The Rich Also Cry

On Monday, Feb. 5, 2024, Buckingham Palace announced that the king of England, had started treatment for an undisclosed form of cancer. The King is currently undergoing chemotherapy at Sandringham. His cancer was detected while he was undergoing treatment for an enlarged prostate in January. While the type of cancer has not been disclosed, the Palace confirmed it was not prostate cancer. The King has since stepped back from all public-facing duties while he is being treated for the cancer, with senior royals – including Queen Camilla and Prince of Wales – taking on his duties for some events. However, King Charles III will continue with his constitutional role as head of state, including paperwork and private meetings.

It is also understood that his weekly audiences with Prime Minister Rishi Sunak will continue and will be in person, unless doctors advise that he limits such contact.

And while the world was still struggling to grasp the implications of the King’s diagnosis, another bombshell was released. Kate’s announcement on March 22nd, that she, too, had cancer after weeks of speculation about her health and whereabouts following major abdominal surgery in February came as another rude shock. 

Two major ‘royal’ diagnoses in a span of six weeks? Indeed, the rich also cry.

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In British history, the secrecy of the monarch’s health has always reigned supreme. Buckingham Palace’s disclosure that King Charles III has been diagnosed with cancer shattered that longstanding tradition and brought a whole new, refreshing prospective to health care. The Royal Society of Medicine has thanked the King for highlighting “how cancer is indiscriminate” and urged members of the public eligible for cancer screenings to make an appointment.

King Charles and the Princess of Wales’s diagnosis reminded me of a true-life story that a friend once told me.

A couple of years ago, two men met at the dialysis unit of a top tier, fancy hospital facility in Abuja. One of them was a 74-year-old retired army general who was quite wealthy by Nigerian standards. And we all know that Nigerian standards are high quite high in that regard: tastefully furnished houses in choices areas in Abuja and Lagos, high-end stupendously expensive cars, private jets et al. 

We will call the rich man, Oga general. Mr General had been diagnosed with end stage kidney disease by his doctors in the UK. They advised him to continue his dialysis at home (Nigeria) because his background medical condition and age did not make him an ideal transplant candidate. A true military person, he took the news in good faith and returned to Abuja where he underwent dialysis three times a week.

The second man was a 48-year-old primary school teacher at a government school in one of the satellite towns of Abuja. He lived in an area called ‘one-man village’ near Masaka, and he was dirt poor by Nigerian standards. Again, the Nigerian definition of dirt poor is the lowliest of the low. The man earned N27,000 per month teaching at a makeshift school located in the slums of Abuja. The students sat on broken benches and tattered mats. The classroom was rundown and infested by rats. Every week, the student contributed N10 to buy a carton of chalk that would be used to demonstrate their lessons on the dilapidated blackboard. 

You get the picture. 

We will call the poor man Mr Teacher. Mr ‘T’ was diagnosed with diabetes more than ten years ago at a general hospital in Abuja. Unfortunately, his type of diabetes required treatment solely with Insulin which he could not afford. The poor chap had collapsed and been admitted for hyperglycaemia (a diabetic emergency) more times than he could count. A devout christian, his church circle did not hesitate to pool resources and buy him his medication every Sunday.

Two years ago, his face and feet started swelling. His urine volume decreased, and his eyes turned deathly pale. Mr T’s doctor took one look at him and delivered the bad news- the diabetes had taken his kidneys.

Diabetes is the commonest cause of Chronic Kidney Disease (CKD) in the world. It is the single most important risk factor for CKD globally. Approximately 1 in 3 adults with diabetes has CKD. However, not everyone with DM will develop kidney failure. Factors that can influence kidney disease development include genetics, blood glucose management, and blood pressure. In Mr Teacher’s case, it was poor blood glucose management. Too poor to afford the adequate dose of Insulin, the excess glucose in his kidneys had ruined his kidneys.

Fortunately for Oga teacher, the doctor managing him in the general hospital also practised in a private hospital which catered to high end patients. The hospital, as part of their charity program, would take on a few indigent patients to access care in their hospital. The doctor knowing fully well that Mr Teacher could not afford even a single session of dialysis, and would die if left alone, lobbied for him to have dialysis at the private facility. 

From the moment Oga general and Mr Teacher met, they became fast friends. You can imagine that not many people wanted to associate with the teacher. One look at his tattered trousers and threadbare shirt, and the security man shot him a filthy look. ‘Oga, na where you dey find?’ The hospital staff on their part found a way to schedule his sessions, either very early in the mornings or around closing time so that he would not meet with other patients. Mr T was struck by how humble the general was and mesmerised by his stories of war. 

Oga soldier, on his part, found Mr T’s honesty and poverty refreshing. Perhaps it was the knowledge that he was dying, but the retired general became kinder, nicer and more tolerating of the local teacher’s ways. He taught the teacher how to use the sensor taps in the bathrooms and how to use the sophisticated equipment in the hospital kitchenette to make tea. In turn, the teacher regaled him with humorous stories about his students and their parents. 

Soon after, the general asked his doctor to align his dialysis sessions together with that of the teacher. He began to confide in the teacher the problems he was having with his sons and his fear of dying. Through the general, the teacher learned how the other half lived. Despite the airconditioned bullet-proof cars, the very-expensive looking beads around his neck and the huge diamond rock that the older man wore on his left ring finger, the general was a very sad and lonely man. 

Mr Teacher, who previously thought that money was the solution to all life’s problems, suddenly found himself in a quagmire. One day, after witnessing a patient vomiting profusely on the floor and losing control of her bladder, thereby wetting her wrapper, the teacher asked the nurse attending to him ‘So, the rich can get sick too? I swear, I thought it was only us.’

Oga General and Mr Teacher’s friendship lasted exactly nine months. The general developed a urinary tract infection that soon spread to his other systems and caused him to go into septic shock. He died on his twelfth day on admission. None of his family recognised the shabbily dressed man sitting quietly in a corner of the hospital, sheddings genuine tears.

The teacher spent two years on dialysis before another charity organisation paid for his kidney transplant. His brother in the village graciously donated one of his kidneys. These days, when he is not in the classroom teaching, he can be found preaching his newfound gospel: 

‘Money is not the solution to everything, faith is.’