The Patient. Olive Kobusingye

waragi glass after another until he passed out on his living room floor.

      ***

      In 1979 when Amin’s government fell, Kimala was back in Mulago training to be a surgeon. The Israeli government requested Uganda to help locate Dora Bloch’s remains. Kimala led the team that located and exhumed the body. “I could remember where the body was buried. We dug up the bones. Benjamin Bloch, Dora’s son, had brought with him her medical records to help with the identification. Based on some documented dental work, and an implant in her vertebra, we were able to make a positive identification. It was a somber moment, but the son appreciated that we were able to find his mother’s remains. He took them and she was given a proper burial back home in Israel.”

       THE ENIGMATIC EIGHTIES

      Do not forget, through all the years

      Those who have gone through the gates of Makerere

      Give them the pride, Give them the joy

      Oh! To remember, the gates of Makerere

      The first weeks of medical school went by in a flash. Everything was new. While the students in other faculties carried on partying as was the custom at the beginning of every academic year, the medical students plunged into serious study. Every morning the medics walked from Makerere main campus across the valley to Mulago, mostly through Katanga valley. The cadaver room was the center of the new class. Small groups of five or six students were each assigned a cadaver. The introductory lecture in Anatomy was on the breast, but nobody called it that. Here in Anatomy it was the mammary gland. The arm, also called the upper limb, was more appropriately called the brachium. It was here that the seeds of complete language alteration were sowed, so that in future the doctors would think that pedal edema communicated better than swelling of the feet, and that epistaxis was clearer than nasal bleeding. It was here in the cadaver room that fears were overcome, and that lifelong relationships developed. There was something comforting about discovering that the smartest sounding guys did not necessarily have the steadiest hands at dissection, and that some unassuming students with thick rural accents had incredible capacity to memorize endless random facts about the human body. In a few weeks, everyone was comfortable in the company of the cadavers, which were slowly but surely being taken apart layer by chloroform infused layer. Prof. Sebuwufu said these were the students’ first patients, and they were to take good care of them. Dr. A. Galloway, the first head of the Department of Anatomy, would have been impressed.

      Some organs were described as being pear or almond shaped although there was not one pear tree in all of Uganda, and God help the student who dared to liken them to an avocado, a fruit the students and their teachers saw and ate on a regular basis. The normal ovary was said to be almond shaped. The students had never seen an almond, and the ovaries in the cadavers were anything but normal, so their imagination of what an almond looked like would have to do. In the clinical years there would be other curiosities, such as the cobblestone appearance of a trachoma eye membrane. No student had seen real life cobblestones, and perhaps neither had some of their teachers, but cobblestone it would be. Then there was the classic anchovy sauce appearance of an amoebic liver abscess. For goodness’ sake, what was an anchovy? The descriptions tended to obscure rather than illuminate. The height of obscurity was perhaps the ‘café au lait’ spots, which would have been familiar had someone told the students that the exotic sounding phrase was French for milky coffee. Students that had not been within thousands of miles of any snow were taught how to recognize a diseased lung by a ‘snow storm’ appearance on the radiograph. The endless hours in the cadaver room, the physiology lab, and the wards that the students would graduate to after two years of basic sciences, ensured that their new language took firm root. Karungi, by nature generously endowed with a curiosity for words and languages, soaked up – or rather, imbibed – this new language like a sponge.

      ‘Science should speak the language of the common people’ Rudolf Karl Ludwig Virchow, nineteenth-century German physician (1821-1902).

      ***

      The post-mortem room – PM room – was cooler than the rest of the hospital, being adjacent to the refrigerators that contained what the Pathology professor called the teachers. “The dead teach us many things. They make us wise if we take the time to study them. They come here carrying many secrets. Every dead body is a wealth of wisdom. So – open them up with respect. Look. Feel. Here in this room the dead speak. This is the House of Wisdom.” More often than not Prof. Wamukota said this while shaking the ash off the end of a cigarette. He probably used one matchstick a day, because he always lit the next cigarette off the butt of the one he was snuffing out. It did not matter that he saw many deaths from tobacco related diseases. He always said it was a pity for one to die with clean lungs. “Look! Clean as can be. This girl never smoked a cigarette, and very likely never cooked on a charcoal stove either. No trace of smoke. But what use are her lungs now?” Prof. Wamukota called every female a girl, no matter how old they were. “This girl of seventy five years came to the hospital with a cough, night fevers, and weight loss…” It always drew chuckles, but one had to be careful to not be seen laughing, because then one became the target for his caustic humor and ridicule. “Yes, you Nsereko. Come and tell us what you see here. Is that a normal liver?” A bony black forefinger tapped ash off the end of the almost finished cigarette, and brought it back to equally black lips, eyes barely open through the cloud of smoke, but clearly seeing enough to decipher the secrets hidden away in the dead woman’s liver. The PM sessions were optional, and they took place during lunch hour, but one missed them at one’s peril. They were introduced in the late 1940s by the first head of Pathology, Prof. Jack Davies, and had survived the many changes in location and management over the decades. The cold grey concrete slabs on which the bodies lay, the strong formaldehyde smell, the solid swing doors that separated this area from the rest of the hospital – this was probably the way things were when the mortuary was moved here in 1962.

      Most of Prof. Wamukota’s exam questions came from his lunchtime sessions, so they were well attended. From here it was rumored that he would make his way to Katanga, an infamous slum sprawled between Makerere and Mulago hills where cheap alcohol and even cheaper women waited for university students and professors alike. There was a running joke that a student who frequented Katanga walked into an oral exam, and the professor looked him up and down before asking, “So – apart from the bar, have we ever met anywhere?” Needless to say, the student failed the exam. The vivas, or oral exams, were by far the most dreaded form of assessment. The student was supposed to be rattled, baited with ambiguous questions, and humiliated for being ignorant. The questions were sometimes about obscure conditions to elicit even more obscure answers. It was not uncommon for a student to be asked about a disease condition that they had never come across in their three years of diligent clinical rotations, and to emerge from the viva in tears. Even in this, the students kept their humor. The more vicious and mean examiners were said to be malignant. The more reasonable, and those that asked about conditions that the student was most likely to encounter in the treatment of everyday patients, were said to be benign. Malignant or benign though, those senior doctors were wholly committed to turning their students into doctors that they could be proud of, and they spared no effort in doing that.

      ***

      Having left Makerere medical school for Rubaga Hospital, D’Arbela had a comfortable routine that rotated between time spent at Rubaga, and an upscale private clinic on Clement Hill Road in Nakasero. One afternoon he was in his office at the clinic when his head nurse burst in and told him to get out. “Leave now. They are looking for you.” D’Arbela had had the sense that he was under surveillance. It was rumored that he was supplying the NRA rebels with medicines using the cover of his clinic. He knew that many people did not get a second warning. He slipped out through the back while the security officers were at the reception asking about him. He had left his car in front of the clinic though, so he had to make the split second decision to either make a dash for it, or abandon it and find some other way to leave the area. He decided to get to his car.

      D’Arbela was just pulling out when the soldiers came out the clinic. He hit the accelerator and sped away, but he knew the clock was