‘May God hold the scalpel steady in your hand’ — and other blessings my grandmother bestowed on me

“Bi hay yeya,” my father, in Mende, always told me. Buy your blessings.

I was reminded of this one morning in 2004 when, as a first-year resident physician, I walked into the Johns Hopkins emergency department ready to begin my shift. Arranged in a semi-circle, feet toward me, were patients doing palpable warfare with death and disease. For one of those five souls, death was summoning urgently. Let us call him Patient X.

Buy your blessings.

Not in a capitalistic sense that God’s favor is for sale but, rather, that our good deeds can be transformed into grace and fortune. In Sierra Leone, where I grew up, a gift elicited much more than a simple thank you. The recipient would bestow beautiful wishes on the gift giver and their family: “God bless you. God bless your children and your children’s children.” To each of these declarations came an amen from the one who had given of their wallet, time, or goods. Depending on a number of factors — the size of the offering, the amount of time available, the mastery of language — this call and response could go on and on, an empowering and loquacious melody of gratitude and hope.

May you live to see your children prosper.

May you never walk on hot earth.

May your words sound sweet in the ears of strangers.

And to each blessing: amen.

The summer before I started medical school, I went to the fabric stores on Malama Thomas Street in Freetown. The snuggly fitted shops that lined the street displayed a vast array of bright, bold, and beautiful prints. There were African wax prints, or ankara, whose unexpected color combinations and whose highlights of shocking pinks, rose reds, and lemon yellows succeeded in tempting every casual browser. There was Sierra Leonean gara and its signature indigo tie-dye technique. There were polished and plain cottons. There was also a wide variety of lace. Each store was the size of a small bedroom and had walls stacked high with neatly folded material; it reminded me of a library full of books whose spines gave a glimpse of their inner promise.

I had gone to Malama Thomas Street to buy ankara for myself. Instead, I found something for someone else. An intricate lace of white and gold, with just the right number of scattered sequins to render it majestic but not gaudy, had caught my eye. I bought six yards of this lace, enough to be sewn into the flowing gown we called bobani and to yield the accompanying headtie and lappa, the long cloth wrapped around the waist, under the bobani. I was certain my grandmother would look great in it.

This is how it came to pass, then, that my grandmother, the late Al Haja Mamie Massaquoi, and I swayed to the rhythm of her blessings followed by my amens. Truth be told, even if I had bought her a cheap and plain cotton, unpolished and un-sequined, instead of elegant lace, our blessing dance would still have been long. Her granddaughter had given her a gift, and, no matter the gift, my grandmother would have been generous with her good wishes. I kept my eyes closed, almost humming my amens until she said, “And in your work in medicine, may God hold the scalpel steady in your hand.” At this, I sat up, opened my eyes, and looked straight at her.

My grandmother was small only in stature. She raised a son who would earn his PhD in engineering, even though she herself had never sat in a kindergarten. Her language was rich, full, and purposeful. She made ordinary stories vibrant for us as children because she understood the importance of detail. Like the fact that medicine is an imperfect art with fallible players whose hands might tremble under the pressure of having to take the next best step, with incomplete information and life itself in the balance. She envisioned moments of my life as a clinician even before I had opened my first medical textbook.

In an instant Patient X’s blood pressure dropped, his oxygen saturation plummeted, and his monitor yelled out the message that he was too sick to verbalize: “I am dying!” A quick look at and listen to his chest, and I understood: His lung had collapsed.

The space between Patient X’s chest wall and a failed lung had filled with air. That air was creating pressure in a place that was not built to accommodate it. Angrily, this air pushed everything out of its way: the bad lung, the good lung, the heart, and the great and mighty vessels, a veritable compressive death force. I had to make the definitive cut in his chest wall that would effectively relieve this tension.

Scalpel in hand, for a moment, I thought of how few of these procedures I had done. Doubt seeped in. Unwelcome thoughts that could make an arm shake and fingers quiver. Thoughts that can undo a person. To counter them, I remembered my amens. I claimed the powerful intentions of the one who had manifested fortitude for me long before I knew to ask for it.

Cut made. Gush of air. Hollow plastic chest tube correctly inserted. Lung reinflated. Patient better.

Though two decades have since passed, though I have lived through years filled with mightier challenges, I still remember this moment with Patient X. To be a citizen of this earth is to know all its seasons, to know times of joy but also grief, of wellness but also illness, of abundance but also scarcity. In all my seasons, my grandmother’s prayers are an assurance. In my most difficult seasons, I find myself wishing that I had bought more lace, bought more anything, more often and for more people.

But it is never too late to go shopping.