Epileptic seizure played critical role to strengthen family bond

“Any past illnesses?” I ask this question to the man. The wife, sitting next to him intervened and said: “My information might not be relevant but I had epilepsy in my early childhood but haven’t had a seizure for many years because I take anti-epileptic tablets regularly.” ILLUSTRATION | JOHN NYAGAH

What you need to know:

  • Between the psychiatrist and the almoner, they have decided to take Gerald out of his mother’s care and place him in a posh, paid children’s home.
  • A day later, when she was pain-free and ready to go home, I asked her the details of the accident, which caused her burns and she gave me a full account of what transpired.
  • “Because of the cold weather, I put the heater on. I must have got my epileptic fit.” Seeing my surprised look, she added: “With all that is going on with my life, I have been irregular with anti-epileptic medication. When I came out of my seizure, as usual, I found that I had bitten my tongue and had relieved myself.”

As usual, when my gynaecologist colleague, Dr Gladwell Nyagah, saw Mr and Mrs Kaggia for infertility, she referred the male component to me for a check-up — and as I routinely do, I requested her to send the couple to see me in the first instance. In this case, my routine paid off, for my first question to Mr Kaggia was: “Any past illnesses?”

I ask this question to the man because mumps in late childhood is occasionally complicated by virus orchitis – inflammation of the testis — which renders them incapable of producing sperms. The reply from Mr Kaggia was, “None.”

The wife, sitting next to him intervened and said: “My information might not be relevant but I had epilepsy in my early childhood but haven’t had a seizure for many years because I take anti-epileptic tablets regularly.”

As my readers will see, epileptic seizure played a critical role in this true story. After asking a few more questions to Mr Kaggia, which included a few  intimate details of the couple’s sex life, I examined him. I checked his external genitalia and the size and sensation of his testes. Finding them normal, I ordered a semen analysis on him.

That gave us the diagnosis, for it was reported as Oligo-spermia. This was followed by figures to suggest low level of fertility in him. I prescribed sperm-enhancing tablets to bring them to normal level. When I updated Dr Gladwell Nyagah, her reaction was: “Your prescription might prove an answer to their problem. I will therefore withhold further investigations on Sally until we give the tablets an opportunity.”

The Kaggias did not keep us waiting for long because eight months later, Gladwell rang me to say: “Sally has missed her period and the pregnancy test is positive.” Naturally there was a big celebration after the toto arrived following normal labour, but soon, sadly, cracks appeared in the family structure.

In the Doctors’ Lounge, one morning, over coffee Dr Nyagah said to me. “Gerald is showing signs of Down Syndrome.”

“Who is Gerald?” I asked.

“Oh, I am sorry, but I thought that you knew the name of the Kaggia baby,” she explained.

“I am very sorry to hear that,” I replied. “To have waited so long and then end up with a Mongol child seems very unfair. Wasn’t an ultra-sound done during pregnancy to warn us?” I asked.

“At the routine tenth week scan, I offered Mrs Kaggia a test for Down’s Syndrome  but she declined because she and I believed that she was not at high risk.”

IMPERFECT CHILD

Dr Nyagah elaborated: “I also thought that the couple was so keen on having a baby of their own, that even if we detected Down’s Syndrome on the scan, Mrs Kaggia would not agree to a therapeutic abortion.”

“How have they taken it?” I inquired.

“The husband has taken it reasonably well but the wife is devastated and finds it difficult to accept her own child, who is not normal in all respects. The baby has put the marriage under a great strain and I hope, he doesn’t wreck it.”

At another similar encounter, Dr Nyagah updated me further. “Sally still finds it difficult to accept her son. As you might have noticed, she is a perfectionist and can’t accept any imperfection in her son. She thinks that her son’s Down Syndrome reflects adversely on her cerebral and aesthetic perfection.”

“And what about Francis?”

 “He is torn between his son and wife, both of whom, he loves dearly,” Dr Nyagah explained.

“So what’s the answer?”  I asked with concern for the couple, I had known briefly but for whom I had developed a special affection because of the unusual circumstances, they were suddenly saddled with.

“I have introduced our psychiatrist, Dr Ndambuki in the case and hope he can drive some sense into Sally,” Dr Nyagah replied.

