had no choice. What remained of the hair was already trimmed, and the trimming price had moved, up.

This has been a difficult week. It has had its own questions, and very few answers. I have heard a lot of talk, as the country stops to examine itself. I have heard voices that should have stayed silent.

I was driving behind this guy when he lurched into my lane. It must have struck him that the he really had no idea where he was going… or something like that. I had to slam hard on my brakes, just to save my day. He was completely oblivious of what had happened, as I passed him. He was focused on the road ahead, and seemed to be nodding to some music only he could hear in his air-conditioned car. Moments like these, make me miss driving in more predictable environments. Where I know that there is a communal commitment to rules and guidelines. Sometimes this dedication is really admirable to see. In a country not my own, I drove a manual car on the opposite side, with the steering wheel in the wrong place, gear lever turned all upside down… and I still had more peace of mind than I have driving in Accra on a quiet day.

The Grand Canyon is an awe inspiring spectacle. The deep gully seems to tickle the depths of the earth, it draws one in. Just standing at the rim and looking down is dizzying. It is not a sight to forget. Somewhere, deep in its inner crevices, a serpiginous rivulet continues to make its way in this chasm. The river Colorado, which created this vast earthly indentation, is missable. In fact, one needs a telescope to see what remains of the force that created this whole spectacle. The days when it needed to be a powerful force are gone. Now with a huge chasm created just for it, and for our wonder, it can afford to trickle its merry way till the end of time. The Grand Canyon is completely natural. A persistent river, breaking down solid rock, just by remaining persistent.

No important project has ever survived only on freebies. Deep in the psychology of any project that fails is that lack of commitment. The inability to put skin in the game. And these are the thoughts that pass through my mind as I go for a fundraiser for a project that I really care about. It is striking to me, how much more giving there is to health, outside Ghana than inside it.

Epilepsy is a devastating disease. In our part of the world it is more prevalent. It is a tragedy to see the most complex interconnected unit in the universe, pulverizing itself into uselessness. Neurons that are built to share information with each other, relay implosions of electric impulse that orchestrate brain malfunction.

When I saw the CT scan my heart sank. The beautiful symmetry that the brain has, the different shades that white and grey matter imprint on the LCD screen were gone. The lines that divide the electrical generating cells, from the transmitting cells, were gone. This was the aftermath of battle, and the brain cells had lost the ultimate war. And now even as the person’s heart and lungs worked together in the unison that is life’s rhythm, the brain was gone. Life had ended. And there was nothing that we could do about what was going to happen in the next few days. 

I have just left a conference that hosted 600 neurosurgeons from all over the world. It has been an intensive 4 days packed with knowledge that is mind boggling in its scope. It is amazing, what has been achieved over the last few decades, by people who have dedicated their lives to the brains and spines of children. There were topics ranging from the routine, to the outright futuristic.

I believe in a God who has created everyone with a purpose. There are too many things I do not understand. I can’t even begin to imagine why some do not even experience earth time. I don’t know why others seem to end their time before they have made any difference. I also can’t tell why others seem to be in the midst of something important… and then just leave.

I was passing by those ambulances on a daily basis. Lined up in neat rows on the parking lots of power. The controversy swirled around them. The need beckoned. The death data swelled. And still they sat, waiting for the word to be given. The dust accumulated. The rust must have started already, the salt breeze wafting off the coast just miles away.

I watched an Elon Musk interview this past week, and one moment sticks with me. He had tears in his eyes.

I became aware of my blackness when I left these shores for the first time. It was a strange self realization that living in Ghana did not prepare me for. I have heard astronauts say that they only grasped how special Earth was, when they had left it, and saw that blue dot floating in absolute blackness. This process was less benign. Over the years I have come to understand that there is a certain acceptance of my humanity that I can only experience in Ghana.

I was on my way out of the country. It was going to be a two week course, and here I was with a patient in the Intensive Care Unit. He had found out from his wife that I was going to be away. He had been where I was going to before, and had fond memories of times long past. 

He has been buried. His face still stares across the divide into my soul. His family must be dealing with unfathomable pain at this time. This life that has ended and cut into our national psyche so deeply. The commentaries will run, the videos will trend, until the public finds something else to ruminate on. It’s been a week when we have been forced to introspect, but the questions remain. We are not a people wont to digging too deep into painful things. We are more likely to find a channel for euphemism and de-emphasis, and keep going. 

