Dr. Farasin Sesay sat between the legs of the woman in labour. It had been a long one, exceeding twenty hours. She could see the top of the baby’s head, but they had made no progress in the last twenty minutes and the mother was tiring.

The labour room nurse, Farasin’s part-time assistant, Kessie, called out, “Foetal heart rate is approaching one-twenty.”

Farasin looked up at the mother. “Mrs. Juma, you must push! Push!”

The mother strained for a few more minutes, tears streaming down her face, before she gasped and fell back on the bed. “I can’t,” she sobbed weakly. “I can’t do this anymore. I’m so tired.”

“Just a few more pushes left,” Farasin urged briskly. “I can see her head. You’re almost there.”

The tired mother lay limp on the bed. “I can’t,” she wailed.

“Foetal heart rate is one-fifteen,” Kessie said.

Farasin’s mouth tightened. If they waited any longer, Mrs. Juma would need an emergency caesarian. “We need to get the baby out now. Prep for an episiotomy.”

She pushed her stool back, and the anaesthesiologist came forward to numb the perineum. She was done in seconds and quickly stepped out of the way. Farasin replaced her and made the incision with quick precision, as she had done countless times before. When she was done, she handed over the knife, and Kessie gave her the forceps.

“Foetal heart rate is one-ten.”

“Mrs. Juma,” Farasin said urgently, “I just need two more pushes from you. Just two more!” she repeated when the tired mother shook her head, crying. “I’m going to help you pull the baby out, and I need you to push.”

“Doctor, I can’t…”

“Yes, you can. Your precious baby is almost out, she only needs a little

more help. Just two more pushes and you can hold her. You can do it!”

Mrs. Juma kept crying. “No…”

Farasin made her voice firmer. “Now, Mrs. Juma. Push! Now!”

Kessie raised the mother and helped brace her.

“Push!” Farasin shouted. “Push! Now!’

Mrs. Juma screamed as Farasin yelled, and the baby was out two pushes later.

The newborn’s thin wail filled the room and the nurses laughed joyfully.

The new mother cried as she watched the nurses clean up her baby and wrap her in a blanket, while Farasin remained between her legs, stitching her up.

“What a beauty! Congratulations, Mama!” Kessie exclaimed as she tilted the bundle of blankets in her arms for Mrs. Juma to get a better look.

The new mother cried harder and Farasin smiled.

***

Farasin smiled as she walked out of the delivery room, buoyed by the spike of pleasure that always followed a successful delivery. She felt as though she could run up and down the corridor a dozen times without tiring.

“Thank God that went well,” Kessie said as she walked beside Farasin.

“I really thought we would have to prep for surgery at the end and you would have to reschedule your meeting again.”

Farasin placed both hands on her lower back and stretched. “I wish I could reschedule it anyway. You know how much I hate the politics at the Ministry of Health.”

Kessie smiled. “You have already rescheduled three times. If you cancel on them again, they will revoke our hospital license. After calling Saran to report you.”

Farasin shuddered at the thought. The last thing she wanted was yet another lecture from her hospital’s chief executive officer. “You are right. Best to get it over with. Let’s go.”

The meeting was to hold via video conference in her office. Farasin had no idea what the Ministry of Health wanted but she suspected it would not be a straightforward request. She was proved right.

Farasin heaved a deep sigh an hour later as she logged out of the video call and closed her laptop.

She really might have bitten off more than she could chew this time.

How was she going to accomplish all the tasks ahead of her within the agreed timelines with only twenty-four hours in a day?

Goodbye sleep.

Kessie smirked at her across the desk where she had sat the entire time. “Perhaps one day when you drop dead from exhaustion, you will learn to say no,” she said sweetly.

Farasin wrinkled her nose at the young woman, who had worked with her for a few years now and was as close as family.

“If I drop dead, I will not be asked to do anything else and get the chance to say no, will I?”

Farasin got up from her seat and reached out to grab her white laboratory coat from the hanger beside her desk.

“We have rounds.”

