Wednesday, 15 April 2009

Kacper is reading about medical evacuation procedures, Part 3 – Post 8

The news of Kacper’s cancer has reached everyone in the organisation both in Sudan and New York with a speed of a lightning. The most sceptical of it was Maria. ‘Olha amorizinho’ (listen darling)- she tried to explained to Kacper in Portuguese (Kacper is able to use that Latin language) – ‘I know that you are worried, but please do not’ – she carried on. ‘It is impossible to make diagnosis of cancer, just by doing endoscopies’ – she kept of talking – ‘the only way to find out is to take the samples of biopsies and have them tested in the lab’. She then tried to convince Kacper that the doctors did not do that, so even if something inside him looked like a tumour, wasn’t necessary one.

In the same time, Pierre with the HR Director of the organisation in New York kept on negotiating Kacper’s evacuation, to which the insurance company eventually agreed. Kacper was going to be sent for further investigations and treatment to the Nairobi Hospital in Kenya, and it is the insurance company, which would take care of everything. Kacper was going to be flown from Khartoum to Nairobi in a business class of a regular KQ (Kenya Airways) flight the following day. He was supposed to be escorted by a nurse from the Nairobi Hospital, who was coming to Sudan to look after Kacper immediately.

On the day of the evacuation, not really knowing why, Kacper was requested to sit on a wheelchair, already in the house he lived in. He tried to explain that he could walk, but the nurse insisted that these were the rules, and he just needed to obey. So he did, but the wheelchair made Kacper feel like he really was dying, and made him simply cry.

There were three Toyota Land Cruisers that assisted ONE Kacper and his ONE nurse Anne to the airport. It seemed like the whole Khartoum office wanted to say ‘good bye’, which he found sweet, but also disturbing. He was convinced, he would never return to Sudan; never see his friends and colleagues. In fact, Kacper already started counting his last days on earth. Even Abdul, his favourite driver, and a friend made sure that he was on duty, so he could bid a proper farewell to Kacper at the airport.

While Anne was unfolding the wheelchair in front of the international terminal of the Khartoum airport, Abdul started shaking Kacper’s hand forcefully. He then embraced him and with the tears on his cheeks handed Kacper a small envelope. ‘It is from Fatima, my daughter’ – he said – ‘for her favourite khowadja (foreigner) uncle’. Kacper opened the envelope and reached for a small piece of paper, which had a drawing of 6 people on it. Each of the figures had a name attached to it. Next to Fatima and Abdul’s, there appeared Kacper’s name as well. At the bottom of the page, the red letters read: ‘FAMILY’. Very moved, Kacper did not really want to say anything anymore. ‘Thank you’ – he whispered and sat on his wheelchair.

Maria and Pierre smiled, and waved, while Anne pushed Kacper’s wheelchair towards the immigration booth. Kacper was leaving Sudan…

In the air, perhaps because Kacper was tired, or perhaps just sick worried with what was happening, Kacper passed out. When he opened his eyes, after some time, a rather peculiar scene appeared in front of him. Kacper was laying on his comfortable seat, one of the air-hostesses tried to hold a small pillow under his arm, while poor Anne with a needle, tried to find a vein in Kacper’s right arm, so she could connect a drip into it later. The other air-hostess, looking rather worried held a drip’s bottle up in the air, ready to pass it to Anne, as soon as she would demand it. There was quite some fresh and dry blood on Kacper’s arm, as Anne found it difficult to find any of Kacper’s veins. ‘Things looked rather messy’ – he recalled. It is needless to say that the happening attracted lots of interest and attention of the other passengers. Kacper noticed that someone was even taking a picture…

The plane started its descent. ‘Thank goodness’ – thought Kacper. He definitely thought that he had had enough of the performance. Ten minutes later however, he heard something, he really was not prepared for to hear… ‘Ladies and Gentleman, this is your Capitan speaking… hmm … we have got some bad news… because of bad weather conditions, we did not receive a permission to land in Nairobi, and therefore will continue to Mombasa’ – said the voice and then promptly added – ‘we are sorry for all inconveniences, and ask for your understanding’. Kacper just couldn’t believe it. However, realising, he had no influence on the situation, he decided, he wouldn’t worry, ‘whatever was going to happen, surely would!’

