The writer Chimamanda Ngozi Adichie and her husband were spending the holidays at their home in Lagos, Nigeria, last December when one of their twin sons came down with what seemed to be a cold. The child, Nkanu, was 21 months old — “precious” and “a funny baby,” in the words of his father, Ivara Esege. He was still playful, but when he developed a fever, Esege, who is a physician, started him on antibiotics.
By New Year’s Day, Nkanu had not improved, so the couple took him to a local children’s hospital. Concerned that he might have atypical Kawasaki disease, a childhood illness that can lead to heart attacks and strokes, Esege also contacted Johns Hopkins Hospital, near the couple’s American home in suburban Maryland. Johns Hopkins agreed to take Nkanu as a patient, but doctors there asked for additional tests to make sure he was safe to travel. Adichie and Esege took Nkanu to Euracare, another hospital in Lagos, for the examination.
The child was sedated with Propofol, a common anesthetic, to keep him still during an M.R.I. of his brain. Adichie was waiting outside when a doctor hurried past her into the cath lab. It was alarming: Why was he rushing to the room where Nkanu was having his test done? She waited in “pure panic,” she said, until the doctor returned. “He was very calm and he said to me, ‘Well, look, they gave him too much Propofol,’” Adichie recalled. “Those were his exact words, which I will never forget until the day I die.”
Nkanu had gone into cardiac arrest. Within 24 hours — it is not clear exactly when — he was dead.
Adichie and Esege told me this story in July, at their home in Maryland. On the table, there was a tray of healthy snacks: bowls of fresh cherries, another bowl of seeds and dried fruit. Adichie, 48, was dressed in a plain, loosefitting dress, her hair combed into two simple braids. Esege, tall with a curly salt-and-pepper Afro, wore a yellow T-shirt and gym shorts. He is 57 and, like his wife, a native of Nigeria.
There was an easy choreography between the couple, but also a palpable weariness. Leading me to the dining room, where we spoke for several hours, they moved slowly, as if bereavement were a kind of arthritis, pain carried in the bones. The house was more than quiet. Their daughter, age 10, was at day camp, and the younger of the twin boys was upstairs, sleeping. (The couple asked The New York Times not to use their children’s names to protect their privacy.)
Adichie and Esege still struggle to understand how their child could have died so suddenly and inexplicably. They have urged a coroner’s court to conduct an inquest — and the court is doing so — in hopes that they can help other Nigerians who have been harmed by the country’s troubled health care system but lack the means and influence to push for change. They stress that they are not suing the hospital or the doctors and just want a better health care system.
“That’s the only thing we can try and do just to help,” Esege told me. “Hopefully someone else will not have to go through this.”
The pain of Nkanu’s death has complicated Adichie’s relationship with Nigeria. The country, with its mix of resilience, vibrancy, corruption and economic desperation, is a vivid milieu in her work, exerting a strong magnetic pull on characters who leave.
In her best-known novel, “Americanah,” the main character, Ifemelu, is a young Nigerian woman who, much like the author, comes to the United States to study and live, only to experience exhaustion and alienation that feels like “cement in her soul.” Nigeria, Adichie writes, was “where she was supposed to be, the only place she could sink her roots in without the constant urge to tug them out and shake off the soil.”
Now Adichie feels uprooted. “My feelings toward Nigeria have changed,” she said. Her son’s death was the first irrevocable loss, her native country the second.
Health care in Nigeria suffers from relatively low government support, limited infrastructure and an exodus of skilled workers. According to a recent estimate from the World Bank, Nigeria has 0.4 doctors for every 1,000 people (the figure is 3.7 in the United States).
But Adichie said she had confidence in Euracare, which she was told was run by international standards. “It was kind of paraded as one of the best hospitals in Lagos,” she explained.
As it happened, she knew the doctor who spoke to her outside the cath lab. His name was Tosin Majekodunmi, and she had met him while accompanying her parents to their annual checkups at Euracare.
“My father liked him very much,” Adichie said. “I did come to consider him a friend. When my father died, he was very kind and called me.”
According to Adichie, Dr. Majekodunmi told her the doctors had saved Nkanu and he was now stable: “He said, ‘But everything is OK now because we got him back.’ And I kind of felt — I felt really confused.”
She shook her head and spoke more slowly, her voice thick with tears. “I trusted him,” she said.
Dr. Majekodunmi did not respond to interview requests from The Times.
The night Nkanu fell ill, she went home to gather the documents and payments necessary to transport him back to the United States the next morning in an air ambulance. She left and Esege stayed at the hospital.
Esege, who retired from his work as a family physician in Baltimore when the twins were born, was still at the hospital when he looked at the report the hospital’s staff had prepared for the air ambulance company. He was shocked to see that it said Nkanu’s pupils were fixed and dilated. And on the Blantyre coma scale the doctors had marked their son at zero in a range of one to five, meaning he had shown no eye movement and didn’t respond to pain.
Egese’s voice cracked as he described his reaction to me: “Nobody said anything to me about this. I mean, this basically means Nkanu is gone.”
Not dead yet, but lacking any meaningful brain function. Esege said he believed, based on the report, that Dr. Majekodunmi knew Nkanu was beyond saving after the first cardiac arrest, but he didn’t want to tell Adichie because of his closeness to her and her family.
Esege said the doctor had urged him not to call Adichie until the hospital could do a CT scan, but he replied that he couldn’t keep the information from her. He texted his wife and asked her to come back, and she returned around midnight. In the next few hours, Nkanu’s heart stopped at least two more times.
“So they basically are doing cardiac resuscitations on this poor boy for more than four hours, until 8 in the morning, when they decided to call it,” Egese said. “Nkanu, our son, was gone.”
