Does it Hurt to Die

by Anderson, Paul G

  As the greetings finished they all turned to look at the top of the stairs where Christian stood with Sian and Ruby. Christian looked down at them thinking what a wonderful place South Africa could be with people of different colour interacting like this.

  ‘So you are the son of the man who saved my life,’ said Sibokwe, taking the stairs two at a time to reach Christian.

  As he reached him Christian held out his hand, but Sibokwe was having none of the traditional greeting, and while a good few centimetres shorter than Christian, gave him one of Mike’s hugs and lifted him off the ground, to the great delight of everyone around them.

  ‘That’s just to show you what a healthy legacy your father left,’ said Sibokwe, putting Christian on the ground and releasing him.

  ‘Well, it’s so good to meet you, Sibokwe,’ Christian said, partly regathering his composure. ‘As you’ll know, I’ve heard all about you, and it’s fantastic to be here and meet you after all this time.’

  ‘Well, without your father, I might not be here. I know that you’re anxious to find out as much as you can about him, so I’d be delighted to help you. I’m eternally grateful that he took a chance to give me a new liver under very difficult circumstances.’ ‘OK, that’s the introductions over. Let’s all go and eat,’ said Sian, leading the way to the table.

  After they finished the first course and Ruby had cleared the plates away, Sibokwe turned to Christian and asked, ‘Would you like to know how I met your father?’

  ‘That’d certainly fill in another blank space for me.’

  ‘Well, it’s just a bit of the story, because I can remember distinctly the day that he came to the small town my mother and I were living in at the time. He also had Mike with him, and so Mike could probably fill in some of the details that I may not remember.’

  Christian looked in Mike’s direction and nodded his agreement, as did Sibokwe.

  ‘Sibokwe was ten years old and had developed hepatic failure. Jannie felt he wouldn’t survive more than a few days, unless he could be transplanted. Because he lived in one of the rural towns of the Cape Province, your father was concerned that Sibokwe’s post-operative care would be difficult, if not impossible,’ Mike said.

  ‘Why did he take on such a difficult challenge then for his first child liver transplant?’ said Christian.

  Sibokwe looked across at Mike and indicated with a nod that he should tell Christian about what had happened to his father.

  ‘Sibokwe is the son of Thompson Tamasala, who was falsely suspected of being an anti-government activist. He was killed by BOSS—the apartheid state’s sinister security service. That didn’t attract too much attention at the time. It was only when Sibokwe developed liver failure that it became known that he was the son of a murdered innocent black man. Nevertheless, Sibokwe became a cause célèbre for the nation’s left-wing anti-apartheid group. Jannie therefore knew that the transplant meant more than just saving a boy’s life, it also meant possibly assuaging a little of the white nation’s guilt over the meaningless killing of his father. That in itself created an enormous pressure to succeed.’

  ‘And that cause was helped immeasurably by the fact that Sibokwe was a very photogenic little boy,’ added Isabella, looking in Sibokwe’s direction to see if she had embarrassed him a little.

  ‘Ignore her, Christian. I’m the brother she never had. Keep going, Mike.’

  ‘We’d first heard about Sibokwe a few weeks earlier when Dr Etienne Truter, a great friend of your father’s from childhood and medical school, contacted us about transplanting a new liver into Sibokwe. Jannie had huge reservations, as you can imagine. One of the things that you probably know is that the body can reject a foreign organ. The possibility of rejection and monitoring his liver function post-operatively would, if he took on Sibokwe, have to fall to a non-specialist. However, Etienne Truter was not only his best friend, but also a man who your father knew was extraordinarily gifted and dedicated. If it was ever going to be possible to succeed with a liver transplant in a remote situation, it would need to be someone with Etienne’s skills.’

  ‘The other consideration, which can’t have been minor, was that I was black, and many Afrikaners considered saving a black life to be a low priority in a system designed to provide white health care,’ Sibokwe added.

