by Bennet Omalu
“A pilot?” my mother yelled out like she’d just discovered a snake under the table. “My son, you will die young in a plane crash. No, you cannot become a pilot!”
Her response surprised me. The beautiful girlfriends in Paris and Sydney and San Francisco wouldn’t do me much good if I were dead. Shaken, I asked, “So what do you want me to become?”
My father’s baritone voice boomed again. “What about medical school?” This was not a question. In Nigeria in those days, many of the top students went to medical school and became doctors. That was the societal expectation. One of my sisters was already in medical school. One doctor in the family was not enough for my father. He wanted more.
“Yes, sir,” I said in my little angelic voice, while inside I was dying. I did not want to become a doctor, but once my father made up his mind about the matter, I had no choice.
I was only fourteen when this conversation took place, but I was close to completing high school. In Nigeria at that time, you could bypass college and go directly to medical school if you passed the entrance exams. I guess I could have purposely failed the entrance exams, but I could not do that to my father. He expected me to try to do my best, and that is what I did. I took the entrance examinations and passed with flying colors. As a result, I got my first choice of schools, which was the College of Medicine at the University of Nigeria in Enugu, Nigeria. Given what happened to me later in life, there have been many days where I looked back and thought I should have stuck to my guns and run away to pilot training school. Instead, at the age of sixteen, I packed my bags and moved away from home to begin med school.
Perhaps it was moving away from home at such a young age, or maybe it was the rigors of medical school—or perhaps a little of both—but I soon found myself battling debilitating depression. The loneliness and isolation I experienced growing up did not suddenly go away when I moved to Enugu to start my training as a physician. If anything, they became worse when I arrived on campus. I was one of the youngest in my class. In truth, I was just a child ill equipped for the strictly regimented and structured life of a medical student, no matter how intelligent I may have been. I did not have the energy or the drive of my peers because I did not want to be there. I did not want to be a doctor. Nothing about the life of a physician appealed to me. In truth, I have many days where it still doesn’t. If it had been up to me, the story of my life would have been written in the skies. But the choice of medicine was not up to me. I was there because medical school was where my family wanted me to be.
Given my lack of enthusiasm, it might have been natural for me to shut down and not try. But I could not do that to my father and mother. My only motivation to succeed came from my deep-seated desire not to let them down. In the super-high stress and ultra-competitive world of medicine, that motivation does not last long. Looking back, I cannot help but believe that God chose this path for me, even though it was the last choice I would have made for myself.
Throughout my first year of med school, I managed to keep my grades up and do what was expected of me. I might not have been excited about medicine, but I greatly enjoyed studying science. It fed my natural curiosity and awakened more questions inside of me. All of my life, I had been immersed in faith in God and His Son, Jesus. As I plunged into my medical studies, I did not find science and faith at odds with one another. The more knowledgeable I became in science, the more I realized what I did not know, which still pushes me deeper into my faith in God. The quest of science was and is a quest for truth. The same is true of my faith. All truth is from God, for God is truth. That means science and faith share a common end point, a common outcome, for they both seek truth. For me, faith and science synergize one another. My faith has enhanced my science, and my science has enhanced my faith.
If medical school had allowed me to pursue this passion with none of the other trappings, I might have found joy there. However, I found very little time for quiet contemplation or for allowing my imagination to take flight with the new truths I had learned. Someone once compared the first two years of medical school to trying to get a drink out of a fire hose. If anything, that is an understatement. Information flew at me so fast that I only had time to grab as much as I could as fast as I could and keep moving. This was not a time for self-discovery; it was a time for digesting more information than any human mind could take in, and to do so as quickly as possible.
During my second year of medical school, I began to lose the little energy and drive I had. Every day felt like the day before. I lost interest in my studies and in life. Many days, I could hardly push myself out of bed. I struggled to keep up with my school schedule, a struggle I slowly began to lose.
One Sunday afternoon, the fight became more than I could bear. I had a test the next day, one for which I was not ready. I left my room and started across campus to the library to study my biochemistry textbook. The book was the only thing I had to study. By this point, I had stopped taking notes in class lectures—that is, when I bothered to go to class at all. As I walked across the campus of the University of Nigeria, I noticed all the other students around me, talking and laughing and acting like they didn’t have a care in the world. A huge weight seemed to come down upon me. I stopped along the sidewalk and sat down upon a large rock. Just keeping my body upright took all of the energy within me. More people moved around me. All of them, every single one, appeared to have a better life than me. They all seemed to have a reason for living. I didn’t.
Once I finally mustered up enough energy to stand up, I stumbled back to my room and collapsed on my bed and did not move for the rest of the day. I failed the exam. My grades in other classes started to plummet. Most days, I could not force myself to get out of bed, much less go to class. Eventually I left school and went to my sister Winny’s house in Lagos, about 350 miles west of Enugu. When she asked why I was there, I told her I was on a school break. About the time she became suspicious that mine might not be an official school break, I left and went to a close family friend’s house in Jos, which was another 350 miles north of Enugu. I did not socialize with him or his family while there. Most of the time, I stayed in his guest room, in bed, lying in darkness and silence.
