Truth Doesn't Have a Side

by Bennet Omalu

  That was a Friday afternoon. What followed was the longest, darkest weekend of my life. On Saturday, I tried to drink and smoke away my pain. On Sunday, I got up and went to church and pleaded with God to save me. On Monday morning, I called in sick to work. I could not go in and face more death, not with a possible death sentence hanging over my head. My mind went back to that first autopsy. He could be me, and I could be him, I had thought at the time. Now these thoughts haunted me.

  I called my sister Winny and told her what was going on. “If the test comes back positive, I will probably kill myself rather than sit around and wait to die in some horrible way,” I told her.

  “Don’t worry, Bene,” Winny said. “We offered you up to God before you left Nigeria. He will take care of you.” She then pleaded with me to come back home to Nigeria if the test came back positive. “You will not suffer alone,” she said.

  “Okay,” I said, but I didn’t really mean it. To be honest, I could not contemplate a future that dark.

  Later that afternoon, my phone rang. A lovely feminine voice on the other end asked, “Is this Bennet—Bennet Omalu?”

  I swallowed hard. “Yes,” I replied.

  “I called to give you your HIV status result. The physician left a note that we should call you.”

  I almost collapsed in fear when I heard that.

  “Your test came back negative,” she said. “However, other tests show that you may have infectious mononucleosis. We need you to come back to see the doctor this week. Does tomorrow work for you?”

  I was so relieved by the good news that I nearly shouted, “Yes, tomorrow, I will be there!” When I hung up the phone, I collapsed back onto my bed, relieved and grateful. I poured out my thanks to God for sparing my life.

  One might think that after such a close brush with death, I would immediately change my behavior. However, within a matter of days, I was right back where I was before, working like a maniac and partying like a maniac. Thankfully, God was merciful, even as I know He grew tired of my contradiction of a life. At one point, I discovered I was impotent. That didn’t immediately cause me to change my ways. I went to see a urologist, who found nothing physically wrong with me. He sent me to a psychiatrist. My sessions with him yielded no answers. The problem persisted.

  One morning during a time of prayer, the answer came to me. God had done this to me to put an end to my contradictory lifestyle. He had too much in store for me to throw it away, as I tried to do during my time in New York. Once I accepted His plan, I was ready for the next step along His path. My struggles with temptation did not immediately end. Do they ever? However, I found myself filled with thanks to God that He still loved me in spite of myself and in spite of my contradictions. His mercy gave me hope for myself, and for my adopted home.

  Chapter Nine

  A Bold Gamble

  By my second year of residency, I knew I wanted to specialize in forensic pathology. The reason circled back to the feelings I had during my first years of clinical medicine in Nigeria. Forensic pathology placed me as far away as possible from living, breathing patients, while still allowing me to practice medicine. However, there was more to my decision than that. While no one wants to spend their career surrounded by death, I found a deep sense of satisfaction in bringing dignity to those upon whom I worked. I became like a servant who prepared his master for the great beyond by the cleansing of the autopsy, as though this was a vital step in the transition from earth to heaven.

  I was also good at it.

  Dr. Carlos Navarro deserves the credit for that. He became a mentor and the father I did not have in New York. I worked alongside him, and he guided me and the other residents through every step of derivative tissue diagnosis. When I had the privilege of working with him on an autopsy, I felt like I was watching Michael Jordan doing his thing on a basketball court or Michael Jackson moonwalking across a stage. Dr. Navarro wasn’t just a skilled pathologist; he applied a level of artistry and perfection that made me want to develop my skills to be the best I could possibly be. Without a doubt, he was the single most influential person in my life in preparing me for the career God had for me. He instilled in me the love for the autopsy and shaped me into the doctor and man I am today. During my residency period, I did not take any vacation days. I felt I had a lot of ground to make up, since I was twenty-six by the time I came to America. Dr. Navarro kindly supported me with whatever I needed to succeed. If this sounds like I am gushing about my mentor, I am. I cannot overemphasize the impact he had upon my life.

