Sickle Cell Anemia: the thorn in Godfrey's flesh
In his many letters to the Corinthians (1 Corinthians 7:12), the Apostle Paul spoke of a thorn in his flesh, which if it was in his powers, he would have willed it away. We don't know what that thorn was. In the case of Godfrey, we know he had a thorn and we also know the thorn: sickle cell anemia.
Sickle cell anemia is a genetically acquired disease that is common in areas where malaria is common. It is caused by genetic changes at different regions of the genome (the blue print that makes us who we are), and it arose due to evolutionary pressure from malaria. Put it simply, persons with the abnormal gene had a better chance of living to adult life and bearing children, so more children with these abnormal genes were more likely to be born and also to grow and have their own children. All human beings have two copies of the same gene. In the case of the genes causing sickle cell anemia, having one copy of the gene is good, but having two copies is not good. Since we get one copy of the gene from each parent, having two copies means that both parents have the gene, while having one copy means only one parent has the gene. With one copy, people are able to resist severe malaria infections than those who don't have the gene, while having two copies causes other problems.
Godfrey had two copies of the gene (the exact genetic abnormality is not known to us. About 5-40% of people in Uganda carry the abnormal gene, depending on where they come from. This tells us something about his parents. More importantly, this caused him to suffer from the negative effects of the double abnormal gene. In Godfrey's case, the complications were anemia and kidney failure. Many people know of this and dubbed Godfrey "omusawo" or "doctor" because of his dutiful attention to his health to maintain kidney function through artificial support through peritoneal dialysis. Daily, Godfrey would interrupt his schedule to go and administer peritoneal dialysis to himself.
Why kidney failure in sickle cell anemia? The basic functional abnormality in sickle cell anemia is that red blood cells, which should be nice and round change to become sickle cell shaped when they don't have enough oxygen. The round cell shape is good for circulation; the sickle cell shape is not good for circulation and causes blockage of the small blood vessels supplying body organs. In the case of the kidney, failure to get enough blood causes the kidney to fail to perform its crucial function of keeping our blood clean- have you never wondered why you pass urine? You are merely passing waste products cleaned from your blood by the kidneys.
The use of peritoneal dialysis was revolutionary because it allowed more independence to the patients, including Godfrey, but it also has complications, which became apparent in Godfrey's case. Infection of the abdomen prevents proper function of the intestines. Ultimately, this great success story had an "Achilles" hill built in, fated to lead to this sad day. So what can we say? Like Paul, Godfrey was powerless to will away his thorn, so he lived with it to the last day of his life. We celebrate his life for it tells the story of survival of human kind against adversity, as well as the triumph, even if ephemeral, of medical technology.
Godfrey would have appreciated this.