Meanings of words

I have been told that there is a tribe in South America which has 40 words to differentiate shades of what we might, in a single word, describe simply as ‘green’. And in a country without sign posts they use these shade words to direct people on forest paths. For example travel on the path for …. (distance) until you see a tree of …. (shade of green) then turn left. in about …. (distance) you will see a bush of …. (shade of green) there turn right. etc – you get the idea. No doubt this has worked well for centuries and still does, but what a mess a traveller would be in if someone purposefully substituted the word for a different shade of green.

I wonder how many shades of green are in this area of Ethiopian countryside?

I looked up ‘shades of green’ on google search and the list is long and interesting. Usually just saying green is enough but sometimes we need to be more specific. And this applies to many other words. And we can get into or cause trouble by unintentionally or intentionally using a shade of meaning which the speaker or author didn’t intend. There are about a million words in the English language but I am told that the average word usage of the common person is only in the thousands – 10 to 20,000. I looked up the word ‘guilty’ in google search. This is part of what I read…

guilty/ˈɡɪlti/ Learn to pronounce adjective

culpable of or responsible for a specified wrongdoing.”he was found guilty of manslaughter” Similar: culpable, to blame, blameworthy, blameable, at fault, in the wrong, responsible, answerable, accountable, liable, censurable, reproachable, condemnable, reprehensible, erring, errant, delinquent, offendings, felonious, iniquitous, criminal, convicted, peccant
Opposite:innocent.
- justly chargeable with a particular fault or error.”she was guilty of a serious error of judgement”
- conscious of, affected by, or revealing a feeling of guilt.”he felt guilty about the way he had treated her “Similar: ashamed, guilt-ridden, conscience-stricken, remorseful, sorry, regretful, contrite, repentant, penitent, rueful, abashed, shamefaced, sheepish, hangdog, mortified, discomfited, distressed, uncomfortable, in sackcloth and ashes, compunctious. Opposite:unrepentant

Let us say that the little baby pictured above died. That is not true, he did very well after his emergency surgery. He recovered quickly and was sent home well, but with a lot of growing up to do. But picture this scenario: –

He came in with an obstructed gut. He was operated upon and the condition corrected. On being woken up from his anaesthetic he vomited, inhaled his vomitus, but after that treated well according to the book but over the next 24 hours dies. A distraught parent accuses me of killing the baby and says that they hope I feel well and truly ‘guilty’. Should I feel guilty? I had made the correct diagnosis and done the right operation. My name was still on the end of the bed as the responsible surgeon. I had seen him and ordered several things post operatively. I was not the anaesthetist. Measures should have been taken by the anaesthetist to reduce the risk of him vomiting to a minimum, which he did not take. But I was by then in a side room writing up the case record. The mistake having been made I raced back into the operating room and did all I could to correct the situation.

But that accusation is that I have killed him and should feel guilty. I don’t think that it is fair to say that I have killed him, even if in a court the lawyers would have tried hard to push that all the responsibility of the anaesthetist fell back on me as the team leader so….? Now coming to the guilty word I have to confess that maybe I should feel guilty. I’ve seen that anaesthetist make similar mistakes before and because it was after midnight and I was tired I chose to do what was legal but maybe not wise i.e. do the rest of my legal paperwork and hopefully get home to bed. I had previously spent time on several occasions explaining the right way and watched him through several operations. I had since then stayed in the room on several occasions making sure that he did the waking up procedure correctly. But he was still relatively inexperienced. Because of the hour should we have waited until the morning, accepting that he may have died overnight and would certainly have been medically worse by the next day. If everyone had rested he might have lived and grown up to be a healthy man.

Would that label me guilty? I understand why the parents did, and I have to struggle hard to say that I bear no guilt. But I reject that I should feel guilty of murdering him or even of having done the wrong thing. Surely there must be a synonym in there for my feelings at this moment. Blameable? – but surely it is not my responsibility to do someone else’s work correctly. Ashamed? – because in the world there is such inequity between what we have in my home country cf my adopted land. Remorseful? – that I didn’t stay in the operating room until the child was wide awake. But then I knew that the post-op care workers often slept on their duty time – so should I have watched him overnight? Am I to bear the whole weight of the medical inadequacies on my shoulders.

Often when I use a word I have to depend on my reader/hearer to discern the context into which I am using it. It is not easy for the user or the recipient of a word to be sure of the correct meaning and I guess we have to settle for being honest, generous and understanding in our assessments.

Auguste Rodin | The Thinker (Le Penseur) | French | The Metropolitan Museum of Art

Dominic Cartier

Under the Thumb.