I did not yet understand that I was suffering from textbook clinical depression. Today, people ask me why I pushed so hard to find answers for Mike Webster, the Pittsburgh Steelers legend, when he died in 2002. This is the answer. Before I went into work the morning of Mike Webster’s autopsy, I watched the news reports about his death. The reporters spoke of how Iron Mike had isolated himself from everyone who had known and loved him. He suffered, they said, from depression and other ailments. I could relate to Mike. More than that, I listened to the tone with which the reporters spoke. They talked down about Mike, as if he had chosen to suffer from depression and the terrors that drove him to my autopsy table at only fifty years of age. Their words made me angry. This man was a child of God—made in God’s image, beloved of God. He deserved better. Watching the reports, I saw myself as a young medical student in Mike Webster. Only those who have suffered depression can understand the darkness that descends upon one’s soul. That’s one of the reasons I believe my meeting him was truly an act of God. The Lord Himself brought the two of us together, two very different men and yet connected by our battles with the darkness of depression.
• • • •
In the middle of my struggle with depression, I tried to reason with myself in an attempt to figure out this dark disease. The more I reasoned and rationalized, the darker my world became. I could not understand the question of why I felt like I did and why this was happening to me. But the more I asked “why me?” the more I realized asking this question was not going to help me overcome the darkness. Instead, I began desperately praying, God, please help me. He did not come down to me as an angel to touch my head and heal me, but God did help me. For one thing, I slowly realized that this was going to be a long journey and that I had to be patient with myself. I also reset my e
xpectations of myself. Before this, I expected to achieve top marks in all of my classes. The depression and resulting lack of energy and focus made this next to impossible. That’s when I decided that it did not matter if I scored an A or a C, as long as I finished the course and graduated.
I seriously considered dropping out of med school, but I dismissed this thought because I knew it would devastate my parents. Instead, I made up my mind that once I finished and graduated, I would reevaluate my life and decide on the course of action I wanted to take. If I still wanted to become a pilot, then I would pursue it. Or maybe I would go to law school and practice medical law. Or, I thought, perhaps I will become a doctor and use medicine as an avenue to fulfill my lifelong desire to travel to the United States or other developed countries. Magazines and movies showed life in the West to be very different from life in Nigeria. As a doctor, that world might be open to me. After all, a physician is a physician all over the world. If I could pass the licensing exams from other countries, my medical degree could be my ticket to travel wherever I wanted to go.
Even with my newfound resolution, I had a long, difficult climb to reach my goal. The depression did not leave me simply because I had prayed and asked God for help. My energy levels remained very low. Getting out of bed was a constant battle. When I did make it to class, I could not focus.
The more I struggled, the harder I prayed. One of God’s answers to my prayers came in the form of a friend and classmate named Kenneth. A very quiet, soft-spoken Christian guy, Kenneth saw beyond my struggles to see the potential within me. We shared most of the same classes. When I could not make it to class, Kenneth left his lecture notes for me to study. Late at night, as my classmates slept, I stayed up studying the notes, chewing on kola nuts and smoking Sṭ Moritz cigarettes to stay awake. In the morning I returned his notes to him. Then, when it came time to take my examinations, I passed. Most of my classmates couldn’t understand how I could digest all the information without attending class. Only Kenneth and I knew our secret.
However, I faced another hurdle. Several of my classes required that I actually attend to get credit. Without attending the lectures, I could not take the examinations. Kenneth bailed me out there as well. On the days I could not lift the weight of my depression in order to function, he secretly signed my name on the attendance book. I never asked him to do this for me. Why he did it, I will never know. He was simply the angel I needed in my life at that time. I could never have completed medical school without him. Unfortunately, the two of us have lost contact over the years. I hope he knows how great a debt of gratitude I owe to him.
Not all of my classes could be handled in this way, however. One professor in particular required that I make rounds with him to be allowed to pass the class. I tried, but I could not do it. He, in turn, barred me from taking the final examination. Another professor was made aware of my struggles through my sister, Uche, who was already a physician. The professor empathized with me, which was rare in those days. Back then, mental illness carried a stigma and was misunderstood. Through my sister, he let me know that if I attended rounds with him whenever I could, he would make sure I was eligible to take all my exams. Good to his word, I was allowed into the examination of the professor who had previously told me to not bother showing up.
I arrived for my examination right on time. I dove into the test, which was timed, and lost myself in it. Thirty minutes after the testing started, the proctor administering the exam came to me and said, “You must leave the examination room.” He then took my examination papers from me.
