Our second baby did not keep us waiting for long

“As we say in my language, the proof of the pudding is in the eating,” Ari said. “So as soon as my chemotherapy was over, Melina and I started trying for our second child and he did not keep us waiting for long.” ILLUSTRATION | JOHN NYAGAH

What you need to know:

  • “He didn’t say much but I could see from his face that he was not very happy and asked me to see a surgeon at the Muhimbili Hospital in Dar,” replied Ari. “My wife Melina and I rushed to Dar and saw a surgeon, who said that I had cancer of my testis and it should be removed.
  • As we walked to his bedroom, I read his hormone report, which was satisfactory. I asked him to undress and stand so that I could see his scrotum, which was empty on the left side. I felt it and found no signs of local recurrence. I asked him to lie down and checked both his groins for presence of any glands. I felt his liver and abdomen for any masses and finding nothing abnormal anywhere said to him. ”I think you can consider yourself cured.”

“Bagamoyo was the capital of Tanganyika when the Germans ruled us,” Melina said while she showed us round her historical town. “It was in 1890 when the capital was moved to Dar,” she continued. “Bagamoyo means, ‘here I throw down my heart’ which was the cry of the slaves who were herded here through underground tunnels to be shipped in dhows to America and Caribbean countries.

They knew that when they reached Bagamoyo, a big slave trading centre, they had arrived at a point of no return and decided in desperation to leave their hearts here.”

Melina was giving Marie and me a guided tour of the town. We started with the “Mission”, a Roman Catholic mission compound where the first church in East Africa was established. She pointed at a Baobab tree in the middle of the complex and said.

“This tree was planted here in 1868 and according to a notice pinned on it, the circumference of its trunk is now twelve and half metres.”

As we were driving in her posh four wheel Discovery car, she said to me, sitting in the front seat next to her. “Please read the notice above that church door.” I complied and I read, “Through this door, David Livingstone passed.”

“This obviously is a historian’s paradise.” I remarked.

“Livingstone’s body was laid to rest here before it was sailed to Zanzibar en-route to the UK where he was buried,” Melina replied. “In fact he, Stanley, Burton and Speke all passed through this town in their search for the source of the Nile.”

This personalised tour took place a day after the quarterly meeting of ASEA - Association of Surgeons of East Africa – council held in Bagamoyo. Some years ago, ASEA decided that since majority of our people live in villages, our council meetings should be held in district hospitals, though the annual conference could take place in the capital city of the host country.

SURGEON'S MEETING

This way, the young surgeons manning the district hospitals would mingle with the top hierarchy of ASEA and even present difficult cases to them and take advantage of their experience and seniority. Accordingly, when it was the turn of Tanzania to stage a meeting, representatives from that country on the council proposed Bagamoyo. We jumped at the idea because most of us knew that its streets were paved with history.

As per the established tradition, the council members from Tanzania arranged a hotel to accommodate all of us but I requested a departure from the usual protocol. I remembered that my Greek patient Ari, short for Aristotle and his Tanzanian wife Melina owned a hotel by the sea in Bagamoyo and had left a standing invitation for Marie and me to stay there whenever we had an occasion to visit Bagamoyo.

The invitation came about because a few years back, Ari had come to see me for an unusual surgical problem. “You operated successfully on a friend’s sister for cancer of her breast and they gave me your name.” As I was contemplating on the power of the word of mouth, in contrast to a referral, he recounted his story. “A few months ago, I noticed a swelling on my left testis and saw my doctor in Bagamoyo.”

“And what did he say?” I asked.

“He didn’t say much but I could see from his face that he was not very happy and asked me to see a surgeon at the Muhimbili Hospital in Dar,” replied Ari. “My wife Melina and I rushed to Dar and saw a surgeon, who said that I had cancer of my testis and it should be removed. That is when we started making inquiries and your name was mentioned by this family friend.”

I took a full medical history and it was in the family history that Ari disclosed. “As you can guess from my name, my family came here from Greece. My father was the manager of a sisal farm owned by Karimjees in Tanga and I went to school there. I was determined to follow in my father’s footsteps and manage the estates but Umoja put an end to that plan. The Tanzania government nationalised farms and properties and took them over without paying any compensation. I went to Switzerland to study hotel management and took a job in a hotel in Arusha.”

