It Never Rained; It Poured

By Dr. Okwun Ojah

When Valentina suffered premature menopause at the age of 27, she thought that she would never be able to be a mother. That was not to be because her brilliant medic husband, Dr MC Trent, quickly organised an IVF. Valentina was so infertile that no viable egg coul

• Language: English
• Publisher: Pen Culture Solutions
• Release date: Sep 22, 2023
• ISBN: 9781638127857

Dr. Okwun Ojah

I'm a Nigerian born author. I migrated out of Nigeria after obtaining a primary medical degree (MBBCH) and went to Botswana and South Africa.It was my childhood ambition to do three things - read medicine (that is become a practicing medical doctor); read law (that is be called to the Bar as a Lawyer) and write books (that is be a novelist).Have obtained numerous medical and law degrees, I thank God that I have achieved the three ambitions by the publication of my first novel - "It Never Rained; It Poured".It must be stated that the order through which my childhood ambition was realised was not within my control, but was within my control was the will and zeal to keep the candle burning till the aims were realised.

Book preview

It Never Rained; It Poured

Copyright © 2023 by Dr. Okwun Ojah

Paperback ISBN: 978-1-63812-784-0

Ebook ISBN: 978-1-63812-785-7

All rights reserved. No part in this book may be produced and transmitted in any form or by any means, electronic, or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

The viThe views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher. It hereby disclaims any responsibility for them.

Published by Pen Culture Solutions 09/18/2023

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It Never Rained; It Poured

by

dr. okwun ojah

Dedicated to:

My wife – Sarah Jane, and our children, the Staff Members of my Clinic, especially Jo Parkes –of Narrabri Medical Centre NSW Australia, for all their love and support.

Acknowledgement:

1. Jan Peters "www.absoluteproof.com.au"- Proofreader and Editor.

2. James and Ann Loder of Loder’s Computers – Narrabri NSW Australia.

3. Doctors and Nurses of Narrabri District Hospital, Narrabri NSW Australia.

Author’s profile

A rural based Medical Doctor practising as a GP Obstetrician in Narrabri NSW Australia, the Author has a Bachelor degree in Medicine and Surgery (MBBCH - Nigeria), Bachelor degree in Law (LLB - UNE – Australia), Post Graduate Diploma in Legal Practice (GDLP - ANU – Australia), Post Graduate Diploma in Forensic Medicine (GDFM - Monash University - Australia) and Master degree in Laws, Legal Practice with Merit (LLM - ANU – Australia), Grad Dip Dermatology (Australia Institute Dermatology with John Flynn University), Dip Clinical Ultrasound (University of Melbourne).

He also holds Fellowship of the Royal Australian College of General Practitioners (FRACGP – Australia), Fellowship of the College of Rural and Remote Medicine (FACRRM – Australia), and Fellowship of the Australasian College of Legal Medicine (FACLM – Australasia).

Prologue

1970

Valentina - a 17 year old girl in Girls College Pietersburg

It was pouring with rain and the forecast was for more over the coming days. Valentina was in a rush to get home as she had chores to do and her Uncle Sitalo would be angry if she was late again. The steps leading from the library were slippery and, as luck would have it, her feet went from under her and she landed in a heap at the bottom, her books scattered around her, quickly becoming wet and soggy. Before she knew it, a young man had gathered up her books and helped her to her feet, while holding an umbrella above her head. Valentina looked up gratefully and gazed into the most beautiful brown eyes she had ever seen in her life.

Valentina remembers that day vividly as one of the most memorable in her unmemorable life so far. The handsome young man introduced himself as MC Trent, and he was in his first year studying to become a doctor. He was somewhat older than Valentina, but they both realised that this meeting was definitely ‘meant to be’.

Years later

Over the next few years, they went their separate ways, studying at different universities. Valentina’s parents had died when she was only four years old, in a car crash that killed them instantly. She only had vague memories of them to this day. Her older sisters related some details, and it turned out that they were very well to do and highly respected in the community.