  By my third year, I knew I needed to figure out my next move. If I was to become a forensic pathologist, I needed to be accepted into a fellowship program after my residency. That is the way of medicine. Medical school prepares you for a career in medicine in a very general way. You study all aspects of medicine and spend four years doing rotations in nearly every field—from anatomy to physiology, surgery to internal medicine to obstetrics and gynecology, etc. Throughout the three to seven years of residency, you focus on one field of medicine, but also in a more general way. Finally, you hone your skills during one- to four-year fellowships in one or more subspecialties.

  The fact that I was an international medical graduate put me at a disadvantage. Fellowships are highly competitive. In those days, most programs were less likely to give me the benefit of a doubt without knowing who I was. But how could they get to know me? I needed some sort of personal touch to overcome the natural barrier of my background. If I did not secure a fellowship, my visa status would be revoked, and I would have to leave the United States. For me, that was not an option.

  I began to pray and ask God to guide me and open the right doors for me. Just like the answer to my prayers years earlier in Nigeria, God’s answer came in the form of a letter.

  One morning when I walked into the Harlem Hospital Center, Dr. Navarro greeted me with an envelope in his hand. “I think this is something you should pursue,” he said.

  I opened the letter, which came from Dr. Abdulrezak Shakir, the program director for the fellowship training program in forensic pathology in Allegheny County, Pennsylvania. After reading the letter, I came up with a plan. Rather than just apply to the program, I decided to send a letter to Dr. Shakir, asking him if I could visit their office for a one-month, self-financed externship without pay. I believed this would give me a chance to prove myself while also giving them an opportunity to get to know me and my skills. The gesture may have been out of the box, but I needed to do something to stand out from all the other applicants. Dr. Navarro also wrote a letter of recommendation for me.

  Several weeks went by. Finally I heard back from Dr. Shakir, telling me that my externship had been approved. I just needed to let them know when I was available to do it. My spirits soared. I went to Dr. Navarro and explained the situation to him. Since I had never taken any of my allotted vacation time, Dr. Navarro modified my schedule to give me the entire month of October 1998 off. With that, I packed my bags, rented a car, bought a map, and headed west on Interstate 80, bound for Pittsburgh.

  The eight-hour drive from New York to Pittsburgh gave me my first real chance to see America. Even though I had lived on both coasts, I had seen very little of the country outside of Seattle and New York. Driving down Interstate 80, with Rod Stewart blaring from the car’s CD player, I marveled at the beauty of the Pennsylvania mountains, hills, and plains. The leaves had started to turn, which set the hills ablaze with color. Because Nigeria sits so close to the equator, it does not experience dramatic changes of season. Trees stay green all year round. But not here, not in the mountains of Pennsylvania. It was as though God had pulled out His watercolor set and painted a masterpiece for me to enjoy.

  I got to Pittsburgh around 7:00 p.m. on a Sunday. It was a dark and rainy evening. I found the coroner’s office on Fourth Avenue in downtown Pittsburgh. They were expecting me. One of the death investigators took me over to the Renaissance Hotel, where I spent my first night. Later, I moved to an extended-s
tay hotel, where the rent was much cheaper.

  Early Monday morning, I reported for duty at the Allegheny County coroner’s office. A staff member greeted me and showed me around briefly. “You can change in there into your scrubs,” she said, pointing to the staff locker room. “The autopsy room is right over there. Dr. Rozin is waiting for you.” Dr. Leon Rozin was the chief forensic pathologist and was on duty that day.

  “Okay, thank you,” I replied.

  I quickly changed into green scrubs and went into the autopsy suite. “You Omalu?” Dr. Rozin said to me as I walked in.

  “Yes, sir. Bennet Omalu,” I said, extending my hand.

  “Yeah, good to meet you,” Dr. Rozin said politely but not enthusiastically. He pointed over to the table closest to the exit door. A young white male lay on the table. “That one’s yours. The instruments are already laid out for you,” he said. “You can handle this by yourself, right?”