The Christmas decorations still hang around. It was nice while it lasted. Now it’s time to move on. Baubles and blinking have become flickering indicators of a society which takes its time, with everything.

I am convinced that service is key to our purpose as human beings. The whole reason for life is service. The highest form of living is service. To serve, is to put effort and time at the disposal of another.

There is this bread selling business in my neighbourhood. I don’t know how they do it. Really. But if I need soft, pliant, delicious, bread at 10pm, I go there. And I get it. Without fail. No questions asked. And me and my indisciplined self… yes, I have tried it after 10. I did not get it. They had closed. And I knew I had pushed it far enough. There is really a limit to soft bread provision. All service, no matter how excellent, depends on well planned duration limits.

It's been 400 years since the first slaves landed in Virginia. Something terrible berthed with that first shipload. Consequences persist today. Societies disrupted. Families torn apart. Humanity challenged in ways that belong nowhere in a world that makes sense.

I know a little about stigma. It was the year 2005. I had just finished my first surgical residency exam. I had left Battor and spent three weeks in Accra burning through anatomy, physiology and histology pages. I battled sleep, tiredness, I pushed through the days, until the final one when I stood in front of the examiners. And they told me 30 minutes after the exam, that I had passed. That was just how things were done. You knew your fate, almost as soon as you finished the exam.

One client walked into my consulting room 3 weeks ago. He sat in my consulting room, engaging with me on current happenings, and lifted me up in a way he would never know. The privilege of being involved in his life is singularly mine. The message that his life carried for me, and members of my team, was direct: Do not give up.

The flowers are beginning to flash their color here again. The birdsong announces the waking hours. The sun stays longer in a brighter sky every day, as spring beckons. But this has been a month of death.

The human body is an ecosystem of value creation and dissemination. It is a collection of cells with an unimaginable capacity to achieve. The scope of what this collection of cells is able to create is mind blowing.

I was standing in the hospital lift, when she was wheeled in. The porter was behind her, and her left leg was outstretched on the improvised splint extending from the ravaged wheel chair seat. She was in a regular shirt and jeans, which had been ripped with surgical accuracy to expose the fractured leg. The skin was broken. The blood was all over the blue jeans, and the white bandage was dirty red. It was obvious this was not what she had planned when she left home that morning. I said hi, she said hello with an attempt at a smile. I asked what had happened. She said she was at the National Service Secretariat. There had been an incident.

I was in a small town called Celebration a week ago. At a neurosurgery course hosted by an ultramodern hospital, built as a resort years ago. The story is that Disney was not sure a hospital would make money, and built it as a resort as a fall back option just in case it did not. It has thrived. It has impacted. And in one of the many twists of life, here I was, the only one from SubSaharan Africa in a class of 28, at a course for key-hole neurosurgery.

I was showing pictures of my home to a dear friend who is not Ghanaian, when she noticed the barbed wire and asked why. I explained that after a burglary we had to increase the height of the walls and place deterrent barbed wire. Until then I had not really thought much about the height of our walls.

There is a dog at my parent’s home, with a scar on his head. It is one of the friendliest dogs I have ever known. It has a very unscarred personality. A few months ago, Boxer had run truant from home, slipping out of the gate as a family friend drove his car in. My mum went out to call it back, but it had scampered away. A few hours later my aunt, who had happened to pass by the small crowd gathering after a hit and run, came to tell my mother about a dog which had been hit by a car and looked like ours.

For most of last month, there was a bed I always stopped at on my morning rounds, I continued stopping there, until he finally left the hospital. Initially it was for his sake, then it became mostly all for mine. There was something about this great person that I needed, to keep me going for the day. He did not need say much, it was just his smile, and his circumstance, and the bravery that put these together in the grimmest of places.

 My route every day takes me from my home down a straight mostly bumpy road to a traffic light, which now, usually works. When it is red, I end up having to contemplate on a business sign sited right in my line of vision. It is very strategically sited, but outrageously spelt. There is no way I am going to take my computer to a shop which has the title ‘comptuer hub’. That is how it is spelt, on a nicely designed board with catchy colours and photos of computer knickknacks.

There is this German car I fell in love with as a child. I sat in one as the car door was shut, and that was it. I just kept wondering how a door could shut like that, and make one feel so secure. I never really lost my first love. I have kept going back to that car. It just happens that I live in a country that may never produce such cars, and my salary may never allow me to afford a new one.
So I have kept my dream alive in second hand versions, inflicted the Ghanaian roads and flood riddled large pathways on the various models I have been blessed to have, and tried to feel a bit of what those engineers want one to feel. Tried to rediscover that contentment of a child awed by the wide back seat of a big car, and the sudden quietness imposed by the shut car door.