Uncle Sitalo was the sole trustee of their wills, with the one request that the girls have a good education if anything should happen to them. Valentina was the only one of her family still alive. Her Aunt Filomena and Uncle Sitalo had both passed away and both her sisters also had gone. The only thing of any value left was the house that her parents had lived in all their lives and which was now hers. Valentina wished and dreamed of becoming a well-respected barrister but was compelled to drop from undergraduate law training because Uncle Sitalo, before his death, had squandered all the money that was intended for her studies.

Valentina and MC continued to keep in touch throughout his University days, seeing each other on long weekends and talking on the telephone whenever they could. So when he finished his studies and got a job in the same city as Valentina lived, it was natural that they move in together. And so it was.

1

Dr Limpopo’s Gynaecology Clinic

350 Seshego Street

Pietersburg South Africa

February 14, 1980, Thursday, 11.00 am

In the waiting room – Valentina was biting her lip, her head bent forward and her eyes fixed on the ground. Her eyes darted from one foot to the other. An observer would have thought that she had a foot fetish or that she was counting the number of tiles that made up the floor. It soon became too much for her, she clenched her fists to stop them from trembling. Her breathing and heartbeat began to accelerate and fill her ears with disturbing noise. She started to chew her nails, but forced herself to keep her hands down from her mouth. She kept wondering when her turn would arrive to see the doctor, and more importantly, will the doctor be able to help her to recover her menses? Will he quiz her and then throw his hands up into the air in resignation as others did? She had consulted nine gynaecologists in the last 18 months and none had been able to help her. Does her medical condition have a name? If yes, what is it? She hopes that this highly reputed doctor will give her the answer.

Observing his partner’s unusual behaviour, MC bent his head close to her ear and whispered. What’s wrong darling? Are you alright? His voice was so soft as if he was scared that the person who sat next to his partner would feel offended if she heard his question.

There is nothing wrong and I am okay, said Valentina with a deep breath. Barely a minute after replying she began to chew her nails again and then she felt that a cold sweat had broken out between her shoulder blades. She felt dampness on her inner thighs and suspected that she was already having an accident. She naturally had a weak bladder that gave way easily when she was anxious. She knew that she had to rush to the toilet before it began to drip out onto the floor.

She stood up and began to walk with a ‘duck waddle’ gait until she reached the receptionist’s desk. Please where is your toilet?

At the end of the hall way, the receptionist replied. Please walk straight to the end of the corridor, and turn left. The door to the toilet is on the right.

As Valentina was about to walk away, the receptionist tapped her. Please, there are forms for you to fill out when you come back.

Okay, she replied and walked away.

When she reached MC’s chair, she bent half way down and whispered to him, I’m off to the ladies.

With his face half buried in the book in his hand, MC nodded, and then looked up to watch her walk down the corridor. He then brought his focus back to the book although struggled to maintain his gaze on it. He was worried about his partner. He tried very hard to concentrate but could not. He, however, kept his eyes on the novel pretending to be reading. After some time he shook his head. Something must be amiss. Valentina had never acted so strangely before. Her strange behaviour began to get out of hand after her last two gynaecology visits. MC had not questioned her, and had never entered a consultation room with her because he believed in observation of absolute privacy. If Valentina wanted him to join her in any consultation, she would say so.

If she was not asking him to come with her when she visited the various gynaecologists because she was trying to remedy her menstrual problems, then he preferred that he be left out of it.

On the other hand, did he want to be in the room with her when they did VE on her? No, he did not think that was reasonable. However, no matter the reason, the recent changes in her behaviour were worrying.

I am back, she announced. Have they called me?

No, not yet, he replied barely lifting his head up.

She walked to the desk and took a huge pile of papers, got back to her chair and began filling them out. She tapped MC.

Do I need to tell them how many doctors I have already seen for my complaint?

