VIP treatment

We had the national police commissioner in the hospital this week after
he arrived after a stroke on Monday. Like most places in the world,
stroke care here is never very satisfying, once the deficits have begun
there's little that you can do, except make sure that it doesn't get
worse. Certainly the lack of CAT scanning makes neurological medicine
feel like you're trying to use an axe to remove a splinter; the tools
you've got just aren't sophisticated enough for the detail that you need
to treat properly.

Certainly we see a fair amount of neurological issues -- right now I've
got 4 women on female ward with various neurological complaints -- one
with high fevers and left arm/leg weakness who we suspect may have a
brain abscess, one with pleasant dementia, not talking, and left leg
weakness who we think may have PML, and two with garden-variety strokes
due to poorly controlled blood pressure. One particularly difficult
situation is the mother whose daughter and mother are both in the
hospital, lying in beds next to each other, one with the suspected brain
abscess and one with a stroke. Her life will change dramatically as she
struggles to care for two invalids at home.

But what was remarkable about the police commissioner was the amount of
people that came by to visit, call, text message, or otherwise inquire
about his status. I'm constantly amazed at the power systems and the
deference given to people of position; from a western perspective it
sometimes seems like toadying, but it's really a different flavor and
emphasis than having a bunch of people come by to see the boss in the
hospital would have at home. It's hard to define, but it's a more
relational concern, and merely marks the co-mingling in so many African
relationships of business and friendship to a degree that we don't have
at home.

Fortunately for me, I survived the onslaught of attention from the
government offices checking up on us (at least I hope that I acquitted
us okay) and he was transferred back to the capital two days ago, where
I hope he arrived well. I'm sure I will hear more follow-up in the days
to come.