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 It sold out and is 10 years out of date at any rate.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? 

The title of the second book.

Maybe more later. Watch this space!

?Dominic Cartier

A picture walk of our life in Ethiopia

Just a bit of a pictorial taste of our daily life in Ethiopia

About once a month we ended the day for a posh evening out at the lake side hotel.
For visitors we usually went out on the nearby lake.
the view from our front door
It reads ‘for all, it is possible’ There is a big push for literacy.
The simple life, but not the usual there.
The common way of life in towns large and small.
The small Indian church we attended put on for the public a pre-Christmas night.
I think they meant ‘drug’.
A modern University admin building
The hospital cafeteria.
Clinical students had a ceremony as they became interns to make somewhat like the hippocratic oath we took years ago.
modern facilities with all mod cons in the hospital!
But my days were spent with real people!

Cutting away.

Some relationships don’t last. Cut them off. Certainly some bumps and lumps need to be cut off. Cancer is often cured by its removal. So much money is spent on face lifts and tummy tucks that it is almost unbelievable.

Could you ask for a more handsome face!

But, as I’ve mentioned in other posts, I’m going through slides and memories. I’ve been thinking, as I’ve looked at slides, about the reasons for which I have amputated kids’ limbs. I’ll tell you a few!

Personally I have not been involved in amputating a child’s limb in Australia. In Ethiopia I have done a lot – too many to count! I just want to mention the reasons. These are not listed in a time sequence, except the first.

  1. The first one, and that soon after I arrived as a young surgeon (28) in the country, was because a kid, playing in the paddock came across an old unexploded Italian bomb. He succeeded in making it explode amd lost an arm, an eye and had a piece of bomb lodged in his heart. Three operations on the same boy at the same time. He did well and left – one armed, one eyed but with a normal working heart.

2. Another because he was run over by a train. He lost 3 limbs, both legs above knee and one arm below his elbow. I was not the first to operate on him but had later to revise a poor job. As he told me the story later, I wished that I had been the first surgeon, because if he told me the truth (and I have no reason to doubt him) we could have preserved more limb length than was saved. I had to reoperate soon after I first met him because there were spikes of bone sticking into his skin making every movement there excruciating.

3. One because of an electrical burn. He lost both his right arm at the shoulder and his left leg below the knee. He had other extensive burns and suffered tetanus infection before his eventual survival.

4. The majority because of no doubt well intentioned but faulty local healer treatment. Of these over many years we had almost one a week. The splints applied were too tight and post splinting principles of normal follow up were not practiced. That is you must release the splinting if there is any sign that it is too tight.

5. Certainly I had to amputate in lepers because of uncontrolled infection, but the only child with infection as the primary cause of amputation was a girl with extensive gas gangrene.

Often in these children there was so much severe infection that they needed quick early surgery to remove the mess and then reconstruction later. One I remember had 3 cardiac arrests on the table. Others were brought so late that they died , sometimes within hours of arrival, because of septic shock.

6. Several for limb cancers. The pictures, if I showed them, are revolting as they came so late. The smell often was nauseating, but you just had to hold it in, and get on with the job at hand!

There are some nice photos of happy customers below the line – no blood, few bandages.

Continue reading “Cutting away.”

Looks or Character? – A nightmare!

I remember hearing a famous speaker talking about the above subject and coming down on the side of character but also saying but noone wants to sit down at the breakfast table every morning looking at a nightmare! Some of us have the problem with even looking in a mirror!

According to my policy I warn you that there are two pictures under the line – with no sores nor any blood – but seeing them is essential to reading my thoughts for today.

Continue reading “Looks or Character? – A nightmare!”

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 “Pictures or Words?”