Rising against the odds

Dr Gladwell Kiarie is a consulting physician and a medical oncologist. She also taught at the University of Nairobi’s Department of Clinical Medicine and Therapeutics for 10 years until last year.

Educated at University of Nairobi (Medicine) and in UK (Master’s in Internal Medicine/ Oncology), she has worked in major hospitals in Kenya and mentored young doctors.

In 2014, she won an award for promoting cancer screening in poor areas. Her plate is full of cancer intervention and management but also with family and God.

She talked to JACKSON BIKO about an accident that shifted her life last year, about God, purpose, family and why she doesn’t see herself retiring to play golf.

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Have you ever been on a flight and heard an announcement by the airline crew, “Is there a doctor on board?’’ and you had to step forward to save someone’s life?

(Chuckles) No, but it happened to one of my colleagues, Dr Dawood, the guy of Surgeons Diary. He was my teacher and a good friend. He was on a flight once and he resuscitated somebody who was having a heart attack. The guy later sued him because he broke three of his ribs, a common occurrence in CPR. So for that reason, I usually don’t look forward to being in a flight like that.

What would be the first thing you as an oncologist would do, if you found out that you have cancer?

I’d follow the algorithms of care which is to make sure I see the right person. Many people are discovered with cancer and they seek the wrong care. I also wouldn’t bury my head in the sand and go see a nutritionist or some of the “miti shamba” guys. I’d make sure that I have a multidisciplinary management because treatment of cancer is not simple. It involves several people, a radiation oncologist, a surgical oncologist, a pathologist, a radiologist, probably a nutritionist, counsellor, the works.

Next, I would arm up my family, friends, people who are going to give me support because treatment is difficult.

Tell me about this red meat thing, does red meat cause some forms of cancer?

People tend to simplify the process of getting cancer and they just limit it to sugar and red meat. That if you eat plenty of vegetables, and you drink water you are going to prevent cancer, it is not necessarily true. Many of the cancers that are very common in Kenya today are due to spontaneous mutations or inherited genetic predispositions, environmental triggers like viral factors, HIV/Aids, hepatitis, cigarette smoking. These accelerate the development of a malignancy and increase the risk. You know what will save your life though; early diagnosis.

You have seen the viciousness of cancer, are you fearful of cancer, for yourself, for your family, for humanity?

Fear, yes, but also a realisation that fear is not going to take us very far. I see fear in the eyes of patients when I tell them that their biopsy has come back positive for cancer. But having walked the journey with very many patients, I know that there is hope. Instead of embracing fear, we should embrace knowledge. A patient needs positive energy around him as you walk the journey, it’s very important to do the right thing, and leave the rest to God.

You fight death here all the time, you are the death fighter, what’s your philosophy on death?

(Laughs) Well, would I say that I am a death fighter? I would just say that God gives life, and He gives us the ability to help him take care of His people. But we all have an end, we were all born to die. Our daily living should be, you know, seeking sanctity and one day ending up in heaven. And having your patients have a good end is important, isn’t that what we pray for? That our end will be good? Because dying we shall die. I always believe that the best thing in life is to have no regret. That you fought a good fight, you made the right decisions, and the rest is God’s will. That gives me comfort all the time.

If you were to die now, what regrets would you have?

That I didn’t see my boys grow up. But I doubt I would regret the choices that I have made in life.

I suppose being a doctor has strengthened your relationship with God now that you work alongside Him...

Definitely. You get humbled every day, we are truly not the custodians of life. I stopped judging who is going to die when. We have all these algorithms about estimates of survival and sometimes I think about a patient “I am not going to see her in the next clinic,” but three years later she is still coming for review. That makes me understand that I am just a supporter of a greater being than myself.

What part of Gladwell is still a work in progress?

(Pause) A lot has to be done, especially in oncology. I see life as a constant battle, of choosing right over wrong. I’m interested in very many things. Until a year ago, I taught at the university before I was involved in a bad road accident and was hospitalised for two months. I was forced to lie in that bed for that period and even after I couldn’t walk for a while.

That gave me a great perspective. It slows you down enough to think. You ask yourself, ‘Why do I do this?’ So you realise that everything we fight for when we are driven and focused, sometimes it’s not really important at the end of the day.

What did you change as a result?

You can imagine how that was; I was a very good student, always reading hard, working hard, competitive in the university, I was a lecturer. I had just got a promotion to a senior lecturer, I had leadership in many of the organisations, I was giving talks all over, I was involved in research activities, I have three young boys growing up. I mean, you have everything sort of going for you. Then suddenly, I can’t even feed myself. Well, my mind was very alert and I think that, you know God is very interesting, He gave me time to think to slow down, and just think. I couldn’t get up or write. (Chuckles)

I needed my son to tap my laptop and I read my e-mails. It gave me a perspective to think. You know all these things that I am able to do every day, one day it’s not a guarantee that I’ll be able to walk tomorrow, I’ll be able to think tomorrow or see tomorrow. It’s a very interesting place to be. It helped me a lot to think which battles are important. You realise that not everything is important all the time.

Are you enjoying motherhood, do you have time to enjoy motherhood?

Tremendously. I have three wonderful sons, oldest 18 and youngest 10, and the interesting thing about parenting is you think you have all the influence to direct and make them do what you want, and make them be what you want, but it’s really amazing how you realise that they are just different people with their own direction. Do I have time? That’s the balance, when you come to the realisation of what is important now. My son is doing A-levels in South Africa, so they move on. You have to enjoy the now with them, because to them that’s not a constant.

As I told you, one of my greatest hopes is as I die, I won’t think I wish I had more time for this, or I did this more, or I saw my friends more, you know you are given the opportunity once, the balance is to make sure that you do the right thing at the right time.

On a scale of one to 10, how do you think you are enjoying your life now?

Well, I love my life. I am a happy person. Probably a nine. But I said it’s a struggle, I am not perfect.

I have been told it’s completely ungentlemanly to ask ladies their ages during these interviews and so feel free not to reveal your age, but at what point in your life did you know like that you had come to as a woman, as a professional, as a wife, mother?

I haven’t gotten there yet. I don’t think I have. I won’t tell you my age. (Chuckles) But what they say that life starts at 40 is true. You learn the balances of life, how to interact with people, when to compete too hard and when not to, when to make a point and when not to, you know sometimes the right answer is to keep quiet. I always thought that if I made a point and tell people that they have said a stupid thing, then I have done a very good job. Sometimes that’s not the right thing. So I think I’m still work in progress. Definitely.

Will you ever retire and what will you do after?

Yes, I will. What I won’t do is I won’t play golf the whole day. I am a pretender golfer, I don’t think golfing is an exercise. In fact, I was being told that now they are going to stretch the handicaps to 54. (Chuckles) I used to do marathons before my accident, I loved running but now I was told I can’t run for a bit. What exercise can I do? I hate swimming, I will need something more intense. But I have a very robust family. Organising people to do that, to go visit who, to see whose parents, and dealing with family dynamics is a very good sort of, you are dealing with different things, you need different skills.

You must have married a very smart man given that you are very smart yourself. And that comment is just so that you can talk about the Mr….

(Laughs) You are interesting, Jackson. You know the more impersonal you make it I think the better. Doctors are very conservative people. (Pause) I am married to a lawyer, I am happy. He’s very laid-back, and that’s why maybe we get along. I am sort of ‘‘do this now or right now.’’ He says, ‘‘no we can wait a day and maybe evaluate and things will become clearer.’’