It is another ordinary first Saturday and I am seated in the Subcounty hospital consultation room.

In walks an old lady. She greats me excitedly, in vernacular. Oh how I have missed doing consultations in vernacular! They are always enthralling. She has a lump on her right shoulder that she needs me to see.

She has had it for the longest she can recall.

It is not possible to use the Gregorian calendar with her, given her age and modest literacy.

So we pick political administrative seasons.

A lump older than the Kenyan democracy

“Did you have it during the first term of the Jubilee government?”

“That is just the other day,”she makes a fool of my stretch of the duration.

“Kibaki government?” She affirms.

We get lost once we delve into the KANU era since I cannot recall the exactitudes.

So we try another route. The Meru age sets (nthukí). She takes to it like fish to water.

She has had it since the birth of her first born son who is “Ndingúri e míríti’. Now, any Meru reading this will know where that age set leaves us. 

When we are done I send her home.

“There is nothing wrong with you, it’s just a lump of fat which has been a wonderful companion to you!”

The boy who shocked his friends, himself and me!

The next to get in is a boy three generations younger. I expect him to speak in Kiswahili since he must be in his upper primary school ( wait, what is the arrangement of classes with the new curriculum?). 

He says hi and sits as if burning to tell me something. Then suddenly he looks like he is not sure of what to say. 

“I am swollen underneath here [sic],” he points to his groin.

I get him onto the examination couch and draw the green mobile screen, 

“Unzip your trousers.”

“Doc, I need you to see something,” the clinical officer in the adjacent room interrupts me. I request her to give me a moment.

When I get to the other room, I encounter a mirror image. A similar patient with the same problem, lying on the couch directly opposite the one I have just left. Only the concrete wall separates them. And the doctor-guaranteed patient confidentiality, I assure myself. How wrong I am on this! 

At least the patient in this room is speaking. He has undergone circumcision. A week prior. But the swelling won’t just subside. 

The circumciser is the less talkative one I have left in my consultation room. He circumcised several boys a few months earlier. And when this season came, more arrived at his door ( or whatever the entrance to his throne). He kept offering the service, at no fee!  Yet he himself has never been circumcised. 

Hacking his own foreskin

Realising that no one else has the skill he has, and that he is promoting other boys to ‘adult’ status without leading by example, he turns to himself and starts hacking his own foreskin. He has some infection and significant swelling. 

The thoroughly trained surgeon in me is still in awe! No single suture? No florid infection? No clots of blood around the ‘surgical’ site? This boy is a legend! 

Remember he is the less talkative one? After half an hour of trying to suss out anything about his technique, tools, steps, duration, blood loss etc, I am left without an iota of information. Surgeon 0 – boy 10! 

The teenager circumciser! 

I admit both the ‘surgeon’ and his ‘patient’ to the male ward and prescribe wound care and mild antibiotics.

“ Doc, what do we do with your urology patients?”the medical superintendent asks over the phone three days after.

To which I reply, “Allow them home. I can review them during the next clinic.”

Whom between the circumciser and the circumcised do you think shows up during the next clinic?