Suddenly Ari asked. “Am I boring you with all these details?”

“On the contrary,” I replied. “I was here when it all happened and it is interesting now to hear a first-hand account from a victim and realise the damage it caused to individuals and families.”   

“While in Arusha, I met a Chuka girl, fell in love with her and married her. I renamed her Melina after the beautiful Greek actress who sang the naughty song, Never on a Sunday,” Ari continued and looking at me with an unsure glance added.

“As you probably know, the Chukas of Tanzania are like the Kikuyus of your country. She hailed from a very rich family from the Kilimanjaro region. So when we heard of a five acre beach plot by the sea in Bagamoyo with an old settler house on it for sale, we bought it with her money. In time we moved there and developed it into a hotel and serviced apartments.”

At the end of an interesting history, I examined Ari. “I am afraid, your doctor in Bagamoyo and the surgeon at Muhimbili are right.”

As I saw the smile on Ari’s handsome face vanish, I added. “I will do an ultrasound, a needle biopsy and hormonal check and if they confirm my clinical diagnosis, which I think they will, I will remove your testis.”

HIS POTENCY

Not surprisingly, Ari’s next question focussed on the consequences of an orchidectomy. “After your surgery will I able to per .....?” his voice trailed off.

“Indeed, you will be able to perform,” I completed his question and allayed his fears.

“Nature is very understanding and most of our vital organs are paired so that if we lose one, the remaining one can carry out the essential function.”

“Melina and I have a daughter of seven and we were thinking of trying for a son when this calamity struck,” Ari explained.

“You need not worry on that score,” I assured him.

All went well in connection with Ari’s surgery. Melina flew in to be with him during his operation period and they flew home together. Just before they left, Ari came for his final check-up. “You will need six courses of chemotherapy, which Dr Abedi can give you in Dar. I know him and have made a report for him and your doctor in Bagamoyo,” I said.

“I don’t know how to thank you,” Ari said with a gurgle in his throat.

Melina put it in more tangible terms. “Come and stay in our hotel in Bagamoyo whenever you have an occasion to visit our town.” Looking at Marie’s photo on my desk and knowing what would turn me on, she added. “It’s a romantic place and you can have a second honeymoon.”

During the council meeting, my days were full so at the request of Ari and Melina we extended our stay by one day and the tour was scheduled for that day. That night they invited us for dinner to their house on the hotel compound.

They also invited Dr Abedi, the chemotherapist who had given Ari his chemotherapy courses. He drove from Dar and arrangements were made by our hosts for him to stay in the hotel for the night in case he did not feel like driving back to Dar late after dinner.

The evening was delightful. The menu was all Greek, comprising of their famous salad containing feta cheese, black and green olives and humus, moussaka and ouzo wine.

After a delectable meal, we were relaxing on the balcony facing the sea. It had been a hot day but now the cool sea breeze and the fragrance from the flowers in the garden were balmy.

As I was enjoying the evening, Ari came close to my easy chair and whispered in my ear. “In anticipation of your visit I went to Dar and got my hormonal assay done. May I show it to you?” he asked.

Taking the hint, I said. “Let’s go inside so that I can check you up also.”

As we walked to his bedroom, I read his hormone report, which was satisfactory. I asked him to undress and stand so that I could see his scrotum, which was empty on the left side. I felt it and found no signs of local recurrence. I asked him to lie down and checked both his groins for presence of any glands. I felt his liver and abdomen for any masses and finding nothing abnormal anywhere said to him. ”I think you can consider yourself cured.”

As we were leaving the bedroom to go back to the balcony, I heard an infant’s cry coming from an adjacent bedroom. As I saw him going back, Ari beckoned me to follow him and I found myself in a nursery all decorated in blue. “As we say in my language, the proof of the pudding is in the eating,” Ari said. “So as soon as my chemotherapy was over, Melina and I started trying for our second child and he did not keep us waiting for long.”

“So as I promised, you preserved your potency and fertility after orchidectomy.” I reminded him of his fears and my assurance. We were in the balcony, within the hearing range of Marie and Melina when Ari replied. “Yes my toto proves my fertility and Melina can endorse my potency!”