A 5 minute experience stretched over 3 weeks!

For the sake of a brother-in-law and anyone else who doesn’t like medical pictures I promise than there are none. And neither will there be any detailed descriptions of the pathology! I have just come across a picture in association with an album of hymns to which I was listening’, and here it is.

The picture reminded me of two things. Firstly of all the anti-Trump news about his attitude to abortion. He may have been lying (an art perfected by politicians) but I heard him say (unless it was doctored by media experts) that he was against the generalization of Roe v Wade but that he felt that the people in each state should be able to vote on it. He claimed that he personally believed that there were 3 legitimate reasons for abortion – rape, incest and if the mother’s physical life was in danger. A very different view from what his opposition presents him as holding!

But what has that to do with the title of my article? Nothing! But the picture reminded me of the hundreds of cases of ruptured uteri that I have operated upon in countryside Ethiopia where in the late 1960s our small hospital was the only hospital for millions of people and we were so busy that we could not operate things like antenatal clinics – to which people wouldn’t have come because of custom, distance, lack of roads and means of travel. We served with 1-2 doctors, 5 trained nurses and a good group of Ethiopian helpers (a few of them trained elsewhere as dressers) as the only hospital area for more than a million people!

So I have seen many babies who have died before they were born. The picture above is one suggestion as to where they end up. But this is not a theological discussion.

One day, when I was the only doctor in the hospital I was faced with three ladies with ruptured uteri arriving within 5 minutes of one another. Our ‘operating suite’ had 2 operating rooms, one of them large enough to have 2 operating tables. So I had 3 tables for the 3 women. I had a nurse who was capable of watching an anaesthetic (she was v good) after I had induced the patient. We called for help from the ward and so ended up with the sickest, having been resuscitated, asleep and me operating on her. Behind a sheet for visual protection a second lady was being resuscitated as was the third lady in the smaller OR.

It was a long morning but all were eventually taken into the ward on appropriate IV, pain and antibiotic therapy. All three babies were dead (and hence the picture above). Two ladies progressed very well and were able to go home in 7-10 days. No matter what we did the third lady did not do well. She ran a high fever and using all our available antibiotics, changing to new ones as appropriate and doing an X-ray to make sure that we hadn’t accidentally left a pack or an instrument inside we eventually had to conclude that we would probably see her depart in a box.

Sadly, I believe that much of what is called ‘faith’ healing is sham. But I do believe in God and I think that He can do wonderful things. While I was operating on that same evening on which we had come to the above conclusion, the nurses and a few of the families of workers on our mission station spent the night in prayer specifically for the healing of this lady. In spite of all our failed treatment, the lady’s temperature the next day was down considerably, she felt much better and was discharged ‘well’ about 5 days later!

Dominic Cartier

Starting again….

It is several years since I have been involved in my Heatedstew blog. There have been good reasons for that. It was necessary to sell our farm and purchase and move into a suburb. Not surprisingly I’m getting older and there have been a number of health problems. I think that I am getting back onto more level ground. So here goes again!

A few months ago our house was tingling with excitement, and with very good reason. A young man was arriving from America, He’s very short having had both legs cut off when he was run over by a train. He is not one eyed but one armed, and he’s making a great success of his life! My wife and I had hoped to adopt him but our government refused. He was adopted into America where he lives and goes to University. He was on an American wheelchair rugby paralympic team in 2016 but now majors in wheelchair basketball.

Here he is as a young teenager playing outside his adopting parents home in America (??2009).

There are some excellent Ethiopian surgeons, a rare one is not! Accordinging to the boy when he woke after the accident (he was run over by a train when he was doing something maybe considered necessary to survive but stupid and dangerous) he still had both knees and several fingers. His amputations are just below his hips and his elbow. Length is very important for making prostheses work, but I assume that as a poor countryside kid they were looking to make him a successful beggar. This surgeon was in the ‘bad’ group!

When I met him he was still in hospital after his initial surgery. I was told that he was due for discharge back onto the street where he had been living. I immediately asked permission to take him home with me. His amputations were not well done and on his left stump the bone end had not been smoothed and the spicules of the non-well rounded bone end, not covered with muscle were sticking into the skin and he was in agony with every slight movement. As he was not living with his family – his dad was dead and his mother ill – he had been a street kid and there was trouble getting permission to take him home with me.

He at that stage knew no English. But in my very average knowledge of Amharic we got on ok. ‘Do you have to pee at night?’ I asked as if the answer was ‘yes’ I’d have to get up and carry him. ‘No’ he said. ‘Good’ I thought! ‘Do you wake up with horrible nightmares?’ I asked. His reply absolutely staggered me. ‘There is a God in heaven and I’ve put myself into His hands.’ he said.