Kessie surged to her feet in alarm. “You’re not really planning to go to the eastern front yourself, are you? It is dangerous. You could be attacked, killed, or worse.”

“What’s worse than being killed?” Fara asked with genuine curiosity.

“Kidnap! Torture! Rape!” Kessie yelped as she blocked the doorway to prevent Fara from leaving her office. “Call the Ministry of Health back and tell them you won’t do it!”

Fara smiled gently, knowing how concerned her assistant was for her.

To be honest, she was also concerned but had chosen to accept her fate. 

“That request from both the Ministry of Interior and Ministry of Health

was not really a request. Yes, they were very gracious and asked me politely to basically endanger my life by going to the border to assess the health crises level there. If I refuse, the international aid agencies will cut off funding to Alounnia. Once those funds are cut off, Alounnia will once again be solely responsible for bearing the cost of harbouring the refugees from Saaginé. If that happens, who do you suppose the whole nation will blame?”

“The ministries and the government!”

“No,” Fara shook her head patiently. “They will blame me. The international agencies specifically requested for my assistance because of the work I did with them in the past to improve maternal health outcomes in Alounnia. And then they will blame Afia Health Services. And then everything my grandfather and father has achieved in the past will be destroyed because I refused to go to the border for a few days.”

Kessie shook her head earnestly. “You are just one woman. You are a doctor, not a politician. You have patients and surgeries to perform here. Why you?”

“Because I am trusted by the international agencies, and there are rumours of escalating violence towards women there. Not to mention the increased mortality rate among pregnant refugees. Of course, they would ask me to go.”

“Your family won’t let you go and risk your life,” Kessie insisted. 

Fara laughed. “When have they ever stopped me from doing what I want? It’ll be fine. I need to go for my rounds.”

“I will go to the border with you,” Kessie vowed. Or threatened.

“Don’t be foolish,” Fara said. “Why would you leave your family and safety to go into a dangerous situation like that?”

“That’s the same question I am asking you!” Kessie exclaimed.

Fara nudged her out of the way and left the office. She stopped at the nurses’ station to view charts, replace her face mask, and wash her hands.

Then she went to visit her patients.

Fara was the head obstetrician at Afia Health Paediatric and Maternal Care Hospital.

After graduation from medical school, she had been appalled to discover the high maternal and child mortality rates in Alounnia, despite the country being one of the richest in Africa.

She came from a long line of medical doctors, and her family owned a large private hospital chain in Alounnia. It had not taken long for her to convince her father to expand Afia Health Services into her specialist area.

She had raised the required financing from investors by herself, all while undergoing her residency at one of the best teaching hospitals in Alounnia.

Afia Health PMC had been completed and became operational a few months after she concluded her residency. She had been one of the pioneer staff of the new hospital, reaching out to all the hospitals in Alounnia to send their most critical maternal cases to Afia. Applying the best standard of medical care, using knowledge gained from countries with low maternal and child mortality rates, it had only taken two years to see significant improvement nationally.

After tackling the health problem, she had taken on the law. Alounnia was ruled by an absolute monarchy and was still very much a patriarchal society. The former King had provided free healthcare to all Alounnians, except unwed mothers. To Fara’s lasting frustration, the ruling council refused to amend this decree, claiming the majority of society was very conservative, and would view support for unwed mothers as a license for women to be promiscuous. A lot of these unwed mothers were young, disowned by their families, and unable to afford the out-of-pocket costs of healthcare.

Refusing to accept this gross injustice and discrimination, Fara convinced the hospital’s board of directors to set up the Afia Health PMC Foundation. The foundation raised money to pay for maternal care for single mothers and rented houses on their behalf sometimes, because a lot of landlords refused to accept them as tenants.

All these activities brought Fara to the attention of international aid agencies who were looking for local partners in Alounnia. They had been happy to support the foundation and encouraged Fara to expand the foundation’s reach to other African countries that were not as prosperous as Alounnia.