  ‘Your father,’ said Mike, ‘with his Afrikaner background, could see this transplant causing controversy, whether it succeeded or failed. Because of the political implications, he had talked to the university chancellor. That discussion only reinforced his apprehension about the whole case. The chancellor, being the libertarian that he was, enthusiastically backed the idea, suggesting it had great potential to address at least some of the wrongs of the apartheid system. Jannie thought afterwards that it was also his way of indirectly criticising a regime that normally allowed few criticisms.’

  ‘That was really quite a courageous decision then,’ said Christian.

  ‘Indeed, it was,’ said Sibokwe. ‘One that I’ll be eternally grateful for that he had the courage to take on.’

  ‘What concerned him more,’ Mike continued, ‘was that the chancellor wanted to turn it into a photo opportunity, suggesting that Jannie take with him a photographer from the university and that we all go and personally see Sibokwe and Etienne Truter, the treating doctor. Jannie felt seeing Sibokwe firsthand was a good suggestion, but the photographer, he determined, could stay in Cape Town. I agreed wholeheartedly with him. Perhaps you could add something about where you lived, Sibokwe.’

  ‘Pofadder had never really featured as a significant South African town. It existed on the edge of the Kalahari Desert and was known only for its relative obscurity. I lived with my mother in the older part of the town. The main street was tarred, and all the other streets, including Smuts Street, where I lived, were yellow dirt roads, suggesting the desert wasn’t very far away.’

  ‘When we arrived after a bumpy three-hour flight on an old DC3, we found Etienne waiting for us at the airport. Seeing his beaten up old bakkie reminded us that he still cared little for the material things in life. The greetings were vigorous and heartfelt. Etienne was genuinely glad to see your father, and I remember well each having to pause initially, to let the other speak. Jannie and I jumped into Etienne’s bakkie and headed to Sibokwe’s,’ Mike said.

  ‘My mother was a cleaner for a white madam, and we lived in the shed at the back of the house, which is where they were headed,’ added Sibokwe.

  ‘Your father and Etienne had been friends from the time they grew up in Paarl. They knew both their fathers believed that the Afrikaner edifice was secured on the grounds of absolute compliance. Criticism of the apartheid philosophy was tantamount to sedition, and so their discussions about a different future for South Africa had mostly been held in private. After many discussions, they became firm friends.’

  ‘And then they went to the University of Cape Town together to study medicine?’ said Christian.

  ‘That’s right,’ said Mike. ‘At the University of Cape Town they both became involved with the Student Health Organisation, which exposed them to the wider needs of the black community.’

  ‘It sounds like they were both trying to distance themselves from not only the indoctrination of their parents but the segregation that they preached,’ said Christian.

  ‘Yes, it was a struggle for them and I remember the first evening we all experienced interaction with the black community. We all piled into the student bus and headed to the black township of Guguletu. The students sought to provide free medical care in the squatter camps and took out a caravan once a week to treat patients. For Jannie and Etienne, it was with some trepidation. They had no experience, really, talking to blacks or coloureds. The only experience of black and white interaction was from watching their fathers command, shout or beat the farm workers.’

  ‘I’ve heard this story,’ said Isabella. ‘It’s actually quite funny. I think you’ll like it, Christian, and it’s a reminder of
how different it must have been for someone like your father.’

  ‘Their first patient,’ continued Mike, ‘was a black man who had been stabbed in the arm after a fight in the township. Etienne had received instructions from one of the interns to inject him with 1.4 million units of an antibiotic Bicillin—to prevent an overwhelming infection. One of the senior medical students had cleaned his infected stab wound and described how to inject. Your father and Etienne discussed how to place the injection in the patient’s buttocks—upper outer quadrant to avoid the sciatic nerve—like it was a major operation. The patient, sensing that he was somewhat of a sacrificial lamb on the altar of medical research, was wide eyed at the discussion. That he could only grasp certain English words was perhaps both fortunate and unfortunate. I tried to calm him down but that just seemed to make it worse.’

