CHAPTER TWELVE: PRETTY MAIDS ALL IN A ROW

I hadn't seen Joshua for close to 15 years. He had been a classmate during my first two years at university. After that, we completely lost touch. The next time I saw him was in one of the sub-waiting rooms in the hospital. He hadn't changed much in all those years and I recognised him instantly. ''Bwanji seni?' I said, extending my hand and using the parlance of the mid-1970's when I last saw him. 'Chishimba,' he said. 'You work here?'

'Yeah,' I replied. I went on to tell him that when we parted at campus I went on to medical school and that was why we had not met. He told me that he had majored in agricultural science and was based in some rural town where he had been for several years. He looked dapper in a grey suit, handsome and seemed as fit as a fiddle. I asked what he was doing in hospital early in the morning as it was just after 08.00 hours.

'It's my wife,' he replied. 'I brought her breakfast.' She was admitted a week ago in this ward, he said, pointing to the ward.

'But that's my ward,' I told him. 'What's your wife's name?' I asked him. He told me the name and I told him I would pass by to see her a little later as I was then rushing to the laboratory.

Mrs. Mutwale, his wife, was in her early thirties, though she looked older than that evidently because of her illness. She was dark with long hair and a very dry-looking skin with pimples all over. One could tell that she once must have looked pretty despite the emaciation. I introduced myself and greeted her. I had been seeing her all week but hadn't really noticed her because she belonged to another group of doctors. She went into a paroxysm of coughing when she tried to answer and my heart sank. The possibilities of her disease were few and all pointed to one thing: HIV-related. After exchanging some banalities I excused myself and asked one of her doctors who had come into the ward what her problem was and he told me that she was HIV positive with chronic chest infection; not T.B., though, for this had been repeatedly negative. The interesting thing though was her chest X-ray which he proceeded to show me. It was indeed interesting. It showed a pattern consistent with a very common cause of pneumonia in Europe but not in Africa. It was a picture which we had seen only in journals and it understandably created a bit of excitement.

A few days later I met Joshua again. He asked me what the problem with his wife was. I asked him if he had discussed with her doctors and he said that he had though he had not been told much because they said they were still investigating. He also said that his wife was complaining a lot. She said that each day there were a minimum of 10 doctors or medical students examining her and her chest X-ray, but nobody had bothered to explain to her why the fuss and interest in her. At a teaching hospital, such things are bound to happen. The triad is of service to the patient, teaching for the students and research in that order. Occasionally the order may be ignored at the expense of the patient's comfort. This is regrettable but sometimes unavoidable. Well, I told Joshua why there was all that interest in his wife and told him that I had discussed with her doctors and they were doing everything possible to try and confirm their suspicions. He seemed to understand and he asked me to explain to his wife.

I went into the ward and found her very agitated. When she saw me she asked why she was being bothered so much. She wanted to know where her chest X-ray was and that she wanted it back. Why were there so many doctors coming to see her? I tried to explain that her case was difficult and that was why so many doctors were seeing her and that her X-ray was also being seen by some very senior people to try and make a diagnosis. She asked me to tell her doctor to bring the X-ray back! I tried to mollify her with no success. By then a group of nurses and cleaners had gathered round and the situation was getting out of hand. The Sister-in-Charge knew that I was acquainted with the husband and she called me aside. She told me that the night report indicated that she had been very restless and hostile the whole night. It was not normal anger, she said, and the disease seemed to have affected her mind. I agreed with her. We could still hear the woman talking loudly. Fortunately one of her doctors came round and he gave her a sedative which seemed to calm her down. Later in the afternoon I was doing some procedures in the ward when one of the nurses called me to attend to a patient who was gasping. I rushed and found that it was Mrs. Mutwale. She was semi-conscious and was frothing at the mouth. Joshua had also come into the ward and was at the bedside but I asked him to wait outside the ward. I tried resuscitation but to no avail and she died. I was in the thick of things once again. I found Joshua smoking a cigarette just outside the ward.

'I have to go and tell the relatives,' he said, before I could say anything to him.

'I am sorry,' was all I could manage.

'Perhaps it was for the best,' he said. 'She has been suffering for so long. Let her rest. Anyway, thanks for your help mwana. Can I go and see her for the last time?' he asked.

'Of course,' I said and led him into the ward. I asked the nurses to leave him alone and went into the sisters' office to write the death notes. He popped in to bid me goodbye and I asked for his home address so that I could pass by the funeral house later on. (In Africa one doesn't need an invitation for a funeral.) One of the nurses came into the office and asked me if I knew the husband. I said I did, and she said he was a very unfortunate man for that was the third wife to die. 'Third?' I asked.

'Yes', she said. 'Number three.' She had been told by one of the nurses who was a friend to the just-deceased woman that his previous wives had also died. I opened the file as it was still on the table and flicked through but there was nothing about this. Well, that wasn't surprising since it was not the husband's file anyway. I asked the nurse if she was sure and she said she was positive. She said his first wife died about 6 years earlier from T.B. His second wife had died 4 years ago from chronic diarrhoea and weight loss. Now this third wife from HIV-related disease. And him, what was his HIV status, I wondered. If you are not thinking what I was thinking then, that's all right for I had developed a high index of suspicion by that time. Joshua was only 36. He was bound to marry or at the very least have other girl-friends. Then what? Fatal attraction of the HIV type?

Thinking of Hollywood reminded me of a Rock Hudson movie I had seen several years back, in which a slight change in the script and characters might describe Joshua's story. Rock Hudson as a High School teacher killed one young girl after another, all attracted to his good looks but not knowing that he was a psychopath. The film was titled 'Pretty Maids All in a Row', Rock Hudson, how ironic.