Then, disaster struck next door. A few months ago, the largest tribe in neighbouring Saaginé declared their separation from the government of the country and insisted on self-rule. Civil war had broken out in Saaginé, and thousands of refugees had flooded across Alounnia’s eastern border to set up rough camps in the uninhabited plains there.

At Alounnia’s request, the aid agencies had initially transferred the funding for the refugees to the government ministries to be allocated at their discretion. However, rumours of mismanagement and corruption had led them to request an audit, to be conducted by a team of independent observers, led by Fara, as a prerequisite for further release of funds. Which was why she now found herself on her way to the unstable Alounnia-Saaginé border.

Recent news reports talked about Alounnia expanding its military presence in that area to protect the refugees and repel increasing incursions from Saaginé’s rebel forces. 

Fara tamped down the knot of apprehension forming in her stomach and smiled at her patient, a new mother who had given birth two days earlier but was still bleeding.

She had just left the patient a short time later when her phone rang.

It was the chief executive officer of Afia Health Services, her boss, Saran.

“No,” he said as soon as she answered.

Fara bristled. “I don’t recall asking you a question.”

“You don’t have to. I heard it all from Kessie!”

Fara silently promised retribution on the nurse later.

“You must be mad to even consider it. Where do you get all these harebrained schemes from?” He was yelling so loudly into the phone, she had to move the device a few inches away from her ear.

“Calm down,” she said soothingly.

“I wish I could calm down,” he retorted. “Your mission in life is to torment me, is that it? You have been the bane of my existence since Ma and Dad brought you home from the hospital twenty-eight years ago.”

Fara rolled her eyes. “Oh my God. Will you ever let that go? I was barely three days old and did not throw up on you on purpose.”

Saran sniffed. “I have zero expectation that you will listen to anything I say today, since you have been ignoring me all your life, so I will not waste my breath. I will escalate to the higher-ups.”

“Don’t you dare,” Fara warned. “You know Dad is not in the best shape health-wise. You would only make him anxious.”

“I! I would make him anxious! I’m not the child about to skip off into a war zone because of her blind commitment to her numerous causes. I’ll see you at the family meeting.”

“Saran!” Fara said urgently, but he had disconnected.

Damn Kessie and her incessant interference!

She had been planning to travel to the border before informing any member of her family. Now she would have to argue and hurt their feelings when she went against their wishes.

And her mother and Saran loved to hold grudges. They would probably not speak to her for a few weeks after she came back.

Because she was absolutely going to the border.

***

Fara’s afternoon surgery went off without a hitch and ended earlier than planned. She ignored Kessie’s continued pleas to reconsider her trip and went home for an early dinner and to do some travel research.

Home was a sprawling family house in an upscale neighbourhood, with a long, brick-paved driveway lined with trees and extensive, colourful gardens, both in the front and rear of the house.

She lived with her parents, as it was mostly unheard of for an unmarried daughter living in the same city to move out of the family house into her own house. Well-brought-up Alounnian daughters from good homes were expected to only leave their father’s house for their husband’s house.

As she approached the house, she was surprised to see two, fully tinted, black, Lexus sport utility vehicles flying the blue, white, and yellow flag of the Royal House of Terfale.

Beside the vehicles were six men, dressed in the royal blue ceremonial uniform worn by everyone who worked in the Palace of Velha. All of them wore matching blue face masks, and she spotted discrete wires in their ears.

As she tried to pull into driveway, one of the men reached out an arm, waving at her to stop.

Fara lowered the driver’s side window by the slightest crack. “What’s going on?”

“Show me your identification, please,” the man responded gruffly.

Fara reached into her purse to bring out her driver’s license and handed it over to him.

He scrutinised the details and peered into her face.

“Are you related to Dr. Sesay?”

She eyed him warily. “Which Dr. Sesay? My family has three. I am Dr. Farasin Sesay.”

He raised a brow and lifted his wrist. “I have a young lady here trying to enter the grounds. She says she is Dr. Sesay.”

After a moment, he returned her license and waved her onwards.

“What is going on?” Fara asked herself, again, as she got to the end of the driveway and saw a fourth black vehicle idling right in front of her parents’ house.