The diversion of the plane to Mombasa created problems mainly for Anne, who unexpectedly needed to find out, how to get Kacper to Nairobi. She did a great job, and after talking to lots of people at the airport, and via her mobile, a few hours later, they were both onboard of a helicopter bringing them to Nairobi! Kacper was so stressed, and tired that he even forgot to be excited about travelling in the helicopter, which he had never done before. As Anne noticed Kacper obvious discomfort, she tried to distract his attention, and started telling him about her family, children and her native Kenya, which she adored. This worked well. Kacper managed to calm down a bit.

The Nairobi Hospital looked really neat and nice. Surely, it was quite different from ‘the Doctor’s Clinic’ of Khartoum. In fact, Kacper thought he had never stayed in a hospital that was so fancy. He got his own bedroom, en suite bathroom, TV, air conditioning – everything really, he thought he would ever need. The new place boosted his morale a bit. He hoped that people in a place like this surely must have known what they were doing. He desperately needed this confidence!

‘My name is Professor Murangi’ – said a rather sympathetic, slightly overweight man, when he entered Kacper’s room. ‘I will be your doctor here, and I would like to assure you that you are in safe hands’. Kacper liked confidence of Professor Murangi, and decided to trust him! The doctor then asked Kacper about what had happened in Sudan, and was especially curious about Kacper’s surgery and endoscopy in Khartoum. As Kacper was giving him his account, the doctor was smiling sometimes, and at times nodding his head. ‘Very well’ – he concluded – ‘I know, you are not going to like it very much, but we will need to do another endoscopy’. Kacper did not mind anymore really, so he just said that he was going to be a good patient, and follow all of the doctor’s instructions. As the doctor was leaving, he asked one more question. ‘I was going to ask where you were from, young man?’ ‘Poland’ – answered Kacper politely. ‘Witamy w szpitalu’ (welcome to our hospital) – added the doctor in Polish, smiled and left the room!

The following night was quite difficult, as Kacper would need to take the salts to clean his intestines before the next day’s procedure. He however became a bit more optimistic about everything, and even planned that next morning, he would call his parents back home in Poland, to tell them that the training that he participated in Nairobi was going on very well (in Sudan he decided not to tell his parents that he was unwell, and invented a story of going to Kenya for a training).

The endoscopies were taking place in a small room on the 2nd floor. Professor Murangi was already dressed in his gowns and mask. While preparing his tools, he entertained Kacper in Polish (!!!) with stories from his time in Poland, where he had studied medicine, during communistic era at the University of Katowice. Kacper trusted his doctor, and was feeling lucky to have someone that nice looking after him. Suddenly, he started feeling very sleepy and soon after, he was deep in his dreams.

He woke up in his bedroom. He was still feeling weak and dizzy. A young nurse came to visit him, with fresh flowers. She smiled, and placed them next to his bed. Kacper asked to turn the TV on, which she did. She placed a remote controller, next to his hand, so that Kacper could reach it easily, when he needed it, and left to a neighbouring room, to look after another patient.

Kacper started changing channels. CNN, BBC, some movie channels, and then there was something that appeared to be the Kenyan National Television. It just happened that the afternoon news journal was being broadcasted. Pictures of crying people, who looked like medical staff, drew Kacper’s attention. The cameraman was focusing his camera on the sign of ‘the Nairobi Hospital. ‘Interesting, this is where I am!’ – thought Kacper. While showing the pictures of the Nairobi Hospital, a man’s voice reported: ‘…Professor Murangi’s tragic death is a blow to Kenya, as he was East African’s leading gastrologist’, the voice carried on - ‘… Professor’s body was found in his car, just 2 km from his residence, to which he drove from the Nairobi Hospital. Professor’s car was crashed by a lorry, and he died instantly.’ Kacper turned his TV off, and closed his eyes. A wired thought that it was he – Kacper, who killed the doctor, crossed his mind…

It took over a week for the Nairobi Hospital to arrange for a new gastrologist to come. His doctor actually needed to be flown in from the King’s College Hospital in London! Kacper wondered why he was not really surprised, when his new doctor announced that he would need Kacper to undergo another endoscopy. ‘Why not?’ – answered Kacper sarcastically – ‘I seem to have lots of experience already, it is going to be my third one within 2 weeks’.

After the familiar procedure, Kacper would start receiving lots of various colourful pills. They would be given to him in different configurations at different times of day and night. Kacper was tired, and strangely wasn’t curious to find out what was happening to his body. He just wanted to sleep, or think about stories he would tell his parents, to trick them why he was in Kenya. He watched lots of silly movies, and his state could be described as ‘NUMB’.

