THE GENOTYPE: Doctor Kiss Me Quick I Need Your Affection

At Grace Teaching Hospital

Dr Chetachi, a 5ft8″ handsome man in his late 30s, a senior registrar in the paediatric department is seated with 3 others, Dr Tony a senior registrar in Neurology, Dr Sebastian a 28-year-old male, Junior Registrar in Paediatric department, and Mr Fred a staff at medical record department. They were in one of the hospital’s canteens having their lunch.

As usual, Dr Chetachi is one person who doesn’t joke with his meal. A very hard working man, whose impact is felt strongly among his colleagues. He is the nurses’ man and he has a way of getting into anybody’s head and will make the person do things for him by way of his charisma.

He’s had to drag Dr Sebastian along today as he was going for lunch and on getting to the canteen saw Dr Tony and Mr Fred and decided to join their table.

Dr Tony wore a black pant and a body-hugging white shirt with a red tie that sits perfectly. He was munching his meat haven bought fried rice with beef, while Mr Fred who wore an army green T-shirt over a white jean, had a plate of yam with egg sauce.

Dr Chetachi who happened to be wearing the same thing as Dr Tony only that his tie was flowery red, called out the waiter as soon as he sat down beside Dr Tony. Dr Sabastine today was wearing his favourite dark blue, white dotted short sleeves which he left flying over his black pant. He also wore black shoe to compliment and as usual, he doesn’t like ties.

Dr Chetachi – “Nwanyi Oma biko bia” (Fine woman please come)he spoke in Igbo language to a beautiful damsel by name Nmachi who has just served the two men at a table adjacent to theirs

As she approaches, a charming smile lit across her lips. She is not only pretty she dresses smartly that you can’t but notice her aura like the scent of Jasmine.

Aware of Dr Sebastian prying eyes on her, she fixated her eyes on him too while talking to Dr Chetachi who called her.

Nmachi – Dr Chetachi “ke ihe anyi ga enyi gi taa” (what are we giving you today) she asked Dr Chetachi in Igbo.

Dr Chetachi – If you like him, just tell me, I’ll arrange him for you he said to Nmachi…This he said haven observed how she and Dr Sebastian were admiringly looking at each other. What followed was a roaring laughter..from everyone on the table until Dr Sebastian spoke

Dr Sebastian – she a pretty lady with good carriage. “who no like better thing, na this type I wan carry go show my mama (he concludes in pigin) – meaning “who doesn’t like good things. This is the kind I would love to take to my mom.

After taking Dr Chetachi and Sebastian’s order, she served them and was about moving to another table when Dr Sebastian got hold of her hand and whispered to her…can we see after work?…she nodded in affirmation

 

Scene 2

At the paediatric nursing station sat Matron Uchechi, a 42year old chubby mother of 4, Nurse Gloria, 24years old and Nurse Ugochi a 31year old lady with the charming look of an amiable Princess.

The three nurses sat there at the nurses’ station chatting when Dr Chetachi and Sebastian walked in and greeted them warmly.

Dr Chetachi – what brings you to our department this afternoon? A question directed to Nurse Ugochi, who is a nurse in the cardiology unit.

Dr Chetachi has always teased Nurse Ugochi anywhere he sees her, he often calls her “mine” and over time, Ugochi has come to really like him. She occasionally visits Matron Uchechi, her presumed mentor, in paediatric in an attempt to get Dr Chetachi’s attention and today wasn’t different.

The mere sound of Dr Chetachi’s voice triggers a hormonal surge in her…today she found herself smiling uncontrollably rather than respond to the question of what brought her to the department.

With nurse Ugochi still lost about what her response to Dr Chetachi’s question, Matrone Uchechi interjects.

Matron Uchechi – Doc, Mr Jim requested to see you. she told Dr Chetachi

Dr Chetachi – who is Mr Jim?