She parked in her usual spot and got out of her car.

A man she did not recognise walked briskly out of the house towards her. He was of medium height, trim, dressed in a blue wool tunic, with matching trousers. He looked to be in his late-forties to early-fifties with a greying beard.

“Dr. Farasin Sesay,” he said without any preamble. “I am Karim of the Golden Palace of Velha. I am the Chief of Staff of the Royal House of Terfale.”

He offered a brief bow, and Fara reflexively curtsied in response, eyes widening with surprise.

“Sir Karim, you are welcome as an honoured guest in our house. Please come in for some refreshment.”

Their culture considered it the height of rudeness to discuss anything with guests without first offering libation to “wet the tongue.”

“I am honoured, indeed,” Karim said as he walked into the house beside her, and Fara spotted their housekeeper, Mrs. B, behind the doorway, wringing her hands nervously. “However, my errand here is most urgent and a matter of life and death.”

Fara stopped in the entrance hall and turned to face him. “How may I be of assistance, sir?”

“The palace requests the immediate assistance of your father, Dr. Yafeu Sesay.”

Fara pursed her lips. “May you please clarify the type of assistance required?”

“A senior member of the Royal House of Terfale requires urgent medical treatment.”

“My father retired from medical practice two years ago and will not be able to perform any medical procedure on anyone.”

Karim raised an eyebrow. “The palace requests that Dr. Sesay come out of retirement for this incident, which, I, unfortunately, cannot share more information on. It is imperative that you let him know I am here.”

“To clarify, my father has health issues that preclude him from performing any medical procedure.”

“If I may see your father to discuss this with him? It is an urgent situation.”

Fara tamped down her frustration as Karim clearly refused to listen to her. Perhaps a different messenger might help.

She turned to the housekeeper. “Mrs. B, where is Ma?”

“She has not returned from her weekly lunch meeting with the members of her women’s society. I tried calling her when Sir Karim arrived, but she did not respond.”

Of course. Her mother’s phone was likely sitting comfortably in the bottom of her purse.

As Fara debated whether to take Karim to her father’s room, the private nurse who worked for her family pushed Yafeu Sesay into the entrance hall in a wheelchair, taking the decision away from her.

Karim stared in dismay at her father, who had an intravenous fluid line connected from his hand to the clear plastic bag hanging off the pole attached to the back of his wheelchair. His gaze dipped to her father’s hand, which trembled slightly, before offering a deep bow.

“Dr. Sesay.”

Yafeu nodded his head. “Karim, my old friend. It has been more than a few years since the palace required my services. Unfortunately, though I remain of sound mind, I have had a stroke.”

“I am sorry to hear this,” Karim said sombrely. “We had hoped you could perform an urgent procedure this evening at the palace.”

For all his apparent frailty, Yafeu’s eyes remained sharp and his voice strong. He said, “There are other doctors who remain on call full time to assist the palace.”

“That is true. We have two doctors on retainer. One of them is currently in surgery, while the backup will require at least two more hours to get to the palace. As you know, the doctors we invite to the palace undergo extensive background checks and clearances before they can treat the royal family. We are limited in our options, otherwise the security risk outweighs whatever treatment is needed.”

“Does my clearance cover members of my family?” Yafeu asked. “Both of my children are highly skilled doctors, and my daughter is available to assist you right now.”

Fara’s eyes widened as she looked at her father. To her knowledge, no female doctor had ever been invited to treat members of the royal family.

Karim hesitated, then said, “I will make a call.” He turned around smartly and disappeared through the front door.

Both father and daughter stared at each other in silence until Fara whispered, “I never knew you made house calls to the palace.”

Yafeu smiled mysteriously. “You were not cleared to know.”

Fara wrinkled her nose at him. “I bet Ma wasn’t cleared either, but you told her.”

“Do I look stupid?” Yafeu retorted.

Karim came back into the house, walking with a brisk, energetic pace that made him seem to be rushing but not rushing at the same time. “You have received one-off clearance for today, Dr. Farasin,” he said. “Please come with me now.”

