Dr. Smith-Aidoo’s face mirrored the anguish of the scenario she was describing.
“How terrible it must have been,” Dawson said. “The private clinic you mentioned-I assume it’s expensive?”
“Very,” she said, wincing. “It’s part of a worldwide chain called International Medical Services, or IMS, with branches all over Africa. It’s not a charity-doesn’t even pretend to be anything else but a for-profit company. You pay with credit or hard cash and the patients are expatriates and well-off Ghanaians. I did an initial evaluation of Angela, which was moderately expensive but still didn’t diagnose what she had.
“Jason was having difficulty coming up with the money even for that first medical work-up. I understand that at the time, he’d just started a real estate business that wasn’t doing very well, and I don’t believe his wife worked or made a lot of money. Angela was going to need a battery of tests and scans, but any movement forward depended on his paying for what had been done so far. Jason begged me to set up some kind of arrangement whereby his payment could be deferred. I asked the clinic administrator if that was possible, and her answer was quite firm. She said IMS doesn’t give out free lunches, and anyone who thought it did was not welcome. Someone in the administrative office called Jason and politely told him that if he couldn’t pay, he needn’t bother to return. I was appalled, but only five or six years out of medical school and brand new at the clinic, I didn’t feel at the time that I could argue on Jason’s behalf, although now I wish I had.”
She must be around thirty, thirty-one, Dawson thought, graduating from medical school at a very young twenty-five or so.
“And at around that time,” she continued, “something else happened that I wish had turned out differently. Jason went to Uncle Charles to ask for a loan, but Uncle turned him down.”
“Did he say why he refused Jason’s request?” Dawson asked.
“He didn’t see why Jason had to take Angela to the most expensive clinic in town. Jason tried to explain that he had been to several public hospitals, including Korle Bu at the very beginning of Angela’s illness back in January. Uncle’s advice was to take Angela back to Korle Bu and insist that they reinvestigate what was wrong with her.
“Soon after that, Jason accosted me one morning in the car park as I drove in to work, making an embarrassing scene. It was a combination of attacking me, saying I was letting his daughter die, and begging me for mercy. The security man had to escort him away. It was horrible-still haunts me. By the end of April, I had heard nothing from him, so I called him. He said he was back at Korle Bu Hospital with Angela. They had done an exploratory laparotomy and found that she had hepatocellular carcinoma. It’s very rare in children, and all of us had missed it. Angela was in hepatic coma at the time I spoke to Jason, and she died about ten days later.”
