SURGEON'S DIARY: Witchcraft, prayers or science: What made Wambui conceive?

Though I surgically manage only the male component of an infertile couple, I make a point of seeing both husband and wife at the first consultation because sometimes revealing details come from both the spouses. I followed the same pattern with Wambui and Maina, who were referred to me by my gynaecological colleague, Dr Ruth Ogada, who gave me some background information.

“They have been married for three years and have been trying since. I told them not to worry when they came to see me after the first year because Wambui had got off the pill when she got married and the ovaries take a little time to recover,” she explained.

“You mean that she was on the pill before she was married?” the conservative and old fashioned inside me screamed.

“Of course,” replied Dr Ogada, “Life is not the same as perhaps it was in your time. Girls nowadays go on the pill as soon as they reach the age of 14 or puberty, whichever comes first.”

She took a brief pause and added the wish of all gynaecologists: “It is better that way than a young girl undergoing an abortion. That’s why we are in favour of early sex education.”

She then descended from her soap-box and concluded: “I would like you to check the husband before I start on the wife.”

So when Wambui and Maina came to see me, I was adequately briefed, which saved me asking a lot of questions. I started with “Any childlessness in the family?”

“None,” they both replied.

“We are five siblings, three sisters and two brothers,” Wambui added. “Three of them married with children.”

I looked at Maina and he took the cue. “Same,” he said. “Two of my siblings are married and have children.”

I asked the couple more questions, some of intimate nature, which they replied candidly and then I said to Maina: “Hop on the couch please and let me examine you.” The Beijing Olympics were on and I was in a sporting mood! As I expected from the history, I did not find anything abnormal. Maina’s external genitalia looked normal and both his testes were of normal size and consistency. I ordered a semen analysis to complete my investigations and that too came normal. It said:

Quantity: 3cms.

Sperm population: Hundred million per C.C.

Motility: Good

Hardly any deformed or defective sperms.

I showed the report to Wambui and Maina and sent a copy to Dr Ogada.

A month later, I met her in the hospital corridor, a popular place where consultants exchange information about their patients. “Incidentally, nothing abnormal was found on Wambui despite the exhaustive investigations I ran on her.”

“So what’s wrong?” I asked.

“We call it ‘Biochemical Incompatibility’,” replied Dr Ogada. “The chauvinists amongst us call the condition, ‘Hostile Uterus’ and blame the woman. We just tell the couple to plod on and some women conceive after a variable time.”

After a thoughtful pause, she added: “I wonder if you can talk to the couple and give them some tips.”

“What makes you think that I am an expert in the matter?” I asked teasingly.

“It’s not that. You will be amazed at how ignorant couples are on matters that promote fertility. Maina is a very shy man and will be highly embarrassed if I conveyed these intimate technical details. Coming from another man, he will be more comfortable,” Dr Ogada said.

I saw the couple again and explained the time in the menstrual cycle that a woman’s fertility is at its highest, the best position in which she is more likely to conceive and the need for her to remain recumbent after the act is over. My entry into their intimate life broke the ice and they often saw me, not in my professional capacity, but sometimes to moan about the adverse consequences of infertility in our society. For example, two years later, when they came to see me, Wambui lamented: “In our culture, the woman is blamed if the couple has no children, and Maina’s mother and sister are making the most of it. I know that they have urged him to take another wife.”

“They can say what they like; after all there is freedom of speech in our country but I am not doing it because I too enjoy freedom of action in my private life,” Maina retorted.

“I think another wife is out of the question because I am not having a co-wife but I can understand your mum’s desire to be a grandma and your urge to have a son to carry your name and legacy,” Wambui stated her position. “I am happy to give you a divorce and walk out of your life so that you can get on without me inhibiting you and raise a family with another woman.”

“Do you realise what you are saying?” asked Maina in a rage, “I think you are losing your head. I don’t want a divorce. I want you, child or no child. I am not the Shah of Iran, hankering after an heir to the Peacock throne,” he added when his anger subsided. In a persuasive tone, he concluded: “There are also alternatives. We can adopt or go for IVF, In Vitro Fertilisation. I have read a lot about IVF.”

“I want my flesh and blood, so adoption is out,” Wambui flashed the urge of every married woman. “As for IVF, I talked to Dr Ogada about it. She explained that if my uterus is not receptive to my husband’s sperm, we can try the sperm of a donor and sometimes it works. I told her that I don’t want ‘my child’. I want ‘our child’.”

BROUGHT A TRUCE

“I am sorry,” I intervened to close the couple’s argument and addressed Wambui. “In my view you are not thinking straight. Last time I met Dr Ogada, she told me that she has put you on hormones to flog your fertility and it could be their side-effect.” This brought about a truce and they went home happily.

Then a few months later, something magical happened. The surgeon preceding me encountered unexpected problems in the operating theatre and my case which was scheduled to follow him was delayed. So my anaesthetist and I went to the Doctors’ Lounge, strategically located next to the theatre, and waited there. While we were having a cup of coffee, in walked Dr Ogada and said, looking at me, “Good! Saves me a phone call. I wanted to ring you and give you the good news about Wambui and Maina. At last Wambui is pregnant.”

As I was waiting for further details to quell my curiosity, the phone rang and my anaesthetist, sitting next to it, picked it up. When she finished, she said: “The theatre is ready and since they are running on a tight schedule, they would like us to go there immediately.”

We rushed out without hearing Dr Ogada, my surgical and social suspense rising. Luckily for me, Wambui and Maina were sitting in my waiting room when I went to my office after surgery. As my secretary ran after me in my consulting room to explain the couple’s unexpected arrival, I said: “I know. Please fit them in.”

Wambui and Maina were beaming when they entered my office. “Dr Ogada gave me the good news,” I said excitedly. “How did it happen?”

WITCH DOCTOR

“Happened the usual way!” Wambui replied frivolously. “Seriously speaking, we went to a witchdoctor in Naivasha, about whom we had heard from our friends. He used bones, zebra skin, feathers and ash to bless me with strong smelling incense and gave me herbal medicine to take a pinch every day with goat’s milk. On the way back, Maina decided to take the old scenic road on the edge of the escarpment.” As Maina shifted in his chair, she continued: “We stopped at the chapel built by Italian prisoners of war and I gave God an ultimatum. I said to Him that if He wished to retain a devoted Christian in the fold, He should make it possible for me to conceive soon.”

As I was unashamedly staring at the intrepid lady, she went on: “Three months after, I missed my period and rushed to Dr Ogada. She ordered a pregnancy test and an ultrasound and both came positive.”

Various theories have been put forward why Wambui conceived after a wait of almost 10 years. The herbalist has already added Wambui and Maina to his list of success stories and is making a fortune out of it. Recently, I understand that he offers a pinch of herbs as a substitute for Viagra and there is a queue of men extending from his hut by the side of the lake all the way to Nairobi! Wambui attributes it to the frank conversation with her God, especially the threat she made. Dr Ogada is more scientific and has my vote as well. “These biochemical incompatibilities sometimes disappear and I have some surprising cases who haven’t visited a herbalist or visited the tiny chapel on the escarpment, facing the Rift Valley.”

These are all academic wanderings of us scientists. What would interest my readers is the fact that Wambui delivered a healthy son after a normal labour. She is still on a pinch of herbs every morning because she wants another baby. Maina tells me that he joins his wife every morning and takes a teaspoon of herbs after he heard of the Viagra theory. “Do you want to become pregnant as well?” I asked to make him laugh.

“No,” he replied. “I need it to fulfil the demands Wambui makes on me in view of her desire to have a companion for our only child!”