The plot thickens. There is talk of peaks, and curve flattening in the atmosphere of a pandemic gathering speed. Physical distancing seems like a dismissed fairy tale. A lockdown seems like that unachievable haven, that could just have offered some security… but the door is closed.

Two weeks ago, in the shadow of the Tower Bridge, I spent 3 days with extraordinary people dealing with extraordinary challenges. I have been for a few conferences tackling neurosurgical topics, but this was the first time I shared the room with so many people who had been on the other side. The other side of my consulting desk. The people who go home and deal with the diagnosis the doctor gives. The people who have to take the medications, and suffer the side effects we tick off in answering our exam questions. The people who have to live with the benefits of good judgment, and the horrors of a surgical mistake.

On the 15th of May 1979, I was a kindergarten pupil who wandered out onto the street in front of the Burma Camp school. I have no recollection of how I ended up there. I don/t know whether I caused a security breach, disobeyed my teacher, and was simply neglected. But I found myself outside with armored cars trundling past, and people in a mad rush to pick their kids up. I had no idea what was happening then. It was the wife of my father’s colleague, who picked me up. She did not know who I was, because I still remember being asked who my parents were. I reportedly gave quite an intelligent answer for a kindergarten kid. I was taken to their home, and the necessary contacts made.

I have been singing with a choir for the last 3 months. I joined them just before Easter, as they were preparing for a Cantata. It was a blessed experience singing with them for the climax programme. There are unexpected blessings at each stage of life’s journey. There are many members of this choir, whose life stories will stay with me for a long time. There are people who have passions in this life, and watching them keep going way into their eighties, is a privilege. The most striking person I have met in this choir however, does not have a voice. He always sits in the front row of church when we are singing. But every day of practice, I notice him sitting with the tenors.

Something momentous happened in health last month. Most of its importance was covered by the inevitable ordinariness of a group of foreign doctors doing outreach surgery in the name of a non governmental foundation. I was on the inside however, and saw perspectives that would not be immediately obvious.

I was driving out of the University of Ghana when I met her. She was standing at the traffic lights at the main exit of the University, just before hitting the main Madina Airport Road. She looked tired, she must have been begging at the traffic light for most probably the whole day. She had a dark complexion, and very wavy dark hair. She did the usual routine of a sad face on my window, and realising that I really had nothing on me started pointing at something on my dashboard. I kept asking what it was she was looking for, because this was one of those days when there was total disarray from the passenger seat upwards.

A few Sundays ago, in a country not my own I sat with an 84 year old man and his wife after church. We sat after the food had gone down, and spoke of days gone by, when he was a young doctor facing the tides of medical discovery. Asthma was a psychiatric disease, TB was incurable, and Africa was the dark continent. 

It’s been a good week, this one that passed. Things have gone the way they should have gone. Maybe outcomes split the country in two, but the process was beautiful. It’s not every day we get something to bask in glory for, so I will revel in this. I will milk the good feeling of having had a professional, proficient and communicating public servant, run an efficient process in my country. I will milk the good feeling dry.

The strike ends. And we are back to looking each other in the face and wringing our hands, because the problems of health care remain. There are still a lot of diseases that we cannot cure in spite of all our years of independence. We are decades behind the developed world, because of choices we have made, and continue to make.

There is a new presence in the skyline of Washington DC just across the street from the Washington monument. It is huge. It is testament to dreams. It is proof of the magic of persistence. It has been decades in the making, and it does not disappoint. It is founded on the depth of human enterprise. It celebrates the story of a transplanted people. It is a reminder of the manner in which the pendulum of time swings. When life happens, it happens.

I am benumbed, with a sadness not that far from grief, as I write this. Human beings are capable of the deepest evil, that is a fact. It just beats my mind how one recovers from loss like this. Tragedy as senseless as this is. How a tryst in the park becomes a death zone, how violent death heralds another week… it beats my mind.

Last Friday I sat on my father’s bed. We talked man to man. And then we prayed. He committed everything we had spoken about into our Father's hands, and I left with his blessing. I never get used to the specialness of moments like these. I am convinced there is a Father shaped hole in every person’s heart that needs to be filled. It’s a hard world, this one. It is a blessing to have a place of solace, a reassuring smile, an encouraging word and then a push back into the grind.

