The serpent in the woodpile


Sometimes there is little traditional doctoring in the work I am doing here. Often I start the ward rounds at 730 in the morning, and then have to stop to see a cleaner who has passed out, or to give a visiting official an impromptu tour of the Creni (the French acronym for the therapeutic feeding centre). The ward round which could be carried out in 2 hours lasts until 1pm as a result of these diversionary activities. Then there are the staff vaccinations to be carried out, and the field debates, and the occasional marriage that I have to attend (in my capacity as supervisor), and that I try to fit into the lunch break In between all this I make my daily visit to Abdou and Harira and the children in phase 2 who have recovered from their illnesses, and now offer me their hand whenever I visit. We are all conscious that they are doing this for my benefit, but we all pretend not to know.

All of this makes for quite a varied lifestyle – rarely a day passes without a new (and often bizarre) challenge to be faced. At 6pm on Saturday afternoon I was preparing to leave for the weekend when someone alerted me to the fact that there was a snake in the woodpile near the kitchen. I asked what type, and they said an Anaconda. My response that this was unlikely served to aggravate the situation, because my interlocutor then demanded I come to have a look. We searched the pile for 20 minutes but could not entice the anaconda out of its lair. Unfortunately the kitchen staff had all seen it, and used this opportunity to inform me that they were not willing to work until a snake charmer was called and the snake was caught.

Now this presented me with two dilemmas. Firstly, I had had a hard couple of weeks and desperately wanted to rest; yet a therapeutic feeding centre without a kitchen is like a hospital without nurses – more of a risk than a benefit. Secondly, I was unconvinced that the snake charmer was the solution – I guess my medical training encourages me to steer clear of interventions that are not evidence based – and yet I could not come up with a better suggestion now that the sun was already setting. So, I bravely called the nursing supervisor and the logistic assistant and arranged for them to meet at once, and then got on my bike.

This may seem like an avoidance of responsibility, and I think it probably was. I rationalised my action in terms of the fact that I was too tired to function well, and that I needed to find a solution that was fair to everyone, including myself. It just so happened that the chosen solution was a bit more fair to myself than to everyone else. And at other times I think that sifting through a pile of mouldy wood looking for an anaconda in the company of a wizened mendicant playing a pipe and burning some herbs could be an excellent way to spend a Saturday night.

At least I followed up on the situation the next morning. No snake was found in the pile of wood. The charmer has been called and will arrive today. The staff have somehow been placated. By Monday this will all be forgotten; and there will be something new, and no less bizarre, to deal with.


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