Do you ever feel sorry for yourself?

To answer the question above, sometimes I do. My knees are giving me ‘hell’ today. I had my knee surgery a good few years ago and they were good for a while.

This was the first day the dressings were taken down. They healed well and I was able to be on a plane back to Ethiopia within a couple of months to help with the first group of year 4 medical students as they came into our hospital there.

They were good for a couple of years then something went wrong and although I am constantly reassured that it has nothing to do with the prostheses going bad, now every step hurts. So today I was feeling a bit sorry for myself. and decided to look at a few photos of those who really did have something to complain about.

I have chosen a handful from more than a hundred leg shots, and cut out the really nasty ones but you choose if you want to read on.

Continue reading “Do you ever feel sorry for yourself?”

Children….

I’m writing this because I read yesterday of the 150 children kidnapped from a school in Nigeria. This is one of many such attacks with about 1,000 children in all being taken since December last year. Some, a minority, have been released. That is mind-boggling and I’m surprised that that it doesn’t provoke international ire and offered help to the Nigerian Government for help. Such help may of course have been offered and rejected. Some of the pictures I have seen from before indicate that some taken were Muslims. The latest school attacked was the Bethel Baptist School.

In Australia as doctors we have to be very careful. It is difficult for medical students to get into watch a child being examined without parental or guardian permission. As a doctor I am not allowed into an operating room without special registration with each individual hospital, even with adults being operated on. This is a long way away from the old system where operating rooms had mezzanine floors built so that many students and other doctors could watch and learn.

It reminded me of a medical student from Australia visiting us in Ethiopia for an elective term, who told me that I dare not treat children with the affection that I did there, if I was in Australia.

This boy had been run over by a cotton picking machine and had massive injuries from his pelvis down. It took my hat on his head to get a smile out of him. It was a weak smile but took weeks to achieve!
Months later when we got him standing with help, I got a real smile! He had about 20 operations.
Sometimes it took my glasses to get any attention

You can see that this poor kid has lost an arm. We had at least one case a week of cases like this. This occurred rarely because of an accident but ususlly because with a fracture (I guess we could call that an accident!) but that had been badly managed by a local healer who bound the limb, leg or arm so tightly that it caused gangrene.

This young guy had been kept at home until his leg dropped off. You can see how flexed his hip is. He was so weak that we had train him to stand up again, initially by holding him. We did make wooden legs initially and later there were prosthetic limbs available.

This is one such limb made in Arba Minch for a teenager who was so ill when he came in with a gangrenous leg and septic shock that even after initial resuscitation he had 2 cardiac arrests on the operating table. He did well and the last I saw him was attending school supported by an Australia who visited us and met him. There is a lot more to the story than I have told here, as you can guess!

You can see the scar on this boy’s head. He was in ICU and with a very low GCS (a count of severity of head injury) and the nursing staff wanted to put him in the ward as they were sure that he would die. I resisted and although he had a few problems (he was nearly blind), he survived and he loved me and would come running to me whenever he heard my steps. Should I have held him and tickled him? His dad was so happy that he lived!

I may show a copy of some gross pictures of suffering in my medical memoirs blog but here sufficient to say that I treated a thousand or more kids and they all needed medical, emotional and often physical loving. My heart bleeds for those taken in Nigeria and their families, but this is a worldwide problem. Let’s give all the help we can!

Dominic Cartier.

Maybe Malnutrition plus ?….

Don’t you wish that you had a better memory. I have a terrible memory for names and it gets me into trouble. My wife accuses me sometimes of not being interested in people. But that’s not true. I understand why it frustrates her and when we meet up with people we’ve not seen for a while she has learnt to say to me ‘Dominic you remember ….?’ The stock answer is obviously ‘Of course I do! So lovely to meet you again.’ Unfortunately, if I’m not very careful I’ve forgotten almost immediately. Not that I’ve forgotten the person, only the name and I can go on chatting about past memories, but not using names! Well, in truth, it’s not quite as bad as that but you understand. On the other hand hand I have little trouble remembering the events of our previous getting to know each other.

Don’t you think she’s beautiful? I do. Don’t you think that she’s skinny? I do. Besides her malnutrition can you pick her diagnosis? We have a lady come in every second Friday afternoon to help a bit. She is a nurses aid. So I showed her the picture and asked her what was wrong with the girl. She said ‘you mean apart from her being malnourished?’ She is pretty skinny but I don’t think is actually malnourished but certainly a bit underweight. But look at her left shoulder. I’ll bet that there was more than 100 cc of pus in that abscess. From the way she is sitting leaning on her elbow I’d be surprised if it is a pyo-arthritis; more likely an abscess in her deltoid muscle. Still pretty painful but not as bad as if there is pus in the joint. And it looks as if the glands are affected in her axilla.

