MEDICAL MATTERS
SHE HAD the information now. She had a map to find a murderer, and she would find him. But there was still the detective agency to run, and cases which needed to be dealt with—including a case which involved a very different sort of doctor, and a hospital.
Mma Ramotswe had no stomach for hospitals; she disliked the smell of them; she shuddered at the sight of the patients sitting on benches in the sun, silenced by their suffering; she was frankly depressed by the pink day-pyjamas they gave to those who had come with TB. Hospitals were to her a memento mori in bricks and mortar; an awful reminder of the inevitable end that was coming to all of us but which she felt was best ignored while one got on with the business of life.
Doctors were another matter altogether, and Mma Ramotswe had always been impressed by them. She admired, in particular, their sense of the confidential and she took comfort in the fact that you could tell a doctor something and, like a priest, he would carry your secret to the grave. You never found this amongst lawyers, who were boastful people, on the whole, always prepared to tell a story at the expense of a client, and, when one came to think of it, some accountants were just as indiscreet in discussing who earned what. As far as doctors were concerned, though, you might try as hard as you might to get information out of them, but they were inevitably tight-lipped.
Which was as it should be, thought Mma Ramotswe. I should not like anybody else to know about my … What had she to be embarrassed about? She thought hard. Her weight was hardly a confidential matter, and anyway, she was proud of being a traditionally built African lady, unlike these terrible, stick-like creatures one saw in the advertisements. Then there were her corns—well, those were more or less on public display when she wore her sandals. Really, there was nothing that she felt she had to hide.
Now constipation was quite a different matter. It would be dreadful for the whole world to know about troubles of that nature. She felt terribly sorry for people who suffered from constipation, and she knew that there were many who did. There were probably enough of them to form a political party—with a chance of government perhaps—but what would such a party do if it was in power? Nothing, she imagined. It would try to pass legislation, but would fail.
She stopped her reverie, and turned to the business in hand. Her old friend, Dr Maketsi, had telephoned her from the hospital and asked if he could call in at her office on his way home that evening. She readily agreed; she and Dr Maketsi were both from Mochudi, and although he was ten years her senior she felt extremely close to him. So she cancelled her hair-braiding appointment in town and stayed at her desk, catching up on some tedious paperwork until Dr Maketsi’s familiar voice called out: Ko! Ko! and he came into the office.
They exchanged family gossip for a while, drinking bush tea and reflecting on how Mochudi had changed since their day. She asked after Dr Maketsi’s aunt, a retired teacher to whom half the village still turned for advice. She had not run out of steam, he said, and was now being pressed to stand for Parliament, which she might yet do.
“We need more women in public life,” said Dr Maketsi. “They are very practical people, women. Unlike us men.”
Mma Ramotswe was quick to agree. “If more women were in power, they wouldn’t let wars break out,” she said. “Women can’t be bothered with all this fighting. We see war for what it is—a matter of broken bodies and crying mothers.”
Dr Maketsi thought for a moment. He was thinking of Mrs Ghandi, who had a war, and Mrs Golda Meir, who also had a war, and then there was …
“Most of the time,” he conceded. “Women are gentle most of the time, but they can be tough when they need to be.”
Dr Maketsi was eager to change the subject now, as he feared that Mma Ramotswe might go on to ask him whether he could cook, and he did not want a repetition of the conversation he had had with a young woman who had returned from a year in the United States. She had said to him, challengingly, as if the difference in their ages were of no consequence: “If you eat, you should cook. It’s as simple as that.” These ideas came from America and may be all very well in theory, but had they made the Americans any happier? Surely there had to be some limits to all this progress, all this unsettling change. He had heard recently of men who were obliged by their wives to change the nappies of their babies. He shuddered at the thought; Africa was not ready for that, he reflected. There were some aspects of the old arrangements in Africa which were very appropriate and comfortable—if you were a man, which of course Dr Maketsi was.
“But these are big issues,” he said jovially. “Talking about pumpkins doesn’t make them grow.” His mother-in-law said this frequently, and although he disagreed with almost everything she said, he found himself echoing her words only too often.
Mma Ramotswe laughed. “Why have you come to see me?” she said. “Do you want me to find you a new wife, maybe?”
Dr Maketsi clicked his tongue in mock disapproval. “I have come about a real problem,” he said. “Not just about a little question of wives.”
Mma Ramotswe listened as the doctor explained just how delicate his problem was and she assured him that she, like him, believed in confidentiality.
“Not even my secretary will get to hear what you tell me,” she said.
“Good,” said Dr Maketsi. “Because if I am wrong about this, and if anybody hears about it, I shall be very seriously embarrassed—as will the whole hospital. I don’t want the Minister coming looking for me.”
