By Emmanuel Fashakin
The Amakis (not real name) were recent arrivals from an African country. They got their American Green Cards through filing from a family member. The wife, Gloria, was an Accountant, and she had a very good job in one of the commercial banks in a bubbling, overcrowded city in West Africa. The husband, John, was a class teacher in a high school. Gloria came to see me a few weeks after their arrival in the United States, and she enrolled in my medical practice because, as she put it, she was thrilled “to have an African Doctor as one of the participating Doctors in her HMO.” Gloria was very thrilled to be in the United States and she came to see me with their only child, a five-year-old boy, Martin.
Gloria, in her early forties, is very pretty and extremely religious. She was polite, soft-spoken, and very respectful. She would kneel or bow whenever she came to see me. She explained to me that they have only one child because her husband is not serious. “He drinks way too much, smokes like a chimney, and chases anything in skirts,” she said. She also told me that they had tried in vain to get pregnant again after they had succeeded in getting Martin after several years of marriage. She wants me to check her thoroughly for any sexually transmitted diseases she might have acquired from her husband. She also wanted my help to deter her husband from excessive consumption of alcohol and smoking, whenever he came to see me, and I promised to do my best. Gloria’s physical examination was unremarkable, and I took her blood samples for the usual tests.
The blood results started trickling into the practice computer the next morning, and I was in for a shock. HIV test repeatedly positive! Sadly, I told them to call Gloria in for consult and counseling. I explained to her that it was unfortunate but her philandering husband had contracted HIV and had infected her with the virus. Gloria wept uncontrollably, and I felt really sorry for her. I told her that it was important that she called her husband, who by now had still not shown up to see me so that we could test him and begin appropriate medical management for both of them.
John came to see me a week later, I looked at him disapprovingly, and I could barely hold myself back from slapping him in the face for causing Gloria’s infection. On the basis of my promise to Gloria, I did not inform John of Gloria’s result immediately, but simply did pre-test counseling for him and acquired his blood samples. The next morning I got the shocker: HIV test NEGATIVE. Are you kidding me? Surely, there must be some mistake somewhere? I called both the Amakis’ in again and re-tested them for HIV. The results were the same: Gloria was repeatedly POSITIVE, John HIV negative. I scratched my head — what precisely is going on here? Now it’s Gloria’s turn to give me some explanations. I called her to the room alone and asked her repeatedly whether she had sex with anyone else apart from her husband, and she denied it emphatically. She would never cheat on her husband, Gloria told me categorically. I became confused because Gloria was so believable.
I considered the possibility of passive transmission: maybe John slept with an HIV-positive woman, and then with Gloria, without proper clean-up, infecting her with the virus. John may have somehow escaped infection. I searched the literature and found no scientific backing for my weird theory, but what other explanation could there be, if Gloria did not have any extra-marital affairs?
I slept very little that night. The next morning, a Saturday, after eating Abby’s special (boiled African yams with corned beef omelet), I put a call through to the Amakis to cheer them up. I called Gloria and the phone rang and rang, and went into voice mail. I called three times, no answer, and I broke out in cold sweat. John had been as shocked as I was the previous night when he learned that the wife was HIV positive, and he HIV negative. As the phone went unanswered for the third time, I went into panic mode: Oh my God, he has thrown her out! No, he has killed her! I frantically called the husband’s number. To my relief, he answered on the first ring. “Where is your wife?”, I bellowed into the phone. “She is right here beside me,” was the cool reply. I drew in a breath of air for the first time in five minutes. Gloria’s familiar voice soon came on the line. I was too high-strung to remember what I told her, but I was relieved that she was still alive and that they were still together.
Gloria had all her viral studies done, and she was started on anti-retroviral medications. Within weeks her HIV Viral RNA levels had become undetectable. The husband told me that he wanted permission to have unprotected sex with Gloria because he wants another child. Luckily, just weeks before, the FDA had approved prophylactic anti-retroviral therapy for those at risk of HIV infection, like sexual contacts of known HIV patients. I warned him of the risk of HIV infection, but that if he insisted, he could take the prescribed medications and resume sexual activity with his wife. But the mystery remained. How on earth did Gloria get infected?
It took nine months, and relentless asking for the one-millionth time, before Gloria finally cracked, after I had earned her trust. Yes, it appeared that the prophet she had gone to for prayers to get a child had hypnotized her and had intercourse with her. She said she was not sure, but she thought that it happened because she was wet afterwards. Then I knew that Gloria was lying all along. She was having a good time with the prophet praying for her to get pregnant, and the prophet gave her more than she bargained for. I had an uncanny feeling that their only child might actually belong to the prophet.
Gloria’s case is not an isolated incident in people dealing with African “prophets”. While I was in Nigeria, there was this pretty young teenager paralyzed in the legs and taken to a native priest for healing. Nine months later, she went into labor. The native priest had impregnated her! But shouldn’t these prophets be bound by some professional oath of ethics, like Hippocratic Oath, or Oduduwa Oath, to prevent them from sexual molestation of those entrusted into their care? Prophet, oh Prophet!
Emmanuel O. Fashakin, M.D., FMCS(Nig), FWACS, FRCS(Ed), FAAFP, Esq.
Attorney at Law & Medical Director,
Abbydek Family Medical Practice, P.C.
Web address: http://www.abbydek.com
Cell phone: +1-347-217-6175
“Primum non nocere”
