My patient had been seen by a doctor who called me to review the patient with him. As I entered the emergency unit, it was the pacing up and down of the mother that first caught my attention. She had tears in her eyes. Her eyes were sore red. She was praying furiously for mercy. I was touched by her agony. I kept wondering what could be the issue that could make a mother be in this excruciating agony. I later learnt our hospital was the third hospital they were referred to today. Huge money had been spent by the poor woman. Emotion and physical strength exhausted. She looked tired. The other doctor called my attention, sir that was the mother, this was the patient. I looked at the patient. He looked like a 13 years old child but lo and behold he was actually 32 years old. No marriage. No work. He actually graduated as a business administration student from one of the polytechnics for the past 5 years. No work. He had been living with his mother. His eyes were deeply yellow.  He was a little bit disoriented but could still answer my questions. He was writhing in excruciating pain. He was a sickler. He had had many crises since birth but this seemed to be the worst of his life according to him. The doctor that called me had done the right things. He had ordered for some tests including the blood level which was okay for his status and the doctor had started strong pain killer. I further discovered there were infections and I added some drugs and ordered he should be put on oxygen. After the initial stabilization, I now took my time to hear the detailed history and did further examination of the patient. One thing struck me most in the interview the mother granted and my patient corroborated. I interviewed the mother also to take much stress off the disoriented patent. The mother said he once stabbed her at home when he was in one of his pain crises. I turned to him, was that true? He said yes doctor  I stabbed my mother because he gave me a lifetime pain. I wanted to make her feel what she subjected me to every day of my life. I looked back at the mother, I saw tears rolled down her cheeks. She said doctor I am 60 years old now what did I know about genotype when I got married. It was because of his constant sickness the father divorced me. I had been the only one battling with this his sickness since. I had forgiven him though. I was moved to tears but I controlled my eyes. Who will hear it that a whole doctor was crying before patient? After attending to them and things looked stable. I invited other specialists in sickle cell anemia (hematologists) to have a third review. They seemed to agree largely with what we were doing so I left the other doctor to keep watch over him and left to continue preparing for some exams I had before me. As I was about to leave the emergency unit, he called me back and said doctor, I am tired of this pain. I want to rest. This would be the second time I would be fighting back my tears today, I vowed I would not shed tears before my patient. I am a doctor. I encouraged him to keep fighting as he had. He was a warrior for 32 years and he was still here.  He had not only fought pains in the last 32 years, he had fought infections, discrimination, joblessness, no relationship and many more for the past 32 years. Not now would you  give up I told him holding his hands like the warrior he had been. He looked at me keenly and said doctor i am tired,i want to rest. Something in me told he was truly tired but the rest he was talking about scared me. You and I knew what he meant by rest. I had vowed I would not cry. I left after he looked calm a little.

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Exactly 4 hours later my phone rang it was the other doctor. He said sir we need your attention urgently please. I rushed down. I met the mother at the door almost tearing my clothe, begging me,doctor please save him. I managed to enter into my patient’s cubicle not minding all the holding of my clothe by the mother. The patient’s condition had suddenly deteriorated in the last 10 minutes I was told by the other doctor. He suddenly started gasping despite the oxygen. This deteriorated further on my arrival. All the vital signs faded. We started resuscitation but alas it seemed he meant his earlier request, he had gone to rest, and he was truly tired of pain. For the third time I tried hard to fight back my fountain of tears but this time my mental and emotional strength failed me. I wept. He looked calm now. He had gone to rest. The mother was torn apart. She asked me so doctor he was truly tired?. He had gone to rest? As I penned down my last documentation for the death certificate to be issued, tears wet my eyes again.  The agony of the mother was loud. She was a true mother. She stood by her son till the end. I would not blame her. She knew nothing about genotype when she got married and had him. You could feel palpable pain. The mother moved closer to me in tears she said doctor I never knew anything about genotype when I was getting married to his father. I said madam I understand and I never blamed you even though he tried to inflict pain on you, it was not him, it was the temporary insanity of pain. I emphasized with her deeply. She was a little consoled. Three days later he was buried. I visited the family on condolence visit. The mother had accepted the reality of painful loss and she told me please doctor help me warn many women to please for the sake of the unborn children, they should never allow love issues to blindfold them to the reality of genotype and its consequences. Even though I didn’t know in my own case, you people were more civilised now, no excuse. She gave me her permission as next of kin to share this story to warn young men and women that are madly in love at the expense of genotype never to witness this kind of agony she witnessed for the past 32 years of her life. I agreed with her completely, no mother should bury her child again because of sickle cell anemia.  I am appealing to you reading this write up this morning, If you will have to choose between LOVE and GENOTYPE, please choose GENOTYPE 100 times over. May you never witness the agony of pain and burying your children in their prime. I dedicate this to all the warriors (sicklers) still fighting, please keep fighting. Dont give up. There is a stem cell transplantation now helping hundreds of sicklers out there. Key in to it. Even though the cost is much, the government, well meaning citizens and organisations can help. Once again I pray may we never witness the agony of burying our children in their prime. Amen.
Written by Dr Adesida Adewumi




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