Unapproved drug that saved my son in his hour of need

Jan was named after my eldest brother, Janmohamed, who was like a father figure and a mentor to me. We shortened his name to Jan and in the process anglicised it as well.

His birth was very nostalgic because precisely 19 years ago exactly on the same date, I had lost my father.

As usual, Jan was examined at birth by a paediatrician, who certified him healthy. But a few days later after we took him home, he started crying incessantly while clutching his tummy, which to me indicated that he was getting colicky abdominal pains.

DEHYDRATED

Soon he started having copious diarrhoea and got severely dehydrated. We consulted Dr KC Patel and Dr Ibrahim, both paediatricians at the Aga Khan Hospital, and they decided to admit him.

They started a drip on him to overcome his dehydration and put him in an incubator because of his gross hypothermia.

His stool culture confirmed gastroenteritis, but the bugs were not sensitive to any antibiotic. He went quickly downhill and the incubator grew larger and Jan looked smaller by the hour.

I saw the lining of his intestine passing in his stool, making him a case of necrotising enteritis with a grave prognosis.

Marie and I made a schedule providing vigil over him during the day, and I slept in a room next to his cubicle, thus not disrupting my daily hospital commitments.

GREAT AFFECTION

Poor Jenny was left in the care of her Ayah, who was very attached to her and looked after her with great affection, which Jenny needed because she was bewildered at having a younger brother; who was suddenly snatched away from her, just about when she had learnt to hold him in her lap.

News of Jan’s illness spread among our friends and my patients, present and past. An Italian couple brought a miniature cross and a white rosary blessed by the Catholic priest and put it under Jan’s pillow.

A Bohra lady brought a glass plate, with verses from the Holy Koran inscribed on it in calligraphy in saffron ink, and placed it inside his incubator.

Mugambi from Karatina brought a witch doctor, who like a magic wand waved bones over Jan’s head and applied ash on his abdomen while uttering words of prayers in his Kikuyu dialect while standing besides Jan’s incubator.

With a flowing white beard and wearing a black turban, the pesh-imam of Jamia Mosque recited a surah from the Holy Koran in a tilting tune. He blew his blessings over Jan’s head while fragrant smoke from incense sticks wafted in the cubicle. Blessed water from Makindu Sikh temple was fetched “to cure him from his near fatal illness”.

BOUGHT FRUITS

An Ismaili lady brought fruits from her mukhi in her jamaat- khana. Bells were rung in Hindu temples and alms distributed to the poor to appease various idols. In happier times, I would have said that Jan enjoyed a comprehensive insurance, whichever religion was the right one!

The crisis point was reached one midnight when a staff-nurse, out of breath, rushed into my room and said.” Jan’s drip has stopped and I can’t feel his pulse.”

I rushed to Jan’s cubicle in my pyjamas, verified the nurse’s findings and shouted.”

Please get me a cut-down tray.” When it arrived, I opened it with clumsy, trembling hands, found a scalpel and made a cut above his left ankle without injecting a local anaesthetic. There was neither the time, nor the need — he was moribund and past feeling any pain.

I found a vein, collapsed and empty and made a slit in it; there was no blood. In fact, the whole procedure was dry and bloodless.

BEDROOM SLIPPERS

I inserted a fine polythene tube, connected it to a saline in dextrose bottle, which the nurse had brought to replace the stalled drip, and waited till it flowed freely into Jan’s vein. I sat in the Sister’s office to take stock of the situation and made a new plan.

The Night Sister had called Dr Patel, Dr Ibrahim, and Marie and I told them of my plan. “I intend to call two senior paediatrician colleagues, Patience Davies of Gertude’s Garden Hospital and Dr Khan at Kenyatta.”

Marie nodded her consent through her sobs and tears, and the two doctors said in unison. “Yes, that’s our only option.”

I rang the two paediatricians and they arrived in a few minutes — Dr Davies in her bedroom slippers and Dr Khan with stubble on his face.

They listened without interrupting me as I presented Jan’s case, examined him and perused his notes and reports. Dr Davies spoke first. “There is no doubt about the diagnosis. Our problem is to find an effective drug.”

Scratching his coarse stubble, Dr Khan said. “A medical rep detailed me last week on an antibiotic specifically for use against refractory gut infection. He claimed that it worked locally and it hits the bugs directly.”

I jumped up. “What’s the name of the drug?”

“Damn me. I can’t remember it.” Replied Dr Khan.

“Do you remember the name of the rep?” I asked.

SUCCESSFUL

“I think so,” he replied. Thumbing the telephone directory, he picked from the Sister’s desk. “He wants my help in getting the drug approved by the Ministry of Health. Since I am appointed to the Tender Board, I see the chap regularly.

His name is Karanja. Here is his private telephone number.” He added pointing it in the directory. He rang the number.

Within an hour, Karanja was in the Children’s ward with free samples of the drug, happy that his drug was to be used on a VIP patient and there were good prospects of being approved if proved successful.

It took three harrowing days before Jan turned the corner, causing jubilation among nurses, especially Sister Laporte, sister in charge from Jamaica, Jan’s family and our friends.

A week later, Jan was discharged. Karanja was also happy because the drug was approved by the ministry.