Chapter 3: Diagnosis Unfolds

Soon, CT result land. Patient run come with report, fear for face, ask if na sure TB be that.

He almost jam door as he rush in, report for hand, sweat for face. "Doctor abeg, this one mean say na TB true true?"

I check scan—lesions dey for both upper lungs, really look like TB. Report even write say TB dey suspected.

I study black-and-white image. Lesion dey where TB dey love. Even radiographer no waste time, write ‘suspected tuberculosis’ in bold.

I tell am, based on test, e fit be TB, but as I talk before, to confirm am, na series of test. CT alone no reach. I suggest admission for proper check—if na TB, he go move go infectious disease ward.

"Oga, CT dey show us, but we never get final answer. Abeg, make we admit you. If na TB, you go move go special ward, dem go take care of you well."

Patient eyes full of fear. I try reassure am, say nothing sure yet. Besides, TB no be death sentence—medicine dey. Your girlfriend even sabi more than you. I try calm am down.

He dey shiver, eyes dey shine with tears wey e no wan drop. I pat am back, "See, you go dey alright. TB get medicine. E no dey kill person like before. You dey lucky say you come hospital."

Girlfriend no let am back down. She smile, press his hand, "My dear, na so life be. Nothing go happen. We go face am together."

As dem dey talk, patient suddenly feel urge for toilet, stomach disturb am, e dash out.

He no fit hold am, dash comot like say e dey run relay. The slippers waka waka for corridor dey echo as he find toilet sharp sharp.

Girlfriend turn to me, whisper, "Doctor, abeg, e fit be say na intestinal TB dey cause all this purge?"

She say she check, TB get lung, intestine, lymph node. Diarrhoea na sign for intestine TB.

She dey quote Google like pharmacology notes. "I read say if person get TB for intestine, diarrhoea go dey."

This girl really do her homework. Family wey sabi dey help for emergency, reduce drama. She dey make my work easier.

In theory, TB fit waka anywhere for body, fit get lung, intestine, lymph node TB at once. But to confirm intestine TB, more test dey needed.

"Na true," I reply. "TB fit waka enter any part for body. But we go still need more test—scan, stool, maybe even scope."

I gently remind her, since he fit get TB and she dey care for am, make she protect herself, wear mask. I even tell am if e sure, she fit need isolate small, so e no catch am.

"Abeg, use face mask. If TB sure, you fit need give am small space, no too share plate and spoon. Na just for safety. God no go shame us, but make we still use sense join faith."

She laugh, slap her chest, "Me? TB no fit catch me, I be Benue pikin!" She talk am with confidence, playfully.

I tell her, TB no dey look face; even strong person fit catch am. Better safe than sorry.

"No be muscle TB dey fear o," I smile. "Abeg, shine your eye. Better safe than sorry."

She nod, say if na TB true true, nothing to do—she no fit abandon am. E dey hustle for their wedding house, never rest all year. She say she must stay.

She fold arm, voice soft. "He dey hustle for our future. I no fit run leave am now. Na me and am go see this thing finish."

Honestly, I touch. I dey give advice, but whether dem hear, na their matter.

I hold back small smile, heart warm for them. Some love strong pass malaria.

When I get small free time, I try piece together his illness. TB still likely.

As I write notes, mind dey replay symptoms one by one. Picture fit TB, but medicine dey always respect surprise.

Early TB dey hide symptoms. If e worsen, you see tiredness, loss of appetite, weight loss, insomnia, night sweat, palpitations, low fever. Many no notice until cough start, chest pain, or cough blood.

For Naija, once person dey spit blood, neighbour go dey whisper. I dey thank God say we catch this one early, if na TB.

He don get low fever pass one month—sign of active TB. He for come earlier, but treat am like ordinary fever, so e drag.

Na so we dey do here. Small fever, manage am, buy agbo or antibiotics from chemist, until e turn big wahala.

For diarrhoea, e fit be sign of intestine TB. Bacteria fit infect both lungs and intestine. Intestine TB dey follow with stomach pain and diarrhoea.

I remember one case for Benue—woman get both. Her story still dey my mind. Sickness no get respect for anybody.

Only thing confuse me—no stomach pain. Almost all intestine TB patients get pain. Many land emergency because of am. To see just diarrhoea rare. That one, I no fit place.

I tap pen for table, think. "Why only diarrhoea? Where pain dey hide?" Medicine sometimes dey behave like Lagos traffic—no predictable pattern.

As e be, I still dey learn.

No matter how long you dey, patient fit still surprise you. Humility na key for this work.

No time to think more. Other patients dey wait. I plan to admit am to respiratory or infectious disease department sharp sharp.

I gather file, check phone for time. Admission now best. No time waste, before case turn emergency for my head.

Just then, girlfriend tap table, voice sure. "Doctor, I sure say na TB dey worry am."

"How you take sure?" I ask.

I raise eyebrow, try hide my own surprise. "Madam, wetin make you talk so?"

She say he get not just lung TB, but intestine and lymph node TB. She just check online, realise the small lump for him neck be swollen lymph node—lymph node TB... This girl sharp well well.

She point neck, whisper, "See that small lump, e fit be lymph node TB. Internet talk am."

But I no fit worry about that now, because sweat dey run my back. My heart dey pound.

As she talk, my own body dey alert. For Naija, neck lump with fever fit mean plenty things, some dangerous. My mind dey race like okada for pothole road.

"Wait, you say your boyfriend get swollen lymph node for neck?"

I almost shout. Voice echo small for room. Na instinct—experience don teach me say neck swelling no dey play.

Maybe my voice loud, she shock. She look me, stammer, say she think na swollen lymph node. She don notice before but no pay attention, think na normal for fever patient.

She step back, eyes wide. "I just think say e normal, as fever dey, but e never reduce."

Honestly, patients with swollen lymph node for neck dey always make me tense.

For Naija, neck swelling fit mean infection, cancer, or even spiritual matter—sometimes, family go rush prayer house first. For hospital, we dey treat am with full attention. But as I look that swelling for him neck, cold run my body—because sometimes, wahala dey hide where you no expect.