Period Pain

by Matlwa, Kopano

  You know mos Nyasha, Lord.

  I asked her if she ever wished certain patients would die.

  She looked at me funny and said no. She said nothing more all the rest of the way to work.

  I know this is no way for a human being, a good human being, to think, Lord. I would never say these things out loud, and I swear not to write this kind of thing anymore. But you know Noluthando, that stage-4 lady with cervical cancer, who’s bed bound and has fistulas coming out of everywhere? Well, wouldn’t it be better if You took her, Lord? Wouldn’t it be better if she died? I have to put up a drip in her daily, Lord. She’s so confused now, she takes her drip out every day. She’s not eating, doesn’t speak much, and we can’t get hold of her family. What’s the point, really? Aren’t we just causing her even more pain and distress than she needs? And Betty. To be honest, I’m surprised she’s still alive. And that Njongo kid in Ward 16. Her mom is MIA and she’s so weak she can’t even keep her head up anymore. I could write you a whole list of names.

  I should probably tear up this page. What would people think of me if they ever read this? It’s the truth, though. Sometimes I wish some of them would die. It would be better for them and for me. I’m stretched so thin, Lord, if only there were fewer of them, then I could do more for the ones who have a chance.

  I can’t be the worst doctor in history, surely? What about those doctors that lied about Steve Biko’s death? What about that apartheid cardiologist who poisoned black people? I’m not like them. They are evil. I don’t make mistakes on purpose. I’m just tired.

  Why don’t I feel anything? Surely I should? All I feel is guilt for not caring, and fear of being caught out. They bore me, Lord, Your people bore me. I know it’s wrong to say it, but they do. Their pain, their problems, their hopelessness, it all bores me. It’s a constant reminder that the problems are vast, multiple, deep-rooted, and that there’s nothing I can do to fix any of it. I don’t deserve to call myself a Christian, because I don’t behave like one. I lie to myself over and over again that I can do some good, but I can’t. I can’t change anything. It’s all hopeless. They die no matter what I do.

  Someone once told me about this gas that’s released from under the earth. Someone started a fire where it gathers, and it’s never stopped burning to this day. It rages continuously, constantly, consuming everything around it, like the pits of hell.

  That’s how I feel inside. Like I’ve got a raging fire burning within me. It’s too dangerous to go in there, and I don’t know how to stop it from out here. It’s a kind of hell inside. It’s consuming me.

  Maybe I’m just PMS-ing.

  I can’t find peace. Not in my head, not in my heart, not in my soul, not anywhere.

  I used to like the Lord’s Prayer. It’s the only bit of the Bible I know off by heart, and as a child I would often say it over and over again when I began to feel scared. At times I would jumble up the words, say them upside down, but didn’t think it mattered. I didn’t think You would care, just as long as I kept saying the words. And it would work. It always worked. Sometimes it took longer than at other times, but it always made me feel better. Now nothing works.

  I so desperately want to be different, Lord. I want to walk into the wards and see the pools of tears and be moved by them. I don’t want to be selfish and irritable and impatient. I don’t want to be an obstacle in Your path. But this is how You made me.

  We were given last Friday off to go and vote in the municipal elections. Only the doctors on call had to go in. I couldn’t convince my body to get out of bed. I wasn’t sure if I was even registered to vote. I didn’t know who I would vote for anyway, so I never left the house. On Monday morning Nyasha looked at me in disgust when I used my black anaesthetic-drug marker to put a fake voting dot on my right thumb. She called me pathetic, and lectured me on how much had been lost for my right to vote. She told me how my ancestors would shower misfortune on my future because I didn’t value my freedom. She said I was a disgrace.

  I asked her how she thought her ancestors felt about her running away from her own country to come make a nuisance of herself here. She didn’t respond, and I could see my words had hurt her. Well, so be it. If she can dish it out, she should be able to take it.

  I’m hungry, but food is the last thing I want to eat.

  There must be more than this.

  Sir, give me this water so that I won’t get thirsty and have to keep coming here to draw water.