Yes, be as truthful as you can because in the absence of those pieces of vital information, the doctor may not be able to help you.

After completing the forms she walked back to the receptionist and handed them to her. She then looked at her watch.

When will I be called in? My appointment was for 11am, but it is 12.45pm now, she heaved a sigh. I have been here for more than an hour and a half.

Sorry, Madam. The doctor will call you very soon. He has been attending to someone with urgent issues.

She went back and sat on her chair beside MC. Scanning the magazines on the table in front of her she saw "South African Women’s Magazine" and began to browse through it. A chapter caught her interest - What are my fertility options? Whether you desire an induction of ovulation, intrauterine insemination (IUI) or far more complex management of infertility such as In vivo fertilisation or prenatal genetic diagnosis, Dr Limpopo’s Clinic is your best option. Each of Dr Limpopo’s fertility treatments is designed to increase your chance of pregnancy by enhancing what occurs naturally, either by increasing the number of sperms that get to where the egg is, and vice versa. An infertile woman in her 40s with endometriosis achieves fertility through …

Ms Valentina Damion, it is your turn to go in, the receptionist announced.

Ms Valentina Damion please, the Doctor is waiting. Please go into the Doctor’s room, the receptionist repeated her announcement.

MC gave her a light rap on the elbow. Darling, they are calling you.

Valentina looked up. Oh, I am sorry. Are you calling me?

The receptionist looked in her direction. Yes. You are needed in the Doctor’s room.

Okay I am coming in straight away, said Valentina apologetically.

She picked up her handbag and glanced at MC who nodded as if unspoken agreement had been reached. She then pranced off to the Doctor’s Room. MC sat back firmly and continued to peruse the novel in his hand.

Valentina walked gallantly to Dr Limpopo’s door and knocked.

Come right in, a voice from inside announced.

Immediately she walked into the room, a cold shiver went through her and up the back of her legs like irritable small ants marching on her skin. The room looked and felt like a shrine where heads and bodies are slaughtered for sacrifice. She wished that MC had come in with her, at least for this consultation. Do I go back? she contemplated. And then she decided against the idea because she was already facing the doctor. He was the last person who held the key to the most important thing in her life. He could make or break her reason for existence.

She proceeded and continued into the room looking rather terrified and fidgety. How are you, Doc? she stuttered while appraising him.

The doctor looked to be in his late 60’s. He was tall and wore a custom-made straight suit. When he spoke, he flicked his hands and jerked his legs a behaviour that he had started when he was a resident in the post graduate medical school. He was bald and had a wizened appearance. He spoke with an air of superiority and had a cultured voice. He wore a loosely hung pair of old small rimmed glasses that weighed down on his nostrils.

I am okay, he replied with a dry smile that exposed a disjointed set of brownish dentures.

He then stood up and extended his right hand to shake hers while using his left hand to adjust his archaic looking bow tie which was out of alignment on his neck.

Valentina reciprocated appropriately.

Pointing to the chair opposite his consulting table, he said, Please sit down. And he too resumed his seat. As he sat back, his bald head sparkled in the glare of light rays from the electric bulb just above his head.

By way of introduction, I am Dr Demp Limpopo. I hold advanced degrees in Reproductive Endocrinology and Infertility. One could rightly refer to me as an Infertility Subspecialist. I obtained my primary medical degree at Johannesburg University, my specialisation degree in London, and then travelled to the United States where I undertook an additional 10 years of training in reproductive disorders and infertility. I have been in practice for a little over 35 years.

That’s an impressive resume, Valentina replied. Thanks for allowing me to see you. I hope you will be able to help me today.

I will try my very best, he responded and then he began to flip through the pile of forms on his desk.

After a while he looked up at Valentina. I gather that you have not had a period for the past two years? Am I right?

Yes you are.

He began to flip through the forms again.

And you have seen about nine gynaecologists?

Correct.

