I watched as he walked slowly into my consulting room. I knew something was amiss from his measured steps and his fairly obvious difficulty in finding his way. I overheard him say something to his companion which made me curious. My interest shifted, momentarily, from him to his companion.
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I decided to put my curiosity in check until after my professional duties were over. Now focusing my attention back on “Mighty Ade,” as he was called, I saw before me a huge man. My entire body could fit into one leg of his trousers.
When he opened his mouth to speak, his voice resonated throughout my office. About two months before, he had been seeing annoying dark spots which suddenly appeared and disappeared in his field of vision. He referred to them as ‘flies inside my eyes.’
He had ignored them until he experienced a sudden painless visual loss in his left eye two days before his visit. He had waited for it to clear but did not. I asked him if he was a diabetic, he said, “Yes.”
He also volunteered the information that he was hypertensive as well, but because the medications slowed him down, he had stopped using them. A few years back, he had accompanied a friend to an eye clinic where he had the opportunity to have his first and only eye examination in his life. His intra-ocular pressure was said to be high in both eyes but he never went back for further investigations and treatment as advised.
“Hmmm,” I interjected, lost in deep thought. “What’s the matter?” asked his worried companion. “I can’t say until I have concluded my examination,” I replied.
I knew Mighty Ade was in serious trouble and he didn’t know it. It was too early to speak. Already, I knew his diabetes was not under control as the familiar smell of ketone bodies around him and in his breath was overpowering. I asked my assistant for records of his visual acuity and blood pressure she had taken earlier and went on to complete my examination of his eyes.
His visual acuity was within normal limits in his right eye and down to perception of light in the left. I proceeded to examine the inner recesses of his eyes. There was evidence of severe glaucomatous damage to his right eye. A terrible fear gripped me when I looked into the left. My fears were heightened when I saw his blood pressure reading – 180/120mmHg!
Now I really have to be careful how I handle any information otherwise, I’ll do more harm than good. “Oga Mighty Ade, how is Penkelemess to you?” He was startled. “He’s my older brother. That’s his nickname. How did you know?” “I heard you call him a few moments ago.”
I was going to ask if they were related to Adegoke Adelabu but decided against it because of the seriousness of the situation.
It was as if Penkelemess read my mind. “I am not in any way related to the great Adegoke Adelabu. My real name is Penkleton but friends chose to call me Penkelemess because of the similarity.
I only learnt about the real Penkelemess later! He then went on to tell me about the great Adegoke Adelabu and how he got his nickname “Penkelemess” from the corruption of the words, “Peculiar mess.”
“What has this to do with my eye problem?” asked Mighty Ade, visibly shaken. Your left eye is a “peculiar mess.” You have had a ‘stroke’ in your eye – the main vessel carrying blood out of your eye is blocked and there’s blood spattered all over the inside of your eye. Your blood pressure is dangerously high and with your diabetes and hypertension uncontrolled, you’re in serious trouble. I am afraid you have to go from here to a hospital for immediate admission and treatment.” I explained. Your brother will see to it that you follow my instructions.
“Apart from my blind left eye, I have no other problem. I am as fit as a fiddle,” he protested vehemently.
Penkelemess responded swiftly, “Don’t mind him doctor. I have told him over and over again to watch his weight. He is too fat. This young man is only 45 and he is looking older than I. I am 55 years old and I am embarrassed anytime I go out with him; they think I am his younger brother because of my small stature.
Actually, I am a medical doctor – an internist, so I understand all you have said. He has all the risk factors for a Central Retinal Vein Occlusion – obesity, uncontrolled diabetes, hypertension and raised intraocular pressure. What do you plan to do for him, Dr. Ben?”
“He needs urgent attention for his diabetes and hypertension. We can’t do anything about his eyes until these are controlled. I gave him some eye drops to reduce his intraocular pressure and asked him to see me in about three weeks with a report of the state of his diabetes and hypertension from his family physician.
and then