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A day in Block B

Block B is an apartment in Upper Hill that hosts male final-year medical students. It stands timidly amid tall cityscapes that define this part of the city in the sun. You can view the city from the rooftop, and Ngong road looks remarkably beautiful. The rooftop is a viewpoint and also the designated smoking area. Most of my classmates squeezed themselves there to inhale a blunt or two of ndom, away from the constraints of the library and the shame of the public eye.

Life in Block B starts at 6.55 am when we all scramble to the bathroom to get ready for the 7am class, Therapeutics, by the one and only pro who fesses knowledge, Prof Omonge. The don was known for his high-charge lectures. We usually complained with Ndonga that some of his classes were at 40000 amperes, too much for a junior doctor!

The bathroom would have a little commotion; Manu’s girl had just popped from the shower, and guys were not taking it easy. That single event would delay the whole ground floor to the morning class.

Ground floor people would cause chaos at 7.35am; in the lecture theatre, walking majestically, some to the right, some to the left but none to the middle. At that time, Prof Omonge would be midway through the antihypertensives lecture, stating significant minor differences that were more often forgotten than remembered.

“And these ones just want to be Medical Officers and stop there, you see; what’s the time?” Prof Omonge would say, whispering clearly over the microphone. Some mouthy guys from the back would not have captured anything from his classes without the microphone.

The wards and their daily routine would carry most of the day. We had a class at 1pm, and someone decided to put a class for finalists at 1pm! And they were given a seating allowance for that!

The next big wave of events that would storm block B would be at 6.00pm. Destination kwa Gatiba. Gatiba is a soft-spoken man; he has a kibandaski near the bridge along the road leading to KMTC headquarters. Everyone went for supper except those who had managed to pair themselves with our campus girls or the nearby KMTC Hub. KMTC is a well that never runs dry. Those people either came earlier or later, just before Gatiba closed.

But block B had hawk-eyed people, and they all knew who each one was shagging; because in block B, there was nothing like shagging someone who your buddy has shagged. Those were the unwritten laws that governed our home. Some people broke that law, much to the disappointment of many. In that case, we would raise a glass and say, “Labda ilikuwa turn yake, acha agonge ilale.”

Collo admitted his girl, so he told me to carry him chapo mandondo take away. Take-away is never the best thing to do. No ugali saucer or supu extra. On that night that Collo had admitted, there was no music. People were eavesdropping, waiting for the sound of his girl. I remember once when Obanyi had rested his ear on Silvern’s door to listen to him at his weakest. That event alone almost split block B into 2. You were either pro-Obanyi or pro-Silvern; there was no sitting on the fence. For personal reasons, I would be on the side of Obanyi, of course.

The night would retreat into silence. Another day, lived in Block B. Each of those days built on each other until we all became doctors.

My Vipassana Meditation Experience

At Kopling Conference Center, Langata, the morning sun gently pierces the atmosphere, penetrating my skin and leaving behind a warmth that I had not appreciated in a long while. That would be at around 11 am when we break for lunch after the morning meditation. The Kopling sun radiates with calmness, hope, and dharmic peace.

It’s day 6 of this meditation course, and I have done more than 50 hours of observing my breath and body sensations. Four more days left of the ten-day course. My back hurts, and my knees hurt even more. The pain I was experiencing made the first few days of my meditation hell on earth. “Oliver, leave; why must you hurt yourself like this?” I told myself on the day that I had made a resolution to approach the management to inform them of my intent to leave. But then folks, my pride. What would I tell my sister? That I couldn’t stand just ten days of physical and mental stress? No way.

I did not approach the management as I had planned. After deciding that giving up was not an option, I stayed behind in curiosity about what this whole thing was about.

I saw people wincing in response to meditation’s deep mental operation. In as much as most were trying to suffer in silence, from my clinical background, I could tell that it was not easy on them as well.