Valentina had started to feel that this was shaping up to be another question and answer session. She went through a similar ordeal in her last gynaecologist’s consultation. As a young girl she used to dread attending gynaecology clinics because she detested the intrusiveness of most of the examinations. These days, as an adult she did not mind it so much. She really hoped that this rather stern looking doctor would help her to get her menstruation back. She seriously desired it, even if only to allow her to bear a child for MC. MC loved children and he would feel empty and disappointed if she was unable to have a child for him. He might even opt out of the relationship. If that happened, she would be heartbroken.

Dr Limpopo raised his head slightly and peered through his loosely hung glasses. Did you do the STD blood check and other tests that were indicated on my website?

Yes I did. Are the results not in the pile of papers in front of you? Valentina asked politely.

Dr Limpopo flipped through the file. No I am sorry, they are not.

Well I did all that the website instructed. I even contacted your nurse by phone and she confirmed that she had received them all.

He frowned slightly. Did you say you contacted my nurse to verify the tests and to confirm that we had received the results?

Correct. Valentina looked flabbergasted. Is she not in today?

No, she is on sick leave today, And he began to stroke his bald head.

Dr Limpopo always got frustrated when the requisite results were not available and his Practice Nurse was not available. Lack of requisite results made it difficult for him to attend to the patients efficiently. He detested giving excuses, especially to new patients. He prided himself on the due diligence that he applied to his medical practice.

Dr Limpopo was sceptical. Did you pay all the fees that the pathology laboratory asked you to pay? Sometimes, if fees are not paid in full, the labs will refuse to release all the results.

Yes I paid all the fees.

Please, to enable me to check things out, which tests did you do?

Valentina was flustered. She was not sure that in her current state of mind that she could remember all the tests that she did. Um, I had an ultrasound of the pelvis, sexual disease screen, some hormonal assay, urine assay and I think a general blood test.

At which lab did you do all the tests?

Urine and blood tests were done at the East End Laboratory, and the pelvic ultrasound at East End Sonographers.

Dr Limpopo stood up. Excuse me; I need to find the results. He then stepped out of his rooms and went into the adjacent consulting room.

He came back a few minutes later with a pile of new papers in his hand. Sorry for the hitches, I have found all the results. They were forwarded to the nurse’s email address and she did not forward them across to me.

Don’t you think that the nurse may have forgotten because she was ill? Valentina asked with a quivered voice as she struggled to lead a conversation with a calm façade. She was disappointed because she was still unable to hold a normal conversation without appearing nervous.

Dr Limpopo nodded in acquiescence. You could be right, Valentina. Thanks for your understanding, And he continued to scan the papers, peering through his glasses that dangled precariously on his nostrils!

You are welcome, Valentina replied. And she continued to watch him as he appeared relaxed and engrossed in the papers in front of him. The more she observed him, the more she thought that he could actually be approaching 70. He stroked his grey moustache as he perused the papers. Valentina wondered if he had a habit of stroking his bald head when he was distressed and his moustache when he was relaxed. Hopefully her results were all normal and had made him feel relaxed.

Suddenly, Dr Limpopo pushed the papers aside. I would like to ask you some more questions before I examine you.

Valentina’s lips and chin were trembling. Before your questions, is it possible that we discuss the results of the tests that you have just reviewed?

Will you permit me to discuss the results, my examination and my diagnosis at the end of our consultation? Looking at Valentina he went on. It will be fragmental if I discuss them bit by bit. Are you happy with that approach?

Go ahead, Valentina replied while tapping the toes of her shoes to the extent that it felt like her toes were going to create holes in her shoes.

You are 28 years old now? Am I right?

No, I’m 27 years and half. She hated people inflating her years even by a few months.

Sorry for that, he said apologetically.

That’s okay.

You have been getting your menses regularly and on time up until two years ago. Am I right?

Valentina squeezed her fingers tightly together. Yes, you are correct.