Karim bowed once more to her father before turning to face her.

“You do not need to bring anything with you, except your identification. All the equipment you will need is at the palace. No phones are allowed.”

Fara waved goodbye to her father and Mrs. B before following Karim out the door. He already had the rear passenger door open for her and gestured her in.

As soon as the front passenger door closed behind Karim, the vehicle tore out of the driveway at top speed.

***

The three-car convoy raced at breakneck speed through the evening rush hour traffic, bypassing red lights and violating all sorts of traffic rules.

Fara held on to her seat belt as her vehicle made a hard left at top speed, the flags on the hood of the Lexus waving madly in the wind.

To distract herself, she spoke to Karim. “Can I see the patient’s chart and medical history? I need to know what sort of treatment is required.”

“We will provide this at the palace,” Karim said, still facing forward.

“Can you tell me who I’ll be attending?” Fara asked.

“You do not require that information to operate.”

Fara sighed. “What happened to the backup doctor? Is it usual for doctors on call at the palace to go so far away?”

Karim gave a brief snort. “He thought it was a good idea to take a quick trip out of town without informing the palace, because he is hardly ever called upon. He will most certainly face consequences.”

Fara grimaced in sympathy for the unknown doctor. In this part of the world, offending the royal family was practically suicidal.

Fara had spent her whole life living in the city of Salvelha, where the Golden Palace was located, so named because of how its stained-glass windows glittered brilliantly at dawn and sunset, and not because it was built from actual gold.

She and her family had driven past the palace numerous times; however, she had never visited nor sighted any member of the House of Terfale in person.

Her father’s connections to the palace had been completely unknown to her.

Of course, she had seen video footage of the state rooms on the news whenever the King received foreign leaders and high-ranking diplomats. She could not help but be excited that she would finally be one of the few people in the country to ever set foot in the palace.

It was the thirteenth year of the reign of His Majesty the King Amare Abdullah of the House of Terfale, who had ascended the throne after the death of his father. One of the last remaining absolute monarchies in the world, the House of Terfale retained tight control over Alounnia and its wealth and were rumoured to be one of the richest families in the world.

The former King had presided over a golden era, in which Alounnia had expanded its economy beyond agriculture into mining, services, and international trade. Alounnia’s natural resources included diamonds, gold, rare earth metals, crude oil, and gas.

The royal family had invested in infrastructure, transport, power, education, and healthcare, creating a society in which the average citizen was well off.

If, lately, there were rumblings about the current King’s excesses, mismanagement, and corruption, they were quickly hushed. Vocal critics of the royal family were rumoured to disappear forever, with the police refusing to investigate.

The Alounnian press hardly ever reported on the activities of the royal family, except on rare occasions, such as weddings and funerals.

Even then, most of the coverage focused on the King, Queen, their daughters, the Queen Mother, and her other three children, the King’s full siblings. It had been years since anyone had seen or heard of the King’s half-siblings. The exception was the former crown prince, Prince Akan, who had died eight years ago, and his wife, a renowned famous beauty, who was still spoken of occasionally despite being secluded in the palace since his death.

Soon enough, the convoy turned off the main expressway into a wide, tree-lined boulevard that was cordoned off from regular traffic by bollards manned by guards.

At the sight of their convoy, the bollards lowered into the ground and a guard waved them through. The convoy did not even slow down. 

Ahead of them at the end of the boulevard was the palace, and it was quite a sight in the sunset. A cream and russet structure, set amid six hundred acres of manicured gardens, the Golden Palace of Velha had been the primary seat of the House of Terfale for over one hundred years.

The previous two kings had expanded what was formerly a ninety-room, oversized mansion into an impressive palace, with over a thousand rooms currently. Fara had read somewhere that it boasted of almost four hundred bedrooms for the numerous members of the royal family, their guests, and the staff who served them.

No expense had been spared to make it a lavish abode fit for royalty.

