When I caught my patient sipping some mysterious-looking fluid from a plastic bottle just three minutes before being wheeled to theatre, I remained motionless for a second or two. Then I casually walked towards him. He had to hide whatever it was that he was trying to drink. As I stood by his bed waiting for the nurses to wheel him to theatre, I couldn’t stop myself from asking him, “George, ulikula mara ya mwisho saa ngapi?“ “Jana usiku, kitu saa sita hivi”, came his reply. I chuckled. He looked up at me with the most innocent eyes I have ever seen. I was about to ask him another question but then the nurses had already arrived by his bedside, ready to wheel him to theatre.
Once on the operation table, the anesthetist asked him the same question, “boss, ulikula mara ya mwisho saa ngapi?” and he gave the same answer. But because anesthetists are anesthetists, he asked another question, “hata maji haujakunywa? “and he said no. I had to walk out of the operation room and wipe the grin off my face before the anesthetists could see it and demand for some explanation. You see, I knew George was lying, but I chose to say nothing. I had done the exact same thing George was doing now some six years ago. I had been scheduled to go to theatre at seven in the morning. The doctor’s instructions were; to take nothing by mouth beyond midnight, when I became a doctor, I learnt a fancy term for “do not eat anything” it is called being nil per oral! So I didn’t take anything. Then in the morning as I was being prepared for the operation, my parents asked for five minutes so they could pray with me (back then, going for surgery was euphemism for dying/going to die/about to die). They were granted the five minutes. And they prayed for me. Then they made me take a sip of some herbs from a bottle. And I sipped and I was taken to theatre and when asked the last time I had eaten, I said midnight. I didn’t even die.
Patients set to undergo surgery are routinely starved for about four to six hours, as a precautionary measure to prevent aspiration of stomach contents into the lungs. This could happen during general anesthesia. Doctors rarely explain the reasons for starving patients before surgery or the real dangers of eating just before surgery. That is why patients are always outsmarting doctors, like the way George and I did! We were just lucky though. The next time your doctor tells you not to feed before surgery, please don’t. Or if you happened to succumb to a little bit of temptation and had to take a slice of ugali and nyama choma, just let your doctor, or at least the anesthetist to know! If you want an uneventful surgery, you can’t afford to keep such things away from the theatre team!