Growing old with purpose!

For some years a group of us held the consultant posts in the major government hospital in our city. It was a big hospital (603 beds), but well away (1,500Km) from the capital, and relatively understaffed at the top level. I was a ‘come and go again’ member of the staff as I spent as much time in Ethiopia as Ethiopian politics and my health would allow. In 1976 when I joined the staff as Surgical Supervisor there were basically 3 general surgeons (the Medical Director was a surgeon but an Administrator (who only treated burns) several orthopaedic surgeons, an eye surgeon, and 2 Obstetrician/Gynaecologists, We had 3 senior anaesthetists and 3 general physicians. Gradually a few others were added. Several years later we got a neurosurgeon, a paediatric surgeon and several younger registrars graduated and joined the staff.

Yesterday was the funeral of the neurosurgeon. There was a huge audience with many family but also many people celebrating his bringing neurosurgery to the north of our state about a thousand by a thousand kilometres! (The state is huge!) My wife and I sat behind the paediatric surgeon and another surgeon both of whom I consider young guys, although in their 70s. I didn’t see him but I have good reason to believe there was a younger, now retired surgeon there and I saw a couple of younger, now older, anaesthetists.

One of the physicians is still alive (nearly 90 I think), an eye surgeon is unwell but alive in the capital city as is a healthy anaesthetist. But we three surgeons sitting together felt that we are the only 3 old brigade of surgeons. And I was there when one was a registrar and years before the other came! I hope for their sakes that I’ll be the next one to die. There is a certainty about death. It reminds me of a story that Jesus told about a guy called Lazarus and a beggar. Lazarus was filthy rich and very self-centred but his wealth didn’t allow him to avoid death. He woke up in hell. The story in the Bible (Luke 16: 19-31) gives several major issues to consider but relevant to this situation – talking across the divide of hell and ‘heaven’ he mentioned that he had relatives who lived as he had and he requested Father Abraham to send a dead guy back to warn them. There was a very powerful statement by Abraham – ‘Even if someone rose from the dead, they wouldn’t believe him!’ This weekend is Easter! He is Risen!

The doctor in hospital….

I’ve heard that doctors and nurses make the worst patients. I had nearly a month in hospital towards the end of last year. I had a very nasty reaction to a medication which my GP prescribed for me. Everyone was very nice to me apart from me being in a mixed ward where a fairly large (huge) lady liked to undress and scream – the screaming not exclusively but especially at night! I noted several things which were marked changes from my training in the 50’s and 60’s and from how I taught during my stay in Ethiopia. As you can see in the picture below they shaved my head and beard (although the beard is beginning to grow when this was taken!). The rash covered me top to bottom front and back (I was so thankful that it missed out the perineum!) – it was itchy but even much much much worse for me – it was like fire! At any rate I’m better now!

I was given several lotions to rub on the rash and the nurses (gloved of course) would apply it where I couldn’t do it for myself. But I couldn’t persuade anyone to give me strong pain relief as you would for a burn patient. I was very glad when after just over 3 weeks the fire went out. I got relief from hot showers which counteracted the burn. I think that the hospital would have had a huge water bill for that month! I had several other problems with heart, kidneys and lungs. So I had a number of doctors who made me feel a bit as if I was a collection of organs rather than a person – 2 dermatologists (one of whom actually touched me!), 2 geriatricians, a cardiologist, a chest guy, a urologist! I had 2 or 3 CT scans, 2 chest X-rays, 3 special heart studies, a couple of UltraSounds, a reading of my pacemaker, multiple blood tests (daily), a urine and a stool test, frequent (QID) blood pressure and oxygen monitoring. And just when I was about to leave one of the registrars listened to my heart, but through my clothes. Seriously everyone was very nice to me (except one nurse) but I felt that I was untouchable! How I would have loved someone to sit down, talk to me, and with their hands (no doubt hidden in gloves) examine me! Now 3 1/2 months after discharge I feel as if I’m as good as I was when I took that b…..y tablet!

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)

Australia Day 2022

Aboriginal Australian Art Tells the Most Important Ancient Stories
Is this person any more or less an Australian than those below?
Our oldest son with our granddaughter, his niece.

We can argue as much as people like about what date we should celebrate as Australia Day, but I would bet that whatever date is chosen the argument will continue! The argument is not only between those of different colours, but of what date we should choose from the arrival of us ‘invaders’ and the formation of different groupings with in Australia. My background is Caucasian, with grandparents from 4 countries – Sweden, Scotland, Wales and England, and my wife adds in Danish and English genes. The granddaughter, in my arms above, was born in Australia from an adopted Ethiopian son of ours, who is an Australian citizen and a mother, also from Ethiopia, who has permanent Australian Residency. And in our immediate family (the four generations springing from my wife and me) there are many Australian born, seven born in Ethiopia (2 white and five coffee coloured), one born in Malaysia and, in addition, a lot of Chinese and some Filipino genes.

Even in another country, I am an Australian!

And while I’m about it, I can add that I am not white – look at the picture above and you can see that I am light brown! In the background are a few of my Ethiopian ‘brothers’.

My other close attachments are with the country of Ethiopia. How my heart aches for its people as they have gone through the civil unrest of the recent past and the even more major tragic events that have occurred there, even within my life time; the Italian invasion, the joining with and separation from Eritrea, the murder of their Emperor and the communist take over, divisions over language, customs, tribalism!

Let us all remember the past, but don’t let it be a cause of division, rather repentance and forgiveness. Let’s live in the present and as One People of many shades and ethnicity accepting our differences and pressing onto a future marked by acceptance, caring and mutual commitment to unity as far as possible. The unity will not be uniformity but may it be in a passionate desire to live at real peace.

Dominic Cartier

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.