  John 4:15

  Coke, KFC, Red Bull, those microwave meals that take up so much space in the fridge, vitamin water, coconut water, cayenne pepper water, holy water. Xanax, vodka, anything just to numb the feeling. Diet pills for energy. Ritalin to stay up at night. The morning-after pill. Mirena for those with more determination. Post-exposure prophylaxis at least four times a year. TB treatment for the unfortunate few. Flu vaccine. Hepatitis B booster. Third generation cephalosporin at the sight of a sneeze. Scabies, a gift from the psychiatry ward. Eczema, asthma pumps, yoga, tofu, detox when on leave, 15 days of eating green. Dubai or Thailand to make up for it all. Then you’re back and the assault begins again.

  I had to leave theatre this morning because I’d developed such severe menstrual cramps I could hardly keep myself from falling over and contaminating the entire operative field. It was odd. Although my periods had reduced to little more than spotting after the endometrial ablation, the monthly cramps had persisted like clockwork, maybe as a reminder that the beast is not dead, only sleeping. Doctor Sage said I should unscrub and go put my head down in the Anaesthetics tea room until the next case arrives. While I was in there I texted Nyasha and asked if she could bring me Ibuprofen from the emergency department. Sister Dlamini sat across the room, watching us as Nyasha took two tablets out of her pocket and offered me her bottled water. I could see she wanted to say something, but I couldn’t have anticipated the words that came out of her mouth.

  ‘Sies doctor!’ she exclaimed. ‘O na le sebete ne? Batho ba ga se batho. You can get sick drinking from their bottles.’

  I couldn’t believe she could say that right in front of Nyasha.

  ‘She’s just dumb,’ I mumbled to Nyasha as she picked up her stuff and prepared to head back to the emergency department.

  Nyasha shrugged. ‘It’s just a period South Africa’s in,’ she said matter-of-factly. ‘Growing pains.’

  ‘Like period pain,’ I said, trying to make a joke.

  ‘Yeah.’ She gave me a weak smile. ‘Like period pain.’

  I didn’t tell Nyasha that I saw a cat coming out from under the table when we were out for dinner tonight, or that there were Portuguese men at the window. I can tell Nyasha most things, but this I’d never tell her. I know for sure she’d leave me if she began to worry I might be going mad. I can’t risk that. She’d stay in the flat but pull away, watch me, analyse my words. Some things you never say. You write them in your journal but tell no one.

  Kgomotso’s aunt approached me today. I’ve noticed her in the ward, watching us as we go about our business, but I’ve never heard her speak. Sometimes I’ve caught her staring at me, but if my eyes meet hers, she turns away shyly. So when she came up to me and asked whether I thought Kgomotso was going to die, I was a little taken aback. She pointed to Kgomotso’s intravenous line that was drawing blood, pointed to her own belly which she shared had a growing baby inside, and began to cry. I mentioned You, told her the intravenous line was nothing to worry about, that we would flush it as soon as we got a chance, asked how far along she was. But she insisted. Said she was alone in Johannesburg and without work, and that there was no money to send a corpse to the Eastern Cape.

  I didn’t know what to say, Lord, because Kgomotso is going to die. You know it, I know it and Kgomotso’s aunt knows it.

  So I called Sister Lebea, who fetched a stool for all of us to sit on. I hadn’t thought to do that. They spoke without too many words. Sister Lebea explained to Kgomotso’s aunt that Kgomotso was likely to die on the
road if she was put on a bus, but that there was a man with a van who was good and did this kind of thing. She spoke of a collection that the nurses took, a raffle, that wasn’t much but would be enough, and that they would give her some of that. To Kgomotso, who had been sitting quietly in the bed listening to her fate being candidly discussed, Sister joked that she needed to take a bath, that she was becoming lazy wasting her days away in that hospital bed. Didn’t she know a woman should be up before the sun? Kgomotso smiled a thin smile. I felt my eyes fill with water, but dared not release the tears. Instead I pressed my arm into Sister Lebea’s as we sat together tightly on that stool, shoulder to shoulder, pretending it was all I could do to keep from falling off. We got up together. She told me to collect the Refusal of Hospital Treatment form and sign it. I did, and gave Kgomotso a pen. Sister was quick to chide me. ‘No pen, doctor, get ink for a thumb print.’ I did, and thanked her.