Did your menses slow down or become irregular before they disappeared completely?

They did not slow down, but rather they became irregular three months before they disappeared completely.

How old were you when you had your first menstrual period?

I was 12 years of age.

Casting a glance at Valentina through his ancient glasses that hung precariously on his nostrils, he asked, When did your mother go into menopause?

Valentina bent her head and dropped her gaze to the ground. I don’t know, she replied in a shrill voice.

Valentina resented discussing anything about her parents, especially her mother. She did not want to discuss it now at all. The story relating to their death triggered her first depression.

According to her late Uncle Sitalo, both her mother and father died tragically when their car flipped as they were travelling back to Pietersburg, their home town, from a wedding ceremony. Her father was the driver when the accident occurred and her mother was the only passenger. One of the front tyres of her parents’ car burst and that caused their car to roll. She was only 4 years old at that time and could not remember much. She had never really believed Uncle Sitalo’s account of events especially about the death of her parents. Filomina – Uncle Sitalo’s wife told her that her parents had made Uncle Sitalo the trustee in their Will before their untimely death. Did it not sound like an organised death? Somebody punctured the tyres of their car and they unknowingly drove off in it without first checking, and subsequently burst a tyre. Would it not have been possible that the person was Uncle Sitalo? At least he confessed that her parents were a successful business couple and were well-to-do, whereas he ... Uncle Sitalo was a lazy man who loved an extravagant lifestyle. She could not comprehend how he was able to get away with the murder of her parents.

Dr Limpopo observed that Valentina’s head had dropped and her face had gone pallid and wishy. Sorry for asking you the question. I will not mind if you are unable to answer it. It is just that it would have helped me to reach a diagnosis as to the cause of your premature menopause, he stated sympathetically.

Here he goes again Valentina thought, and looked up immediately, with her mouth partly open. Did she hear premature menopause? Probably she was dreaming. Doctor did I hear you say that I have premature menopause? she asked very boldly in a voice reflecting sudden acquisition of new strength.

She had researched her condition extensively in the medical section of the library and noted the possibility that she could be going into menopause. She was not medically knowledgeable enough as to understand what name it should be given. Some of the books also mentioned how dangerous and frustrating it could be for a lady of her age to go into early menopause. She wished that this doctor could do something to help her. She desperately wanted medication or treatment that would restore her menses.

Haven’t other doctors told you that yet? he replied.

No, they have not.

So what have they been telling you? he probed.

She pulled out her mobile phone and began to click through it, then yelled out, I have found it.

Taken by surprise Dr Limpopo asked - Found what?

The name they gave it.

So what is it?

They called it ame-no-rrhoea of unknown cause. She spelled and pronounced it at the same time so that she would not get it entirely wrong. Indeed, she could not remember how the exact words were pronounced but that is what she documented. She actually did not care if she misspelt it. She wanted this man to make up his own mind and tell her what she had and the cure for it.

Let’s not worry what your condition is called for now. Can you ask your mother when you go home?

Ask who? Valentina retorted. Her frustration was slowly building into anger. Why would he not drop her mother from the whole conversation?

Your mother, he replied. Is she not available?

No, she is not, she replied tacitly.

My apologies.

That’s okay. She died when I was a toddler, so I am told, she continued.

Dr Limpopo stood up from his chair and walked across to Valentina and placed his hand on her shoulder. Please accept my sympathy, he uttered and then he returned to his chair.

Thank you.

Finally, can you explain to me the symptoms that you have had since your menses ceased?

Valentina had been noting the symptoms in a small diary. She half expected the questions and was prepared for them. She pulled the diary out and said, The symptoms include: hot flushes, crawling sensation under the skin, sweats, urinary problems, such as incontinence and increased frequency of urination, mood changes, weight loss, joint pains, dry skin and others.

Dr Limpopo stood up and stepped away from his chair, then began to pace around the room. Briefly, what are the other symptoms? Can you enumerate them in the order of importance? he asked.

