Machete

It’s the fourth time in this week I was called back to hospital for emergency operation. Luckily, it was 8 o’clock on Sunday morning after my early morning run ( 37 minutes for 5 laps ) and breakfast. We start working at 9:30 on Sunday, so I may have a chance to run before work. It was a man chopped by someone with machete. Local colleagues told me that it was a weapon strong enough to cut off one’s head in one goal. He had multiple cuts on back of chest with left lung exposed and scapula split, on arms and legs with right lower leg hanging on skin only, and on neck and scalp with part of skull bone cut. He was “lucky”. There was no major injury except we had to discard his right leg. I did my first thoracotomy in Teme Hospital. The third time was on Friday early morning, 3am, with two patients admitted with gun shot wounds in chests and abdomen. One man had been shot on left chest with left lung, diaphragm and spleen injuries. I had to take out his spleen. He developed respiratory failure after operation. It was so bad that we had to intubate him again and later send him to other hospital. In Teme Hospital, we do not have intensive care and ventilator support. It made James, the American Orthopaedic surgeon an unforgettable 40th birthday as I had to wake him up after his birthday party on Thursday evening. At night, the two orthopaedic surgeons and anaesthetists can take turn to be on call. Most of these emergencies are either abdominal or chest injuries. They have to be attended by the general surgeon. So I have to be on call everyday. As we can only operate by one team of night duty nurses after 7pm, we have a new arrangement after 7pm. Two surgeons and one anaesthetist will stay behind and the other surgeon and anaesthetist can go home earlier. We can take an early break in turns. It does make a lot of difference.