  ‘Yes doctor,’ was her response as she pulled a teabag from her large cooler bag and sat down for a cup of tea.

  Kgomotso died that very afternoon, before her aunt returned with the man with the van, before Sister had fetched the money from the collection, before I had had an opportunity to complete her discharge summary. She could have waited. Dying people are selfish. She should have waited.

  Nobody had bothered to tell me to my face that Tshiamo was dead. Instead Ma came into my room while I was pretending to sleep and whispered it in my ear. When I confronted her about this months later, she said Aunty Petunia had advised her that this was the best way to break difficult news to children, while their spirits were hovering over their bodies.

  I emailed Tshiamo about that too. I put a lot of LOLs in that email because I knew it would make him laugh. He’d always thought Aunty Petunia was a stupid old woman just waiting to steal the expensive plates Papa had left for Ma when he moved out.

  Sometimes I can feel my lips curling into a snarl and my eyebrows burying themselves deeply to form a line across my forehead. When I catch myself doing this I quickly try to correct it, try to convince the muscles in my face to relax, the bones of my jaw to let go a little. I wonder how I look as my face contorts into an ugly knot. The anxiety in my heart is so full it brims over, seeping into my blood and poisoning even the hair that grows out of my flesh.

  Ma called today. She asked if I was still living with ‘that Zimbabwean girl’. She wants me to come home and go to the cemetery with her this weekend. I lied and said I’d be on call.

  Sometimes, in the very early hours of the morning when I’m driving home from a split-call and it’s just me and the night lights on the empty highway, I let go of the steering wheel just for a second and push down hard on the accelerator, and wonder, if I were to go fast enough, would I take off into the sky and soar like a plane? Disappear into the darkness of the night? And if I were to land on the other side, would Tshiamo be there?

  This doesn’t interest You, does it?

  I know, I know, You’re busy saving lives in Sudan. Never mind.

  Part 2

  The heart is deceitful above all things and desperately wicked: who can know it?

  Jeremiah 17:9

  Last night Mamokgheti Sesing of Vukani News told the world that a mob of 20 South African men set a street of shops belonging to a community of Somalians in Sechaba township alight. In addition, three young Somalian girls were stoned to death, and many families had to flee their homes. They showed a woman who’d been beaten by the crowd crying outside her ashen store, her children staring wide-eyed into the camera.

  I called Nyasha immediately, but she didn’t answer. It was perhaps a blessing, because I had no idea what I was going to say. When I went to the bathroom in the early hours of the morning, I heard her crying on the phone, telling her mother, far away in the UK, that she was afraid to open her mouth in public places in case people heard she was foreign and hurt her too.

  I was angry. How could we be so savage, so cruel, so inhumane? What kind of people are we?

  I wanted to make things better. I set my alarm and resolved to tell Nyasha in the morning that those murderers didn’t represent the ordinary South African. They were criminals, mobsters, lowlifes. But as the thought entered my mind, I knew it was a lie. I thought of Ma, how she frowns every time I mention Nyasha and refuses to try the food she’s cooked. Ma – churchgoing, God-fearing, people-loving Ma.

  I remembered laughing myself in first-year varsity when Zanele called them all oorkants and refused to share a dorm room with one because she said they smelt of menstrual blood.

  So when Nyasha walked into the kitchen this morning, eyes all puffed up, sclera bloodshot, I pretended not to notice. I acted like it was just another Thursday morning and played dumb.

  Of course I’m ashamed. But it’s not our fault. It’s the white people’s fault, Lord. Everything is. They taught us to hate ourselves. They made us like this. We weren’t like this before they came. This is not the way we would have been if they hadn’t come and messed everything up for everyone.

