Hafiz Ali Goes Home

The Dutch doctor had been with the ECWA hospital at Jos, Nigeria, for a long time, but he still had trouble deciding exactly when a patient would die. And that was always a problem with someone like Hafiz Ali.

The doctor had admitted Hafiz Ali and grown fond of him, but he had not yet worked out the pathogenesis of his disease. The spleen, he could feel, was huge, too big for malaria in an adult. And there was a fever that might indeed have been malaria, but no organisms showed on a thick blood smear. Intravenous antibiotics seemed to help at first, yet, day by day, the old man's conjunctivae and oral mucosa showed increasing evidence of coagulopathy. Still, Hafiz Ali was astonishingly tough. On certain days, he would rally. The intravenous site would stop oozing, and the doctor would hold out a little hope to Hafiz's twin sons, Rashid and Hamid, who attended their father devotedly. Don't take him home yet, he would say on these “good days.” Miracles do happen. But then the next day would be a “bad day,” and the oozing would spread to the old man's gums, which were purulent and rotting around his last decaying stumps of teeth.

The doctor knew that his patient had not wanted to come to the hospital at all. A bush aide had held out the hope of a cure, so his family had insisted. But if there could be no cure, he wanted to die at home or, failing that, in an open field, a palm shelter, any place where he could go in peace with no more company than his two loyal eldest sons. Definitely not in the hospital. The doctor had promised to tell him when there was no more hope.

And so the day …