Valentina wondered why he was pacing around his room Why are you no longer seated?

I have been sitting since early this morning and I tend to have back pain when I sit for too long. I hope you are not concerned that I am pacing. For me it is a form of exercise which helps my back. I am just obeying my doctor.

Valentina chuckled. So doctors can also be ill and be given instructions by other doctors?

Yes we are only human. All humans are mortal beings.

Okay, other symptoms are dry vagina, inability to sleep at night and depression, she concluded.

Dr Limpopo either did not hear very well or heard her clearly and chose not to respond.

I get the impression that your lack of menses is causing you a lot of grief? he asked.

I guess so, she responded.

You will not mind if I check your blood pressure and perform a general examination on you now?

No, that’s okay, Valentina replied.

Would you like a chaperone? he asked. I always ask every new female patient of mine, as I presume that having someone with them will help them to feel relaxed and comfortable.

I don’t think it is necessary, she replied and walked into the examination cubicle to undress and prepare for his examination.

After Dr Limpopo had completed the general examinations he went back to his chair and ushered Valentina to sit back.

So what’s the verdict? Valentina asked. She was at the stage that she wanted the news now, no matter what it was.

Dr Limpopo was looking thoughtful. With his two open palms cupping his chin, he sat still for some time, before clearing his throat. He hesitated again before speaking, as if measuring his words. I have looked at your pelvic ultrasound and all your blood tests. I could not find any cause as to why your menses have ceased.

Valentina’s eyes became dilated. So what are you telling me?

I am afraid you have what is referred to as premature menopause or primary ovarian failure. he expressed soberly.

Valentina’s hands were folded in her lap. She wore a pensive expression. She sat quietly and was staring directly at Dr Limpopo but uttered no word.

Do you want me to continue? Dr Limpopo asked.

Her voice became choked with tears. Yes. Go ahead. And then she shook her head in utter despair.

Permanent cessation of menses is referred to as menopause. Typically it occurs between the ages of 42 and 55. Some women will experience menopause before that age range and others much, much earlier.

Can it occur in my age range? Her voice was barely audible.

Yes it is quite possible. I have actually encountered one or two ladies in my medical career who suffered cessation of periods before they reached 30 years.

Tears began to stream from her eyes. Is there any cure for the premature menopause?

I am afraid not, he replied.

What are the causes? she asked despondently.

Luckily for Valentina, the room was quiet enough that Dr Limpopo was able to hear her.

Causes include pathologies such as some autoimmune diseases, surgeries, chemotherapies and genetic problems. In some other cases, we are unable to put our fingers on the reasons for the cause of the cessation of menses. This latter group of women fall into the idiopathic subgroups, he continued.

At that instant, Valentina felt a grinding weakness engulf her legs, accompanied by a wave of heat. She also became lightheaded, her heart began to race, she began to feel faint and felt a sudden desire to lie down. Dr Limpopo’s voice began to sound distant and she began to feel extremely sleepy. She could not help herself and crumbled onto the ground.

At that instant Dr Limpopo looked up in Valentina’s direction and saw her. Oh my God! he screamed, and jumped from his chair to save her from falling, but he could not reach her in time. She fell heavily on to her left shoulder and her head hit the left arm of the chair as she did so. She sustained deep cuts and bruises.

Dr Limpopo carried out resuscitation on her. Having determined that she was still breathing, he pressed the emergency bell on his table to summon for help.

His receptionist rushed in. What’s wrong, Doc? She then looked and saw Valentina on the ground. Should I call the ambulance?

Yes and do it very fast, he replied.

Shortly thereafter, MC rushed in. What’s happening to her, Doc? he asked.

Who are you?

I am Dr MC Trent. I am her partner.

I explained to her what she has and the news was too much for her to bear, I assume, and she went into vaso-vagal syncope or panic attack and collapsed.

MC dropped down onto his knees beside Valentina and examined