Tuesday, May 7, 2024
[email protected]
Lagos, Nigeria

ight years ago, marking two years of her exit, I researched in the Bible to know where the people who stopped breathing and laid under the ground are and I published it in five episodes on this on-line newspaper, titled "The Resurrection of the Saints and the 5th part, titled "The Resurrection of the Unrighteous" courtesy of the Publisher.

1. - The Resurrection of the Saints (Part 1)

2. The Resurrection of the Saints (Part 2)

3. The Resurrection of the Saints (Part 3)

4. The Resurrection of the Saints (Part 4)

5. The Resurrection of the Unrighteous

My intention was not to write about her exit any further after those but to nurse my wound internally henceforth.

However, over the time, I took a closer look at her illness cum management and some decisions taken at certain stages particularly towards the end as it relates to cultural differences. What I did is similar to what the Doctors do, which they call "Morbid conference or meeting" after a patient dies; a review of the management and I am publishing it in the hope that someone else will benefit from it. A close relation has actually benefitted from my experience.

I will be surprised if there is anyone in the year 2024, who does not know that diagnosis and pronouncement of certain types of cancer is like "Death sentence" This depends however at the stage of detection. For instance Doctors believe that Breast cancer is treatable when detected very early and should not again lead to death. There are however other types that are not possible to be detected early enough and by the time they are, it may be too late; the cancer cells have spread to other organs from the primary site and death is imminent. Such a one is Pancreatic and Liver cancer.

I trained as a Health/Medical Physicist and included in our training and practice is treatment of cancer using high energy radiation beam and in high dose, fractionated per treatment. The management's team work at the bad stage of cancer is primarily to see if the patient's life can be prolonged a little bit and also make him get some affordable fair quality of life and reduce the suffering.

One common characteristic pain of Stomach, Pancreatic and Liver cancer is like epigastric pain, common with someone suffering from gastritis/Acid reflux. It occurs just beneath the diaphragm. It is usually a terrible pain as if it wants to snuff life out of one.

Treatment of cancer is either by a set of combination of drugs referred to as chemotherapy or by high level energy dose of radiation or both. I am trained in the aspect of Radiation treatment and I know very little about chemotherapy.

Oncologists are primarily Physicians who further received training in the treatment of cancer. They are the leader of the team work. Those who treat cancer with radiation are called Radiation Oncologists while those who use combination of drugs (Chemo) are referred to as Medical Oncologists.

The decision for what type of treatment to adapt for the treatment of any particular type of cancer is taken by the Oncologists (Medical and Radiation), Surgeons and other relevant Physicians, which can be by chemo or by radiation or both, depending on what the patient presents i.e. the situation of the patient.

High energy radiation beam kills both the diseased and healthy cells but kill the diseased cells faster than the healthy cells and there comes the duty of the Physicist who by using a computer model, targets with high precision the tumor site with high energy radiation beam, sparing as much as possible the nearby healthy cells. The team of Physicists will first demonstrate the direction of the beam to the tumor site, using a dummy in what we call "Simulation"

The Radiation Oncologist decides what appropriate dose of radiation he wants to use to kill the tumor but such doses if delivered uniformly to the whole body at a go is capable of killing the patient in a matter of days. So the Physicist divides the dose in what is called 'fractionation' i.e deliver a certain amount of dose on a particular date to allow some healthy cells, which have been hit to recover before another dose is applied.

I want to believe the chemo drugs work in a similar way. I said 'believe' Remember I had said that I am experienced only in radiation treatment.

Chemotherapy option was decided for my wife. She took the first dose on Friday May 2. She was doing well afterwards for few days until the adverse effect of the chemo drugs on the relatively remaining healthy cells started to take its toll.

By Saturday morning May 10, we had to call 911 as she became severely weak. We were driven to Emergency Department, which is usual and within minutes in the Emergency, she was resuscitated, wearing the look of a relaxed person who had just woken up from a deep sleep. I asked her if she recognized me and her unspoken words were "What a question?"

She was returned home in ambulance. But before my Pastor friend, his wife (an experienced nurse) and my young son departed, a woman Physician in the Emergency Dept. asked me if I will return her to the hospital if she fits again to which I answered "No"

I answered 'No' because though we might not have many years with each other any longer, it promptly came to my memory how she had cheated death on a number of occasions with her strong faith and seeing how she just came alive and relaxed, I believed in my heart that immediate imminent danger was over. The power of God to change the situation positively was not lost on me either. Besides, I have, with time contacted many men of God who I grew up with in the faith all over the world and I was sure that they were praying.

So, I did not in my wildest imagination have any inclination that the smile we exchanged in the hospital was going to be the last. I did not imagine that the question I asked her was going to be my last conversation with her.