It may be almost illegal these days to say that about a husband-wife relationship! Particularly if you are the male speaking! There I go, being provocative again. But I’m not talking about a person but about a load of work.

Some years ago I self published a book – a sort of autobiography come medical journey of mine. It sold out and is 10 years out of date at any rate. Then a few years ago I wrote a book, probably better called a booklet, for my students as they began their clinical surgical courses. It was relevant to their situation with lack of facilities and language difficulties. Their ability to read thick tomes was limited, so I tried to put the very relevant stuff in a compressed form. As I meet a new era of Western students sold on investigations, before physical examinations, I’m convinced that it may be of use to them also.

I’m pretty dumb, computer wise, but my eldest son, who lives on our farm and runs it and who runs me is a wizard. He wants to reproduce them and also shortly after them another pictorial cum anecdotal short book of our lives. So at the moment the thumb of pressure to get it done on time is hard on me! Publication date for the first two is set for November 27. Between now and then we have a granddaughter’s wedding to attend about 1,500Km away, and a sheep shed to get built, so the pressure is on, the thumb is pressing down.

My first book was called ‘Have Scalpel – Will Travel’, and the new edition will have the same name but with ‘Revised and Updated’ added. The other will be ‘Medical Diagnosis – a Surgical Approach.’ I’m slowly labouring through the third one – as yet unnamed.

The introduction to the first book was and will remain as follows: –

They cut off the tip of his ear.
Yes he was a thief and this was the custom.
He was naked and caught stealing clothes left out by the river to dry.
He could see no-one but they saw him!
He was tightly bound with his hands behind his back and taken to court.
Eventually he was brought to the hospital.
One arm was already gangrenous. It had to be amputated.
The other – the nerve supply had been cut off by the pressure of the binding and the arm was paralysed, probably forever.

How did he feed himself?
How? He had his food put on the cupboard by the bed – but there was no one to feed him.
He had to feed himself.
So he got up like a dog on his knees and elbows.
He ate like a dog.
My heart was touched and so each day I stayed back at lunch time and fed him myself.
What became of him? I don’t know.
But to God he is a person – to the others he was just a thief.

One night I sat in the common room of Addis Ababa HQ of SIM – the mission with which I was associated. I had just come up from Soddo on business and had left behind this one who deeply disturbed me. People were singing that beautiful old hymn ‘Peace, perfect peace when all around….’ Yet I was not totally at peace. Sitting in that common room I was not totally at peace. Was I doing all that could and should be done in these circumstances? Certainly the future my young thief saw ahead had no pension, no physiotherapy, and no social support.

Am I my brother’s keeper?

Maybe more later. Watch this space!

?Dominic Cartier

Pictures or Words?

Already some people have indicated their gladness because I put a marker across my posts if I’m going to show a few medically mild photographs. We all have different backgrounds but I’ve been thinking a bit lately about this issue. I wonder what people do when watching a news presentation about rioting or some natural disaster or catastrophic event and a nasty scene comes on. Do they immediately turn them off? Is it possible or wise to hide from these terrible realities?

Thinking again, I wonder if more damage is done by what enters the mind via the eyes or through the ears. Reports of the political discussions about the very abnormal sexual behaviour being accommodated, or the legal destruction of life, both at its beginning and its end, entering the mind by reading or hearing, in my thinking, immunises minds against truth. I’ve read of high school kids being expelled for insisting that there are only 2 sexes. I personally think the authorities should be expelled.

Some may explain me away as a psycho-pathological religious nut. But it is they who are forsaking science for emotive who-ha. Please don’t think that I’m totally naive.

I had a young trainee Orthodox priest come to me with his penis halfway severed through because he, as a normal young man, was having difficulties balancing normal human reactions to the monasteries insistence on celibacy. He was trying to cut off his problem.

I’ve had to deal with a pre teenage child brought up as a girl but with strong desires to be male. On examination he had testicles but a grossly deformed penis, and no female organs. I won’t show you the pictures, which I have.

I’ve had to deal with a young man who often had meals with us, who as Orthodox got a Muslim girl pregnant. He was too terrified to tell his father so he used me as a listening ear. I said if you want an abortion you’re talking to the wrong person. He replied that neither he nor the girl wanted that. They had obviously discussed it. We had good talks, but in the end I said he had to talk to his father but that I would go with him. I had discovered that he was the illegitimate son of his father, but had been brought up with the family’s other children by the father’s wife and treated as one with the other kids some older, some younger than him.

