By Minabere Ibelema
As a young boy growing up in one of the villages that line the creeks southeast of Bonny, I had a crush on quite a few of the beautiful women that grace the village. Among them was one that wasn’t tops in beauty but more than made up for it with her flair. She had two truly beautiful daughters, toddlers at the time. After all these years, I still remember her most by a jocular banter with my aunt about one of the girls.
The conjecture led me to thinking about actress Angelina Jolie’s pre-emptive measures against cancer. In May 2013 the glamourous Hollywood actress shocked the world by disclosing that she had double mastectomy to remove her breasts. She followed that up about two years later in announcing the removal of her ovaries. She has a family history of deaths from cancer. So when tests during a routine checkup showed an uncommon mutation of cells in her breasts, she sacrificed them. For a similar reason, she did the same to her ovaries.
Jolie wouldn’t have had the opportunity to make these choices if she didn’t know exactly what killed her mother, aunt and grandmother. I can’t help wondering whether my might-have-been bride-in-waiting and her sister would still be alive today had they known what killed their mother. Might they have taken preventive measures? Maybe nothing as radical as Jolie’s. Perhaps some things as simple as dietary changes, regular exercise and routine diagnostic check-ups.
The lady was making a courtesy call at our extended-family home, and after the usual greetings my father’s older sister jocularly said she would like to reserve the daughter as my future wife. Though she said it light-heartedly as a compliment to the girl, there is no knowing whether there was a grain or two of seriousness there. After all, it was common practice at the time for mothers and aunts to “marry” a young girl and raise her to become a son’s or nephew’s wife.
In either case, the lady was having none of that. In her typical flair, brimming with a high-wattage smile, she shot down my aunt’s proposal. “No way,” she said in the local language. “My daughter will only marry someone who has been to oyibo land.” To which my aunt responded with corresponding lightheartedness, “What makes you think Minabere will not go to oyibo land?”
They both chuckled and turned to other chitchats for another hour or so. She had been a friend of the family for many years. In fact, the two families had been friends over the years. So, when years later the lady died after a brief illness, it was a shock to us all. I estimate she was still in her thirties, perhaps early forties.
Fast-forward to about 30 year later, her two girls were now at the prime of their lives, both happily married. And then the tragedy struck again — and again. First it was the older daughter who became so sick that she had to be flown abroad for treatment. It was to no avail. Then the younger sister followed the exact pattern not long after. They were both at the same point in life as their mother when she died.
One doesn’t have to be a pathologist to plausibly conjecture that there was a genetic connection. Based on the bits and pieces of information I could gather, I suspect a cancer with a high mortality rate. The conjecture led me to thinking about actress Angelina Jolie’s pre-emptive measures against cancer. In May 2013 the glamourous Hollywood actress shocked the world by disclosing that she had double mastectomy to remove her breasts. She followed that up about two years later in announcing the removal of her ovaries. She has a family history of deaths from cancer. So when tests during a routine checkup showed an uncommon mutation of cells in her breasts, she sacrificed them. For a similar reason, she did the same to her ovaries.
Jolie wouldn’t have had the opportunity to make these choices if she didn’t know exactly what killed her mother, aunt and grandmother. I can’t help wondering whether my might-have-been bride-in-waiting and her sister would still be alive today had they known what killed their mother. Might they have taken preventive measures? Maybe nothing as radical as Jolie’s. Perhaps some things as simple as dietary changes, regular exercise and routine diagnostic check-ups.
I must say that I was hesitant to begin the New Year with a column on deaths. But on further reflection, it is actually a column on living. I deferred it for quite some time because of some pressing topics. Now, I can’t think of a better time for it than the New Year, the ceremonial new beginning.
In a culture where every misfortune is attributed to supernatural forces, autopsies can’t possibly be a priority. Yet — paradoxically — they might actually help to reduce the resort to superstitious explanations. Might, I should emphasise. The sway of superstition is so powerful that scientific evidence often seems trifling. Still, every little bit helps.
And then there is the pressing matter of coronavirus. One of the reasons for the high rate of COVID-19 pandemic denial in Nigeria is that autopsies are rarely conducted. Of course, there is the reality of a relatively low incidence and morbidity. Yet, without autopsies, we don’t really know the extent of the havoc of coronavirus. People die, people get buried and that’s it. As it has been before coronavirus, so it is now. So, why bother? Yet, bother, we should. And it’s not just about coronavirus. The more we know about the exact cause of a person’s death the better equipped we are to prevent others from dying.
About two years ago, a lady from an adjourning village from mine died following a long trip. She had journeyed to Lagos to assist her daughter who had just given birth. Just a few days later, she suddenly died. The death could have resulted from thrombosis, the blood clot that often results from sitting for hours, as in long bus rides or flights. Were that determined to be the case, the woman’s death would have provided a teachable moment. It would have been an opportunity to teach or remind people the importance of getting up and stretching often during long trips.
Autopsies are valuable even when the cause of death seems self-evident. Take the case of people dying in a fire. It would be easy to assume that they were burnt to death. But an autopsy might reveal that they actually died from asphyxiation or smoke inhalation. With this knowledge, safety experts advise those caught in a fire to crawl on the floor and cover their nose with a wet towel. It can be life-saving advice.
Even drownings and deaths in plane crashes may have explanations that veer from what is presumed. In such accidents, it has been determined that some people died before the presumed cause of their death. When there is a boat accident, for example, a person might panic and die of a heart attack before actually taking in water. The same goes with plane crashes. Some passengers die in fear before the plane actually crashes.
What difference does it make?, you might ask. Quite a bit! Such findings demonstrate that the odds of surviving any situation are much better if one remains calm.
The cost of autopsies is quite high, and that’s a major dissuasion for many bereaved Nigerian families. Last June, The PUNCH reported on two families who abandoned the quest for autopsies after being asked respectively to pay N80,000 for one autopsy and N400,000 for five. These are considerable amounts, especially for families that have already spent much on treatment and were about to spend a lot more on funerals.
That raises the question of whether all autopsies should be paid for with public funds, maybe through the Nigeria Centre for Disease Control or major hospitals. Knowledge of the precise cause of deaths is a matter of public interest, not just families.
Ibelema writes from Lagos, Nigeria