One week after Father’s day, on Sunday morning, I lost my Dad. I got in in time to see him alive. Just in time. But it was like arriving at 11.01 for the 10.59 train. Seeing it pulling away, and standing powerlessly. Seeing all the glory of an express train, with no possibility of touching it, being on it, experiencing it.

I started dreaming of going to Achimota School as a year 4 primary pupil. I had read about Aggrey in a history book. I had read about this school which was born on the principle of collaboration, playing harmony with the different chords that all human beings bring. I suspect I also must have seen them marching past on Independence Day, on the black and white TV sitting in its pride of place in the hall.

When I started Achimota, it was rocky in the beginning. I had to rediscover myself in the eyes of the people who would become my friends for life. It’s been 25 years since I finished, and it has almost taken me that length of time to understand what my parents have always wanted me to understand. I remember my mother, coming to visit every time she could. She would sit with me in front of the Form two block, on the low wall of the long white building which was usually isolated at the weekend. And we would talk about life, and hope and everything.

Now I look back and it strikes me what she must have done. She would have had to leave her job in the middle of the day, take two buses to the Achimota Station, then walk from where the bus would leave her at the cross roads. All the way up to Aggrey House, in the noon day sun, so she could maximise visiting time. And she would usually have a basket of food. Somedays, there would be a car that would bring her up, but that was just some days.

Boarding school had a way of redefining the way I saw myself. Suddenly I was thrust into an environment where I related to myself considering only what I had, or knew, or could do. Not who I was. Decades later, the conversations I had with my mother on that wall in front of the form one block, register in their truth. She would always remind me to be myself. It did not matter what the guys in my house thought about me, or the girls, or my housemaster, or my teacher and all the people who formed my socio-academic space. It was more important to be whom I had been brought up to be. And she did bring me up well. She made sure I spoke with respect, and looked out for my younger siblings. She showed me how to take care of myself, dress neatly, speak respectfully, use cutlery.

She was always there, in spite of the hard work she committed herself to. Her salary was meagre, but she did the best that she could. My siblings and I were blessed with two supportive and loving parents, but we did not call our mother, Mother, for nothing. She was really the rock around which our home revolved. I owe quite a bit of whom I have become to her mothering. It was her love that has formed the reference point for all the love I have experienced in my life. It has made me understand a bit of God’s persistence in my imperfection. If I had not been first loved by her, I would not know how to sift through all the various relationships that this life brings. Sometimes, it is only because of exposure to a special love, that we can appreciate the really good people in our lives, and pass by the unhelpful ones.

I still have to think carefully before I tell my mother I am not feeling well. Sometimes I do not even call, because the moment she hears my voice, she will know there is something wrong. And then I have to add to my recovery, recuperation from the pain in her voice as she wonders what I could take. I was a sickly kid. I have taken many a walk with her to hospitals, and have woken up many nights to find her sitting by my bed, brooding over me with her towel and thermometer in hand. I received care from her that no hospital could give. She knows more about the ravages my body has suffered, than anyone. And when she says she is thankful for what a healthy man I have become, I know she means that more than anyone else.

And above all, her message in all those conversations on the Achimota form two block wall, ring truer today than ever. It is not as important what I have, or know or can do as it is who I am. In a world that tries to dictate a reality to live in, I have run circles around this truth, but keep coming back to it. It is the people who reach out to who I am, in spite of what I can do, or have, who really make a difference in my life.

This weekend, I have an Israeli grandmother celebrating 90 years of life. She is out with my Israeli mother, and my Israeli family. I love them. I have been blessed with more families like this along the path of my life so far. I am privileged to experience love from all kinds of places, and feel at home in different houses not my own.

I am able to treasure them, and love them back, because of my mother.

I spent a lot of time on the road with my mother as a kid. The road to the hospital. I was a frequent flyer along that route. Usually, it did not take long for any virus or malaria parasite to find I was a willing host. By the time I was 12 I had accumulated a significant number of flyer miles, to various hospitals, and also mother-son hours. I remember her basic message then, because it has never changed over the years. A week ago, the kids went to visit her, and as I debriefed from far away, my daughter said she had a message for me from my mother. She asked for the phone to be brought closer to her so she could relay it with satisfactory gusto: Work harrrrrrrrrrrrrrrrrrrrrrd!