  I hoped the expression on my face didn’t give me away. I lied and said, “Yes. Of course. Thank you.” In truth I had never performed an autopsy all by myself. An attending physician always supervised me at Harlem Hospital Center. Nor had I ever performed a forensic autopsy, where the cause of death is completely unknown. For most cases in the hospital autopsies I had performed, we already knew generally why and how a person died. Those autopsies studied the body for differential diagnoses, quality assurance, and academic purposes. Now I had to determine the cause of a sudden and unexpected death.

  Dr. Rozin turned and walked to another table in the suite. Slowly, I walked over to the autopsy table. A technician handed me a file with the case narrative. “White male . . . twenty years old . . . found dead in his bed in the morning . . . no abrasions or lacerations on the body . . . no other signs of foul play.” I glanced around the autopsy suite. Everyone was busy doing what they were supposed to be doing, and no one paid any attention to me. If I had turned around and called over to Dr. Rozin and told him I could not do this, my chances of a fellowship would end right there. Nor could I call out to anyone else in the room for help. These were all strangers to me—strangers who had their hands full with their own work.

  I looked down at the face of the young man lying in front of me. He seemed so young. As I stared at him, a revelation came to me. He knew how he had died. All I needed was for him to tell me. I patted the young man on the shoulder and called out his name. Very softly I said, “Please help me. Show me why you died. I am afraid, and I have never done this before. But I don’t want to let myself down, and I don’t want to let you down. Help me, please.”

  My fears suddenly evaporated. I felt that the spirit of the young man was in the room. You can think what you may of that statement, but I am telling you what I experienced in that moment. Confidence filled my soul as I took a scalpel and made the first incision. Slowly, methodically, I checked each vital organ, weighing them, examining them closely. Given the facts of the case, I went through and eliminated every possible reason for a sudden death. His heart was strong and healthy, as were his lungs. I found no signs of a stroke in his brain. Nothing looked out of the ordinary. Given his physical condition, this young man should have been anywhere other than my autopsy table.

  After two hours, I was done. The autopsy technician packed the dissected organs back into the body cavities and stitched him closed. I put my notes together and went to find Dr. Rozin. “I can find no physical cause of death. Everything checks out perfectly. I believe he died from a drug overdose, but we will have to wait for the toxicology reports to come back to know for sure,” I said.

  “Very nice work, Dr. Omalu,” Dr. Rozin said to me. “I’m impressed.”

  “Thank you,” I said. I then walked back over to the young man on the table. “Thank you,” I said very softly. “Thank you so much for what you have done for me. I hope this gives you peace.”

  When the toxicology report came back, it confirmed my diagnosis.

  Over the course of the next month, I threw myself headlong into my work. Every morning, I tried to be the first doctor to arrive at the office and the last to leave. No matter what I was asked to do, I did it without griping or complaining. Following the example of my mentor, Dr. Navarro, I tried to elevate my performance each and every day, to improve my skills and not be satisfied with good enough. I got to know the other people in the office and established good relationships with them. The longer I was there, the more I wanted to come back and work here. I liked this place.

  I also began to do some research into the Allegheny County coroner’s office. Dr. Cyril Wecht, the coroner, was, I learned, basically a rock star in the world of forensic medicine. He first became a public figure in the 1960s, when he poked holes in the Warren Commission’s findings that President Kennedy had been killed by a single shooter. In his assessment, the prevailing global forensic scenario and medical evidence simply did not support that. When I read of his connection to the JFK investigation, a bell went off in my head. I had heard his name years before when I watched a documentary about President Kennedy while I still lived in Nigeria. After making a name for himself with his response to the Warren Commission report, Dr. Wecht was part of some of the biggest cases in America, including investigating the deaths of Robert Kennedy, JonBenét Ramsey, and the victims of the Manson family murders. He’d penned bestselling books about famous and infamous murder cases and was brought in as a forensic expert by attorneys like F. Lee Bailey. The more I discovered about Dr. Wecht, the more I realized that working in his office was the chance of a lifetime for an aspiring forensic pathologist like myself.