Omashola’s Father. The man that lost his son to sickle cell disease last month  Matrone Uchechi replied

Mr Jim is a 48year old businessman whose second son(Omashola) died a month ago at the age of 7 years in the paediatric unit. He had died following an acute chest syndrome, a complication of sickle cell anaemia. He was a known sickle cell anaemia patient who’s had a recurrent crisis. He was rushed from school down to the hospital the said day and subsequently died less than 10minutes after arriving at the hospital

Ohhh!! I remember. Where is he ? Hope he is doing fine? Has he left yet? Doctor Chetachi asked

For Dr Chetachi, 28th of June was really a day to remember. He lost 2 children the said day. One to neonatal tetanus and the other to sickle cell disease.

Up until then, he has always had his sickle cell disease patients treated and discharged in good clinical condition. It was the first time he would lose a sickle cell disease patient directly under his care. They have been other deaths but they weren’t his direct patients. So the remorse he feels only last few hours or days but losing Mr Jim’s son was a turning point for him

He was full of life about five days before the sad incident when they came for follow up, cheerful as he is with a natural dimple that sits pretty on his face like his mother’s. While chatting him up as he would do to all children he comes across, Dr Chetachi had asked the little boy “What would you like to be when you grow up” and he had gleefully answered, “I want to be a doctor when I grow up”.

Each time Dr Chetachi remembers him(Omashola), his innocent smiles graces his memory and the sound of ” I want to become a doctor when I grow up” plays through his head. And sometimes he has had to question himself if he truly did everything possible to save the little boy from death and his answers have always been reassuring.

As Dr Chetachi was about heading to his consulting room, Mr Jim was seen approaching and from 5 meters away, one could tell he is obviously worried. He hasn’t been himself since the demise of his second son. It’s only the first child, an 11year old male that is left. He also has sickle cell disease but he’s not frequently admitted to the hospital like his younger brother who just passed.

Dr Chetachi – Ahh! Mr Jim good afternoon, I was told you asked to see me. How are you today?

Mr Jim – Not feeling too well Doc. I’m yet to get over the recent event

Dr Chetachi – Oh I see. I know it’s really been hard on you. Come with me to my office.

Ugobekee, Let’s see at the close of work before you go Dr Chetachi said to nurse Ugochi as he walks along with Mr Jim

Mr Jim was putting on a black pant with a well-tailored purple shirt and a smart black shoe to complement it. But for his facial look that bore worries, he could pass for a jovial model especially with the fittings from the dress that matched his lean muscular body.

He followed after Dr Chetachi as they head to his consulting room.

In Dr Chetachi’s office, Mr Jim who sat adjacent to him narrated how the death of his second son has devastated his family especially his wife and their only surviving son Fayemi.

He, however, said his visit to Dr Chetachi today was to discuss how to possibly prevent the only surviving son from having complications from sickle cell disease just like the younger son that died.

Dr Chetachi – It’s good that you are here today for Fayemi. I’m very glad that he’s being fine and the rate of admission to the hospital for him has been fairly minimal. The recommendations for him remain the same which is 1. Taking his routine medications – daily folic acid – needed by the bone marrow to make new blood, proguail – a prophylactic antimalarial and others 2. Drink plenty of water – as dehydration increases risk of sickle cell crisis, 3. Avoid extremes of temperature – exposure to extreme cold or heat can increase the risk of sickle cell crisis, 4 Avoidance of smoke 5. Use of over the counter (OTC) pain medications – however, you have my number, you can call me before giving him OTC medications

Dr Chetachi further reassured Mr Jim that having lost Omashola does not mean that same fate will befall Fayemi and that with the needed support, he would do well just like his peers without sickle cell disease.

Mr Jim who appears to be looking brighter than he came very much thanked Dr Chetachi for the information but however needed more clarification

Mr Jim – Doctor can this sickle cell disease be cured?

Dr Chetachi – Yes. Bone marrow transplantation (BMT) is currently the only known cure for sickle cell disease. It involves replacing the abnormal stem cells residing in bone marrow with healthy cells from an eligible brother or sister. This procedure is also sometimes called a stem cell transplant. It is an expensive procedure.

