Miracle Makers

Easter has begun and I am fortunate enough not to be working the long weekend. Word in the hospital is that Easter is much like Christmas: families and friends coming together with knives and fists. People keep telling me it’s a cultural thing. I am sure there is a simple enough equation that can explain the festive fun: ((Money × Alcohol²) + difference of opinion) ÷ (Love + rational thought) = x. ‘x’ may be a kiss on the cheek or a stab in the face, depending on the weight of the different variables. Take away the liquor and I expect one would see a massive reduction in violence.  However, life isn’t that simple and one cannot simply things down to a silly equation. The social issues and inequalities here in South Africa are gargantuan – something that I am still trying to get my head around.

Not working Easter apparently means I should be spending it at Church, according to my nurses. “Gawping amazement” is how I would describe the look on their faces when I tell them I don’t subscribe to their school of thought and that I shall be spending most my time at a music festival. However, occasionally I feel I could almost believe in some kind of supernatural force: the seven month old infant that was shot in the chest last week in the hands of her dying mother came back today. By some miracle, the bullet prodded it’s way around the lung and ended up in the muscles surrounding her abdomen.  She was giggling and smiling while I stood there with a massive grin slapped over my face. I discharged her with the bullet still lodged inside. The aunt will look after the baby. On a side note – the aunt found the helicopter ride terrifying.

***

Often one is presented with an interesting history written on the casualty card. Often this is the result of a dodgy Xhosa to Zulu to English translation. The first time I saw: “Struck by lightning,” written down I felt my own heart beat accelerate rapidly – however, a quick glance at the smiling patient swiftly relieved my initial fear. Being struck by lightning in the physical sense is a very loose term here – however, the social and cultural connotations are massive. A home that has been “struck” by lighting must be abandoned and if a person is “hit”, they may be ostracised by the community. Lighting is the ancestors saying: “We are not very happy with your affairs at the moment – you must be punished.”

This week I have seen two patients where I assumed the history on the casualty card was misinterpreted.  The first was a girl in her early twenties who came with the story: “glass stuck in foot for three years.” Obviously it was three days, and not years. No, I stood corrected, it was three years. Being slightly cynical of her story I examined her. She was rather tender in the said area, but still I didn’t believe it. Glass shows up remarkably well on an x-ray, especially the two large shards that she had in her foot. I referred her to my surgical colleagues.

The second history was that of: “Tick in ear.” How can one possibly know it’s a tick in the child’s ear? It could be anything – far more likely to be a bean or cotton bud. The mother hadn’t seen it, but, without giving any reasonable explanation, she was adamant it was a tick. Much like the other pathognomonic sign for worms that grandmothers often like to describe: “The child is grinding their teeth at night.” Low and behold, the child had a gargantuan tick in their ear gnawing away at a tasty bit of ear canal.

***

I thought I had turned into a miracle worker yesterday. I reduced an angulated forearm fracture of a child under ketamine with that satisfying grinding click of the opposing bones realigning under a bit of manual pressure. The subsequent x-rays looked as if he had never broken his arm in the first place. For a brief second I thought that I had manipulated and plastered the wrong arm; then I thought I had performed some sort of divine intervention; finally I realised the two repeat x-rays were of the same view (one always needs to look at the bones in two angles to create a kind of 3D picture). The second x-ray showed that the results were not perfect, but pretty good if I do say so myself.

***

I should probably mention that this week was my last on the paediatric unit. One of the sister’s in charge was extremely upset when I told her the news – very flattering. However, it is time for a change and with our new cohort of doctors we can spread our wings a little. I shall be spending the next four months trying to help the medical ward recover from a dismal year of neglect and try to clear the cobwebs from my murky medical brain.

The mega tick that I fished from a toddler's ear. Notice the hunk of ear canal still being gnawed on by a very alive critter.

I shall miss paediatric ward rounds - the kids start to join in once they've been around for a while.

Now you see it, now you don't. The fractured forearm that I thought I had miraculously reduced. Unfortunately, the image on the right shows the same view. However, the arm is much better than it was.

Happy punters.



"slash and burn" next to the diesel generator tank.



Happy punters make happy workers.

The nature reserve (Mkhambathi) at the end of my road is magnificent.



Burger boy.



The South Africans love a braai (BBQ). I have turned my fire place into an indoor braii - my new favourite cooking station.

Improvisation can be key sometimes - this lady was referred from clinic with a septic operation wound. They have used sticky labels as tape - the adhesive, unfortunately, can be an irritant. Her skin was fine, however.

Here she is - the 7 month old infant who was shot in the chest. A very moving tale and a true wonder that she survived.