Where do babies come from?

Ah, isn’t that the hardest question? I don’t mean for me. At least I know that there are usually two people involved, preferably a man and woman with a steady income and a place to live. Then a surge of hormones making them behave much like animals, genitals meet, body fluids are exchanged and for the next nine months, the woman’s body is an anatomical and physiological mess that hopefully comes to a climax when a live healthy baby pops out of her vagina. But try explaining that to a five-year-old. At the height of curiosity and an all time low of social propriety, the toddler asks the one thing their mind is least developed to grasp, from whence their baby sister or brother came.

We were told a number of things growing up. A friend of mine’s mom told him that a very bright light shines in mommy’s stomach and voilà, a baby appears. My mom told me they’d bought my sister from a shop and that she actually came in a box (face slap). And my all time favourite: that mommy and daddy hug so tight until a baby starts growing in mommy’s stomach; like that’s all they did.

Sex has always been a hard topic for my dad and I. I know he has had tonnes of it. Legend has it that when he was my age he got lucky many more times than I hope to ever get. And now that sex occupies a considerable part of my fantasy, he won’t share his secrets with me. C’mon Dad! I mean we talk about the more elegant aspects of sex like marriage. Namely whom to marry, what qualities to look out for like is she homely, does she have a head on her neck, but never about sexual compatibility.

When your toddler asks you the question, where do babies come from, you probably have one of three choices. One, to lie. This is what my mom did. By no stretch of the facts do we end up buying children from a shop. I know that now. (I actually didn’t believe her the first time. I always knew that the truth was probably too embarrassing for her to admit which is why she hesitated before telling me that)

Two, only tell half the story. Like mommy and daddy hug very hard until a baby starts growing in mommy’s stomach. Leave out the greasy details and spare your child the trauma of knowing the basic nature of human reproductive biology.

Third, go the whole mile. Lay down the facts like they are. Tell them like I said it in the opening of this article. You could never tell a lie, could you? After all, it’s wrong to lie and lying to your own flesh and blood has got to be the worst. Have only a little concern for how it affects their little minds like how they will sleep at night knowing that mommy and daddy are probably making a baby. Don’t worry they can handle it.

Of all three courses of action, which one do you reckon is the worst? The third? I think it is the third. The truth should not always be told, ask a guy that told his girlfriend that her friend is hotter than her. Or that she’s fat, and talks a lot and is nagging. All these may be true but it was probably best for you, your girlfriend and your relationship as a whole not to confess every time you cheated on her. (Just kidding, I’d never cheat on my gal) But seriously, little minds shouldn’t be introduced to matters of an adult nature like sex when they don’t have the capability to properly discern between what is good and proper and beneficial.

But before we move on from this, let me weigh in on the second worst way to go about this question. In fact, it’s not listed among the three I have offered because it happens after your child has been told from elsewhere where babies really come from. What do you do, say your child’s friends’ parents told them the whole truth and you are lucky enough to have your child share with you this new found knowledge. Do you:

A. Call your child’s friends’ parents lairs and offer an alternative truth

B. Throw in the towel and admit to them that that is in fact how it all goes down but caution them not to make babies before they can handle the responsibility. Or,

C. throw in the towel and admit to them that that is in fact how it all goes down but vilify the whole baby making business lest they indulge too soon.

C is in fact the worst way you can handle this situation especially if you don’t know when to stop. Time will come when your children have no doubts about the pleasures of sex and sex related activities and you will still have your head buried in the sand pretending like nothing is happening. And you better hope your child is getting the proper guidance because guidance they will get. Of course if your children developed a different world view than yours then I appreciate the difficulties this presents but all the same, I believe that everyone stands to lose when something so natural and so beautiful in painted black and red on the pages of porn websites or left to the devil while we take cover in church buildings.

Featured image: Hon. Robert Kyagulanyi, MP for Kyadondo East with his family


The Mundane

Today I return to the ward for my hardest course unit since I joined medical school. At this time, I have to actively remind myself of how extremely lucky I am to be in medical school; even if at a university ranked _ (I’d rather not say) in the world and in a third world country. I actually get to live my life long dream to help people! But I don’t wake up every morning thinking to my self, o how lucky I am to be going to medical school today; to learn more about how to help people. In fact, on more days than I am proud to admit, I drag myself to class, then to ward, back to ward for call or the library and back to bed. On some days I am really motivated, but there are some days I wish I was in a different place or time because I am tired, hungry and sleep deprived.

Saving lives is hardly a daily concern of mine. This is what goes through my mind on the daily, hunger, fatigue, assignments, exams and dirty dishes that have over stayed in my room. At the end of the day, I don’t have much time left to think about strangers. Not that I don’t care for them but that the mundane things of life have clouded such thoughts.