  Throughout the day the TV has been ablaze with burning shacks, burning shops and burnt people. The streets are crawling with bloodthirsty men calling for foreigners to leave the country. Nyasha came home a little after me and went straight to her room and hasn’t stirred since. So I watched the news alone with the sound on mute. They showed images of a naked man being dragged by a mob of boys, blood gushing from his head, and then an image of a group of policemen pouring water over the body of an elderly woman. Hammers, axes, knives, bottles, sticks, rocks, men, women, children, animals everywhere.

  Of course it was difficult to watch. But I had to. I had to face this horrible thing that we’ve become.

  Things have got worse. The xenophobic violence has spread like wildfire. On my call last night, the Emergency Medical Services brought in a foreign national who’d been burnt alive and sustained third-degree burns to 80% of his body.

  When Nyasha came home, the first thing she said was that she’d heard that a victim of the xenophobic violence was a patient of mine. She wanted to know what ward he was in so she could go and see him and give support to his family.

  He wasn’t my patient, I told her. He’d arrived already intubated on my emergency department call and I prescribed fluids, antibiotics and analgesia, and then handed him over to the surgical team.

  ‘Which ward is he in?’ she’d insisted. ‘And what’s his name?’

  I explained that I last saw him in the emergency department on a ventilator, waiting for the surgeons to take over. They were aware of him but were held up in theatre. So I didn’t know which ward he’d ended up in. Probably ICU or Burns Ward. I didn’t remember his name.

  ‘You just left him there?’ she retorted accusatorily.

  ‘I couldn’t get an ICU bed, Nyasha,’ I tried to explain. ‘I called the surgery register and handed him over. But with third-degree burns to 80% of his body, you know mos, Nyasha, the treatment would probably only be supportive.’

  ‘So you did nothing?’

  ‘I couldn’t get a bed, Nyasha. What was I supposed to do?’

  ‘Did you call Imhotep Academic Hospital?’

  ‘Of course I called Imhotep,’ I lied. ‘You know it’s always full.’

  ‘So you went back to bed?’

  ‘Nyasha, for goodness sake, he had third-degree burns to 80% of his body, his chances of surviving were slim to none. I put up a line, we gave him good analgesia and antibiotics, and then handed him over to the surgical team. I’m a house officer, I’m not Jesus. What on earth was I supposed to do?’

  ‘What is his name? Tell me his name so I can go back to the hospital and find him.’

  ‘I can’t remember, Nyasha. It was a really busy call, the emergency department was packed. There were so many patients, I honestly can’t remember.’

  ‘You don’t even know his name?’

  ‘Nyasha? Do you remember the names of every patient you see on call?’

  ‘You don’t care, do you? He’s j
ust another foreigner to you, another kwere-kwere!’

  ‘Nyasha, come on, don’t say that. You know that’s not true.’

  ‘Where’s the family? How did he get there? He couldn’t have come alone.’

  ‘Emergency Medical Services brought him in, Nyasha, but I didn’t ask where they found him. I’m sorry, I should have, but I didn’t think to ask, with the third-degree burns to 80% of his body and all.’

  ‘You’re pathetic. You’re all the same. Fucking monsters.’

  ‘Nyasha! I’m sorry about what’s happening with these xenophobic attacks, I really am, but it’s not fair to take it out on me. I didn’t do anything wrong.’

  ‘Didn’t do anything wrong? You leave a helpless man, who’s burnt throughout his whole body by your people, to die in casualty with a drip in his arm and some Brufen, and you tell me you did nothing wrong? What kind of animal are you? Do you think those nursing sisters and those surgery registrars who despise us foreigners are going to make an effort to attend to that man properly, sit on the phone and find him an ICU bed, give him a fighting chance? Why didn’t you stay with him? Why didn’t you stay on the phone? Why didn’t you call Hamilton Naki Academic or Mary Malahlela Central Hospital? Why didn’t you get the consultant on the line? What about a central venous pressure line? Did you catheterise him? How were you monitoring those fluids you were pouring into him? Did you consider any of that? You were the only chance he had, and instead you chose to go back to bed. You think you’re different, Masechaba, but you’re all the same.’