Far in front of us in the meditation hall were old students, most of whom were already established in the Vipassana meditation technique, referring to the technique we were all gathered for. When I saw them during each session of group meditation, I marveled. The sight of someone in the meditation pose strikes a deep sense of peace in the tender human heart. I thought I was in a monastery at the foot of The Himalayas. You know, folks, even as my mind agonized, the meditation hall vibrated with profound peace and harmony that I had never experienced before.

*Silence please. Meditation in progress.*

On that sixth day that I made a solid resolve to stay in the course, the universe conspired to make it a little tolerable to my weak mind. I asked for an extra cushion. Within a few tries, I found a reasonably comfortable position, enabling me to withstand the physical impact of the meditation on the body. Then I put my head into what was going on. I listened carefully to the instructions and followed them to the letter.

On that afternoon, my thoughts did not wander, and for once, I felt the stubborn, unpleasant gross sensations of my frail and unaccustomed body dissolve. Areas of pain started vibrating, and I felt a wave of electricity engulf my body for a brief moment. The feeling was pleasurable, and that is where the catch was; I was not supposed to react to it with any sort of craving. That subatomic feeling did not last, for as soon as my body realized that I was developing some bit of liking for those sensations, they disappeared, leaving me with the uncomfortable feeling of pain here, itching there, pressure here, and so forth. These feelings were not supposed to make me angry and develop aversion. Reaction to both the feelings of craving and aversion are the products of conditioning of the mind.

The keyword was equanimity, to observe your sensations without reacting to them. You would hear the voice of SN Goenka, the late vipassana teacher (May he RIP), echoing from the audiotape in the deep mental silence that had been part and parcel of the meditation hall since we first stepped in here. “Maintain perfect equanimity. Perfect equanimity. Work hard, Intelligently, and ardently. You are bound to be successful.”

On most days, the technique’s success came as a bit of anger off the jar of rage or a heavy sense of gratitude settling in one’s own existence. The experience made me dissect my mind in a profound way that I had never envisioned before. Our misery lies from our constant reactions to constantly changing events and circumstances. In the Vipassana meditation technique, you get to learn this by experience, in your own body, the very law of impermanence that governs nature. Our only work is to observe our respiration and sensations. Then we can watch pleasure and pain as possessing one quality: arising and passing.

For the next four days, I found my happiness and peace dissecting and removing the impurities of my mind. The experience might sound fiction and near impossible, but I developed truth from an experiential level. Suppose we pay attention like Gautama Buddha did under a tree 2500 years ago; enlightenment remains within our grasp in this life. Human misery is a product of the mental habits that have been formed at the level of the subconscious mind. That reality is hidden from us because we have a weak sense of awareness, an art hidden away in the noisy recesses of the mind. It takes practice to incorporate this wisdom into our daily life. Maybe you will tell me how it turns out when you have gone to the course and gathered your own experience.

I wish I could talk more about this life-changing experience I had on my ten days of meditation. Folks, challenge yourself to one day challenge what you have always believed as truth. The only truth that one can attest to is one they have experienced. The rest are dogmas, opinions, and things passed down as the truth but never experienced. Vipassana is an art of living that makes someone experience their own true north, with the reality in the framework of their own body.

Meditation does not offer superhuman powers that make you have the high of psychoactive substances. Still, definitely, it gives you a fresh perspective of how your mind sabotages you in the grinds of daily living.

I leave you with the words of Rudyard Kipling,

“If you can meet with triumph and disaster.

And treat those two impostors just the same; ….then yours is the earth and everything in it. And which is more? You will be a man, my son.”

A road trip with Sammy

Sammy has made fortunes in the IT world. He develops apps for start-ups and is paid in dollars. His father wanted him to be a doctor but he missed the mark, with only a few points. Knowing what he knows now, I don’t think he would come into medicine. He is not ready for the midnight groans in the labor ward. He had previously asked me why I chose to be a doctor, I told him it is because I had a deep desire to save humanity, and possibly myself.