The father booted him out of the house and stated he never wanted to see him again. We cared for him until the ‘mother’ persuaded his father to take him back some weeks later.

The girl was not prepared to meet me, but the young man and I had input with her. She, too, was unprepared to talk with her family. He could have remained quiet but she had an expanding reason to do something. So while her father was away she spoke to her mother who demanded that she have an abortion. The mother explained that her father would kill her if he ever found out that she was pregnant and particularly to an Orthodox boy. Eventually she was, very tearfully, dragged off to the local American run abortion clinic and the child’s life terminated.

Am I being judgemental in discussing these things? I guess the answer in some ways is ‘yes’. Are there many things with which I disagree? Celibacy should be chosen not forced; a decent look at the child could have seen testicles and no vagina; he explained that he had erections but although everything became hard nothing stood up except for an intense C-shaped thing; intecourse runs the risk of pregnancy – so although not uninformed the pair were stupid. I would say that intercourse is intended to be within marriage but I recognize that is an unpopular concept these days. However, the knowledge of pregnancy prevention is well known and easily obtained; I can’t understand the parents behaviour on either side. Am I judgemental? Maybe, but I sought to help without verbalized criticism to anyone except for the young man, who was like a son to me. Certainly I didn’t reject him.

I loved treating kids. Under the line are some of my ‘kids’. I challenge you to look at them and see them as real people! You will see some dressings but no open wounds.

Continue reading →

Who deserves or wants praise.

Getting old, if nothing else gives you time to think. Someone very generously nominated me for an Australian medal, and justifiable or not, it was granted to me. Twice I’ve been nominated as Australian of the Year, but I didn’t by a million miles deserve it and didn’t get it. Perhaps what I cherish most is a simple piece of paper which my medical students gave me when I was retiring.

So what am I really writing about?

We had the chance to listen in on zoom to a funeral this week. The funeral of an old lady who died at 96 in an old folks home, well cared for but at the end separated from her family because of the Covid precautions, except for daily visits by her husband. She did not get the disease. She had written a book about her experiences, which I had enjoyed, but the funeral service was a great reminder. Her husband outshone her in the eyes of the world in which they lived, or so it seemed to me. But as I listened to the service, heard the eulogies and then watched the slide show, I couldn’t help thinking that she deserved an AM much more than I do. As a child she only had an education up to grade three, but then as a young adult went on to become a triple certificated nurse. Became a nurse in the back blocks of Ethiopia, raised a family of four and still managed to achieve what I mention below. There are now tens of thousands of women emancipated and brought into real liberated life, in the Omo Valley region of Southern Ethiopia because of her work amongst women in the churches which were founded through the work of her husband and others. You could almost envisage a halo hovering above her coffin. She was a great lady.

Or I remember bringing a young down-country teenager who had never played a musical instrument, nor ever even seen a piano, into a room where a lady was playing beautifully. He listened in amazement, and when she left he went and sat down at the piano and played with the notes. Minutes later he was playing the tunes of the local songs he knew from his countryside background. Amazing – to me, who occasionally while singing accidently hits the correct note! What talent. I remember a visiting doctor friend saying that he wondered how many young geniuses were lying with bare bottoms up to the sun just watching a few animals.

Or now we have a young man (at least 25 years younger than me) living with us so that my wife and I can remain living on our little farm. He’s very naughty because he does lots of things that he doesn’t have the pieces of paper which the government want tending to confuse them for ability. He fences, builds roads, adds a patio, builds a small kitchen and replaces cracked walls inserting windows to bring light into a darkened area, puts in electrical points, answers all my questions that I need answered to keep my computer working, and many other things. But no one employs him because all of his Tertiary degrees (4) are seen as impractical. They are linguistic and theological and not seen as practical. His wife left him, so some denominations have taken away his licence to preach; others are so liberal that he cannot sign their bases of belief.

Among my slide sorting I have come across two pieces of paper which give me more joy than the several accolades which I have been given. I share them with you.

The undersigned were all final year medical students, who asked me in addition to teaching them medicine to give them some Bible teaching. You may be able to understand why sometimes I found their English a bit difficult.

They are more important than this…

There were a number of expatriates, mainly from India and the Philippines, but I was the only white person in the department of health and there were only two of us *on staff* in the University. Arba Mintch University had 39,000 students in 2018. The hierarchy of the University were very gracious to me but the words of a child patient and of 5 students mean more to me. I’m not ungrateful for the several go away functions and the gold medal, but a patient’s or a pupil’s thanks is worth so much more.

Dominic Cartier