It seemed that Esege’s theory about the timing of Nkanu’s death was not one he had shared with his wife. Adichie looked at him, incredulous, and asked, “So, sorry. We don’t actually know when our son died?”
She paused and then said again, in disbelief, “We don’t know when he died.”
Turning to me, Adichie said, “I’m actually hearing this for the first time. Some of it.” She then referred to Esege by his nickname. “I didn’t know about Ivy’s conversation with the doctor when I went home to try to get the payments for the ambulance. I think Ivy’s tried to protect me.”
Near us in the dining room, Nkanu’s highchair was still at the table, next to his brother’s. His clothes were still folded upstairs in his room. Adichie mentioned that she now had to buy clothes for one boy, not two, but was still in the habit of adding two of every item — T-shirt, shorts, sweater — to the online shopping cart.
Intermittently, throughout our conversation, she took out her phone and showed me videos of Nkanu. For brief moments, there were echoes of his laughter. On the screen of his mother’s phone, Nkanu sang and danced, played with her jewelry and climbed on Esege’s back while he pretended to be a horse, galloping the child across imaginary fields.
Not long after Nkanu died, Adichie and Esege filed a complaint with the Medical and Dental Council of Nigeria — a separate entity from the one conducting the inquest — and in February the council announced an initial finding of negligence on the part of three physicians: Dr. Majekodunmi; Dr. Titus Ogundare, the anesthesiologist who sedated Nkanu; and a doctor from Atlantis Pediatric Hospital, where Nkanu was first treated. The three were suspended pending a formal hearing; the Atlantis physician has since been cleared.
Dr. Ogundare did not respond to requests for comment.
The coroner’s inquest itself has turned into a battle, with Adichie accusing Euracare of playing a “monstrous cynical game” by creating unnecessary delays. (The inquest has been delayed until the fall.) When Esege joined an inquest hearing remotely in June, Euracare shocked the couple by accusing them of a crime: destroying evidence by having their son cremated. According to local news reports, the hospital’s lawyer, Taiwo Osipitan, said: “What they did is punishable by 15 years imprisonment. The issue is whether somebody who has done something wrong under the law can push for an inquest.”
Sylvester Shih, Euracare’s chief operating officer, did not respond to a request for comment.
“I feel so bad for Ivy,” Adichie said. “He’s on Zoom. He’s hearing it all. He’s hearing when someone is saying that he destroyed evidence, and by evidence, they mean our child.”
Even before Nkanu’s death, Adichie and Esege were adjusting to the losses of both of her parents and Esege’s brother in recent years. She recalled a conversation she had with her husband on Jan. 7, the day after Nkanu died.
“I just remember looking at Ivy and saying, ‘Do we have to have another funeral?’ Ivy said, ‘I cannot.’ And Ivy said, ‘We’ll cremate him. We’ll take him with us because we can’t leave him behind.’”
Along with her four novels Adichie has given popular TED talks and published short fiction, essays, children’s literature and, after her father’s death in 2020, a book called “Notes on Grief.”
“When my father died, I was struck by the physicality of grief. And this time, even more so,” she told me. “I feel it. It’s in my stomach and it’s in my chest, and you’re just so tired every day. Everything is difficult. Everything. And then you have to pretend. You have to pretend because you have children, and you’re terrified of how they’re doing. Sometimes my son doesn’t want me to hold him because I’m so weepy. He’s 2. So I really try. It feels like the full manifestation of my grief is impossible because of the condition of being a mother.”
About then, the little boy woke up with a wail and Esege went upstairs to get him.
Later, he swept into the room, his sister’s sweater draped over his shoulders like a superhero’s cape. He crawled into the cradle of his mother’s lap until he saw that his father had a soccer ball and went tearing after it. It was the week of the World Cup semifinals and the family found the games to be an engaging distraction.
Then the front door opened and the couple’s daughter bounced in. Tall like her father, she was dressed in all pink, her favorite color. She whispered something to her mother and Adichie smiled. Monday is hamburger day and her daughter wanted to make sure that even though she had eaten a burger over the weekend, she would get to have her favorite American meal because it was still Monday.
When we talked, Adichie had not been back to the country of her birth, the place she has brought to life in novels beloved by millions of readers, in six months. She had mentioned that she and Esege were planning to return there soon, and I asked if they planned to take their son and daughter with them. They have taught their children to love Nigeria even as they learn about its structural and political challenges.
Adichie grimaced and said, “They’re the reason we’re going.”
“Really, we’ve had two homes forever,” she continued. “We were in Nigeria every Christmas, every Easter, every summer. Our daughter said to me recently, ‘Mama, Nigeria is my happy place.’ She’s the one who wants to go.’”
I asked what her little boy understood about all that had happened. She shook her head and said, “He always says his brother is in Lagos.”
Adichie said she had always loved Nigeria and felt grateful to have a home there and one in Maryland. She came to the United States at 19 to study at Drexel University in Philadelphia and went on to earn master’s degrees from Johns Hopkins and Yale.
“I think that America made it possible for me to write, which is my life’s vocation,” she said. “But Nigeria gave me everything I needed to be able to write. And I feel grateful for that.”
But is Nigeria still where she is supposed to be?
She wiped the tears from her face and continued: “I mean, it is so surreal, all of this. I still can’t believe we’re talking about my son who died. You’re going through something, but you also feel like you’re outside of it.”
After a moment she said softly, “I do not want to go back to Nigeria.”
Deborah Segun (b. 1994) is a multidisciplinary artist from Lagos, Nigeria, based in London.
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