Chapter 2: Suspicions and Tests

Before I fit finish, girlfriend just jump enter matter. She say na tuberculosis dey worry her pass.

She no even let me end talk. Sharp girl. Na so some Naija babes dey do research. She adjust Ankara scarf, dey talk like person wey cram textbook.

She yarn say him grandma get tuberculosis before, cough bad. Earlier this year, when e go village, he stay with her, maybe na there e catch am.

She lean forward, voice low, "Doctor, him grandma get am before. When he go village, he dey stay for the same room. Maybe na from there e catch am."

I look the guy. Tall, slim, skin poor, tired face.

Light from above make im skin look like overripe mango—pale, tired. You see lines for face, cheeks hollow. Na the look wey sickness dey give person when body dey fight silent battle.

As I listen to him lungs, I hear small moist rales, and with that kain long fever, TB fit dey possible.

Stethoscope pick up crackling sound, like rain dey tap aluminium roof. For my mind, red flag begin wave like NLC protest.

I sharply adjust my face mask.

Omo, for Naija, once TB enter gist, even doctor dey respect himself—mask tight, sanitizer full hand.

He say he always dey healthy, except grandma, no other sickness for family. Dem both sabi say TB dey spread from person to person.

Dem look each other, fear hang for air—"God abeg, make e no be TB o."

After I check heart and lungs, I order some tests: routine blood and chest CT scan.

I fill form quick, write name bold, make lab no waste time. Na so we dey do for emergency.

I no ask opinion—this one no be negotiation. E must be done.

Sometimes, na we dey decide for patient. For Naija, you go take charge before family start debate for corridor. Health no be market price.

Chest CT no cheap, e cost well—tens of thousands—pass normal chest X-ray. But X-ray no dey show enough, CT dey clearer, so you no fit cut corner.

For this country, na money dey talk for hospital. Some go beg, "Doctor, abeg, try X-ray first, CT dey cost." For this case, I no gree. Health first.

To confirm TB, CT no reach. You need sputum smear, sputum culture, dem go check your blood well, do all the test wey dey important.

I explain: "Una go still do sputum test—dem go ask you cough inside bottle. CT just dey show us wetin dey happen for chest, but we need see am for microscope."

But for night, na only simple CT I fit run. The rest, after admission if e need am.

Night shift get own wahala—no full staff, machines dey sleep, lab people fit dey vex. We dey manage the one wey dey available.

Dem agree to CT.

Guy nod sharp, eyes heavy but hope dey. Him girlfriend squeeze his hand, whisper something for only am. You go feel love even inside worry.

The patient dey fear, say TB hard to treat; grandma drink medicine taya.

He mutter, "Doctor, na this TB wahala my grandma dey suffer since. She drink plenty medicine, e tire her."

I tell am, e no mean say na TB sure—we just dey suspect.

"Calm down, oga. No be say na TB sure sure. We dey check everything. No panic yet."

Girlfriend squeeze his hand, look him eye, say, 'I dey your back, no shaking. Na together we go waka this journey.' She encourage am, say TB no be death sentence; if e dey, face am. She talk say she check, medicine dey, just long—half year to one year.

She put hand for his shoulder, smile: "No worry. TB no dey kill person again, as long as you take your medicine. E just dey long small. Even government dey help for drugs."

I look this girl with respect. Many for run if dem hear say boyfriend get TB. E no easy.

Na real woman be this. Some go carry bag run. But she stand gidigba, encourage am. For this life, na only God dey reward loyalty.

But my mind dey pity her—her boyfriend dey hide something from am.

Her face open, but if she know say the guy dey hide HIV fear for chest… For life, secret dey heavy for relationship. Sometimes, na fear dey make person lock mouth.

I repeat am again, e no mean say na TB sure. I gats repeat, if result talk say no be TB, make dem no blame me or talk say I do test for money.

For Naija, if you talk say na TB, e no be TB, family fit talk say you wan chop their money. I dey protect myself with small explanation.

Chronic low fever and cough no be only TB. Lung cancer fit show like this too. Other chronic infection dey. Until result drop, I no fit talk too much.

I dey careful with my words—experience don teach me. Sometimes, diagnosis dey hide like snake for bush.

First, draw blood, do CT, when result drop, we go decide. Cough medicine fit enter—no matter the sickness, small cough syrup dey help.

Na that cough syrup—codeine-free one o—people dey call doctor’s blessing. At least, e go help sleep small till results ready.

I tell them, after test, make dem no leave—wait for result.

"Abeg, make una no waka go anywhere after test. Just relax for waiting area—so we go talk once results land."

Blood count come out first. E normal; white blood cell no high, so ordinary pneumonia no likely. Pneumonia dey cause fever and cough, but e dey quick—few days or one week, hardly pass one month.

I scan printout, everything normal, but lymphocyte low small. The paper heavy for hand—sometimes, number dey tell story.

Wetin make me suspect na lymphocyte count—just below normal. For Naija, we dey suspect HIV when lymphocyte drop. But other sickness dey cause am too. E mean immune system dey drag leg.

Next, stomach wahala.

I ask am to provide stool, but he say e no feel like go, so e no fit give.

He try laugh, scratch head. "Doctor, belle never gree me go."

Girlfriend add say e don purge five times today—belle don empty. She say e no be today e start; e don dey do am like that for a month, on and off. Any small dirty food, diarrhoea go start, go last all day.

She shake head, "E don purge tire today. Even Indomie wey he chop, e no hold for belle."

"Gastroenteritis fit last like that?" the guy ask me.

He sound confused, maybe dey find reassurance. Eyes dey talk: "Doctor, abeg, talk say no be big wahala."

Stomach no normal, e no be acute gastroenteritis. Gastroenteritis dey quick—few days at most. This one drag pass one month, plus fever.

For Naija, when belle dey purge and fever dey join, we sabi say no be ordinary pepper soup wahala. This one pass am.

Wetin really dey happen?

Inside my mind, I dey arrange symptoms like beans for akara—trying to make sense of the mixture.

Na just simple TB?

Or e get both lung and intestine TB?

Or na another sickness dey hide?

I no know.

Hospital life dey humble person. Even with book and training, sometimes, you go still dey guess, dey hope say result go guide you.

Plenty patients dey that night, I no fit settle down think too much. As long as vital sign dey okay, no emergency, e good reach for now. The rest, make am go clinic—if big wahala land, I go dey in trouble.

Emergency na war front. If you dwell for one case, another go land with gunshot or birth pain. Na survival tactics we dey use.