CT Scan in Africa

Afraid of light?  No, that’s not what photophobia means.  It’s simply the medical term for light sensitivity, which I’ve experienced since 2022.  When Dr. Frederick in 2023 prescribed the lifestyle regime which controls my migraines, I resigned myself to dark sunglasses, hats, closed curtains, and dim lights.  But after observing that these measures interfere with my work and inconvenience those around me, I recently decided to pursue a better solution for my photophobia.

An American doctor friend suggested a CT scan of the brain.  Dr. Frederick had actually ordered one a year and a half ago in response to my query about any necessary tests, but when I heard that it cost $300 at the public hospital’s fee-based special clinic where I saw him, I decided not to proceed.  I still had the signed order, though, so I asked my friend Dr. Carlos whether the 2023 date would invalidate its use.  He recommended asking Dr. Frederick to re-order the exam, and relayed to me Dr. Frederick’s instruction to meet him at 7:00 on Thursday morning (March 20) for that purpose.

I left home at 6:00 that day, knowing that parking at the hospital would be tricky.  The guard wouldn’t allow me into the closest lot, where I’d parked on my last visit, because I wasn’t a hospital employee.  I parked in the general lot and tried to walk around the back of the hospital to the clinic, as per the guard’s instructions, but when the route began to look like a deserted alley I turned and circled around the front of the complex until I arrived at the clinic.

Though my previous appointment was at the clinic that charges for VIP care, this time Dr. Frederick directed me to meet him at the neurology department of the general hospital’s outpatient clinic which provides free medical services to the public.  In my seven years in Africa, I had heard stories about the long waits and other frustrations patients experience there, and I was eager to experience the situation firsthand.  My medical condition wasn’t an emergency, and I had time to wait.

As directed, I walked upstairs at the clinic and began roaming the halls in search of the neurology department.  Twice I passed someone in a medical uniform and asked for directions, on the basis of which I eventually found a door with the exact “Neurology Appointments” sign I was looking for.  It was closed, like most of the doors around it labeled with other medical specialties.  I sat in a chair in the hall to wait.  It was 6:49 am.

Over the next hour and a half, some patients hobbled by on makeshift crutches while others were carried by family members for lack of wheelchairs and stretchers.  With coughing and other signs of illness in close proximity as the chairs filled up and waiting patients lined the walls, I put on the mask I carry in my purse.  Medical personnel opened other doors and began calling names from handwritten slips of paper which patients had stacked on the nearest surface.  But there was no sign of activity from the “Neurology Appointments” door I was interested in.

Finally, around 8:30, a lady working in a nearby exam room called out that anyone waiting for a neurology appointment should go around to the other side.  I followed her directions to arrive at a door in an outdoor corridor that said nothing about neurology, but that apparently led into the same suite as the door where I’d sat for an hour and a half.  Following the posted instructions, I knocked at the door.  An older man in a medical uniform answered and told me that Dr. Frederick would be back later, and I could either look around for him, call his phone, or simply wait.  I chose the latter option and continued observing the bustle of a normal weekday at the public hospital — now with a refreshing breeze instead of the stifling indoor heat.

As he worked at his desk and helped other patients, that man checked in with me several times, called Dr. Frederick to check on his whereabouts, and assured me that he would come and attend to my case.  When I needed to retrieve more drinking water from my car, I left the outdated CT scan order with him so Dr. Frederick could use the data to create an updated order if he came during my absence.  Dr. Frederick finally arrived around 10:15, and though I didn’t speak with him personally, the man advocating for me soon handed me the new order and sent me to the radiology department.

Once again, I had to ask for more directions along the way, but I eventually found the office that scheduled these exams.  The man who took my order requested my appointment card, and when I asked where I could get one, he told me to return to where I had received the exam order.  Back I went to the neurology department, where the kind older gentleman filled out a form and handed it to me.  This time the radiology personnel accepted my documents, but said that the schedule was already full through the appointment date written on the card.  They said to leave the documents with them and return at 10:00 on Monday to see whether the director had approved fitting me in.  I left the hospital around 11:00, barely able to maneuver my way out of the parking lot which was filled to far over capacity.

I arrived Monday morning by bus to avoid parking problems.  The man working in the radiology department thumbed through various stacks of papers until he found mine.  I gathered that not much had happened to them since I’d left them there on Thursday, but the fact that this was my second visit and the card showed that I had an appointment on Wednesday convinced him to try to fit me into the schedule, though his colleagues were pessimistic about that plan.  He knocked on a nearby door (the director’s?) and received no response, so he asked me to join the crowd in the waiting room.

I had brought food, water, and a fully charged cell phone, expecting a long wait.  But within ten minutes, a young professional called my name and led me straight into an air-conditioned room with a large machine that I quickly realized was a CT scanner.  As she adjusted its settings, I removed my sunglasses and earrings, and put my purse and backpack on a chair.  I lay down on the machine’s table and she used pads to hold my head in place, instructing me not to move.  She entered the adjacent control room and slid its heavy door closed.  Then my table moved into the scanner, which whirled and clicked for the next few minutes.  Soon it was done; she lowered the table so I could stand up and instructed me to return at 10:00 on Wednesday for the results.  I collected my bags and left.  I had been in the room for a mere five minutes.

On Wednesday I drove to the hospital and parked on the street to avoid potentially being blocked in at the hospital’s lot.  The radiology office staff gave me my CT scan results in the form of a handwritten half-sheet of paper.  I returned to the neurology office, where the same man who had helped me before directed me to return at 7:00 on Friday for Dr. Frederick to explain the results to me, and he wrote that date on my appointment card.

A few minutes before 7:00 on Friday, I arrived at the neurology exam room, added my appointment card to the stack on the window sill outside the exam room, and sat on a bench in the corridor.  At 7:03, Dr. Frederick arrived, greeted the seated crowd, took the stack of appointment cards, and asked patients to wear masks when entering for their appointments.  For the next two and a half hours, I ate, drank, read, and watched other patients pass in front of me through the passageway pictured here.

At 9:30, Dr. Frederick called my name.  I quickly entered his office and found four people in medical attire, probably doctors in training, standing behind his desk to observe his work.  Though obviously a busy man, Dr. Frederick greeted me warmly, shook my hand, and asked why I had been absent for so long.  I gave him the handwritten CT scan results sheet and he confirmed what my medical friends had surmised: it showed no abnormalities.  He asked how my migraines were doing, and I told him that they were under control thanks to his instructions.  I told him that photophobia is my biggest concern; he asked whether I had seen an ophthalmologist but didn’t have any other solutions to offer.  I thanked him for his time and shook his hand once more as I bid him goodbye.