They drove through the first massive black gates and around three magnificent gold, opal, and marble fountains spewing water in a dazzling array. The green park surrounding the palace spread as far as her eyes could see.

The second set of gates opened into a stone courtyard, and the grand palace entrance was right opposite, under a massive, covered archway. Fara had seen this archway numerous times on her television. Just a few weeks ago, the King and Queen had received the President and First Lady of the United States right here.

Her friends would never believe this, Fara thought to herself, while wishing desperately for her phone so she could take pictures.

The vehicle they were in stopped in front of the double doors, and the palace guards stepped forward to open the car doors.

Karim gestured her through the doorway, saying “We will go straight to the medical wing where the patient has been prepped for operation by the nurses.”

Head twisting about as she stared at the gold-panelled white walls, intricately painted ceilings, richly woven tapestries and rugs, crystal chandeliers, and enormous mirrors, Fara had to force herself to pay attention to his words.

“Under whose direction?” she managed to ask.

“The backup doctor has been directing the team here via video conference until you arrive.”

Fara nodded.

Karim said, “While your father’s clearance does include members of his immediate family, the palace will send you a nondisclosure agreement tonight. Please sign and send it back to us as soon as possible.”

Fara said, “As a doctor, I am bound by my oath to preserve the privacy of all my patients. Royalty or not.”

“Nevertheless. We will still require you to sign the binding agreement.”

Karim led her to the east wing, where she caught glimpses of glittering state rooms, an ornate ballroom, and the blue throne room.

The few people they passed bowed or curtsied quickly to Karim and continued briskly on their way.

The corridors were beautifully appointed, and Fara could spot jewels in the walls, winking in the light. There were numerous paintings and portraits that she wished she had time to inspect. Instead, they went down a stairway, and Karim opened the doors to the medical suite.

The reception looked more like the entrance to a wellness clinic than a hospital. It was clean and less lavishly decorated but still managed to look like a very high-end spa.

A nurse in green scrubs waited by the doors and curtsied to Karim.

He said to Fara, “She will show you where to scrub in and take you to the OR. I will monitor the procedure from another room.”

Fara followed the nurse, who directed her to a room with a large sink, germ cleaning fluid, and scrubs. Fara changed into scrubs that were her size, put on a face mask, and tucked her curly hair tightly under a cap. Then she spent several minutes washing her hands and forearms up to her elbows before following the nurse into the adjoining operating room.

There were several people inside already, and another nurse snapped sterile gloves onto Fara’s hands.

The patient lay on the operating table, wearing pants, but no shirt.

The left shoulder and part of the chest were covered in blood, and a nurse was applying pressure.

Another nurse brought a tablet to Fara, showing her a video of a man dressed in casual clothes, sweating profusely, and speaking quickly from the back of a car.

Fara waved the tablet away and asked for the medical chart, which was quickly handed to her. The patient was a thirty-nine-year-old male, nonsmoker, with no prior surgical history or family history of disease, with an allergy to multiple different anaesthesias, and currently presenting a gunshot wound.

“Has an x-ray been taken?” Fara asked and someone handed the films to her.

She held them up and saw the bullet was lodged against the patient’s clavicle but had not damaged any artery or vein or major organ, thankfully. 

She was also relieved to see that there were no bullet fragments in the wound.

She could see that the patient was already hooked up to a vital sign monitor, and his blood pressure and oxygen levels were holding steady.

His heart rate was elevated. A bag of blood hung by the bed with a line connected to the patient to replace the massive blood loss that must have occurred.

It really appeared that the medical team were top notch and had everything well in hand. All they needed was someone to extract the bullet and suture the wound closed.

Fara finally turned to take a proper look at the patient lying on the table with his dark eyes fixed on her. He was tall and muscular, with beautiful, almost glowing, brown skin. His black hair was cropped close to his scalp and a stubble gave him a dashing look.

His handsome face was one that was very familiar to her, as she had seen it several times on television over the past few years. His portrait hung on the walls of every government agency she had been to in the past thirteen years.

Her patient was the King of Alounnia.