There are times when I see a colleague do or say something that makes me wonder whether or not they actually care for the people they serve. But almost invariably the answer is that they actually do care for their patients. They cared enough to at least drag their feet to work that day even when they had better places to be and better company to keep. They care most of the time though there are times when they kind of don’t care! The mundane things of life occasionally cloud their minds enough so that they forget and say or act in ways not congruent with the commitment they made to human life.

A good health worker does well to remember that in times when they forget why it is that they joined the medical field, these times are not definitive of their overall attitude towards health care. That these moments may only prove that we are in fact humans after all. We get tired, pissed, disgusted, discouraged and bored just like everyone else. These moments remind us that like every other human, we need a break every now and then, we need someone to cut us some slack and we need a pat on the back especially when we deserve it.

Don’t let the mundane take your eyes off the prize, the best quality health care. For when we focus on the dullness of the mundane, we risk losing sight of the more exciting most important things. We actually get to save lives. I sometimes in such moments of weakness think to myself that even if all I did was save lives, I’d still be pretty awesome. It is that noble a profession and it does not come cheap. It is merely doable on average and one may excel if they can afford to pay with their lives.

You may perform a cricothyroidotomy one day with only a knife, some vodka and a pen or relieve a tension pneumothorax with a 16G cannula to the second intercoatal space midclavicular line on another day but most days will just be plain. You may counsel a mother who brings in her baby with a diaper rash and prescribe bed rest for the common cold. And yet everyday you are extremely fortunate to be given the opportunity to save lives.

A twenty-four year old man

Today I make twenty-four and if I am not in my mid-twenties then no one is. It actually came to me that if I told you I was in my mid-twenties, you could easily assume I was twenty-seven. Pretty old eh? But try convincing my father of that.

One time I was talking with my father when the conversation turned into a debate about whether certain elements of our culture were not in keeping with modern lifestyles. I offered an example of the way we greet; it is laborious. There’s like three greetings in one and a lot of humming and cooing in between that I’ve never mastered up to this age. So every time I try to greet an older person in vernacular, I leave them perplexed at my ineptitude in the art.

And we’ve had many such debates, like whether one is better off going to a vocational rather than a regular school or whether there is any upside to Trump being president. And almost every time we have them, my opinion is less valid because I am young, ignorant and inexperienced. In fact, I once heard that I thought the way I did because of my youth but that I’d know better when I got older.

I am older now, I know better and I think differently than I did then. For example, when I was 17, I thought I’d like to get married early, make a home and raise kids properly. And that that had to be the greatest contribution I’d make to advance mankind. Now, I don’t care for much of that happening for me even though I appreciate the contribution that good parents like my own make towards society. But the question had always remained for me, when will I be old enough?

When was I old, wise and experienced enough to make the really important decisions pertaining my life? When did I cease to be a boy and became a man? I think it was when I started making decisions with substantially high stakes. When the decisions I made would determine which career would make me miserable for the rest of my life, whether or not I’d inadvertently assume responsibility for another human being for about the next thirty years of their life and which lifestyle disease would eventually kill me.

I am suggesting that being old enough has more to do with the magnitude of responsibilities you have than with how well you execute these responsibilities. I am more as old as I am required to be than as old as I’d like to be. Therefore, I’d think of myself a twenty-four-year-old with no prospects or plans for the future not as a boy because I am irresponsible but rather as an irresponsible man because I am a twenty-four years old with no prospects or plans for the future. As such, having the responsibility of a magnitude that is usually bestowed upon those that are old enough should afford me the license and audacity to self-determination.

That said though there is something castrating about being a man without a job and still living off of his parents. And I guess it’s only fair that since it’s their money they also get to call the shots. What I do however is that in every situation that I am allowed to decide, I take the responsibility as an adult; like I alone are to blame for the mishaps that may ensue. Now here’s a toast to old age, wisdom, and experience.

Featured image: Sandile Shezi, South Africa’s youngest self-made millionaire was only 23 years old when he caught the media’s attention in 2015. In the picture, he delivers a talk at University of Cape Town, 2016. Image by Sam Bears from here

How to make a dress code

Today is the last of this month; but before we move on to August, allow me to consider one last event in July. Earlier this month the Ministry of Public Service, Uganda released a circular in which it prescribed a dress code for the non-uniformed officers in the public service. Notable no nos were mini skirts, cleavage, and multicoloured nail polish for women and for men, there’d be no tight trousers, short sleeved shirts and open shoes except for medical reasons.

Now all these seemed fair to me until I heard the reactions from the civil servants and others concerned. Some said the rules were oppressive, others said they’d need a dressing allowance to cover the cost of buying new clothes (as if they were walking around naked before) and others thought the whole dress code thing was rather trivial.