Sammy has reminded me several times that I should have gone to an Ivy League university, where I would have had the opportunity to be scouted by top global companies like Microsoft and McKinsey. I have told him more than a million times that I am a happy doctor. I would rather be taking care of kids in an isolated ward at a sub-county hospital deep in the intestines of Nyakach than be on a constant move creating profits for multinationals.

“Sammy, medicine offered me an opportunity to learn about life and its ills, particularly the ills of modernity,” I tell him one day when we are on our way to Nairobi, to celebrate Dorah’s birthday. Dorah had just turned 23. I got her a pair of Nike shoes and Sammy organized a bash for her in Milan, and that’s how she crossed over. Still young, but wild at heart.

“What is your greatest fear, Sammy?” I asked him as we scrambled for the basement parking in Milan. He looked at me right in the eye. “I fear bringing up a dysfunctional family,” he said staring into blankness. “I love my wife so much that I fear bringing up kids with her who will become addicts and or criminals. If not, they just become a bunch of unhappy adults. I don’t know how I will handle it.”

Then he tells me how he goes to the extremes to ensure his family never lacks. He also insists on giving children unconditional love as they grow. It is the small humiliations, neglect, and lack of parental presence that make children disconnect from themselves. And then they spend the rest of their lives looking for this reconnection. Some children of course end up finding their true north, and others navigate life as broken adults, with anxiety and always on the edge.

“What do you teach your children ?,” I asked him. His eyes rolled sharply to the left as he reached out for his car keys, which he uses to press onto the lift buttons. 2nd floor. “I teach them kindness, by showing them kindness. every month, my family reaches out to vulnerable people, in children’s homes, in prisons and in the streets, in our small way, we want to embrace kindness, practically.” I looked at him and nod in agreement. Virtues are actually taught, practically.

Milan is punctuated by a motley of humanity. Dorah and her friends are dressed for the wilderness. One of her friends is damn beautiful. I like. “Daktari, huyo ni mdogo bado, she is just 19,” Dorah says when she sees me looking at her friend. I signaled her and told her that it was fine, but I will have her number and wait till she matures. Hahaha. I am joking.

We order a bottle of Glenfiddich, 12. It’s about to go down in Milan. The bills are on Sammy, much to my relief. I was broke.

Fit to Plead

There is a section in the Kenyan law that provides for persons accused of Capital offenses to be seen by a psychiatrist to assess their fitness to plead. That law protects psychiatric patients from being tried when not in a fully functional state. Patients with debilitating mental illnesses cannot plead in a court of law. Dear readers, this is one subject that has baffled me as a doctor. The mental acuity to stand a trial.

Maundu* would be referred to us from a nearby remand for a mental assessment. We had our forensic psychiatry clinic that day, and so our clients were those who had found themselves in conflict with the law. He had been charged with second-degree murder. The details, he says, are a little hazy. Still, he remembers finding a man, deep in pleasure with his wife at their matrimonial bed. He was hurt. The man escaped by a whisker, and consequently, his wife got a lethal stab in the chest to quell his gladiatorial anger. The knife must have found the heart because Maundu says, “It was all red, I know no amount of medical prowess that could repair such a wounded heart.”

Maundu was a jua kali artisan. He made jikos and metal boxes for form one students. He tells me how he was a happy man when he came back from work on that fateful day. Then when he got home, he found the living room in a bizarre state. The room was cluttered, with clothes strewn all over. A man knows his sitting room just like Dr. Mokaya knows the labor ward. His wife did not respond to his sweet nothings, and the door was wide ajar. The man had left his open shoes at the entrance, big open shoes.

His wife was moaning in ultimate pleasure when he stormed into their bedroom, breaking Maundu’s heart into small pieces. A fight ensued, and the estranged man clutched his clothes and fled. Then anger filled Maundu’s heart, and the next thing he went for was the kitchen knife, straight from a local grinder. “It was sharp; that’s all I remember,” he says with a trembling voice and teary eyes. He was well built with fat cheeks. The tears from his eyes flowed freely in the crevices that formed on his wrinkled face when he was crying.

