I am writing this very reluctantly; But it is informed by a chat I had with a friend earlier today. The friend has lost “suddenly”, a Family member to death from LEUKEMIA (Cancer of the Blood).
Apparently, as the friend related it to me, the deceased had been going to the Hospital for some time because of “unwell feeling” but she had been given the diagnosis of TYPHOID, TYPHOID, TYPHOID severally. Until she was finally diagnosed with LEUKEMIA sometime in December last year and by mid January this year she was dead!!!
This, regrettably occurs too frequently in our clime. I have seen too many of such heart wrenching cases. Whereby people are diagnosed too late or altogether misdiagnosed entirely.
In previous roles, I have had so many referrals patients from Nigeria who had been so thoroughly misdiagnosed/mismanaged, sometimes you throw up your hands in the air and ask “what’s going on” ?
I shall illustrate two (2) examples of such from out of Nigeria that still sadden me.
EXAMPLE #1: Involves a University Hall mate of mine. We were in the same residence hall.
He had developed unrelenting Epigastric pain (“heart burns”). He went to a local Hospital and was diagnosed with “Stomach ulcer” – which is fair enough. But the Ulcer was recalcitrant to every Ulcer treatment thrown at it!
As a result, he went to the regional University Teaching Hospital where they kept him for months before they decided they will need to do a Biopsy. But the Gastroenterologist doing the biopsy did not do the biopsy because he said his “scope saw veins and if he took the biopsy, the Patient will bleed; and they do not have that facility to to control the bleeding”!!!
This is supposed to be a teaching Hospital.
So my Friend was transferred to another Regional Teaching Hospital where a biopsy was Performed alright. However, they said the Biopsy Specimen “could not be Interpreted” Meanwhile my Friend is rapidly emancipating as by now he could not even eat anything anymore except liquid food. This was the time, Providence decided to make our paths to cross again more than 2 decades after our University graduation.
I was home in Nigeria on vacation. And his plight was told to me; and the effort being made to take him “to India for treatment”. I cautioned against going to India based on horror stories of some Indian Hospitals who drain Nigerian patients of their money – even when they know they are unable to help or their diseases are incurable. I indicated that an option is to come to the Hospital where I practice overseas, but I told them it would be more expensive than India, however, I would try my best to keep their costs low and get them discounts.
And that was how my friend ended up in MediClinic City Hospital Dubai which was, at that time the most Prestigious Hospital in Dubai; and within 24 hours of his admission, he has had a Flouroscopic Guided Needle Biopsy. With Histopathology Reading (Interpretation) that diagnosed SQUAMOUS CELL CARCINOMA of the Esophagus. Next we had to stage the disease.
Therefore he went straight for MRI/Total Body Scan. Regrettably, it was discovered that the cancer had spread all over his body and there was not much that could be done.
Therefore, the decision was made to send him back home to Nigeria on palliative therapy including Radiation – No point in wasting resources that those he will soon leave behind could need.
I talked on the phone to the radiation “experts” in Nigeria to arrange Radiation care. I was assured that he will be taken good care of. Therefore, I wrote a comprehensive report and included all copies of Laboratory and Imaging studies.
I instructed the patient to go to Hospital straight as soon as plane touches ground in Nigeria; But guess what, Nigeria’s efficiency in doing things took over – it took the Hospital 1 month to accept him for admission.
And after they gave him the first dose of radiotherapy, he died!
Basically they “fried” my Friend’s already Cancer ravaged throat.
EXAMPLE #2. The second illustration which I will give is of a gentleman that came to us through referral by one of our patients that I had cared for previously.
This patient had taken his personal health seriously; he has had regular yearly health check up for time immemorial.
During one of those check up, they found that his Prostate Specific Antibody (PSA) the marker for Prostate Cancer was Higher than normal level.
The Hospital where he went for the check-up rightly decided to do a Biopsy. The procured Biopsy Specimen was correctly interpreted (diagnosed) by the Pathologist as Negative.
So the Urologist told the patient not to worry. Everything is alright.
