Wednesday, November 16, 2011

"No, Sir; you cannot conceive with what acceleration I advance towards death."

Those are the words of Samuel Johnson bellowed from his deathbed at his physician Thomas Warren, when asked if he were feeling any better. Sadly, in those final daysthe leading figure of 18th Century literary London was not paid a visit by his celebrated biographer and drinking buddy James Boswell, as he was away in Scotland at the time. When Boswell heard the news of his friend's death, he remarked, "My feeling was just one large expanse of Stupor ... I could not believe it. My imagination was not convinced." This is the story of how I was there for my Dr Johnson.

It's 10:15 pm on November 8th, 2011, and I am on board an air ambulance en-route to Nairobi.  My best buddy is reposed and scarcely visible in the glow of monitors and cabin lights around him. He has suffered a massive heart attack and I'm praying to God he gets the care he so desperately needs. His condition is serious, yet he grips my hand with a strength that assures me he might just make it.

Our Cessna Citation took off a moment ago from Entebbe Airport and we are ascending rapidly into a strobing cloudbank over Lake Victoria, which looks like a row of plasma globes through the windows of the turboprop jet. Nonetheless, the ride is smooth. It shouldn't take us more than an hour to reach Jomo Kenyatta International Airport (JKIA) where a waiting ambulance will transfer us to the Intensive Care Unit at Nairobi Hospital, and into the superlative care of Dr David Silverstein, one of East Africa's foremost cardiologists.

As though trying to free himself from a fishing net, my buddy is agitated and fidgety from the steady dose of adrenaline coursing through his veins, and struggles with the temporary pacemaker and a plethora of tubes and wires attached to his body. The two volunteer flying doctors at his side - one black one white - urge him to relax while they tend to his failing heart. Their expert cardiological skills are a wonder to observe, and a testament to the capabilities of the African Medical Research Foundation (AMREF), who operate the air ambulance service.


It was late morning in Kampala when I received the call from The Surgery notifying me of his grave condition. "It's not looking too good," the Dutch nurse informed me, "He did not want to call anyone, but I thought it was important he has a friend with him at this time..." Riding on a back of a speeding boda boda (a motorcycle taxi, which serves as a poor man's helicopter in this part of the world) on my way to the clinic, I searched the gathering storm clouds above the city's seven hills for the face of God, so I could petition Him directly to save my best friend's life. By the time I reached the clinic, my friend was conscious, but they informed me he had flat-lined more than twenty times that morning. He did not look good.

"What's your prognosis?" I asked Dr Richard Stockley, the clinic's leading physician.

"What he needs is a pacemaker," said Stockley, "He's suffered significant damage to the area known as the sinus node which generates the electrical waves making his heart beat. We're calling all around Kampala right now trying to find one, but it's doesn't look promising. His best chance is if we transfer him to Nairobi as soon as possible."

"What are we waiting for?" I retorted, "let's do that."

"Air ambulances don't come cheap," said Stockley, raising an eyebrow and stroking his prominent chin, "And these people are brutal: they will not leave the ground until they know full payment has been made."

"How much?" I asked with trepidation; my friend was not a man of means.

"Around $10,000."

I immediately began fundraising on my cell phone, and woke up a few friends around the world. Another kindred spirit on another continent agreed to front the costs, if no one else would. (How amazing is that?) Armed with her pledge, and a financial guarantee from the British Residence Association in Uganda that Stockley had secured, we green lighted the air ambulance, which then took off from Nairobi's Wilson Airport with a pacemaker on board. Thankfully, by the time the flying doctors arrived, my friend's employers had agreed to foot the bill, and his benefactress on the other side of the world could put away her cheque book.

It's now five hours later, and we're cruising at 10,000 metres, surrounded by sophisticated machinery, both medical and aeronautic. Together they produce a kind of ignore-changes, avant guard Bebop that segues reassuringly from monitor to monitor as we vault across the Rift Valley. My friend is finally sleeping. I can't bear the thought of loosing him. He is my anchor out here on the high seas of exile, my mentor, my hero, and a beautiful human being. We share a love of literature, and (though in my case only by ancestry) a Scot's ire with the world. I am Boswell to his Dr Johnson. 