I have been thinking about Shifa this week. One lone Ghanaian voice on the international spelling stage. Counting herself among the spellers who have come together in Washington to celebrate knowledge. She did not win, but that is not the important thing. She has traveled the road that many great people have traveled before her. Now it is completely up to her, to make this count in her future.

The sun was shining again. Shards of light split the overlying clouds and bounced off the asphalt into my eyes. It was a regular morning, cars front to back in rush hour traffic. There was a woman in the car next to mine fixing her hair in the rear view mirror. There was nothing on the road to indicate that the road was a river the night before. Uprooted tufts of grass lined the shoulders of the road, along with the heaps of unearthed debris. The waste once conveniently out of sight, returning to haunt our capacity to solve problems.

There is a lady I meet on a daily basis at one of the traffic lights on my way to work. She sits in a wheel chair, well padded with a mishmash of cloths of various shades and textures. The grimy cloths tell stories of many hours of sitting and begging. Her lower limbs hang ineffectual over dirtied, small pillows, but she lugs herself around in the old wheel chair with surprising agility. She has given up on me now. I have usually had nothing for her but a smile, and now she usually just swooshes by in her wheel chair to the next car. Smiles have no financial, or nutritional value.

I had not sat in a trotro for some time, so getting back brought back memories. It is striking how much perspective is lost in a self-driven car on the streets of Accra - the entrepreneur at the bus stop with the neat stacks of coins atop her cloth covered box, the rice seller artfully enhancing her eyebrows in the quiet of the dying queue. The gel-o of smells, beverage, sewerage, cabbage, sausage… swirling invisibly together, almost solid enough to hold.

Last Saturday I went for a ninetieth anniversary walk organized by my Alma Mater - Achimota School. Special experience. It was a walk back into time for me, and also into the future. I saw people I had not seen for decades. Faces that had receded far into the back corridors of my memory suddenly resurged. Sometimes it was a smile, sometimes it was even how a person walked, that brought back powerful memories of what used to be life, what used to be the whole world. Seven years of boarding life.

The Aviation Road runs at a right angle to the Spintex Road. One is tarred and usable; one is a wet weather disaster. In the last two weeks, two parties have campaigned on both. The first one was cacophony on a Saturday morning. A motley of bandana wearing, motorbike riding, party colour clad cross section of Ghana chanting political songs. 

A virus is an inanimate particle with the capacity to hijack the reproductive capacity of a living being, to produce more of itself. It has no capacity to do anything on its own. It is just a strand of genetic code surrounded by protein membrane. It is even incapable of protecting itself, but give it one chance. And it does not discriminate. Animal cell, human cell. As long as it has a nucleus, it’s game time.

There is something striking about taking an afternoon walk on the University of Ghana campus.  Birdsongs! Straight lines of old trees, their branches filtering out the sun, shelter the walkers along the pavements that are almost everywhere.  Walking in the afternoon is a breeze. The afternoon sun almost seems too far away to burn skin. 

Some things never change: the one who looks after my car is still in Korle Bu.  So this week, whilst waiting for him to fix the trauma that the Spintex roads have inflicted, I took a walk.  I retraced steps from my primary school alma mater, along the still pavement-less roads onto the hospital campus. 

On the final approach home, there is a turn unto a narrow dirt road. It is a left turn over an open gutter, with a limited concrete bridge of a cover. In the centre of the bridge, there is a hole, just big enough for a car tyre to get trapped in.

Life is a precious gift. It is meant to be used. It can be wasted. Time can fizzle away into nothingness, with nothing gained. Or it can blossom into fulfilled dreams, realised aspirations and birthed success. It is all up to the person using it. I wonder how the time passed for my country. I wonder how it happens, that in 2016, the world that we were once at par with, moves on with us in a distant wake basking in our irrelevance.

There is something special about being human. We walk individual paths on the sands of time, and each footprint is different. There is nothing uniform about who human beings are, and yet our greatest achievements are birthed in walking together. Sometimes, strength may seem to be grounded on the uniformity of action and synchronicity may look powerful, but it is really synergy that achieves. All human endeavour that has achieved anything of note, has harnessed differences in one direction, and not just promoted uniformity.

It was one of those good days. I had closed for the day, and the sun had just begun to set. So I decided in obedience to science… and to my wife, to do some brisk walking in the Ridge area. Just for some droplets of sweat to convince my muscles they were good for something, before I headed on the long drive home. I was now on the homestretch back to the hospital. It had been a pleasant walk so far.