Thankfully, for persons like Fayemi who barely show symptom, you might not need to consider that.

Mr Jim then asked another question. Doc. you were telling me how I and my wife would have prevented this if we had checked our genotype before marriage. How is that?

Dr Chetachi who happen to have had this discussion before with Mr Jim and his wife when he tried explaining to them the condition came to be doesn’t seem to be bordered on discussing it again. Perhaps if Mr Jim understands better, he can explain to other people around him and more people will be more enlightened.

So Dr Chetacha started explaining – Sickle Cell Disease(SCD) is a group of inherited red blood cell disorders. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle”.

It is a genetic condition that is present at birth. It is inherited when a child receives two sickle cell genes—one from each parent.

He further explains that “sickle cells” die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems such as infection, acute chest syndrome and stroke.

For obvious reasons, which appears to be a remorseful feeling, Mr Jim who was so enraptured by Dr Chetachi’s detailed explanation then interjects with another question.

Mr Jim – Doc, you mean my son inherited this disease from me or my wife?

Dr Chetachi – Mr Jim, you see, there are different types of sickle cell disease which are HbSS, HbSC, Hb beta thalassaemia and others. The one you son had was HbSS

Furthermore, Dr Chetachi explains. There is what we call the sickle cell trait(SCT). People who have SCT inherit one sickle cell gene (“S”) from one parent and one normal gene (“A”) from the other parent. People with SCT usually do not have any of the signs of the disease and live a normal life, but they can pass the trait on to their children.

Your two sons inherit two sickle cell genes (“S”), one from each parent. This is commonly called sickle cell anaemia and is usually the most severe form of the disease Dr Chetachi said.

Ohh! I see. my wife appears to understand this better than I do Mr Jim said and she has tried to explain this but I didn’t understand it clearly but now I do.

So what we are advocating Dr Chetachi continues is that before getting married, people should do their genotype to check their compatibility. AS should not marry AS or SS just as SS should never marry SS Or AS. Those who are AA can marry from any of the group

Mr Jim now looking brighter added, that’s for those yet to marry as for me and my wife, no more childbearing ooo..we are okay with the one remaining. God willing he will live for us..AMEN he concludes

Mr Jim thanked Dr Chetachi and then left much happier. He had actually needed someone to talk to and coming to Dr Chetachi was really helpful.

 

SCENE 3

It’s 4 pm and Dr Chetachi was preparing to go home when he held someone knocks on the door of his consulting room. Yes! Come in, he said. The person hesitated and then the door swung open.

At the entrance was elegance in its full description, gorgeous as the kiss of the early morning sun on petals of hibiscus after a late-night shower of rain.

Nurse Ugochi had close for the day but decided to come to Dr Chetachi before going home. She had fallen “head over heel” for him over time but still confused whether or not she should clearly shoot her shot or keep giving him green light till he aligns. But for him to have asked to see her after work today obviously means he sees the light and Ugochi wouldn’t miss this opportunity

Everyone knows and acknowledges that nurse Ugochi is beautiful but this evening, the way she was looking was extraordinary, perhaps her rose flowered body-hugging gown that seems to caress just 2cm below her knee defined her “Queenly Beauty” better.

All Dr Chetachi could say was “WAOO”.

Quickly, all the accumulated stress of the day dissipated. The testosterone in him was put to work and his face was red with desire. Again he altered it ” WAOOO” and in addition, “You are amazingly Beautiful”

This stirs in her an Angelic smile that sends waves of lasciviousness flying in the space that separates the two of them

Dr Chetachi – come inside

She takes 4 steps forward and stood opposite his table. She could see his eyes fixated at hers, occasionally drifting to her heaving chest…

For split seconds that seem like an eternity, she resisted the intense urge to throw herself at him

Just then, he moved closer to her and bent his head towards hers. Redden with anticipatory pleasure, she closed her eyes and parted her lips expecting her first kiss with him, she said “Doctor Kiss me quick I need your affection” but no…he whispered to her left ear “WHAT’S YOUR GENOTYPE? ”