It Was Just a…

Read This First

"It was just a headache." "It was just the flu." "He was just tired." People say these words at funerals. This book is here so you never have to.

If someone is in danger right now, stop reading and call your emergency number: in Kenya 999, 112 or 911, or Kenya Red Cross on 1199; in the US 911; in the UK 999. Then turn to the Go Now card at the back of this book. It lists every emergency sign in these pages on one page.

Numbers were checked in October 2026. Check yours and save it in your phone today.

Who this book is for

• Anyone who has ever said "let's see how it is in the morning" about a sick person.
• The person in the family everybody calls to decide whether it's "hospital serious."
• Parents of teenagers, people who live alone, and community health workers.

What this book will do

It teaches you to recognise the small number of "just a…" symptoms that are actually emergencies: sepsis, stroke, heart attack, blood clots, pregnancy emergencies, diabetic emergencies, meningitis and brain bleeds, emergencies in the belly and groin, carbon monoxide poisoning, severe asthma and anaphylaxis. For each one you will learn what it looks like, what it is disguised as, how fast it can kill, and exactly what to say at the hospital so you are taken seriously.

It ends with a Household Emergency Plan you fill in and keep on the fridge and in your phone.

What this book will not do

It is general health information. It is not medical advice, and it cannot assess you or anyone you love. It does not teach home treatment, apart from first aid recommended by resuscitation and first-aid bodies.

It is also not a book that says "go to the emergency department for everything." Most headaches are only headaches. This book is about specific signs. When you see them, waiting is the dangerous choice.

How to read it

Every chapter has the same boxes. Go Now lists the signs that mean emergency care immediately. Ask This gives you the exact words to use, and what a good and bad answer sound like. Myth / What the evidence says takes one thing people believe and checks it against the evidence.

Stories in this book

Some stories are composites; names and details are changed. Where a story is a real, public case, we say so and cite the public record it comes from: an inquest, a coroner's report, a published case or a news report. No quote in this book is invented and put in a real person's mouth.

About this book

This book is educational. It is not medical advice, and it is not a substitute for a clinician who knows your history. If you have warning signs now, use the Go Now card or call your local emergency number. For everything else, take the questions in this book to a doctor, nurse or pharmacist.

Find the Go Now card at the back of this book and take a photo of it on your phone. It takes ten seconds and it is the most useful page here.

Why We Wait

It is 1 a.m. in Kayole, on the east side of Nairobi. Otieno's mother, who is 67 and lives with him, has been "off" since lunch. She did not finish her ugali. She has been to the toilet more than usual and says it burns. Now she is on the sofa under a blanket, shivering, and when he asks if she wants tea she answers as if he asked about the weather.

Otieno does the sums every family does at that hour. The clinic down the road opens at eight. A taxi to the county hospital will cost money he was keeping for school fees. Last time they went, they waited six hours and left with paracetamol. She is breathing. She is talking. She is probably tired.

"Mama, we'll go first thing in the morning," he says. "Sleep."

By morning she cannot sit up, and she does not know his name.

This is a composite story: Otieno and his mother are not real people, but every detail is something that happens in families every night.

Sound familiar?

• You have said "let's see how it is in the morning" about someone who was confused, breathless or shivering.
• You have decided against the hospital because of what the last visit cost.
• You have waited because "if it were serious, she'd look worse."
• You have sat in a waiting room, watched people who came after you go in first, and felt ignored.
• You have been told "it's just anxiety" or "it's just a virus" and gone home feeling stupid for coming.
• You are the one in your family everybody calls to decide whether it's "hospital serious."

If you nodded at any of these, you are normal. Almost everyone waits. This chapter is about why we do it, what it costs, and how to walk into an emergency department and be taken seriously.

The decision every family makes

Every emergency starts with the same decision, usually made by someone with no medical training, at night, with incomplete information: wait, or go now?

Doctors who study maternal deaths have a name for this. They call it the first delay: the time it takes to decide that care is needed. It is followed by the second delay, getting there, and the third, being treated once you arrive. The model was built to explain why women die in childbirth, but it fits every chapter in this book.

The delays add up. In one study of 56 maternal and newborn emergencies among island communities on Lake Victoria in Kenya, the average total delay from the start of the emergency to getting proper care was more than a day and a half: 39.3 hours. Eighteen of those 56 people died.

High-income countries are not immune. The American Heart Association has said for years that patients' own delay in seeking help is "the major factor limiting delivery" of the treatments that work for heart attacks and strokes, and that "most patients still do not seek treatment in a timely manner".

The rest of this book teaches you to make the first decision faster and better. Not "go to the emergency department for everything." Go for these signs.

Why we wait

There is no stupid reason to wait. Every reason below makes sense from inside the room. The problem is that each one has a cost.

"We can't afford it"

This is the most honest reason, and in many places the fear is justified. A taxi at 2 a.m., a deposit at a private hospital, a day off work, a bill you cannot see coming.

Here is the thing nobody tells you: in several countries, the law is already on your side for the first part.

• Kenya: The Constitution says "a person shall not be denied emergency medical treatment". The Health Act 2017 repeats it: "every person has the right to emergency medical treatment," which includes stabilising you and arranging a referral if the facility cannot cope. A facility that can treat you and refuses commits an offence.
• United States: Under a federal law called EMTALA, emergency departments in hospitals that take Medicare must give anyone who asks a medical screening examination and stabilising treatment "regardless of an individual's ability to pay". You may still get a bill later. You cannot be turned away first.
• United Kingdom: Accident and emergency care is free for everyone, whatever country you normally live in. Charges can apply if you are admitted as an overseas visitor.