The weather was drizzly and as we came near Addis the mud thrown up by other vehicles made it necessary to use the windscreen wipers and washers. He had as far as I know never been in a car before, although he was pretty streetwise. When the water was squirted onto the window he asked me where that came from? I said ‘There are two little boys under the hood and I give them a shock and they pee for me.’ A horrified gasp, followed by a healthy laugh ‘Now tell me the truth.’ I knew then that we would get on!

He had several trips into hospital in Addis to have his amputations made more appropriate. He stayed with my wife in Ethiopia for a year while she taught. I was diagnosed with cancer and had to come back to Australia for surgery. Then I returned to Ethiopia and we three made arrangements for a medical visa for him to come here for prostheses but the Australian Government wouldn’t allow us to adopt him. We still consider him as a ‘son’.

Dominic Cartier (maybe more later)

A memory stirred.

I’m pretty deaf, with combined middle and inner ear problems. I’d been taken in an ambulance to the Emergency Department of the local University Hospital. Years before I had been a consultant there for some time. After I had met the young Intern, a more senior guy came in. As you would expect he was masked and in a discernible slightly foreign accent said something, which was to me undecipherable. So with his mask down and me asking him to come nearer I understand that his name was Graeme and the accent marked him as a Scot. ‘I know you he said.’ I did not remember him at all until he said that he had worked, as an intern, in a country hospital about 130 Km away from my hometown and I had been flown in to deal with a young man whose motorbike handle had, when he hit a tree, gone into his upper abdomen and caused massive bleeding. I still didn’t remember the doctor but I did remember the incident – some stories you don’t forget!

There were no specialists at the hospital but the medical superintendent was a very experienced and highly capable GP. Early in the evening he called me and said that he had just ordered a plane to bring a team up to deal with the above described young man. ‘Could I come, urgently?’ ‘The plane will be ready to take off in half an hour’, he said. I owned a Mitsubishi Starion and (maybe illegally) had it up to 230 km per hour. Knowing how long it took to set up people and equipment for the journey by plane I told him that I would be there long before the plane was. And I was.

He was a very capable GP anaesthetist so I told him to get everything set up and knowing him to be a good diagnostician told him to be ready to start the moment I got there. The patient was shocked and being resuscitated as well as they were able, but the family were JW’s and refused a blood transfusion. The parents had, however, agreed to allow me to transfuse him with his own blood, which I knew was collecting in big volumes in his abdomen.

He had a massive stellate tear of his liver. I rescued as much of his blood as I could and by filtering it through gauze, we put it into an emptied saline bottle and transfused it back into him. But I was losing him and bluntly sent out the message to the parents that if I couldn’t give him more blood he was going to die. They agreed for a transfusion to be given, but there wasn’t a store of transfusable blood.

As I said earlier the GP Superintendent was a champion guy. He had previously, knowing that such emergencies arose from time to time, formed a blood bank of living people who all had agreed that, if called upon in an emergency, they would come ASAP to the hospital and be bled. Three of the right grouping came and donated their blood.

The bleeding was so massive that after my attempts to stop it failed, all that I could do was put a large number of packs into the traumatised area thus controlled (stopped) the bleeding. He was sewn up and kept under the anaesthetic.

About a half an hour into the surgery the plane had arrived and the medical crew were very helpful when they joined us in the operating room. After a bit more stabilising of his condition he was flown back to our local city hospital. The next day he was flown about 1,500 Km to the capital city of the state for further definitive treatment under much better conditions. What follows I have only heard secondhand and some of my assumptions may be wrong. I think that the big boys in the big city assumed that the probably rather limited ability-wise country surgeon was making a mountain out of a molehill. For them it would be a ‘cake walk’.

At any rate they took him back into the operating room, removed the stitches and the packs, but could not control the bleeding and had to end up repacking him and sewing him up again. Eventually he was transferred to the liver unit where he had about half his liver removed. He eventually recovered and went back to his local area. I hope that he and his parents were able to curb his desire to race his bike through the forest tracks!

Dominic Cartier.

They’re beautiful but I hate them!

Dingoes are a 'fair dinkum' separate species needing better protection, researchers say - ABC News

I’ve had a week of visits to doctors. I am glad to discover that I am still alive. I know more about the workings of my heart; the complications of various medications; but on a positive side I have discovered that sleep apnoea is a real thing. And I’m getting used to using the contraption.

