Over the years, I have spent not a few nights outside. Becoming a connoisseur of the sounds that the darkness may hold, I looked forward to coming to Ghana, in small part, to listen to the night. The last time I was here, in the middle of the dry season, about the only sounds I heard was the one per second, creaky-door noise of the local fruit bat. While evocative and all, it does easily slip into the background and let you sleep the night away.

I arrived this time about six weeks earlier in the season and Nalerigu is a far different place than what I experienced before. The night is full of sounds. It has become difficult to sleep. Not that it is ever easy.

Thursday was a big night for funerals. I could locate two, one with major detonations of some explosive, starting in the mid afternoon. I could hear a shaman/land priest/local healer/witch doctor screaming imprecations for about a half-hour before the drums started up again. It was a school night and the whole thing was over by nine.

I start going to bed about 9:30. It takes some time and it starts getting light at 5:30, so that is when I get up anyway. Besides the usual stateside ablutions, brushing up and in and over, I have to make my bed. This is complicated. One has to be sure the mosquito netting, a cone suspended from the ceiling, does not interfere with the ceiling fan, to dire consequences. The netting must be tucked in all around so that it won’t drape over exposed skin, defeating its protective purpose. The aforementioned ceiling fan must be ginned up so that a little breeze gets through the netting and it is not so claustrophobic. Too much, of course, and if I can get to sleep with the noise, I have dreams of being a slice of papaya on a dehydrator sheet. Truth.

Finally, I to bed, comfy enough if under-generous and limited by the enclosing net. I read until I can doze off using a headlamp I bought for an Alaska trip. Practically like new. Summer trip. I never used it.

It is then that the night noises intrude: wolf-whistles, frog creakings, laughter that I swear comes from a Three Stooges schtick of the forties. Just when I think I have gotten all the acoustic signatures lined up, a battle breaks out in the “screaming bloody murder” genre, setting my teeth on edge. The combatants gradually subside with snarky comments back and forth before settling in. There is the slight shift of the wind, and an owl outside my window asks unanswerable questions. In short, it sounds like a Foley table from a cartoon with unlikely “whoops,” braying calls (some from the musical donkeys about), yakking laughs, clanks, knocks, dribbles, and the creak of a nightjar when all seems to have quieted.

I was called out on Thursday, my first full day back at work after a run in with a gastrointestinal grippe of no small proportion but no lasting significance. The man was lying unconscious in bed, covered in dried blood from tip to foot, with a swathe of gauze wrapped around his head, stiff and dark with more of the same. His buddies gave me the story: while riding on his motorbike he hit another motorbike. The other fellow was not so badly hurt and he went away, but their friend was knocked unconscious for the two hours it took them to get him to a district center and then on to the “big hospital” a Nalerigu. My patient was in his early twenties and a well-built worker-type, his hands telling me what he could not. During my exam he woke up and was cooperative. He was oriented and had no localizing signs. His retinas showed no hemorrhages. There was a certain ethanolic scent about him. Examining the wound was a process: soak the stiff bandages with saline, peel away a few square inches of gauze, repeat. When we finally got down to cases, my young friend’s wound was singular: a deep curvilinear gash on the top of his head, deeper in back and shallowing in front, about six inches long and down to the bone. I asked, “What happened?” He said “They attacked me.” “And you were running away.” He nodded.

By the next morning when we got down to putting it back together, the assailants had miraculously become a bridge abutment. When we asked how it came to be on the top of his head, it became a bridge girder. It closed with 3-0 nylon. He should have a nice scar.

During the dry season, the local constabulary close some of the roads east of here toward Nakpanduri because of tribal tensions. At the end, a few bodies might be discovered. Think Hatfield-McCoy, if you want to go that route

As I walked back from seeing my head wound patient about 2 AM, through the shadows now thick with dried leaves, rustling in the wind, I looked up at Orion, too big by half than what we see at home, I pause. It is all there, just like my father pointed out to me as a child. The three stars of the belt, the red shoulder star, the sword with its fuzzy central gem, the lion skin skein of stars facing off against the Bull, his one eye red with anger. The night hides and reveals. It is a privilege to be here.