I know how it hurts to get ‘bitten’ by a rose thorn. And if dad or mum couldn’t get it out, a child in our land would be taken to the hospital emergency or the doctor’s surgery. They obviously were not the poorest of the poor, (look at that pretty pillow), but even so she didn’t turn up at the hospital until the abscess was this size.

Seriously thank God and the government and a slowly changing attitude to illness, things are a lot better than they were fifty years ago. But the need in Ethiopia and many countries is still huge. At least momentarily it makes you wonder if you or I can make any useful difference. Our grandkids and great grandkids have already so much more than we did or our kids did when we/they were young. So we have (except when they are very small) stopped giving presents. So for Christmas in all their names we give a larger gift to an organization who we believe we can trust to deliver aid on the ground. For birthdays we tend to give smaller gifts in the person’s name to a worthy cause – and there are so many of them around. Do any of you have good suggestions to pass on? If so please let us know.

Cain years ago try to fob God off when he was asked a question about his brother Abel (whom you might remember he had murdered) by saying ‘Am I my brother’s keeper?’ Well I’m not going to run around wringing my hands because I can’t solve every problem, but the question is thought provoking.

Two loveable imps. One having lost most of his right arm; the other with half a thumb gone and having lost his scalp to a hyena. You can see the dressing under his cap. Lovely kids!

Dominic Cartier.

Giving a lift in the countryside.

Do you ever watch ‘Morse’ on Television? Have you noticed that the main actor Morse (John Thaw) has a ‘dropped foot’ on the right? As a doctor you tend to spot diseases. And one day I saw this guy standing on the road side.

Taken on the road to Jimma in this picture you can see a lot.
  • The gum trees came from Australia.
  • You can deduce that we are driving on a high plain and in the distance, after a valley unseen for the cloud that fills it, is another mountain range. Going to Jimma from Addis you pass through several mountain range.
  • The ground looks fertile.
  • The old man isn’t standing up very straight. His knees are bent and his crutches don’t go up to fit nicely under his arms.
  • He’s obviously thumbing a ride. I can’t see a house anywhere near, and he is not at a designated bus stop. So I wonder how long he’s waited and to where does he want to go. It’s a long hard walk to any clinic in the area.

Either he’s got a bad medical practitioner who doesn’t know how to set up his crutches correctly or he’s got some nasty orthopaedic problem. His knees are bent; his back is bent over, but if they both were straightened out his crutches would be long way too short. I am most unlikely to know his language as this is a different tribal area. He looks a bit scruffy – see that patch on his knee? He probably has a different scent but most likely BO. I think we could make room for him but the kids would have to be squashed up. We’re in a bit of a hurry, and someone says ‘we’re running late already’. Look carefully – he is human. Wife says ‘well, are you going to give him a ride?’ Should I have?

Dominic Cartier.

Looking at a picture..

You can wander through your photos and think different things…..

  • Why did I take that?
  • I can’t remember what that was!
  • Weren’t we stupid to do that.
  • I wonder where they are now? etc
There are no other nasty pictures to follow and this is just a little six week old baby boy.

This photo takes me back over a lifetime of medical practice.

The past…As a first year intern in Adelaide, in the days when specialists were not as plentiful, I was sidelined into being a temporary anaesthetic registrar for six months to cover a shortage. It would be not even an option in this day of many more available people. But it gave me the opportunity to have a hands on experience which has served me well throughout my years of practice as a surgeon. Almost all of my time in Ethiopia I had to give/supervise all of my anaesthetics when I was the surgeon. So for chests and abdomens, orthopaedic and urological procedures the responsibility for the anaesthetic lay with me. Sometimes I even had to unscrub and deal with a problem before getting back to the operation. And tiny babies are a special problem; this boy was vomiting and needed to have his abdomen opened. I was, once the child (everyone knew that he was a boy, in spite of the troubles which politicians seem to have these days!) was properly anaesthetised going to leave the management at the head end to a cleaner. The length of the trachea in which the tube had to stay was only a couple of centimetres long – if it moved up he couldn’t be breathed for; if it went in too far, one of his lungs and maybe even one and a half of his lung capacity would be blocked off! I can remember my years of specialist surgical training; I can remember leaving my parents and siblings for a life in a land with, to me, a variety of unknown languages and a totally different culture.

The present….Here was the first born son a young family whom they had watched for a couple of weeks as he vomited everything they fed him and they were afraid that he would die. They were unsure if they could trust this young foreign white man, in their eyes an infidel. But they came and all their hopes were hanging on this moment.

The future…He survived and they were very, very happy. But here I have to let my mind float away into the ether. What sort of education did he get; is he married; did he become a good boy and make wise choices; is he a blessing or a curse to those around him. But that is the future of every patient you treat – some you get to follow and know, others are just passing in the night. Do you wonder why I like looking at the photos on my computer?

Dominic Cartier