The Hospice team had during the week suggested that she goes into Hospice but she refused. But by the time I returned home from the Emergency Dept. she was already on a Hospice bed. It must mean that the Hospice team entered the house soon as we left for the Emergency Room and set up all that were needed and the Ambulance team, on arrival home simply put her on bed, fixed the drip and departed. So by the time my family friends, my young son and I reached home, she was fast asleep. I thought it was a normal sleep and I kept on hoping that she would wake up until very early morning Sunday May 11, Mother's day when her breathing changed and it dawned on me that she will no longer smile at me again until later in heaven, though there will be no marriage there (Matt. 22:30).

So, I kept wondering what must have happened. I concluded that there must have been added in the drip, a tranquilizer (very strong analgesic/sedative). But she was a woman who 5mg Valium was too much for. She splits it into two but now given what I suspect was Morphine or the like.

And did she need such a strong analgesic? Not at all!

Of all people that I knew, who suffer Pancreatic/Liver cancer, hers was the mildest in terms of pain. I was with her right from the first day, December 31 2013 when she raised an observation. Even three or two weeks to her exit, she wanted to go to work, telling me that her duties at work were relatively easy. I rejected it. In fact, her work place was calling her, threatening her with a query for not reporting to work. Her bosses and co-workers were later shocked after they heard she was no more.

About a year later, I visited a family friend in Atlanta. The wife is a nurse who works in the Hospice Department. I told her "You people hastened my wife's exit and did not afford me the opportunity to bid her fare well at her conscious stage"

Answering "No" to the woman Doctor who asked me if I would return her to the Hospital if she fits again was all she (the lady Doctor) needed to hear, to write a tranqulizer to be put in the drip of someone who 5mg valium was too much for.

Our family Hospice friend nurse in Atlanta who has wide experience with people in such a state said many people, whites, in particular prefer to just sleep off after they reached such a terminal stage. That is not we Africans, particularly when we are not in a very severe pain. This is the cultural differences, which I mentioned at the beginning.

In the way which high energy Radiation works; where no matter what; healthy cells will be killed, so do chemo drugs attack the immune system. In my wife's case, probably, if they had tried to stabilize her after she was knocked down after the first chemo when her immunity was down, she might have lived longer, rather than medicating her to sleep where she woke up on the other side.

With all my years in the Oncology Department, meeting cancer patients, will one not be surprised if I did not perceive the Diagnosis with the symptoms she was presenting? I did but I had to wait till one examination or the other confirmed it. Even our youngest son, a senior in the High school perceived it after he goggled all the symptoms.

If weeping could raise the dead, the weeping of two people could have done; Alhaja Awawu Sheik is the head of the Aweda dynasty. She was about 86 then. I returned to Ilorin, the remains was to follow few days later. We decided not to let her know until the following day. All of a sudden at about 6.30pm we heard the dirge of someone on the football pitch adjacent to my compound. Is this not Alhaja's voice? It could not be mistaken!! For God sake who told her that I arrived? Her grandson who drives her was not around, so she chattered a Marwa Bicycle. All who heard her dirge from far and near were moved to tears. The other fellow is my wife's cousin-twin sister, Mrs Bose Famisa (nee Adebiyi). We met the motorcade that was bringing the remains from Lagos at the outskirt of Ilorin, precisely at the ECWA Youth Camp, close to Ilorin Airport. Bose could not be consoled. Her eye balls were completely red.

Blessed be His (God) verdict. In the wordings of a song by Charles Albert Tindley "When the morning comes and the Saints are gathered home, we shall understand it better by and by"

Lessons to learn

1. Never be shy to ask your Doctors for their treatment plan.

2. Never be shy to ask your Doctors what they want to do and what the intentions or goals are.

3. Never be shy to ask for a second and even a third opinion.

4. Never be shy to disagree with any procedure you are not comfortable with.

5. Ask for the pros and cons of any procedure they want to do and the pro and cons of any medication they want to give.

6. If a test is carried out, make sure you have a copy of the report and read it very well. Seek for the interpretation where necessary. In my wife's case, an Ultrasonography was conducted sometimes on a Sunday evening in March, which result indicated a suspicion of malignancy. But no Doctor noticed it I want to believe, yet they were conducting more tests. It was at such a further test, I flipped through her chat, as the Doctor concentrated on something else and I read that malignancy had been suspected in a previous ultrasound test of the Abdomen. I shouted and that was when I demanded that a biopsy is done. It was done under Computerized Tomography (CT) guide on Thursday April 17. She attended the Easter Sunday service on the 20th. The devastating report was read to me on phone on Easter Monday April 21. The first and only Chemotherapy was done on Friday May 02. She breathed last on Sunday, Mother's Day on May 11.

Some years later, a close relation in the North East (USA) was experiencing similar symptoms, which my wife went through and was similarly diagnosed. The carers listened to me and the life of the relation was prolonged as long as could be.