Senje
The sick are entitled to sanctioned deviance. The way I understood this, was that the sick are allowed to do and feel what they want, like Americans, last born children and creatives. This was my coarse interpretation of what Talcott Parsons theorized in 1951 as the ‘sick role’. Stay with me here, you’ll like how this paragraph ends. Your employer might not. The ‘sick role’ defines 2 rights and 2 obligations for anyone who is sick. They are obligated to do everything within their control to get well and secondly , to seek technically competent help. They have the right to not be responsible for their illness and the right to be exempted from normal social responsibilities. The latter is why deep down in the bowels HR manuals it is nuanced that if you are well enough to come to work, you aren’t sick. A lot has obviously changed since 1951, but to simplify this, if you are sick, be sick and stay away from work.
Olivia didn’t work, so the exemptions didn’t apply and despite being 4 weeks late, she was doing everything she could to get better by seeking technically competent help. She hobbled into the consultation room, hunched over, carrying two translucent cylindrical bottles that looked like the bellows of an accordion connected to transparent tubings that disappeared under her tie and dye dira. She groaned and sneered as she walked in, alternating between kissing her teeth and patting her itchy weave. She was accompanied by her ‘friend’ Tobias, a tall athletic gym instructor who walked on his tippy toes and had on one of those noisy tracksuits that whistled whenever he moved a limb. He’d tucked her handbag under his right armpit, and in his left hand, he’d palmed four mobile phones, a half naked USB cable and a powerbank.
Tobias had been in the friend-zone so long, he’d probably picketed the lawn himself. Now, I didn’t immediately assume this, Olivia told me later. He was also clueless as to her true sexual orientation. ‘Weh, doc, such revelations are not good for African men. It would destroy him.’ Besides, he was loyal, and more importantly it was in her best interest to keep him around for times like today.
Olivia’s partner, Elaine, was rich. With a name like that, you’d have to be. She’d made a killing trading in cryptocurrencies and used the money to setup a chain of car dealerships littered around town, her investment portfolio also included some decent suburban real estate properties and of course a small hotel on the way to somewhere, in the middle of nowhere. At least, that’s what she’d been told. They’d been together and not together for the past 1, maybe 5 years (if you’ve dated in Nairobi, you know what I mean). Olivia, had been in and out of hospital a lot, but never once with Elaine.
The sick role manifests differently depending on who’s in the room, especially the right to not be responsible for the illness; because if i’m not responsible for it? who is? and this generally tends to get deflected onto the caregiver, in this case, Tobias. She loved the caring and attentive blanket Tobias provided, perhaps a projection of what Elaine, her true love, couldn’t provide. She groaned and winged the entire consultation as Tobias pet her forehead and told her ‘everything will be ok mum.’ every so often. I wasn’t quite sure myself if I’m being all the way honest.
Olivia was a very naughty patient. She had a penchant for defiance. A month ago, she’d convinced Elaine to fly her to Brazil for a solo vacation. Only it wasn’t. She’d gone to get cosmetic surgery; A tummy tuck and breast lift, or what we call the mummy makeover. She’d gone to Brazil because she had no idea Kenya had Plastic Surgeons, and it was cheaper than the UK & USA, and sounded a little more adventurous than India.
We broadly divide surgery into 3 parts. Pre-op; the stuff that happens before surgery, intra-op; the period of the actual operation itself, and post-op; the stuff that happens on the days after your surgery.
Olivia had cruised through the first two, it’s the post-op she couldn’t stand. The gratification comes late in cosmetic surgery, if you’re not patient, you’ll initially hate it. She loved comfort, and post-op is anything but. She had surgical drains sticking out of her lower abdomen, and everything ached. The food was either too salty or too bland and the water tasted like used pillows. Her Brazilian Plastic Surgeon was fantastic though, cute too; geometric chin, oily hair and a shy beard stubble. His broken English was adorable too. He was patient with her, he had to be, but Olivia was losing her mind in hospital. She chose to escape from hospital after his morning ward round, out of respect. 11am-12pm was the best time, during visiting hours, it was a large busy hospital, so the bustle of visiting hours provided deep cover for her escape, and escape she did.
Elaine had left her with no choice. The day before, Elaine had found out why Olivia was really going to Brazil, so she’d blocked her credit and debit card in a vengeful rage leaving Olivia with a 10,000 dollar bill. Elaine had stumbled upon her search history and perused the open tabs on her laptop that showed the trail of her planned medical holiday. Tobias, Elaine’s gym instructor as well, had corroborated the story in between Russian leg curl sets, because of course Olivia tells him everything.
