The Tribune

By DR KENNETH D KEMP

ALONG the double-stranded DNA helix, and coiled chain of anti-parallel genetic code, lies the biological information necessary for the survival of our species. This very same genetic code within DNA is made up of chemical bases occurring in pairs which, unless damaged by mutagens that radically alter its sequence, typically remain the same for generations. Interestingly, more than 99 percent of the three billion nucleobases within DNA code are the same in all humans, lending scientific accuracy to the axiom that we are much more alike than we are different.

Metaphorically crystallised inside this biological matrix are the characteristics of self, passed down from one generation to another, heedfully unburdened by either circumstance or tradition. My patient, hereafter referred to as Eric, like many others, doesn’t necessarily understand the complexities involved in genetic biology but what he does know is that he looks and sounds like his father. His father looks and sounds like his grandfather. The two, unsurprisingly, even walk and think alike.

Recognising this from a young age, environmental influences aside, Eric knows that the DNA of his ancestors, men and women who’ve suffered through much harsher realities than he can fathom, flows through him. That realization gave him the strength to survive multiple trials throughout his life with grace, gratitude and humility.

Eric’s father was born in Jamaica but moved to Freeport, Bahamas, to live with his aunt when he was in his teens. There, he met and fell in love with a young woman. After a year of courtship, they married in their early twenties and together had three children. Eric was their first child. While Eric’s mother was 27 weeks pregnant with him, her water broke. At the time, she didn’t experience any contractions. Surprised and assuming that she’d urinated on herself, she re-showered and went to work. Two weeks later, she went into labour and her contractions were intense.

Given the diminished amniotic fluid present during her delivery, her labour stalled. She pushed over and over again, causing her heart rate and blood pressure to rise to critical levels, but Eric wouldn’t progress through the birth canal. To assist, an obstetrical forceps was used to grab and guide him out but, in doing so, the forceps punctured Eric’s soft newborn skull. Now, 24 years later, he still has a notable scar in the centre of his head, serving unapologetically as a constant reminder of his traumatic birth.

Notwithstanding the events of that day, Eric was a healthy baby. He developed quickly and his parents noticed his athletic interests early on. From the age of five, he began playing baseball and two years later he suffered his first of several injuries. He was lined up to bat when an incoming ball smashed his lower lip. It took five stitches and one month of recovery before he could return to the sport. He vividly recalls the pain of the striking blow and the stinging incurred from eating salty foods during his healing process.

Three years later, at the age of ten, Eric attended a classmate's birthday party. While playing in a bouncing castle, he jumped, flipped and used his right arm to break his fall. Landing abruptly, he felt a snap and immediate pain. He was taken to the hospital and X-rays confirmed his arm was broken. He was placed in a cast for six weeks. Overjoyed to finally have it removed, the following day he went to a beach party with some friends. But after swimming for a short while, his arm felt sore so he got on his bicycle and rode back home. On the way, riding along the rough and loose terrain of the dirt road that led to the house, he stumbled. He was tossed off his bike and fell, refracturing the same arm. The relief from his cast was short-lived. He was placed back into a cast for another six weeks, followed by physical therapy for one month.

By the time Eric was 14, he transitioned from playing baseball to soccer. He enjoyed the fact that soccer was more challenging because, in many aspects, it’s an individual sport that required him to work much harder and further develop his skills. Not being able to rely on his team for every play was both frightening and exhilarating at the same time. Unfortunately, Eric soon discovered that his desire to be challenged came with consequences. During one game he was tackled by an opponent, fell forward, and extended both arms to break the impact but it was so extreme that he dislocated both shoulders. Within minutes both of his arms began to swell and exhibited a dark purple discoloration.

A medical professional working with his team came running off the sidelines onto the field as soon as he noticed Eric’s devolved stance. With his upper body slumped, he mustered the energy of his legs to stand. As his shoulders were popped back into place, Eric recalls the extreme burst of pain that shot from his shoulder to his neck and the rest of his arm. The pain was mind-numbingly severe but he found relief with rest, icing and pain medication. Eric wore a double sling for three months and underwent physical therapy for six weeks before he fully recovered.

Eric hoped that would be the last of his injuries but regrettably when he was 17, he suffered another blow. At practice, he went to recover a soccer ball and opened his legs during a kick much farther than he intended. It was cold outside and he hadn’t stretched so, when he felt pain in his groin, he thought nothing of it and continued to play. As the pain intensified, Eric stepped off the field and sat down but after 25 minutes he couldn’t stand. His leg was locked in position and any attempt to move sent a wave of crushingly explosive spasms throughout his groin, thigh and lower torso regions.

Eric had an MRI performed at the hospital and it was positive for a complete rupture of his groin muscle. He quickly lost both strength and function to the area and a week later, once his inflammation had subsided, he underwent surgical correction. It took a month for him to recover.

Injuries aside, Eric never considered not participating in sports. He’d grown to truly love soccer and when he went out onto the field, he felt alive, intoxicated by the thrill of victory and spurred to excel during the bitterness of defeat. He hoped to play forever but those dreams nearly came crashing down when he became curiously sick at age 19.

Eric developed flu-like symptoms, fever, fatigue, headaches, nausea and vomiting, coupled with significant sensitivity to light and diffuse pain in his back. He had a summer job at the time and continued to work, hoping that over-the-counter flu medication would help but his symptoms were only exacerbated as the day progressed. By the end of the week, Eric could barely move his neck. Confused and concerned, his parents panicked when a local doctor told them that Eric might have meningitis. This rare and life-threatening condition refers to inflammation of the protective membrane that lines the brain and spinal cord and it’s typically caused by infection, injury or cancer.

Memories of injuries and conditions in the family’s past resurfaced. Family members recalled that Eric’s grandfather had lost his vision at the age of eight due to an unknown illness. So, as Eric sat in the car being escorted to the hospital, pale, weakened and curled up in pain, his eyes protected by dark shades, his grandmother cried, softly. At the hospital, Eric was quarantined. Blood was drawn, diagnostic scans were performed and a spinal tap was taken. As the long needle was inserted into his spinal canal, pain radiated up and down his back. It took doctors several attempts before any cerebrospinal fluid could be successfully withdrawn and by the end of the procedure, his headache was worse and pain was now surging throughout his entire body.

A few days later, doctors delivered the news to Eric’s parents that he didn’t have meningitis. Unfortunately, they still had no idea what was causing his symptoms and were baffled by his sudden deterioration. As doctors prepared them for the worst outcome, his mother began to cry, her shoulders shaking as she wept while her throat dried and tightened. As she hugged her son and kissed his warm forehead, tears rolled down her cheek. She prayed for a miracle and begged Eric’s doctors, with the impassioned determination of a desperate and frightened mother, to do whatever they could to help her son before it was too late.

This is the KDK Report.

Part 2 of this series will be published next Monday, May 8.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.