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.

 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

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.

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.

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…