Mistaken genotype

The Ugwus arrived at the hospital unaware of what was amiss. The week before, Doctor Mbah had called and said that he wanted to have a meeting with them. He told Daniel Ugwu that it was about his wife's pregnancy. The doctor had reassured Daniel that all was well. The Ugwus though took some time before answering the call because Nkechi, his wife, said she was tired of walking, her legs were painful, and she wanted some rest.

Doctor Mbah was all smiles as they entered his office. The family file was already on his desk. He looked through the file as if pondering over some details. His white overcoat was sparkling, accentuating the beige paint on the walls. It was remarkable that for a man his age he wore no glasses despite reading countless books every day. By his right was a clock, along with a bell that he used to ring for the attention of the nurses. On the wall behind him were several awards that he had won as a doctor and that had been given to his hospital.

When he spoke, his tone was grave. "So, my dear Nkechi Ugwu, how is the baby? I hope she is pushing?"

Nkechi smiled. "Yes, doctor. Thanks for your care."

"That's good to hear. As I told your husband, something came up about the baby."

Nkechi Ugwu sat upright, holding her husband's right hand. Daniel Ugwu only pondered what the doctor must be about. He tightened his grip on his wife's arm to reassure her.

"We conducted some tests from the baby's blood sample," Doctor Mbah began. "It's a normal test to make sure our babies turn out well. I don't want you to be alarmed but you have to know that we found something interesting with the genotype test."

She breathed forced air, putting her right palms on the bump on her tummy. She had done several scans and the nurses always told her everything was okay. The baby was good. She only had three more months and she would have a bouncing baby girl; her first in her two years marriage. She straightened up once more, tying and untying the scarf on her head. "I hope nothing is wrong, doctor?" she asked.

Her husband repeated the same question.

"I must say there is something wrong." Doctor Mbah paused. "We did a NIPT test or what is called a non-invasive prenatal test. We discovered that your baby has sickle cell disease."

"That's not true," Nkechi retorted, looking at the doctor straight in the face.

"What are you saying, Nkechi? Could the doctor be lying?"

"But your genotype is AS and mine is AA. How could we give birth to an SS?"

Doctor Mbah allowed both of them to argue before he asked Nkechi. "Our tests are ninety-nine percent accurate. Why do you say I am lying?"

She stammered for an answer and apologized.

"But Sir, it's not possible."

"I suggest both of you go and do a test all over again. Either both of you are AS or one of you is SS. Twenty-five percent of Nigerians are AS so I presume you did a bad test from an inferior lab. Our labs are the best in the country. "

Daniel Ugwu cleared his throat and asked the doctor: "What does this mean for us? I mean, for our family since the child has SS genotype. All I know about children with sickle cell is that they regularly fall ill."

"That's right. Sickle cell disease is a condition where the oxygen cells cannot carry enough oxygen around the body, starving key organs. That brings a lot of sickness with it. Many sickle celled children die at an early age. That is a prospect both of you need to take into account."

"And apart from that?"

"That is all. Just the frequent cases of illness. But the burden of the illness can take a heavy toll on the family, both financially and emotionally."

"I don't understand, doctor."

"I have to be frank with you. The cost of treating a child with sickle cell disease can be up to eight to ten million naira every year. You have to be ready. Also, there is the fear that your child could die at any time. Even a disease like the common cold can make her sick and die."

The amount the doctor said they would need each year to care for a sickle cell child was beyond his means. Daniel Ugwu mentally calculated how much he made every year from his auto spare parts business. He had not bargained for this. He brought his head down, staring at the floor.

"What can we do?" Nkechi asked the doctor. "I don't believe all hope is lost."

"There is no cure for sickle cell disease. No known cure yet. You just have to manage it and pray your daughter survives the crisis she will regularly be going through."

"Have you heard, dim," she said to her husband.

Daniel sighed deeply, shaking his head. His eyes were closed with his head bent as he imagined what the future will be with this child. This is a gift from God, he said to himself. I cannot reject this gift come whatever sacrifice that was needed.

"We have heard, doctor. Thank you for making us aware."

"I want you to have this card. It's that of Doctor Ahmed, a specialist doctor who treats children with sickle cell disease. You would need to be calling on him regularly from the day your daughter is born."

Daniel Ugwu took the card and dropped it into his purse. He hugged his wife and told her it would be okay. The cost involved in caring for this baby was prohibitive but the Lord knows best. "Who are we to reject a gift from God?"

"It could never be true," she kept saying as they drove home. She would not accept what the doctor had said. She had done what the Pastor had advised her before their marriage. She and Daniel had gone for marriage counseling where the Pastor told them that they needed to do a genotype test before fixing the wedding day. "To make sure there are no complications in your marriage," they were told.

Daniel was the first to do the genotype test. He turned out AS.

"If your husband is AS, I will not marry both of you if you are also AS. There is a possibility of your child being SS."

