US Records First Ebola Case—Lessons....
The recent past days witnessed variable screams from the news media regarding the diagnosis of the first case of Ebola Viral Disease by the US. A Liberian (cf. Nigeria) was on a visit to relations in Dallas, Texas. He developed a febrile illness. He was taken to the hospital. He was attended by a US-certified medical doctor or doctors who took blood and other bodily samples from him, then promptly sent him home to await his lab results! And as soon as such lab results were "ready", his home was assaulted by a barrage of stern-looking men in body armour "ojuju style" as he was whisked back to hospital in ambulance.
Robotic approach! Bad management! No history! Or at best a shoddy one!....which the doctor could not marshal coherently enough to correctly interpret and match with management. Clinical assessment.....a careful history and thorough physical examination....forms the bedrock of medical practice. It separates the good physicians from also-rans! Check out the clinical scenario again....fever, other "constitutional symptoms" in a Liberian on a visit from "home"! Next logical step by the "well-baked" doctor? Isolation! Barrier nursing! Official notification!
Quarantine....of the patient....and all his contacts! Primary contacts! Secondary contacts! All these while awaiting lab confirmation!....knowing that the patient is from a "hot" zone. Etc! Etc! Our own Dr Ameyo Adadevoh did better than that! By admitting the patient to an isolation ward and notifying the authorities, she practically saved our nation from an Ebola epidemic. Only that our dear president has an allergy to honouring the dead....for Ameyo's only "crime" was to have served her nation unto death! Mr President "explained" that our national honours are reserved for the living. Not the dead! Even laymen in my dear country know the next thing to do about Ebola.... And when I submit that an average man on the Nigerian street would not be given to such blunder, I am by no means exaggerating.....
If you wonder how an American doctor would blunder so badly, I'd say "put it down to robotization of medical training and practice in American clime". An American doctor is accosted by a patient: He is expected to run a barrage of lab tests.....mostly irrelevant....in the first instance. He accords less significance to patient history....which he can ill take, document and interpret. He engages in other retinues of actions absolutely irrelevant to the case at hand. His training "equips" him to lay more emphasis on "protocols". His experience teaches him to hold fast and robotically to such protocols to protect himself from litigation....which is so rife in his clime! He is fixated on "evidence-based diagnosis"....and in his notion.....and nation, evidence translates into "machine-generated" proof! For if he cannot provide such machine-led support for his actions and inactions in court, he and his practice is licked! His situation is not helped by medical boards devotedly snooping for excuses to yank off his license! So he becomes an efficient robot expending much brun on machines.....with which he copiously surrounds himself.....and placing more faith in such earthly contraptions than his God-given insight, instinct and judgement.
A stage comes in the life of The Good Physician when he can "smell" a particular disease.....an attainment of rare proficiency that only comes with thorough training and experience! Imagine the number of primary and secondary contacts this Liberian would have infected with the disease by being treated on outpatient basis! Though the medical family is expectedly global.....and a doctor may not gloat on the professional blunders of his colleague, these things need to be said. Besides, the American medical community treats foreign medical graduates like slime.....confronting them with even high school questions in their "qualifying exams".
This mindset....albeit unnecessary....is borne out of a superiority complex that also leads them to raise pass marks for foreigners to 70%.....regarding 80% as "marginal" pass! And our citizens achieve such scores....effortlessly! The Americans expect their citizens to score just 50% in exams of similar strengths.... Nigeria would be unwise to ignore Congolese counsel on Ebola management. The US would be daft to ignore Nigerian counsel on Ebola management....
Dr Tosin Akindele is a Lagos-based Medical Practitioner, a former Secretary of AGPMPN Ikorodu zone , a former Secretary of the Quackery Committee of AGPMPN Lagos State Branch, founder of Analytical Minds, a good health advocate and social critic.