When I was in high school, I ran for prefect. On the day of open campaigns, after I had embarrassed myself by dancing for the school badly, one of the teachers asked me, “What would you and your fellow prefects do about the improper dressing of the students?” Which was a bit unfair of him to ask me since I was not standing for Head Prefect but anyway I went on to answer.

Now I went to an international school for my final year of high school so the environment there was much unlike other local schools in the country. For a conservative, which I think the teacher was, the students’ dressing was anything but proper. To the liberal, which seemed to be the more influential group in the school, everything was fine. Actually, a few would say we were smart.

It appeared that I had three choices: go with the conservative and condemn a good number of the students, side with the more influential liberals and win the favour of the students or take a politically neutral standpoint and neither offend nor side with either group. I chose the third. I answered then as I would now that “Morals are not universal, but we as an institution have to set a standard by which we operate and my job would be to encourage my fellow prefects to set an example for the rest of the school by how they dress.” And the students cheered for me.

Now, of course, certain elements of our moral codes are so ubiquitous they seem to be universal and self-evident but the way in which they manifest practically is anything but universal. For example, we may all agree that one should not walk around naked but the length of one’s skirt is still debatable. But as an institution with a vision for the desired future and a reputation to create and protect, it would be wise for us to decide on which length of a skirt we shall allow our representatives to don. We must have had a dress policy at my high school but I don’t know whether it went as far as stating the length of one’s skirt relative to their anatomy.

But if and when you decide to have an institutional policy on how your members dress, I suggest from my inexperienced but good observational point of view that it satisfies at least two criteria. The first, it should be functional. There are many public servants doing all kinds of jobs. Some work indoors, outdoors, both in and out doors; some are more physical than others, some interact with people on a daily basis while others only interact with a few people rarely. And I think it is common sense that the rules not be so strict as to deter a person from properly carrying out their duties. Which is probably why it wasn’t mentioned in the circular that there are cases in which the prescribed dress code would not be functional.

Now I don’t know where exactly doctors fall, whether uniformed or non-uniformed officers but let me take them for an example. A doctor interacts with people on a daily basis so yes he/she should look professional but his/her work is so physical and long that the prescribed dress code is not functional. In the daily tropical heat of Uganda, wearing a vest or undershirt, a long sleeved shirt, neck tie and white coat and then standing on a ward round for four hours is neither necessary nor practical. Personally, I gave up on vests and undershirts altogether while at the hospital. The circular maybe should have implied or explicitly allowed for the dress code to be interpreted on a contextual basis to cater for the variety of posts in the public service.

Secondly, the institutional policy should not be seen to inadvertently promote useless prejudices that it should in fact actually be seeking to challenge and nullify. I was watching a female YouTuber go on about modesty talk in the church and she made a point that I’d like to paraphrase. Isn’t it a problem that a woman is told to dress for the benefit of the man. If she is smart, it is to please the man and if she is modest, it is so that the man is not stumbled in his walk of faith. Why can’t she do it for herself; look sexy for her confidence, be modest for her honour? Why is it always about the men?

And I get it, maybe most women that have been raped have been raped because they looked too appealing that their rapists had no choice but violate their rights but you’d have a hard time proving that. And now let me borrow something from the ex, why does a woman have to lose her femininity in order to be taken seriously in the work place? In her words, “We can be both sexy and serious at work.” An institutional policy on dress should not be seen to promote deleterious prejudices on the basis of religion, tribe, sex, and race and it especially shouldn’t promote sexism (misogyny).

I get it, these prejudices are so entrenched within the societal mindset that it’s almost futile to radically challenge them individually or as a singular institution. But rather than buy into and therefore promote them, we should nibble away at the edges of these prejudices with the hope of one day to have eventually eaten all of them away.

Featured image: The cast of Suits, a Law TV series


When Doctors strike

When I got into medical school, many people would say to me that I had made it in life. To them, medicine was a big deal because it was somewhat a comprehensive solution to all one’s needs. I’d make a decent living, have respect from nearly all men and attract a quality variety of ladies. And though these were not my primary reasons for joining the profession, I’ll admit that their impressions of the profession were pretty impressive.

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A Case for Male Nurses

My university does this cool thing where they send us off to the community for a month or two. In summary, we get to closely and extensively interact with the people we are trained to serve while we learn to serve them better. It’s nothing fancy, we get the basics while the rest we learn to fend for ourselves. Most notably, we cook for ourselves; we all take turns.

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To Help People

During orientation for my third-year obstetrics rotation, one of the senior obstetricians picked on me and asked, “Why did you choose to study medicine?” and I almost immediately answered, “To help people.” Then he accused me of being a liar insisting that we had all joined medicine to make money.

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