Next time we met, I asked. “How is the Kaggia family doing?”

“Not very well,” replied the gynaecologist. As I raised my eyebrows, she elaborated:  “According to Dr Ndambuki, Sally is developing suicidal tendencies. She has tried once with an overdose of sleeping pills and tranquillisers, which he prescribed for her because she is highly agitated and can’t sleep. Fortunately, Francis came home early that day because the golf course was closed early. It was his golf after-noon. He found his wife in a stupor and rushed her here, where with a stomach wash and a drip with brain stimulating drugs she was revived.”

“Strange, I didn’t know,” I exclaimed.

“Neither did I,” replied Dr Nyagah. “The family naturally wants to keep it hush-hush. I only heard it from Dr Ndambuki, when he was justifying the drastic decision he had made about Gerald in conjunction with our almoner.”      

“And what’s that?” I asked quite alarmed.

“Between the psychiatrist and the almoner, they have decided to take Gerald out of his mother’s care and place him in a posh, paid children’s home,” Dr Nyagah replied.

“And when is this cruel decision being implemented?”

HEARTLESS ARRANGEMENT

“Gerald is three now and so sooner the better, before he is old enough to realise what’s happening,” Dr Nyagah said.

“And what does Francis think of all this?” I asked.

“He is tearing his hair out. He has no choice but to accept this heartless arrangement. Dr Ndambuki told him that in one of his psycho-therapy sessions with Sally, she threatened to cut her wrists next time and complete what she calls her unfinished business. I can’t blame our psychiatric because his hands are tied too. He doesn’t want to take the risk because he believes that Sally will successfully carry out her threat.”

Dr Nyagah replied. “I was very disturbed but there was little I could do. Nevertheless I rang my friend, Dr  Ndambuki and said to him: ‘I don’t want to interfere in the treatment of your patient, but I know the Kaggia family and think that sending their only son to a Home is a bit too drastic.”

“I am glad you rang because it gives me a chance to explain my viewpoint,” my friend explained.

“In my terrible decision, there is a built-in potential therapeutic benefit, which is that Gerald might tug at his mother’s heart more strongly in his separation in relation to time and space and he might be brought back home.”

But I didn’t have to wait for that possibility because soon after, events took a radical turn and gave me a role. I was no longer a helpless spectator in this tragedy. One mid-day in June, as I was doing my ward rounds, Gladwell rang me from Accident & Emergency to say. “I have brought Sally here with burns.”

“How bad are they?” I asked.

“The burn on her left forearm looks deep but the rest are superficial,” she replied.

I apologised to my junior colleagues and rushed to A&E. On arrival in A&E, I was taken to the cubicle where Sally was receiving an intra-muscular injection for the excruciating pain from her burns. I examined her and concluded that all her burns needed a pain-relieving cream, which I told the Sister to apply and admitted her. A day later, when she was pain-free and ready to go home, I asked her the details of the accident, which caused her burns and she gave me a full account of what transpired.

“Because of the cold weather, I put the heater on. I must have got my epileptic fit.” Seeing my surprised look, she added: “With all that is going on with my life, I have been irregular with anti-epileptic medication. When I came out of my seizure, as usual, I found that I had bitten my tongue and had relieved myself.”

She took a long pause and went on: “I saw the burns on the left side of my body and the heater turned off and moved away, obviously by Gerald who was screaming and our neighbours knocking at the door.”

As I was absorbing her fascinating story, she concluded. “I grabbed Gerald to check that he had not sustained any burns and in that moment, he looked up and made an eye contact with me, something he had not done before.”

The burns on the left side of Sally’s body healed with application of antibiotic and analgesic cream without leaving any marks. Even the deep burns on her left forearm scabbed quickly. A couple of days later, she asked: “When can I go home?”

“What’s the hurry?” I asked. “You have had a rough time lately and I am sure that the rest will do a lot of good.”

“I need to go home to look after my husband and my son. I also need to thank my son for saving my life and assure him that he is not going anywhere .”

 “I am sure the experience has strengthened your family .” I remarked.

I quoted to everybody connected with this human drama, the famous last words of Sally Kaggia before she left the hospital.