Having sown enough wild oats, I’m ready to be caged

One advantage of a long surgical practice like mine is that we have an opportunity to operate on successive generation of patients in the same family. One such patient of mine was William Kuria, on whom I operated once and his son, Eliud, who went under my scalpel twice.

When Kuria came to see me for the first time, his swanky mode of dressing reminded me of the late Dr Hastings Banda, the self-proclaimed life President of Malawi. He wore a trilby hat, at a rakish angle. He had a three piece striped suit on, which covered a chequed shirt and a white detached collar. A gold stud was visible under the narrow knot of his sober tie.

In the right pocket of his waistcoat was the traditional gold watch with a chain and jutting out of the left breast pocket of his jacket was a handkerchief which matched his tie. His black brogue shoes were brightly polished and he was clean shaven and it was so close that I suspected that he had used a cut-throat razor. As soon as he was ushered into my office, his first remark was. “Gosh, you are a busy surgeon and I had to wait a long time before my turn came, in spite of a prior appointment.”

“A surgeon’s time is not his own and emergencies sometimes hold him up,” I explained. “But never mind because once you are in, I give you all the time and never rush you out. My consultation fees don’t go up with the time you spend with me.” After these opening remarks, I took his history and examined him and found that he had come to see me for piles.

“I know that piles operation is very painful, but talking to patients operated by you, I discovered that they suffered no pain,” Kuria said. “How do you achieve that miracle?”

“It is no miracle,” I replied. “Early in my training period, I worked with a surgeon who did not want his patients to suffer from any post-operative pain.

“He devised an oily solution of local anaesthesia, which he injected under the skin of the region he operated upon. Because of the oily solution, the effects of the local anaesthetic lasted for almost two days when the pain was severe.”

 As I saw Kuria listening to me carefully, I added. “Of course now we have many better pain-killers and less painful techniques of surgery on piles, so the question of pain in that delicate region shouldn’t bother you at all.”

PAINLESS SURGERY

My surgery on my patients’ piles kept to its promise of being painless and Kuria was very impressed, so much so that a couple of years later he called for an encore on his young son. This time he came with his wife and son. To put the toto at ease, I asked him. “How old are you son?”

“Twelve.” He replied.

“And what’s your name?”

“Eliud.”

“He is ready to be initiated,” said Kuria. “And I want to do it the modern way. But I also want to maintain our cultural traditions.” As I was wondering how he was going to do it, he elaborated. “I would like you to  circumcise him in a sterile theatre in a modern hospital but, at the same time, I intend to carry out our tribal rites and celebrations on our farm in Kikuyu. What do you think?”    

“Brilliant idea!” I remarked. “Though we need to abandon harmful customs from our rich culture, we don’t need to throw the baby out with the bath water. That way we can have the best of both worlds.”

As a result Eliud’s ritual circumcision was carried out at two levels; the surgical part was conducted in the hospital where I was the main actor and the traditional feasting was scheduled at the farm where I was the most impressed spectator.

Fast forward 25 years, not too long in a surgical practice which spanned over half a century. One morning, I saw the name Eliud Kuria on my list of new patients. Not recognising the name after so many years, I asked my secretary. “Which doctor has referred him and for what?”

“He tells me that he is an old patient of ours but he is coming for a new problem,” replied Regina.

“Have we his old file?” I asked.

“I can’t find it so I asked him and he says it was 25 years ago,” Regina explained. “When he comes, I will get some more details from him and am sure I will find it.” And she did.

Njuguna’s entry into my office was a breath of fresh air and also a bit of an anti-climax, considering that he was William Kuria’s son. He was dressed in jeans, T-shirt and running shoes. He seemed unpretentious and candid. “What sort of surgery did I do on you all those years ago?” I asked him after exchanging the usual greetings.

“Doc,” he replied. “Twenty-five years ago, you initiated me into manhood and I must admit that I put my new faculty to full use. In fact, it has been functioning full-blast since.” As I looked at him with amusement, he continued. “I have utilised all my abilities as soon as I acquired them and this was no exception. For example, when I could sit up, I sat, when I could articulate my speech, I talked and when my feet were able to propel me,

I walked. In the same way, once you made me a man with your magical scalpel and as soon I was able, I used my skill to the maximum.” His charming smile never left his face as he went on. “I see that with that operation you have minimised my risk of getting HIV and cancer penis.”

He was obviously well informed. “Having sown enough wild oats, I am ready to be tamed and caged,” he concluded.

STOP THE RACKET

“So you plan to lead a celibate life and go into a monastery!” I remarked.   

“Nothing as drastic as that,” Eliud replied. “I have come to ask you for a big favour. Since you were instrumental in starting the racket, I want you to stop it as well.”

“What do you mean?” I asked, ignoring his brashness.

“I want to undergo vasectomy,” Eliud quietly slipped in his request.

“But you haven’t sired any children to require permanent sterilisation,” I objected.

“Not officially but we won’t go into that,” Eliud replied. “The woman who has won my heart and who I want to marry has a serious genetic problem and we are likely to produce defective children.”

“What is the problem and how does she know?” I was intrigued.

“The matter is too complicated for my simple mind to comprehend,” he replied and then asked. “May I send her to you? I am sure she can explain it better.”

As he prepared to leave, I asked. “How are your parents?”

“Fine, but they are getting on,” Eliud replied. “They have moved to the farm.”

A few days later, Rhoda came to see me. Not having met me before, she seemed uneasy. So I put her at ease and asked. “Eliud tells me that you have a genetic problem. What is it?”

“Yes I am a carrier of haemophilia genes and have been told that all my sons will suffer from a bleeding diathesis,” she replied.

Impressed by her clarity of thought, I asked “How did you find out?”

There was initial hesitation but eventually Rhoda relented. “I was studying law in Florida and fell pregnant with an American white.

“Of course, he took flight when I informed him. So I was planning an abortion and, in the process, met a fine gynaecologist. She told me that she had on her waiting list an Afro-American couple wanting to adopt a ‘mixed’ child. If I carried my baby full-term and legally committed to give it to them for adoption, they would pay for my antenatal care, delivery and going away expenses when my pregnancy could not be concealed.” Listening to her, I wondered what her decision was, when she added.

“I jumped at the idea because I wanted to save my baby’s life. After all it was not his fault that I was a victim of an unplanned pregnancy.” As a gurgle rose in my throat, Rhoda went on: “When my baby was born, being a boy, his adoptive parents decided to have him circumcised in the hospital, where I had my confinement.

We almost lost him because of his incessant bleeding.” Wiping a tear from her eye, she continued: “That is when the neonatologist diagnosed him as being haemophilic.” She was referring to a specialist for newborn babies. “He organised blood transfusion with fresh blood containing coagulation factors missing from my son’s blood.”

I offered her some water to drink to comfort her. She took a few sips and concluded. “They counselled me and informed me that I was a carrier and all my sons would suffer from haemophilia. When I met Eliud in the law school in New York where I went to do my master’s degree, we fell in love and when we both returned home, he proposed to me.

Before accepting his proposal, I related my saga and he said he wasn’t interested in having children and was not keen on contraception either for him or me.” With a sigh of relief, she added: “So there you are. You have our complete brief.”

“And what an incredible brief!” I exclaimed.

So after consulting two surgeons of my vintage, because of the uniqueness of their request, I carried out a vasa ligation on my favourite young man. He is the only one in this special category in my archives!