He could have lived

He could have lived

• Editor's Memo: The MDC is part of the problem

• Editor's Memo: Voters must demand better leadership

• Editor's Memo: Cut the chase, blame Blair

• Editor's Memo: Zimbabwe's future lies in voting

By Mduduzi Mathuthu

NINE days ago, HE was a sprightly retired man, looking and sounding gloriously unstoppable in the enjoyment of his peace.

Eight days ago, HE complained of a severe headache. HE told me he was feeling as if someone was knocking his head with a hammer.

A doctor who saw him administered pain-killing pills, and asked him to return a day later if the pain persisted.

A day later, the pain had spread. Another doctor suggested a troublesome tooth was the problem, and it was extracted. Yet the pain stayed on.

Six days ago, HE complained that when the headache subsided, the left-side of his body shuddered, as if that pain had been transferred. This made him numb. Still, the doctors told him they “couldn’t see anything”.

A day later, his speech became slurred. HE lost his vision. Normal conversations with him became like the mutterings of a two-year-old. He ate by way of a drip, which relatives were told to buy because the hospital couldn’t afford.

A third doctor suggested that he be taken for a scan. The results of the scan, the gathered relatives were told, would only be known a day later.

By now, HE was bedridden in a Bulawayo hospital. HE had lost his speech entirely, but not his will to live.

Offers of help came in from friends. A friend offered to airlift him to South Africa if that would help. That, of course, hinged largely on doctors quickly determining what the problem was, and whether there was a requirement for such a drastic step to be taken.

I sought the help of a Zimbabwean private healthcare agency based here in the UK, which has a network of doctors in Zimbabwe. Another doctor was sent in to look at HIM and offer his opinion. His naked eye diagnosis was chilling, and late: brain stroke.

I turned to Google, keen to find out what chance there was for survival for someone who has suffered a brain stroke.

Within a minute, the whole terror of what was unfolding hit me. Déjà vu, I thought.

On the US Department of Health and Human Services’ website, I came across the story of Dina Pagnotta, one person who has lived to tell the story of the overpowering and devastating effect of a brain stroke on a human body.

I cannot tell her story without heavily borrowing from the website.

On one morning in May 2002, Pagnotta had been sharing jokes with a friend. Then she took a sip of water but couldn't swallow. She choked and the water came right back out of her mouth.

Seconds later, she couldn't move her left leg or arm, the left side of her face went limp, and her speech was slurred.

"It felt like I got a shot of Novocain in the whole left side of my body," Pagnotta says.

Her friends lowered her to the ground, and someone called 911 (emergency services).

"The next thing I knew, I was in an ambulance with the sirens screaming and a paramedic calling it in: '30-year-old female, CVA,'" which stands for cerebrovascular accident, also known as stroke.

I learnt on the website that a stroke occurs when blood flow to part of the brain is interrupted, which is why it's sometimes called a "brain attack."

Pagnotta had an ischemic stroke, the most common kind. It occurs when a blood clot blocks a blood vessel or artery in the brain.

In America, ischemic strokes account for 80 percent of all strokes, the website says. Hemorrhagic strokes, which account for the other 20 percent, occur when a blood vessel in the brain ruptures and causes bleeding.

John Marler, a nurologist, explains on the website that when blood flow to the brain stops, brain cells are deprived of oxygen and nutrients.

He adds: "A stroke is a medical emergency because brain cells start dying quickly. And treatment is most effective when given promptly.”

Further, I learnt that a drug called activase (alteplase), which is a genetically engineered version of tissue plasminogen activator (t-PA), is the only drug approved by the US Food and Drug Administration for treating the sudden onset of ischemic stroke.

The drug dissolves blood clots that block blood flow to the brain, improving the chance for recovery and decreasing disability. But the drug must be given within THREE HOURS after stroke symptoms begin. IT HAS NOT BEEN SHOWN TO BE EFFECTIVE BEYOND THREE HOURS.

"The longer blood flow is cut off and the longer treatment is delayed," Marler says, "the more likely it is that the patient will suffer permanent damage."

Stroke experts commonly refer to the sense of urgency in stroke treatment with this expression: "Time is brain."

"This is why it's so important to recognise the symptoms of stroke and call emergency services right away," Marler adds.