I had a good sleep last night. The app tells me that I have 1.4 episodes of apnoea per hour and that all of them have been managed properly. So after 8 hours sleep, undisturbed apart from the main disturbing problem of an aged man’s continuous sleep, I was sitting at the table eating my pretty boring breakfast (I’m trying to lose weight) when I sat up with a jolt and yelled out to my wife (of 59 years) and my son for help.

Our sheep usually have a slow measured way of walking, nibbling as they go, but I saw a group racing lickity-split past our back house fence – chased by a dingo! Having lost too many lambs and some ewes to dingoes in the last year or so, yelling like a banshee, I hobbled to my ute and driving at about 70 km/hr along the road which I have signed up saying the limit is 15 Km/hr to get to where I knew the fence would entrap them. They were grouped in a corner of the fence but the dingo had disappeared. I fancy my yelling helped to speed the dingo on its way! So I checked the other mob of lambs (they’re fattening nicely and look good) the members of which were happily munching away in another paddock with no dingo visible.

But as our neighbour saw a family of six of them just outside our place yesterday, we are very aware of their presence. Hopefully they will return as dust to dust soon, when they taste the goodies that we have for them. And if you feel sorry for them, I would prefer my sheep to be alive!

The men (2 sons, 1 grandson) returned to their job for the morning. They were moving a tank to collect water from an old shed and a skillion that we are adding onto the back of it. You need to be inventive as a farmer, and so it was successfully shifted! Water is precious here in the North!

Dominic Cartier.

Are we being led by the nose?

The picture shows a severe case of bilateral TB. There are people who affirm that it is best treated by going to a holy place and drinking holy water. I don’t agree.

We all know that languages change with time. When we first went to Ethiopia the common greeting in Amharic was ‘tenastelign’. That was a brief, shortened way of saying “Igzehabier tena ystelign’ which translated means ‘May God give you health on my behalf.’ If you wanted to say, ‘How are you?’, you had to choose one of three ways. You used one for females, one for males and another for important people. After some years away I went back after the Communist takeover had been overthrown. I went to a university teaching post. After a short time I found the students addressing me in what used to be the common feminine greeting but had now become the friendly greeting between people with whom you felt comfortable. They were really honouring me as someone they trusted. I had not lost respect. Older people still stood up when I walked into a room and said ‘nuur’ or something like ‘May you live forever!’

The language had changed.

In English when the Bible was first translated into English the word ‘conversation’ referred to the way one lived. Today it means a talk together. A change occurring over time with usage. ‘Gay’ used to mean ‘jolly’ or ‘happy’ the meaning has been changed to mean what used to be thought of as a sexual perversion. ‘Marriage’ used to mean a state between a man and a woman wherein there was a commitment to sexual and emotional faithfulness, in a lifelong commitment. It was a basic functional unit of society. Today it seems to be either, for some, what it has always been, but for others an excuse for a party and a declaration that they are proud to be different and want to declare their situation as normal.

The first example (about conversation) which I gave, seems to me to be like dropping the ‘ye’ and ‘thee’ of older English for just ‘you’. The next two seem to be purposeful alterations to fool the masses into seeing things differently and with the purpose of making, what was previously seen as immoral, acceptable.

The above is a prelude to the use of the word ‘vaccine’.….

The meaning of ‘vaccine’ has been purposefully redefined by the government to include altered rna (ribonucleic acid) material being injected into people to alter the body’s ability to immunologically respond to some outside attack. Previously a vaccine was always produced specifically to attack a specific infecting agent by using an attenuated bacterium or part of the troublesome ‘germ’. I am not an expert and have no desire to be such, I am retired. But what concerns me is that the ‘vaccines’ being used against COVID 19, under the new definition, have not been, by usually accepted medical and legal standards, adequately tested. They are causing at least occasional, and some claim more frequent, deaths and serious complications. I have several personal contacts who have become seriously ill. And without a doubt there are a number of cases of significant heart problems (myocarditis and/or pericarditis) in young people.

Many experts, even though a minority, in the field have warned of late serious effects, maybe even in future generations. There is a sizeable body of reported deaths and significant immediate complications, enough I believe to stop the use of a new medication. Honest discussion is, I feel strongly, being suppressed by authorities and the mainline media. The statistics which we are fed seem slanted to a desired result. Can you remember – lies, damn lies and statistics?

I am not an anti-vaccine person by the old definition but am dubious about substances produced under this new definition until they have been adequately and thoroughly tested.