  I met Dr. Wecht for the first time on the first day of my externship when he took me and the other pathologists in the office out for lunch. He immediately struck me as a man who was different from others. Forthright and no-nonsense, with an assertive persona, Cyril Wecht spoke his mind and was not afraid to go against the tide of popular opinion when he believed he was right. And when he believed he was right, I found he usually was right. His jovial loquaciousness struck some as abrasive. Me—I found it refreshing. He had a good, transparent, and sincere heart, while also doing his work at a level few people have ever attained.

  During my first meeting with Dr. Wecht, he turned to me and asked, “So how did you get Harlem Hospital Center to pay for this externship? If they’re like our office, money is always tight.”

  “The hospital isn’t paying for my time here,” I answered.

  Dr. Wecht looked at me with surprise. “Then who is? I don’t recall signing off on a grant for you.”

  “I’m paying for this myself,” I said.

  “You’re what?” he said, with more than a little shock in his voice.

  “I knew this was a once-in-a-lifetime opportunity, so I am paying for everything myself,” I said.

  Dr. Wecht smiled. “You won’t mind if I pick up our lunch tab, then?” he said jokingly.

  I laughed. “No, not at all. Thank you.” From that moment forward, I think I had a special place in Dr. Wecht’s heart. In me he saw someone just as driven to succeed as he was. And in him I saw someone after whom I knew I should pattern myself.

  I came to Pittsburgh to audition for a fellowship, but I also came here to learn. Early on, I learned to take Dr. Wecht’s advice. Once while making a presentation on a case to him and several other people in his office, I humbly offered my opinion as to what had happened to the deceased person. I used words like may and might and possibly throughout my presentation. Dr. Wecht stopped me in the middle and said, “Bennet, Bennet, Bennet, you are now in America. I know you were raised in a former British colony and in the old British way, where being meek is regarded as strength. But not in America. You have to be assertive, speak out confidently, and be bold and arrogant if need be. Americans respect that. If you come across as meek in America, some people will want to run right over you.”

  He did not have to tell me twice. I edited out such words from all future presentations. When I knew, I said it boldly. If I did not know, I said t
hat as well.

  At the end of my month in Pittsburgh, Dr. Wecht asked me to come see him in his office. “Bennet, the fellowship position is yours if you want it,” he said. “We’d be honored to have you join us here in Pittsburgh.”

  I fought back tears, smiled, and said, “Thank you. Yes, sir, I would love to join you here. Thank you for offering the position to me.”

  At that moment, I had no idea what was ahead of me in Pittsburgh, nor how this externship would change the course of my entire life. For now, I was simply grateful for the opportunity.

  • • • •

  Before I could begin my work in Pittsburgh, I had to finish my residency in Harlem. The anatomic and clinical pathology residency program was five years when I started in 1995. I applied to the American Board of Pathology to reduce my five-year training to four. Given the progress I’d made and the position waiting for me in Pennsylvania, I did not believe I needed the fifth year. In my application letter, I included academic justifications, along with a list of professional accomplishments to support my request. Dr. Navarro penned a support letter for me. A short time after submitting my request, the board sent me an approval letter.

  I spent my final months in New York learning all I could from Dr. Navarro and the rest of the staff at Harlem Hospital Center. With the fellowship in hand, I was able to focus more clearly on exactly those skills I needed to hone to be ready for my work at the Allegheny County coroner’s office, which was converted into a medical examiner’s office in 2005.

  At the end of the academic year, I gave away most of the possessions I had acquired while living in my Harlem studio apartment. I loaded what was left into another rental car and set sail on Interstate 80 on a warm June 1999 morning. Once I left the city, I pulled the car onto the shoulder of the freeway, stepped out of the car, and took one long, last look at the city that had given me so much. The twin towers stood as majestic as ever over the New York skyline. “Thank you, New York,” I said. “I hope Pittsburgh will give me what you have given me.” I let out a long sigh, got back in my car, and pulled back out on the highway headed southwest.