It had now been a few days since HE fell into that motionless state. And reading that detail, all hope ebbed away. But if I was feeling disappointed, that turned to despondency when I read further about the symptoms of a stroke.

They include “sudden confusion, or difficulty speaking or understanding speech” and “sudden severe headache with no known cause”.

There! Within two minutes of clicking a mouse, it had become abundantly clear what had just occurred.

I could now tell that the spasmodic attacks which he reported earlier on were a transient ischemic attack (TIA), also called "mini-stroke," which also requires prompt medical evaluation.

When a TIA occurs, the US Health and Human Services website says, symptoms may last only temporarily and then disappear.

"About 1 in 4 people who have a TIA go on to have a bigger stroke within five years," Ralph L. Sacco, the associate chairman of neurology and director of the stroke division at New York Presbyterian Hospital at Columbia University said.

"Stroke may have been prevented if the TIA had been detected and appropriately treated. For us, TIA is to stroke what chest pain is to heart disease. It's a warning sign that shouldn't be ignored," Sacco added.

Back to Pagnotta, she recalls that a doctor kept lifting up her left arm.
"Each time, it flopped back down," she says.

Pagnotta didn't receive treatment with t-PA. Two hours after her symptoms began, she could move her fingers again, then she could move her whole arm, and her speech improved. After conducting tests, her doctors concluded that there had been a blood clot that temporarily blocked an artery on the right side of her brain, but it dissolved on its own.

"I was lucky," says Pagnotta, who ran the New York City Marathon in November 2004.

Pagnotta is among the roughly 10 percent of stroke survivors who recover almost completely in the United States. The National Stroke Association (NSA) says 25 percent recover with minor impairments, 40 percent experience moderate-to-severe impairments that require special care, 10 percent require care in a nursing home or other long-term care facility, and 15 percent die shortly after the stroke.

If HE were American, I cannot say with certainty that he would have been in that small minority that fails to beat a stroke. But HE is an African, a Zimbabwean, where budgetary spending on the military and wars far surpasses the health services allocations.

In Zimbabwe, HE is part of the majority that are allowed to die in hospitals that are now nothing more than halls of residence for the sick and dying.

In life, HE was a giant. He once told me his father’s best teaching was not to be like him.

HIS father was a drunk who, due to lack of better information, thought nothing of education. Instead of feeling sorry for himself, and wallowing in self-pity, HIS life became a personal crusade to work towards and secure a better future for himself and his children.

Using his mother’s little savings, boosted by the occasional cattle sale, HE sought an education.

At the Mission school which HE attended, he would stick around during school holidays, volunteering to do the gardening for the white missionaries – a gift of Britain’s colonial legacy. That way, he raised a few more pennies. His garments, not the best on the washing line, would get a little patching from the missionary Samaritans.

This, HE was to tell us later, was his making. That experience had taught him how to live, and how to make the best out of a position of powerlessness and misfortune.

HE would go on to become a school teacher for many years. HE used his savings to offer all his seven children the best education. HE dedicated every little financial resource to that cause. Every one of the seven children was given a chance to make their life better than the social squalor so beautifully represented by their grandfather, which HE so totally despised.

Along the way, HE helped hundreds of the less privileged. AIDS orphans and sufferers, spat out by the system, turned to him for help. Many of them, he never knew. Where he could, no resource was spared.

His other love was gardening, and farming. HE grew enough crops and vegetables for all the family’s requirements so that there was never a need to buy.

In later years, HE said he had “found Jesus”. HE became a church minister. His life appeared fulfilled.

In the early hours of Sunday, October 15, 2007, eight days after a series of events not entirely unstoppable, HE lost his battle to live. HE was 67.

If things had been done slightly different, would HE have lived? Sure.

HE was my father. Moses Nicholas Mathuthu.

There is something which HE taught me, which may have been insignificant then, but which has found its meaning today: riding a bicycle. For the first few practise rounds, HE supported me by holding the saddle. Then a few sessions later, and without warning, HE released me. When I turned to look, HE was gone. I was alone. Today, I am in that position again. I am on my own.

I hope no-one else has to go through a similar agony. Yet with the political course that Zimbabwe has been put on, I can’t say that will not happen with confidence.

Mathuthu is the editor of New Zimbabwe.com. He can be contacted via e-mail: mathuthu@newzimbabwe.com
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