And for the next Four (4) years, patient goes for annual Medical checkup, PSA result is high, they do a Biopsy which is interpreted as Negative by Pathologist. 3 additional times.
Meanwhile the patient is deteriorating. He is loosing weight, his energy level is getting lower and lower, and he is beginning to feel “small small pain in his bones”.
His ovularia (apologies Damola Ilori) decided. No, something is wrong, we will seek second opinion. And that is when he was adviced to get in touch with is me with a view to coming to our Hospital.
When he came, Radiology Department did an Ultrasound Guided core Needle Biopsy. They took 10 cores and sent to me (at that time I was also filling the role of Surgical Pathologist/Histopathologist. When we examined it, 9 out of the 10 cores were chocked full with Cancer Cells.
He has had PROSTATIC ADENOCARCINOMA (Cancer of the Prostate) all along!!!.
Next thing is to Stage: On Radioisotope studies his body just lighted up like Christmas tree. Basically, the cancer has literally deposited seeds on practically every bone of his body.
The My Nuclear Medicine Colleague actually practically ran accross the corridor to my office came to fetch me, saying – Dr. Musa, your countryman’s situation doesn’t look good.
When we broke the news to the patient, who was a High Level Staff in one of the “Juicy” Federal Institutions, he just dropped his head and said “Doctor, I did everything, healthwise, that is expected of a man my age. I did my regular check-up as you doctors adviced”. We were practically in tears for him.
Anyways, we arranged for aggressive treatment. With new forms of chemotherapy that was at that time not available in Nigeria. So he had to come into Dubai every month for a 2 hour IV infusion. Regrettably, he died within 12 months! At the age of 54 years. Leaving behind a loving wife 2 handsome boys and parents.
Because this patient was obviously misdiagnosed, I felt, it is proper to rely the information to the Medical Director of the Hospital where, over a period of 4 years, his correct diagnosis was repeatedly missed.
I was non-accusatory. But I told he, the Medical Director, that this is what we found on one of his hospitals patients. I offered that I will send him copies of our findings because he might find them useful in their internal QA and Quality improvement process.
To my shock, the medical Director was not a bit interested. Infact, he cut me short because, as he puts it, he has an interview in NTA in 45 minutes. I sent him a report anyway. Whatever he did with it is good your guess as mine!!!
Folks sorry, I know I have bored you with this foolishly long writing but I am saddened about the sorry pass our health care system has come to. We used to be second to none. What happened to us. We have to have a discussion. We need to hold our Healthcare providers accountable.
Health advisory are these:
i) You as the patient Know your body more than any Doctor. If you are sick, and you are going to the hospital and the Doctor is saying Typhoid, treating you for Typhoid but no improvement, please please please, it is not Typhoid. Infact, the truth h is, 90% of the diagnosis of “Typhoid” in Nigeria in WRONG diagnosis.
Typhoid is a dying disease! You will not have typhoid and still be walking around. Impossible.
ii) The Doctor is not all knowing. Only God is. There are many things doctors do not know. And a good doctor, worth his or her salt should not be afraid to admit not knowing. But the good doctor would be ready to help channel or source for you the appropriate expertise you need to sort yourself out – healthwise.
iii) Do not be intimidated by any Doctor, or any Healthcare provider for that matter. They are there to provide comfort and healing in time of your DIS EASE. So, if a doctor makes you feel intimidated, he or she has failed in their first duty to you as a patient.
iv) Don’t be afraid to be afraid to ask for a second, or even third opinion. If any Doctor gets angry because you ask for it, or mention you are going for a second opinion, then that doctor has something to hide.
v) If you feel you have been mismanaged, you owe it to yourself and the greater society to report such matters to the appropriate regulatory bodies. That is a way to make our Healthcare providers know that they may not be callous or incompetent and get away with it without repercussion.
Dr. Musa Mbahi is a Consultant Anatomic and Clinical Pathologist at the MediClinic (Middle-East) City Hospital , and he writes from Dubai.
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