During our countless Saturday afternoon sessions at the Bukoto Beer Garden, he consistently lamented his isolation in Africa. He had lived on the continent for a decade and a half, during which time none of his family had ever come to visit. I began to wonder if they were real. But any doubts about his support network were quickly dashed after word got out of his condition. During the course of that afternoon, I spoke to nearly all of his loved ones, as I sought to reassure them the doctors were doing everything in their powers to save him. His son booked himself on the next available flight to Nairobi so he too could be at his dad's bedside. I was finally going to meet one of his bairns.

My buddy awakes and smiles. "I love you," he tells me, with a twinkle in his eye. One of his favourite sayings is "There is no communication without love," so it may just be the parsimonious Scot talking, spendthrift in every way, including matters of the heart. Nonetheless, I feel grand to hear him say it.

A familiar pattern of flickering lights comes in to view on the ground below as the Citation jet begins its descent into the Kenyan capital. Soon we're on the ground and while the medical team carry him into the ambulance I race across the tarmac with our passports to the Arrivals hall. Having experienced a fast track service with few formalities at Entebbe, I'm expecting the same at Kenyan immigration. No dice. The oversized school boy displaying a droopy lower lip you could recline on, and the stripes of a senior officer, refuses to allow anything other than the protracted procedure of filling out lengthy visa applications and immigration forms, while my friend remains in critical condition in an ambulance outside. "How would you feel if it was your mother?" I ask, but all he does is shrug. After handing over the cash, I wait for his subordinate to slowly paste a page-sized visa sticker in each of our passports, and then fill out receipts. 

At long last, we reach the Emergency Room at Nairobi Hospital. The flying doctors race him into surgery while I deal with formalities at Admissions. I had spent a number of years in the UK where most medical treatment comes free of charge, consequently I am quite shocked by the emphasis on up front payment. It's 2 o'clock in the morning, but before they agree to admit him for such intensive care, they insist I raise his boss or anyone with a credit card and make a deposit. Eventually they agree to admit him without the deposit, but warn me they will be forced to move him to a 'local' hospital if payment is not made before noon the next day. Phew!


A week's now passed since that fateful night, and my buddy remains in the ICU in Nairobi Hospital, where he is slowly recovering. Each of the medical interventions has gone to plan, and all that remains is to fit him with a tiny pacemaker in his chest next week. His son arrived a few days after us, and he and I bonded straight away. When he wasn't at his father's bedside, we spent the hours lionizing the great man over Tusker beers. He appreciated the insight into his old man's mysterious life in Africa, claiming dad always insisted it was far too daunting a place to allow them to visit him. Nevertheless, the patient was delighted the pair of us had finally met, and seemed pleasantly resigned to the fact we were now connecting the dots in his life. 

I returned to Kampala in an overnight Akamba bus, a far cry from the comfort and speed of the medevac jet I'd flown out on. It did give me pause to reflect on what had been a dramatic week in Kenya. I decided it should not take something as drastic as a cardiac arrest to make one seriously think about one's own mortality. I know my friend will experience a sea change in his life; he's quit smoking for one, and probably won't be drinking anything stronger than tonic water during our regular sessions at the Bukoto Beer Garden when he returns. That is if he returns to Africa after convalescing in Europe. I truly hope he does, because Kampala is downright diminished without him. 

No doubt he will find inspiration in his experience. As an eloquent wordsmith whose prose has yet to see the light of day, and a gifted painter whose not painted for years, my friend is, I would say after this episode, God's gift to the world. Perhaps like Boswell and Johnson, we'll both become celebrated men of letters in the years ahead. Maybe one day you'll read one of his books and realise about whom I have written. This is my communication to him.

1 comment:

  1. I have no words to express how grateful I am for what Greg has done for my father and, by extension, my family. You may only perceive from this beautiful description of the events, the emotional stress that Greg and my father's family and friends have experienced during the last 3 weeks...

    Again, thank you!
    Dr. Johnson's son