  ‘Most of the poor blacks in the townships had never experienced white medicine,’ said Sibokwe. ‘They much preferred going to the Sangoma for traditional African herbal medicine, despite it having very little efficacy. The Sangoma were quite antagonistic to white medicine, as it threatened to undermine their authority and so they often spread the rumour in the townships that white doctors stole your spirit. Many therefore were hugely anxious, like this first patient of your father’s and Etienne.’

  ‘That’s absolutely right, and when Etienne decided that he was going to be the doctor in this situation, he jabbed the needle into the patient’s backside with the extra force of inexperience. The patient let out a blood-curdling scream, and the room in the caravan was plunged into darkness. From where the patient had fallen on the floor, he then called out in a terrified voice, “Am I dead?” repeatedly. We could see little in the dark and were unsure how to proceed. Fortunately, one of the senior medical students, having experienced a situation like this before, came to the rescue.’

  ‘What did he do?’ said Christian.

  ‘The patient, in reacting to the injection, had pulled out the only power lead to the caravan. The older medical student located the plug and re-established power. By this time, the patient was totally overwhelmed by the experience. He took one look at Jannie and Etienne and fled through the door, never, I suspect to be seen again—at least not by another white doctor,’ said Mike, grinning.

  Christian was a little embarrassed but then joined in with the others’ laughter.

  ‘That was one of many shared moments they recounted, which allowed their friendship to surmount their growing ideological differences. Etienne had grown to see a greater need in the rural communities, while your father’s ambition and background demanded that he achieve in the university environment. I think he partly chose the university path because his father considered him a deserter of his Afrikaner heritage and had rejected him. His achievement was a way of trying to regain respect in his own right.’

  ‘And these are the things they talked about on the way to Sibokwe’s?’ said Christian.

  ‘Yes, and very rapidly, if I remember, as it was only a twenty minute trip to where Sibokwe lived. But back to that story. Sorry for the distraction, but I thought you might find that story with Etienne amusing. It was interesting to know that there was obviously a concern about the lack of health provision for blacks back then even if only through the medical students.

  ‘OK, so where was I? That’s right; we were driving to Sibokwe’s and finally turned left down a dusty road where Etienne managed to stop his old bakkie outside a large white painted brick house. The Tamasala’s, as Sibokwe has told you, lived in a small shed attached to the garage. An elderly white couple, the Reimans, owned the large house. We made our way to the house and walked around the side before we knocked on the door of the shed attached to the garage. Kathleena, Sibokwe’s mother, greeted Etienne with a wonderfully warm smile and extended a shyly held out hand. As he shook hands, Etienne explained to Kathleena that Jannie was the surgeon and I was the anaesthetist who would look after Sibokwe in Cape Town. I remember that the door was so low that your father had to stoop to get in, and once inside our eyes needed to adjust to the relative darkness. The only natural light was from a small window at the back of the room. There was a little wood fire in the corner and several schoolbooks on a small desk. We could see that it was really one room in which there was a table and three beds. A small blanket served as a divider between two of the beds, which we imagined separated the children’s beds from Kathleena’s. Once our eyes had adjusted, Jannie asked Kathleena about Sibokwe’s illness and when she had first noticed that he had become sick. I remember clearly her reply.’

  ‘Master, he started to get tired about six months ago. It was as though he was carrying a huge burden, and he wasn’t his normal happy self. Shortly after that I noticed his eyes a little yellow.’

  ‘It was about three months ago when Kathleena brought Sibokwe to see me,’ explained Etienne.

  ‘Kathleena then explained that the white woman that she worked for had also noticed that Sibokwe was not bringing the full load of wood into the white house for the fire. Sibokwe was trusted and was allowed to take the wood into the white house and stack it next to the fireplace. One of Sibokwe’s other chores, which he shared with his two brothers and sisters, was to trim the edges of the white woman’s garden twice a week. However, his brothers and sisters had recently complained that he was not doing his share. They thought he was getting lazy as he got older.’