“With pain and anger, I took her life,” He lets a sharp, wry cry that would have me look aside to avoid his gaze. It takes a man, to know a broken man. Moments change lives. He had lost it that night, and his life was about to drastically worsen. I imagined the day of the jury’s final verdict. The heavy voice of a drunk magistrate would burrow into his heart, tearing it into pieces.

His speech is coherent, and he does not seem like someone with a psychiatric problem. He is well-kempt with appropriate behaviour, befitting a dutiful citizen in any republic, anywhere in the world.

“Do you ever see or hear people or things that other people do not see or hear? ” I asked

“No; I just don’t know what happened that day,” he says.

“Do you use any substances of abuse?”

“No, I don’t. I only drink occasionally.”

Then he tells me of the beautiful times he shared with his wife, from the courtship years a decade ago, all to the events that led to her tragic demise.

“I met my wife when I was a young man; I loved her with all that I am.”

“And then what happened?”

“Anger descended on me, why did she decide to give herself to another man? I felt betrayed. When I picked up that knife, I found myself in the police cell. That is where I put into perspective what had happened.” He says, staring at two flies mating on the bench in front of us. The male fly was too brief. Maundu had made friends with the officer who brought him, and therefore, the officer immediately granted his wishes when he requested his hands be freed so that he scratched his back. I didn’t think he would jump at me with violence, and therefore I did not move an inch. Not a flinch.

My mental assessment did not reveal any signs of mental disease. Maundu talked normally, behaved normally, felt about the situation in the way that an average person would: His judgment was reasonable, and his memory was above average. “But, what about the grief and the remorse?” I asked myself as I was concluding my assessment. “Is he really fit to stand a trial with all the heaviness in his heart?” I didn’t know about this.
“Fit to plead,” my notes read.

*not his real name. The identifying clinical details and identifying information in this story have been changed to protect the identity of those involved.

It’s all a show!

In the extremes of my imaginations, I have imagined myself a full-time writer and a part-time doctor. I want to walk the world and search for my truths and those of others. Only by listening and telling stories do we ever get to deeply connect with others. It is by the conversations we stimulate, do we ever get to know the core of the people we interact with. Most importantly, I would love to follow stories of compassion, stories of grit and bravery, and sometimes stories of anger, angst, grief, and pain. For life, is an oscillation between emotions of happiness and sadness.

A few weeks ago a bunch of us became buddies. 5 friends. A young doctor that is me, is always the convener, young, no money, no anything, just ideas. Then there is a very happily married man, this one tells us the morality of our decision-making, every time we meet together. The guy we always go to when things are thick. We shall call him Sammy, he is 35. The third person is a single lady, a respected gynecologist at a thriving private practice in town, recently graduated with a master’s, she is 32.

The fourth is an Engineer from Kitale, he wins a lot of business county tenders that guy, Joseph is his name, a shrewd investor, 64 and not so happily married. He has lost it all and rebuilt from scratch. He reminds us of how to pick up in life at our lowest.

Then there is a tiny college girl that found herself in our circle. Her name is Dorah, she is 23. She does some social media work for Sammy. That’s how I got to know her. Once in a while, we call her for a little office work here and there to help her get money through college. By the way, Sammy is an IT guy. As men in this clique, we held a WhatsApp crisis meeting and said there is no chewing anyone in the club and we were serious that we want to be proper friends. Folks, these are new friendships that I am building intentionally. I told them, we want to have candid conversations about life, but we mostly want to savor life. Most of it through telling our stories. For the stories that we cant tell, may we have the willingness to forgive ourselves and treat our failures, guilts, and shame with compassion.

Stay tuned at The Doctor On Call, and let’s see life from the perspective of 5 of my friends. Most entries will however remain the diary of a junior doctor, just some little dessert on top of the usual drama that is the life of a doctor.

That will form the foundation of The Doctor On Call, telling stories of the comedy that is life, from the perspective of my newly found friends and I. Immerse yourself and follow. It’s all a show!