Not all birds in the Luo community were considered beautiful beings to behold or could be eaten due to the belief that there were some evil powers and dark forces behind their existence. One such bird was Tula Nyongoro the owl. when Tula visited a village and was heard hooting, what would follow next was a catastrophe. A disaster. Children would die in large numbers and this was not something that anybody would want.

Another bird that would cause the village to be perturbed was Arum Tidi the horn bill. The Horn bill brought the message of death as well. When it was heard in a village, an old man was next on line to join the ancestors. The community would gang up together and chase away the bird or possibly kill it.It was a case of killing the messenger if you did not like the message. People reacted to such messengers promptly more than they would if a home was being raided somewhere by thieves. My uncle once told me that the highest point in a luo hut should be made sharp and pointed to eliminate chances of this bird perching on the roof.

The last time I went back to the village, the bird was heard a distant far from our village and every body was awake ready to receive the message that was so obvious. I heard the sound faintly. The emotional setting bestowed upon the sound made it scary. The next day the elders would cram up together and whisper in low tones,

           “Who is next? Did this bird bring us the news that son of Owiti Kisero would  succumb to his illness?”

Son of Owiti Kisero seemed next in line because he was frail and had been sick for the last couple of months. “Son of Owiti Kisero has fought this disease like a wounded soldier, let him go in peace,” an elder would say, announcing a death that had not even landed. One by one ,the people of my village would pay their last tribute to a man that was still alive. Son of Owiti Kisero would later put everything in order. He divided his land to his sons, gave his wives a long lecture on how things should be done when he is gone. Now Arum tidi the horn bill had sealed his fate with the news that it brought. Slowly, life ebbed out of the veins of Owiti Kisero’s son.


     I remembered this scene two weeks ago when we were in our usual ward rounds. I was rotating in the gynecology ward. I felt touched when I saw people suffering all manner of illnesses ranging from bleeding disorders to cancers. I then realized the nobility of the path that I chose to tread. I don’t know whether I was to treat or cure or heal. all I knew is that I was called for service, I don’t know by who.

Dr Otholo was known for his educative ward rounds. He was always patient with students because he knew that medicine is apprenticeship and some things could not be picked overnight. He was a gifted diagnostician and a dexterous surgeon. His surgeries were however limited to the pelvis. The gravid uterus, c sections, hysterectomies, prolapse repair were his metier.

On this particular day Dr Otholo was taking us through history taking in obstetrics and gynecology. ” Parity is the number of pregnancies a woman has ever had irregardless of the outcome,” he emphasized. He was not so fast, neither was he too slow. He delivered just at the right pace and decibels.He punctuated his teachings with long awkward silences. The kind of silence we use to honor departed souls. During one of those episodes of silence, we had a sound from a lady next to the door. The sound was very strange but it was all pointing to one direction, the woman was dying, or so I thought. I looked towards the direction of the sound. All I saw was a frail looking human being, wasted in every sense, empty and forlorn.

The sound from the woman kind of merged with the one that I had heard before. The horn bill was now roaming in my mind, its sound loud and clear. I knew what would follow next. it had happened before, to someone I knew so well. To son of Owiti Kisero. I wondered whether the bird had followed me to the wards, to keep reminding me when the angel of death was amidst us.In such cases, I wonder whether my efforts would count. Efforts to bring back life in a soul that is at the intersect of this life and another…

” Oliver, she is dying. My uncle made similar sounds when he was dying,” I was woken up from my reverie by  a classmate who had noticed that I was carried away. All this while the round was on. I did not want to see this lady pass like that. It was scary. We expected Dr Otholo to do some heroic act. This was clearly above him. He had tried the best he could. At such times even the authorities in medicine resign to fate and admit the imperfection of this art.

The registrar was brief with her case. She was still breathing. Some times it took long for her chest to rise. At such times I prayed that she doesn’t die, at least not in our watch. it would not augur well.

” The neurosurgery team has declined having surgery done on her until the primary source of the cancer has been determined. She has a cancer of unknown origin that has metastasized to the brain. we are trying our best to find out the source and act accordingly.”





Author: Dr. Kiaye Oliver

I am a dreamer. I love medicine. She is generous. I am also in love with literature, she makes me see the world the way I want to and sometimes the way it is.

5 thoughts on “Metastasis”

  1. Such experiences remind us of nobility of the medical profession. Though imperfect an art it is, it teaches many lessons and reveals of our imperfection and weakness as human beings. Thank you Oliver for the inspiration.

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