Honestly, Olivia had meant for it to be a surprise, she just knew Elaine wouldn’t agree to it if she’d been forthright. Fortunately, she’d booked a return ticket, so she hopped on the next plane out of Rio.
Tobias picked her up from the airport and drove her home. She didn’t live with Elaine, they’d talked about it many times, and fought about it just as often. Elaine preferred to ‘limit exposure’, and Olivia lived her entire life fast paced and in high definition. This time round the separate living arrangements were probably a good idea. Elaine still wasn’t picking up her calls or replying her messages. This had always been her fight persona, Olivia was sure she’d simmer down after a day or two…she did.
I politely asked Tobias to leave the room so I could take a look at what was causing Olivia so much anguish. From the story she’d narrated and the fact that it had been 4 weeks since she last saw her doctor, I was concerned by what I thought I’d find. She lifted her dira up slowly as I mumbled under my breath for God to spare this woman from sepsis and wound dehiscence. What I saw took that very breath away…
The result was fantastic. If her torso were a stage, her breasts were confidently perked up on it, preaching, giving an eloquent masterclass on symmetry and proportion. Her cleavage lines transitioned precisely across the mid-line expertly choreographed by just the right amount of medial fullness in both breast. The lower pole vertical incision lines were neat, with not a single crease visible to the naked eye. Her flank lines trickled down smoothly on their way to snatching her waist with such guile and gentle authority. True craftsmanship. Her bicycle handlebar incision lay completely concealed under her bikini line; a textbook tummy tuck. I was impressed. She did however, have a significant amount of bruising evidenced by patches of purple spread unevenly across her abdomen. She also had quite a bit of tenderness along the bruised areas.
My immediate concerns were her drains. Typically, after a tummy tuck, or various other surgeries, we leave in surgical drains. Reason being, one of the most common sequelae of this operation is collection of haematoma or seroma; blood and fluid, to keep it simple. Completely normal and expected. These fluids need a way to get out, and that’s why we leave in drains. Here’s the thing; we leave them in as long as they’re carrying out their function which is usually, in my experience, around 3–5days or until you have less than 50cc’s draining. If you keep them in too long, you’re a sitting duck for infection. If you remove the drains to early or when you’re still draining a lot, then it can significantly affect the results of your operation.
Olivia had had her drains in for 4 weeks by the time she’d been referred to me, and she was draining in excess of 200cc’s daily. I’d never faced this kind of dilemma before. If I removed the drains, she’d continue to collect, if I didn’t and infection was inevitable. I explained to her the situation. Rash decisions have no place in surgery, the responsible thing to do would be to buy time and consult widely, there’s always someone who’s been in a similar situation and I explained to her as much. I prescribed some anti-inflammatories and a prophylactic antibiotic and retreated to my professional circles to debate.
Olivia had come to me, nervous and frightened because she’d neglected her health for 4 weeks. She also felt guilty for having absconded the Hospital in Rio. She now felt relieved, comforted and safe. I thought this was a good thing until I realized that my reassurances had only served to embolden her stubborn super-ego and whimsical id.
As she got up to leave, she looked me dead in the eye, pat her weave and asked ‘So doc, how soon can we do a boob job?Next month?’, it wasn’t the fact that she want a breast augmentation; it’s perfectly normal to have a breast augmentation after a breast lift, it was the timing of it all. Tobias was back in the room at this point, causing a racket with his whistling tracksuit as he gathered all her belongings, I could hear him grunt in disapproval.
In 1837, Charles Dickens wrote a series of Novels about an Orphan called Oliver Twist. The similarities in name between this Charles Dickens’ protagonist and mine were purely coincidental. The thing that brought me back to this novel was a scene in chapter two of the novel that sprung to memory. To summarize, Oliver and the rest of the parish boys were being starved by the rations of porridge they were getting at the home. So much so, one of the boys suggests his next act would be one of cannibalism if he doesn’t get an extra ration of porridge. Not taking his threats lightly, the boys cast lots as to who is to ask the chef for an extra serving the next day. Oliver drew the short straw. The following day, under a lot of pressure, he bit up the nerve to ask for more, an act that was so shockingly absurd, it got him kicked out and sold for 5 pounds.
I never saw Olivia again. She did text me 3 days later from a +33 number saying she’d decided to yank the drains out herself and that she was ready for her boob job. I think about Olivia a lot, I’m not quite sure whether what she wanted was more surgery or more love? or whether they both meant the same thing to her? or if sanctioned deviance was the only way she how to get loved. It’s none of my business, but I hope she’s fine wherever she is, shaking what her doctor gave her.