Shocked, I immediately ran to the second professor and explained the situation to him. He went back to the examination room with me and requested that I be allowed to finish the test. The proctor agreed. Unfortunately, the time I lost while all this took place was lost. I still had to finish the exam at the same time as everyone else. I looked up at the clock. I only had forty-five minutes remaining. O Lord, help me, I prayed. I then began answering the multiple-choice questions as quickly as I could. With no time to sit back and think deeply about each question, I circled the first answer that came into my head. In desperate times you do what you have to do.
I passed the test. When I received my grades, I thanked God for the angel He had sent to help me. Without the kindness of the other professor, I would have failed the class and not graduated from medical school.
• • • •
In my final year of medical school, all graduating students were asked to write a short section for the class yearbook. “What are you going to do after medical school?” we were asked. I guess they wanted to have us write out all the great things we hoped to do and accomplish in the future. Some people wrote about how they wanted to become the best neurosurgeon in the whole country. Others spoke of building hospitals in underserved areas of the nation. Still others spoke of moving into administrative positions or curing diseases.
I gave the shortest answer of all my classmates. In answering the question, I wrote just three words: to be myself. I was still trying to figure out who I was as I fought through the fog of depression that had descended upon me, yet I held out the hope that I could find myself there. This was my one desire. I had only this one life as a gift from God. I now had to discover who He had created me to be and then pursue this man with all I had within me. Only then could my light shine for Him.
My answer did not win me any accolades. My classmates looked at me like something was wrong with me. I did not care. I had one desire, and I planned to pursue it. I was going to be myself, no matter who that turned out to be.
Chapter Four
Answered Prayer
When I was ten years old, my father returned to work in Jos, the city where my family lived prior to the Nigerian civil war. My mother, brother, sister, and I stayed behind in Enugu. I couldn’t understand what was happening. My father returned home from time to time, and we occasionally visited him in Jos. The first trip there made me angry. In Enugu, we lived in a small rental house in a middle-class neighborhood, or at least middle class for an Igbo family in Nigeria. Such a neighborhood would never be thought of as middle class outside of Nigeria. But my father—he lived in a palace in Jos. The government provided the house to him as part of his job as deputy director of mines. The British built the house many years earlier for colonial administrators from England. Even though the British were gone and Nigeria was an independent nation, the house still carried the perks that the English administrators enjoyed, including a butler, a chef, domestic helps, and even a chauffeur. We stayed with my father during our two-month summer vacation from school, but then it was back to the small rented house in Enugu. To my young mind, this just seemed wrong.
At the time, I had no way of understanding the level of fear my father felt just being in Jos after witnessing the widespread violence against the Igbo in the streets during the civil war. Even ten years later, he could feel the tension that remained between the victorious Hausa people and the losers, the Igbo. He did not encounter as much prejudice, in part because he spoke the Hausa dialect fluently without an accent. Even so, he remained petrified by his experiences during the war. He lost many friends and witnessed the slaughter of his fellow Igbo by the Hausa. No wonder he did not want his family to move permanently to Jos. He had us stay in Enugu for our own safety. The war may have been over, but the deep scars remained.
My young mind could not yet comprehend any of this, although I recognized something was broken in the culture around me. A state of progressive decay had set in, but no one seemed to mind. Mediocrity was the order of the day. School classrooms were filled with litter and remained year after year in a state of disrepair. Yet at the back of the room sat the civil servant whose job it was to keep the place clean. No one seemed to mind that he didn’t do his job. Nor did anyone else seem to notice all the days when the water wasn’t working and toilets wouldn’t flush. Garbage littered the unpaved streets that were filled with ruts and potholes, and yet no one complained. Every
one simply chose to keep quiet and look the other way.
• • • •
Ten years later, when I graduated from medical school, nothing had changed. Nigeria remained in a state of decay, and no one seemed to care. My frustration grew when I entered the mandatory National Youth Service Corps, a Nigerian national program where university graduates engage in service to the country for a year. Because I was now a doctor, I was assigned to work as an emergency room physician in the city of Jos. I also worked part-time as a general practitioner in a family practice clinic. The experience only confirmed my original reluctance to become a doctor. I was not comfortable working with living patients. No matter how many patients I treated and no matter how positively they responded to me, the old feelings of inadequacy always came rushing back to the surface. I really just wanted to fade into the background and be left alone.
More than the discomfort I felt working with patients, my soul was weighed down by the brokenness I saw in the country around me. Every day, I encountered distraught families who carried in their sick children. Many of the children suffered from preventable ailments like malnutrition. How can we not have enough food for our weakest members? I wondered. It was as though no one felt it their responsibility to watch out for the society as a whole. As Cain said in Genesis 4:9 when confronted with taking his brother’s life, no one felt compelled to be their “brother’s keeper.” In addition to malnutrition, the children usually came in with malaria or gastroenteritis, vomiting, and passing loose stools. I treated them the best I could, but my efforts failed because more often than not, the hospital did not have the medications my patients needed. As a result, children died needlessly and preventably. But just like with the broken streets and schoolrooms, no one seemed troubled by the system. I could not understand that. I still cannot.