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.

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