By Frances Mensah Williams

Theresa stared at the grey-haired physician who seemed in no hurry to break the silence. Instead, he returned her stare calmly, while the pages detailing her test results wilted between his damp fingers.

The doctor’s office was stuffy, and the ceiling fan that turned listlessly above his head generated only the promise of coolness. A bead of sweat broke out at the top of his nose but he appeared oblivious to any discomfort and leaned back in his chair with a grin.

Theresa’s confused thoughts bumped up haphazardly against each other. His teeth are amazingly white – I wonder which brand of toothpaste he uses. His grin widened and she shifted uneasily in the consulting chair, gripping the thin strip of worn leather that cushioned its wooden arms. Are doctors supposed to smile at you when they’re about to break the news you have a terminal condition?

Apparently deciding he had tortured her for long enough, Dr Owusu finally spoke. ‘Congratulations, Mrs Brew.’

Theresa frowned in bemusement. Even the most insensitive doctor wouldn’t congratulate me before telling me I’m dying, surely? Unless this is some bizarre Ghanaian tradition no one’s told me about.

Shaking his head impatiently, the doctor straightened up and pushed the report towards her. ‘Here, look!’

Reluctantly, she reached out a hand, her eyes still fixed on him as she grasped the dry end of the sheets. Without giving them so much as a glance, she dropped both hands, still clutching the report, into her lap and waited.

The doctor’s grin faded, and his forehead folded into deep furrows of concern as he watched her fingers crease the papers.

‘Mrs Brew? There’s nothing to worry about, my dear. You’re pregnant, that’s all.’

Theresa blinked rapidly as the words washed over her, and then slumped down into her chair as the initial rush of relief was quickly replaced with incredulity. Pregnant! Not cancer, not leukaemia, not ME or MS or any of the other alphabet diseases she had imagined while waiting in the airless, stiflingly hot reception area for her test results. Diligent to the point of obsession about taking the pill, this was the only condition she hadn’t considered over the past three weeks as constant fatigue wracked her body and almost everything she ate heaved around unpleasantly within moments of swallowing.

‘Dr Owusu, are you sure? I’m on the pill!’ She could hear her voice, normally low, sound almost shrill with disbelief.

‘Very sure, Mrs Brew.’ Dr Owusu looked pointedly at the report she was now crushing in her agitation. ‘The results of your tests are right there. Your iron levels are a bit low, but your blood pressure is good. By the look of things, you will have a strong, healthy baby.’

Biting hard on her tongue to hold back the wail of protest threatening to escape, Theresa watched in dismay as the doctor uncapped a scratched plastic biro and scribbled energetically on his prescription pad. Dr Owusu had come highly recommended, but he must surely have made a mistake. She couldn’t possibly be pregnant. No! This cannot be happening to me!

‘Now, you must start taking these vitamins immediately. Baby will need them to help his bones grow big and strong,’ Dr Owusu continued, scrawling his signature with a flourish.

Theresa was still grappling with the idea of herself and pregnancy appearing together in one sentence, and she gaped as he turned her shock into a bouncing baby boy. Once again, she reached out dumbly to take the paper he was thrusting in her direction.

‘Thank you,’ she said dutifully. Her mother’s training hadn’t been in vain. The sign of a true lady is her ability to remember her manners, no matter what the situation. She’d lost count of the number of times Clementyne had parroted that particular one. The doctor’s raised eyebrows made it clear the conversation was over, and Theresa stood up. Well, Mama, I remembered my manners, but I seem to have forgotten where the door is.

Dr Owusu solved her dilemma by coming around to her side of the desk to show her out.

‘I’m sure this is all a shock, my dear, but it’s wonderful news. Take my word for it, you will soon be jumping for joy.’

The touch of his hand pressed against the small of Theresa’s back galvanised her paralysed legs into action and he followed as she walked shakily out to the waiting room, clutching the report and prescription like certificates she’d just been awarded.

Dr Owusu’s modest surgery in the busy commercial district of Accra, Ghana’s capital city, was a six-hour flight and a million light years away from the elegant Georgian building that housed her Chelsea GP’s practice. Out in the waiting room packed with chairs arranged in tight rows, the muggy heat felt even more oppressive. Theresa struggled to suppress the nausea that was never far away. The rusty electric fans suspended from the ceiling had long since given up any pretence of working, and the patients waiting to see the doctor flapped magazines and newspapers in a desperate attempt to generate cool air.

The receptionist was perched on the corner of her desk and the seductive smile she had been directing at Theresa’s driver, Joseph, disappeared the instant she spotted her boss. She reached for a stack of files in a bid to look busy while Joseph took one look at his employer’s face and hurried across to her.

‘Madam! How you dey? You be sick?’

He glared accusingly at the doctor who hastily removed his hand from his befuddled patient and stepped back, clearly unnerved at a woman reacting so strangely to good news. He plucked the crumpled report from Theresa’s slack grip.

‘I’ll need that for your file, my dear,’ he muttered irritably, smoothing out the crushed sheets of paper. He glanced at her, and his face softened, his brilliant white smile returning as he leaned in to quietly add, ‘Make an appointment with Rose for two weeks’ time, Mrs Brew. I would like to take a scan to make sure Baby’s sitting in the right place. In the meantime, make sure you get plenty of rest and eat well, eh? You are growing a new life now.’

Theresa walked unsteadily out of the clinic into the brilliant sunshine and came to an abrupt stop on the uneven pavement, vaguely aware of Joseph behind her. Unable to recall where he had parked the car, she rummaged in her bag for her sunglasses and slipped them on with shaky hands while her driver strode ahead, visibly befuddled by what the doctor might have told his madam.

Parked on the dusty verge of the roughly tarred road, the car’s shiny newness seemed completely out of place against the backdrop of uniformly drab wooden kiosks, scarred with peeling paint and displaying identical stacks of tinned fish, toilet rolls, washing powder and mobile phone cards.

Joseph started the car engine and then raced around to open the back door for Theresa.

‘Madam, you want buy some medicine before we go house?’ His face was clouded with anxiety, but Theresa couldn’t summon the energy to comfort him. Let’s not forget our manners. She forced herself to smile.

Frances Mensah Williams (@FrancesMensahW) is a Ghanaian-British writer and the author of the From Pasta to Pigfoot series. This is an excerpt from Frances’ latest novel, Imperfect Arrangements. Make sure you grab a copy to find out how the rest of the story unfolds!

- All rights to this story remain with the author. Please do not repost or reproduce this material without permission.