Man Proposes, God Disposes – By: Fatima DAMAGUM

IIt was a sunny day a year ago when a colleague referred his son to me. The boy had obtained admission and a scholarship to a prestigious flight school in the United States. His parents were so proud of this achievement. Not only had his son, Tunde*, gotten all A’s in his WAECs and IGCSEs, but he had also gone the extra mile to apply to every major flight school in the world seeking admission and scholarships, without any assistance. Flying was one of his childhood dreams and knowing that his parents could not afford to send him to the school he dreamed of, Tunde put all his heart and strength into his studies to be able to meet the conditions of ‘admission.

The school offered conditional admission and required, among other things, a medical certificate of fitness before confirming his place at the school. When I met Tunde, I was impressed by his enthusiasm and drive. We chatted happily about life while I filled out the test forms. Some of the more specialized tests required required the attention of other specialists, so I called on my colleagues from other departments to help. I wanted everything to go well for this charming young boy.

A few days later, my friend from the eye department called me with his findings. A thorough examination of Tunde’s eyes showed he had a rare condition called retinitis pigmentosa, commonly known as ‘night blindness’. My heart sank.

Retinitis pigmentosa (RP) is a term for a group of eye diseases that can cause vision loss. What they have in common are specific changes that the doctor sees when they examine your retina. a bundle of tissue behind your eye. When you have retinitis pigmentosa, cells in the retina called photoreceptors don’t work as they should, and over time you lose your sight. It is a rare disease that is passed from parent to child. Only 1 in 4,000 people get it. About half of all people with RP have a family member who also has it.

Retinitis pigmentosa usually begins in childhood. But exactly when it starts and how quickly it gets worse varies from person to person. Most people with RP lose a significant amount of sight in early adulthood. Then, at 40, they are often legally blind. There is no cure for retinitis pigmentosa and the best that can be done is to help slow the progression of the disease and help with low vision aids.

His other tests were all normal and so when he came back I started with the good news first. All of his blood work, urine toxicology and hearing tests were within normal limits and therefore in good condition. I then broke the bad news as quietly as possible. There’s just no easy way to tell someone they’re going to lose their sight.

His dad had gone with him, so I started by asking the dad if there was a history of eye problems in the family which he said yes. Before his death, Tunde’s grandfather was completely blind. The cause, however, was unknown as the old man lived in the village. Tunde’s father denied any visual issues which made me realize that Tunde’s RP may have been autosomal recessive.

Autosomal recessive RP; Here, each parent has a problematic copy and a normal copy of the causative gene, but they show no symptoms. A child who inherits two problematic copies of the gene (one from each parent) will develop this type of retinitis pigmentosa. Since two copies of the problematic gene are needed, each child in the family has a 25% chance of being affected. Similar to how sickle cell disease is hereditary. Tunde was the first of four children. I asked her to bring the other children for an evaluation.

As expected, the news devastated father and son and I urged them to get a second opinion before sending the results to the school. A week later the father called to tell me the results were the same, Tunde actually had retinitis pigmentosa. He asked me to go ahead and send the results to the school as requested.

A few days later, Tunde’s father called with sad news. The school had written to say that his admission had been revoked due to his condition. Tunde cried with all her heart and refused to eat or leave her room. When his grief lasted for weeks, his mother dragged him out of the room and took him to the hospital.

Gone is the charming young boy I met months ago; in his place was a disheveled, cachectic, dark character. This boy, who was once full of life, confided to me that he was thinking of suicide. He was severely depressed and saw no need to continue living. His mother and I advised as much as possible, but I knew he needed more than our words. When I mentioned admission to a psychiatric ward, her mother was adamant. She didn’t want her only son to be in a psychiatric ward. We consulted and we found a solution, he would be admitted, but in a private hospital managed by a psychiatrist.

Tunde spent two months in hospital on medication and therapy. Gradually, the depressive symptoms diminished and the suicidal thoughts ceased. At home, he was encouraged to try applying for other courses at university. He confessed to me that the only thing he liked besides flying was animals. He had many pets at home: cats, rabbits, dogs and turtles. He had a cat that had been with him JSS1. The cat had helped him through his depressive phase and had accompanied him throughout his stay in the hospital. They slept and ate together! Apparently pet therapy isn’t just for Caucasians. I suggested veterinary medicine or zoology and he said he would think about it.

Her father called me a few days ago to tell me that Tunde had been accepted to study veterinary medicine at a university in the United States. Based on a strong motivational statement he had written outlining his journey from being diagnosed with retinitis pigmentosa to being denied his pilot dreams and subsequent battle with depression and being admitted to a mental hospital, he received a full scholarship with the only caveat that he maintains his GPA at 3.5 and above. Her parents were thrilled, but most importantly, Tunde’s confidence was restored and her mood improved.

Retinitis pigmentosa is not an easy diagnosis. To date, there are only numerous clinical trials without specific treatment. The reality that you will gradually lose your sight requires herculean resilience to continue living. I’m glad he chose veterinary medicine because it’s a versatile career that can accommodate his disability in the future.

This morning I woke up thinking, what if he hadn’t taken the eye test sooner? What if he had received his pilot training? He is said to have finished his training, started working only to have visual problems and go into early retirement at a young age.

We plan and God plans, but ultimately He is the master of all planners.

Man proposes, God disposes.

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