What's her name? A love triangle to beat them all

On a Monday morning, just as we were finishing the ward rounds, I saw a nurse coming my way with a gentleman in tow. Seeing no quick exit, I waited.

“Daktari kindly see Mr Rubai who has a matter to discuss,” the nurse said. 

He was known to me and we still had his wife’s file in the unit. A quick read told me Mr Rubai lost his wife in the ICU two days ago. Ruby Rubai was transferred to the hospital from another facility. She had sustained 50 per cent burns in a house fire.

At admission, she was diagnosed to have smoke inhalation that affected her lungs. Once in the burns unit within the hospital, her breathing changed and she came to the ICU for respiratory support.

She was only able to communicate nonverbally. Every time we called her, she seemed to always say no and not like the sound of her name. Mr Rubai called her sweetie, and that got a positive nod.

She could indicate when she had pain, needed a drink or felt too hot. I took a family history and learnt that the Rubai’s had three children, teenagers.

As Ruby’s condition deteriorated I asked her husband to bring the children in so that we prepared them for a possible bad outcome, but he never did.

Eventually Ruby passed on from a chest infection.

Now here was Mr Rubai. As he was ushered into my office I noticed an apprehensive man, deep in thought.

“Thank you for seeing me on such short notice, I need an urgent favour,” he blurted out. “Please change the name on my wife’s body.”

As I looked at him in confusion, he repeated the request with more details.

“The lady I lost in the ICU, I need you to put the correct name on her body.”

“Sorry Mr Rubai on our mistake, I will follow up and make sure the names are correct as registered at admission. Please share a copy of her ID so that we make sure the names are correct especially in the death certificate,” I answered.

“No Daktari I can’t, that is the problem,” he replied.

I felt the pain in his voice as he continued, “I gave my wife’s name at admission.”

“Ruby your wife was not your wife? Oh… is she your second wife?” I took a stab.

“No,’ he mumbled, “more of a side chick. She is/was Njeri, my girlfriend, I was with her when a fire destroyed her house. When she got burnt I needed to get her the best possible care, so I used our employers insurance that covers my wife. Now she is dead and my wife is still at home.”

I was stunned.

“That is a difficult position to find yourself in, however am not able to help you. Once a patient dies the body moves to a different department for an autopsy and preservation. I will give you a note to the head of pathology and the hospital morgue they will advise you on the way forward,” I told him.

I quickly filled in a referral note to my colleagues in the other departments and sent him along.

An hour later a knock on my door brought in another gentleman with a totally different request. His name was Mr Kariuki and he was looking for his wife by visiting all the hospitals ICU’s and mortuaries.

He had documentation from a police station having reported his wife missing. I was happy to help and asked the nurse in-charge to take him on a tour of the ICU so that he could look at each patient.

Eventually the visit was done and Mr Kariuki came to tell me the sad story of his wife Njeri who had been missing for the last two months.

Her husband said she had a job with a tour company which took her away from home, but this time he had lost contact with her. Her employer was not helpful and denied having seen her recently.

My initial instinct was to ask the nurses to keep Njeri’s photo and a copy of her ID, because maybe, just maybe, I did know a Njeri!

However, seeing things could get complicated. I encouraged Mr Kariuki to visit our mortuary as he continued to look for his wife.

As he walked away I thought of a quote I had read about the different flavors we add to our lives. “If life were predictable, it would cease to be life and be without flavor.” – Eleanor Roosevelt.

What would you have done?

- An anaesthetist and palliative care doctor, specialising in total pain management, tells of her experiences with patients at the end of their lives and their families.