“I understand,” said Mma Ramotswe. Her curiosity was thoroughly aroused now, and she was anxious to hear what juicy matter was troubling her friend. She had been burdened with several rather mundane cases recently, including a very demeaning one which involved tracing a rich man’s dog. A dog! The only lady detective in the country should not have to stoop to such depths and indeed Mma Ramotswe would not have done so, had it not been for the fact that she needed the fee. The little white van had developed an ominous rattle in the engine and Mr J.L.B. Matekoni, called upon to consider the problem, had gently broken the news to her that it needed expensive repairs. And what a terrible, malodorous dog it had turned out to be; when she eventually found the animal being dragged along on a string by the group of urchins which had stolen it, the dog had rewarded its liberator with a bite on the ankle.
“I am worried about one of our young doctors,” said Dr Maketsi. “He is called Dr Komoti. He’s Nigerian.”
“I see.”
“I know that some people are suspicious of Nigerians,” said Dr Maketsi.
“I believe that there are some people like that,” said Mma Ramotswe, catching the doctor’s eye and then looking away again quickly, almost guiltily.
Dr Maketsi drank the last of his bush tea and replaced his mug on the table.
“Let me tell you about our Dr Komoti,” he said. “Starting from the time he first turned up for interview. It was my job to interview him, in fact, although I must admit that it was rather a formality. We were desperately short of people at the time and needed somebody who would be able to lend a hand in casualty. We can’t really be too choosy, you know. Anyway, he seemed to have a reasonable C.V. and he had brought several references with him. He had been working in Nairobi for a few years, and so I telephoned the hospital he was at and they confirmed that he was perfectly all right. So I took him on.
“He started about six months ago. He was pretty busy in casualty. You probably know what it’s like in there. Road accidents, fights, the usual Friday evening business. Of course a lot of the work is just cleaning up, stopping the bleeding, the occasional resuscitation—that sort of thing.
“Everything seemed to be going well, but after Dr Komoti had been there about three weeks the consultant in charge had a word with me. He said that he thought that the new doctor was a bit rusty and that some of the things he did seemed a bit surprising. For example, he had sewed several wounds up quite badly and the stitching had to be redone.
“But sometimes he was really quite good. For example, a couple of weeks ago we had a woman coming in with a tension pneumothorax. That’s a pretty serious matter. Air gets into the space round the lungs and makes the lung collapse, like a popped balloon. If this happens, you have to drain the air out as quickly as you can so that the lung can expand again.
“This is quite a tricky job for an inexperienced doctor. You’ve got to know where to put in the drain. If you get it wrong you could even puncture the heart or do all sorts of other damage. If you don’t do it quickly, the patient can die. I almost lost somebody myself with one of these a few years ago. I got quite a fright over it.
“Dr Komoti turned out to be pretty good at this, and he undoubtedly saved this woman’s life. The consultant turned up towards the end of the procedure and he let him finish it. He was impressed, and mentioned it to me. But at the same time, this is the same doctor who had failed to spot an obvious case of enlarged spleen the day before.”
“He’s inconsistent?” said Mma Ramotswe.
“Exactly,” said Dr Maketsi. “One day he’ll be fine, but the next day he’ll come close to killing some unfortunate patient.”
Mma Ramotswe thought for a moment, remembering a news item in The Star. “I was reading the other day about a bogus surgeon in Johannesburg,” she said. “He practised for almost ten years and nobody knew that he had no qualifications. Then somebody spotted something by chance and they exposed him.”
“It’s extraordinary,” said Dr Maketsi. “These cases crop up from time to time. And these people often get away with it for a long time—for years sometimes.”
“Did you check up on his qualifications?” asked Mma Ramotswe. “It’s easy enough to forge documents these days with photocopiers and laser printers—anybody can do it. Maybe he’s not a doctor at all. He could have been a hospital porter or something like that.”
Dr Maketsi shook his head. “We went through all that,” he said. “We checked with his Medical School in Nigeria—that was a battle, I can tell you—and we also checked with the General Medical Council in Britain, where he did a registrar’s job for two years. We even obtained a photograph from Nairobi, and it’s the same man. So I’m pretty sure that he’s exactly who he says he is.”
“Couldn’t you just test him?” asked Mma Ramotswe. “Couldn’t you try to find out how much he knows about medicine by just asking him some tricky questions?”
Dr Maketsi smiled. “I’ve done that already. I’ve taken the opportunity to speak to him about one or two difficult cases. On the first occasion he coped quite well, and he gave a fairly good answer. He clearly knew what he was talking about. But on the second occasion, he seemed evasive. He said that he wanted to think about it. This annoyed me, and so I mentioned something about the case we had discussed before. This took him off his guard, and he just mumbled something inconsequential. It was as if he had forgotten what he’d said to me three days before.”