He really thought of some misunderstanding, when the nurse announced that Kacper had visitors, one afternoon. ‘Visitors? Me?’ – he asked with disbelief. A young, white woman with a big grey envelope entered his room. ‘Good day’ – she said in Polish (which somehow freaked Kacper out – as he remembered what had happened to the last person, who spoke Polish that Kacper met). ‘My name is Agnieszka, and I am from the Polish Embassy in Nairobi.’ – she paused for a second, observing Kacper’s face - ‘We just received a call from your office in New York, and I thought you might like to read some Polish newspapers.’ Agnieszka turned out to be a very nice person, and she visited Kacper two more times, at the hospital, and called every day as well.

Kacper’s numbness started wearing off, and he started getting annoyed about not knowing what was happening t0 him. He kept on asking various questions to his doctor, but he would never receive proper answers. There was still a lot of blood, whenever Kacper went to the toilet, and that worried him a lot.

Finally, one morning, Kacper’s London doctor came over, and asked whether Kacper would agree for an HIV test. He was shocked and puzzled and therefore did not even manage to ask, why the doctor suspected that he might be HIV positive. He agreed promptly though, and half an hour later, a lab technician was filling his plastic containers with Kacper’s blood.

Kacper never slept so badly in his life. He just kept on thinking about AIDS, and about how he could have contracted it. Kacper was sure he had never exposed himself to a risk, but the doctor seemed so confident that Kacper might have AIDS – and this made him very doubtful. By the sunrise, Kacper was already planning how he was going to commit a suicide, and imagined his own funeral, and who would be attending it, and the speeches people would make in honour of him…

The next thing in the morning, the doctor came and announced that Kacper’s HIV test was negative. He also added, he would like that Kacper has his CAT scan done. After that, he would have a longer chat with Kacper. ‘CAT scan… I surely have cancer then’ – dramatised Kacper… In his mind, the CAT scans were done to people having cancer. They performed the scan the same day, and the results should be delivered to his doctor still the same evening. Kacper was preparing to face the worse…

‘You have a condition that we refer to as ‘Inflammatory Bowel Disease’ – said the doctor, during the next morning’s conversation. ‘I am afraid, I am not sure what it is doctor… is it really bad… am I going to live?’ – enquired scared Kacper. The doctor just smiled and answered: ‘this is not necessary the nicest condition to have, but with some discipline on your side, you will just be fine, …and yes, you are not dying’ – he added, when leaving the room.

As New York was in touch with Kacper’s doctor directly, they found out the diagnosis soon after… What followed later just overwhelmed him and left him helpless again. ‘Inflammatory Bowel Disease? We demand Kacper’s evacuation to the Pasteur’s Institute in Paris for re-confirmation of the diagnosis. We will not reimburse any treatment costs, if patient refuses…’

Kacper was not sure anymore what was happening to him, where he was, and to whom he was speaking. Dr. Luc appeared very friendly, and spoke good English, despite a fairly strong French accent. ‘Welcome to France’ – he said. ‘I understand that you have been going through some adventures recently’ – he smiled. ‘Yes, I think it is a fair statement’ – agreed Kacper. ‘Are you going to perform an endoscopy?’ – asked Kacper right at the beginning of their conversation. ‘Yes, we will need to do it, how did you know?’ Kacper just answered that he had a feeling of it and asked for some practical information on when it would be done.

Kacper needed to admit that it was the most spectacular endoscopy, he had ever had, and could dream of (in every sense of the word)! Kacper’s bum was displayed on a cinema-like screen in an auditorium filled with students of medicine from the Sorbone… ‘Great’ – thought Kacper – ‘my bum is now helping the science in France… what else will happen?’

Luckily nothing much happened after this occasion. Doctor Luc confirmed the diagnosis of Nairobi, explained Kacper how he should live with his condition, demanded that Kacper went home to Poland for his rest for at least a month, and visit doctors for check-ups regularly in the future...

Some 6 weeks later, Kacper was leaving the arrival’s terminal of the Khartoum airport. ‘Amorizinho!’ – shouted Maria, when she spotted him in the crowd of people desperately trying to find their families. Pierre was there as well, with a big smile on his face. ‘Next week, you are off to Wau, you lazy bugger’ – he said – ‘works is waiting for you!’ As they approached the car, little Fatima on Abdul’s arms looked at him and asked ‘did you bring me a doll, uncle?’ Kacper was back home at last, his second home!

PS. Kacper is wondering whether the relations between Cuba and the USA are finally warming up?

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