  ‘Perhaps I can take over from here,’ said Sibokwe, ‘as I remember coming in and seeing your father, Mike and Dr Truter standing there at that time.’

  Christian looked at Sibokwe, and could see by the strained look on his face that it was not going to be easy for him to relate what he went through.

  ‘I remember that your father was very tall. When I walked in that day, his head almost seemed to be touching the roof of our house. Next to him I could see Dr Truter and Mike and they all stood looking at me for quite some time before they spoke.’

  ‘Nice to meet you, Sibokwe,’ said your father. ‘I’ve just been talking to your mother and she was telling me about when you started to first feel unwell and that you are very tired.’

  ‘I told him I had little energy and that the other children were calling me yellow eyes. They then took me down to the medical clinic where your father examined me. I can remember him looking into my eyes and feeling my abdomen and remarking on how big my liver had become. He then turned to my mother and told her that I should come back with them on the plane. That way they could do all the blood tests that they needed very quickly and start looking for a new liver for me because they didn’t have much time to lose. I can still see the tears welling up in my mother’s eyes and then your father very softly and kindly spoke to her,’ said Sibokwe.

  ‘Kathleena, I know it’s going to be really difficult, but this is the only way that there’s any hope of saving Sibokwe.’

  ‘That must have been so difficult for your mother and you, Sibokwe,’ said Christian.

  ‘Each time I think about it, it amazes me how my mother dealt with the situation. As a ten-year-old boy, I had no idea that I might die. I just thought that these big white doctors were here to make me well and I’d soon be back with my mother. My mother, though, must have understood that she may never see me again. However, she has an amazing faith, as you’ll find out when you meet her, which has pulled her through many things, including my transplants and my father’s death. I still remember her reaction and words that day when she spoke to your father.’

  ‘We’re strong, Master Jannie, and I have prayed for you to come and save my little boy. I know that God has sent you and that you will make him better. Dr Truter has said that you’re a wonderful surgeon, and when I was praying about it, I was reminded of a hymn. I think that was His special word to me, and so these are tears of joy for God answering my prayer. “When peace, like a River attendeth my way, when sorrows, like sea billows roll, whatever my lot, thou has taught me to say, it is well, it is well with my soul”.’

  ‘Th
ose words sustained me through the transplant, and if I’m not careful they still bring tears to my eyes,’ said Sibokwe. ‘But I do remember your father and Mike looking very uncomfortable when my mother started talking about God and her faith.’

  ‘What you picked up on, Sibokwe, was true,’ Mike said. ‘I’ve never been convinced about how much of a role God plays in our lives, and we were overwhelmed by your mother’s amazing faith.’

  ‘I’d have thought my father would’ve understood, given that the Afrikaner background was so biblically based.’

  ‘I think there’s a huge difference between having the Bible as your reference point and having a living faith as my mother had. When you meet her, Christian, I think you’ll understand more of what I mean; she remains a wonderful example of God’s love in action.’

  Christian looked across at Mike and saw that he clearly was still uncomfortable talking about things like faith.

  ‘She sounds an inspiration, Sibokwe; it will be great to meet her.’

  Mike waited until Christian had finished and then continued. ‘We knew that a transplant for Sibokwe was the only solution. He had a rare condition called Alagille syndrome, in which the bile ducts are only few and partly formed. That’s the reason why, eventually, at around ten or twelve years of age, someone like Sibokwe has liver failure.’

  ‘So it was lucky that Dr Truter had identified this and contacted my father.’

  ‘Yes, but it was still a very difficult decision to make even though we knew that without accepting Sibokwe he would die. I can remember clearly the conversation that your father and I had with Etienne Truter.’

  ‘Etienne,’ said Jannie, ‘you realise that there is a high risk involved if we transplant Sibokwe. He will become something of a cause célèbre for the liberal lefties, and that’s without all the surgical problems and logistics. While I have come to see some of the inequities of apartheid, I’m not that comfortable with the liberal left that I want to embrace them, or even be their hero, if this succeeds.’