She did the first test and it turned out her genotype was AS. On a premonition, she decided to do a second test. The second result said she was AA. She told the Pastor about the confusion and he advised her to do a third test. When she did the third test, she turned out AA. Not satisfied with the result, she did a fourth and fifth test. She was AA still.

"There is a mistake somewhere," she said adamantly to her husband.

"Doctor Mbah is one of the best in his field. Please, let me have my peace. What has happened has happened."

"I will get to the end of this," she promised him. "My baby is not a sickle cell child."

That evening Daniel Ugwu's mother called. Daniel told her what the Doctor said.

"Shame on you, you stubborn child," his mother, Faustina Ugwu, said to him.

"I don't deserve to be insulted, mother. I just told you the problem we will be facing when this child is born."

"Did I not tell you not to marry that lady. That ogbanje lady. You have to carry your cross."

"This is not what I wanted to hear from you."

"What did you want to hear from me? That I should be dancing; that you want to give me a granddaughter that has no hope of surviving on this planet? Is she not ogbanje? Only a witch can give birth to a witch. I told you right from day one that your wife is a witch. Everything is revealing itself."

"If this is what you have to say, I think I will have to cut this call."

"Cut the call. Your stubbornness is what is leading you to problems. Let me talk to that your wife."

"Nke, my mother wants to talk with you."

"I heard what she said. I don't want to talk with her. It's all abuses and insults I hear from her."

"Just hear her out. Please."

"I will not!" She walked out on him and went to the bedroom, slamming the door behind her.

"Mama, maybe she will talk to you when she is in a better frame of mind. Right now, we are all stressed out. Both of us are on edge."

Daniel Ugwu endured the insults that his mother unleashed. Listening patiently, he tried to reassure her that everything was part of God's plan.

"You will see me in that your house tomorrow. I have to talk sense into that your stupid wife. That ogbanje woman. I warned you, didn't I?"

******* ******* *******

Every permutation Nkechi did led her to the conclusion that Doctor Mbah could not be right. It was inconceivable that their child would have the SS genotype. She repeated it for the umpteenth time to her husband at bedtime.

"Woman, I know Doctor Mbah very well. He has been our family doctor for ages. Get that out of your head."

"It will not cost us anything to do another test. Let's just do it; just to be double sure."

"Did you not tell me you took your genotype test five times? Now, look at what we are facing. Please, let me have my peace. I'm not interested. I want to sleep, please."

"So, you will just accept his words like that! That's unlike you, dim."

"What's not like me? I have lots of mental trouble thinking about this. I don't want to compound my problems. We should be preparing for what will happen when this child is born, not doubting what has already happened. Not thinking about spending money for unnecessary tests."

She knew that when her husband went on like this, it was pointless discussing with him. When he has made up his mind, he could be very argumentative. What she wanted was to find out what side was lying to them - the doctor or the labs where she had done her tests. Or maybe her husband's test was wrongly done. She was sure there was a problem somewhere. It was hard for her to believe that one doctor would know best. Angry at his reaction to her suggestion, she turned her back to him.

"I just want to let you know," he said. "My mother is coming tomorrow."

"I know that's what she will do. She is always interfering in our lives."

"She's not interfering. She's only trying to help. You might not like her methods, but wisdom comes with old age. She might give us some suggestions that could be helpful. I am sure of that. By the way, you know she's well connected in Lagos. We could use her help."

"But whenever she's here, there is always trouble."

"Who conceives the trouble? Is it my mother or are you the one causing the trouble? Are you saying my mother is a troublemaker?"

"That's not what I am saying but that's what happens all the time."

"I've always told you that you need to change your attitude towards her. She is a very good woman, and motherly."

The last time his mother visited, her complaints had come in daily doses. The first day, she complained that Nkechi was not cleaning the house the way a housewife should. The second day, she complained that her son was bearing all the financial burden in the house. "We are in a modern age, Nkechi. A woman should be working." "But mama, you can see that I am pregnant. I am two months pregnant," was Nkechi's reply. On the third day, she complained that they had given her a small room because they did not want her around. "I know you are secretly plotting to throw me out of this house. For your information, this house belongs to my son." Everything about her was complaints upon complaints. Although they were not as rich as Daniel's parents, she and her husband were content. Nkechi did not want anyone reminding her that they needed to live like others, or assume the status of his parents. Or that they needed to build a house or buy a luxurious car. There was no relationship between having the most expensive pieces of jewelry and family happiness.

"When your mother comes, I will be on my own. I just want to let you know."

But Daniel did not hear her. He was already fast asleep and snoring.

She stood up from the bed and went to sit on the only chair facing the wall. Thank God, the electricity distribution company did not take the power. She needed some fresh air which the fan would blow her way. Thinking about their two years old marriage made her anxious about Daniel's mother's visit.