It's been a while...

So I have been quite bad at updating my blog and think it's time I try again... My love for surgery has been renewed. I was on call yesterday, Sunday, and really thought that it was going to be a relatively quiet one. It's the middle of the month, no huge soccer games were on, the weather was quite cold, so plenty of time to study on call for those upcoming surgical primaries. Well, I think I jinxed myself, because as I arrived at the hospital and did my scan through the surgical wards for problems, I heard that we, my senior and I, needed to take an acute abdomen to theatre. Her bloods showed a raised white cell count and clinically she had generalized abdominal tenderness, with a history suggestive of appendicitis. In theatre we found a perforated appendix with quite a bit of purulent fluid in the abdomen, but after doing an appendicectomy and a thorough washout I think she'll be okay. That may have seemed pretty mundane and the norm for a weekend call but what came next was anything but. The intern phoned us as we were waking the patient up and informed us that a gunshot abdomen had just arrived in casualty and was fairly stable clinically and on blood gas. But, we needed to come down and see the patient and he was getting the patient prepared for theatre. My heart skipped a beat at the news. I really do love the fast-paced part of surgery that gets the adrenalin flowing. The times when we get to take critically injured patients to theatre and save their lives. Yes, that's the part i love. And, we get quite a few cases at Natalspruit, which makes me smile. In theatre, I learn that this 24 year male patient was actually a hi-jacker who attempted hi-jacking an off-duty police officer who was armed. He was shot once in the abdomen, with the entrance wound in the area of the left renal andgle and the exit wound was on the left upper abdominal quadrant. He had large bowel diembowelment, but was not actively bleeding from the wounds. Well, once we opened him up, it was a whole other story, the abdomen was filled with 2 liters of blood and continued to fill as we tried to find the source of bleeding. After packing the abdomen and searching for the source of bleeding we realized the disaster we had to fix. Two large holes in the jejunum that needed to be resected and primary anastomoses done. There was also a large 5cm hole in the sigmoid colon that needed resection and luckily we could anastomose. And, lastly the lower pole of the left kidney was shattered by the bullet and we were unable to stop the bleeding so we had to perform a left nephrectomy. aftre 4 hours of nail-biting action, we closed the abdomen up and transferred the patient to ICU. You may be reading this and think how hectic it was and may even be angry that we saved this criminal's life. I must admit I had those same emotions when I heard about the circumstances surrounding the shooting. But, whenever I am faced with those feelings, I have to remind myself why I became a doctor and the Hippocratic Oath I took when I graduated from medical school. I have to treat all sick people and may not discriminate. In the end, all patients have the right to emergency medical care and if I am the practitioner involved in giving that care, I may not choose who I treat and who I don't. In a way I hope that by helping these criminals, they remember me and don't target me or my family when going about their crimes. But, I know that in actuality they don't care who they have to kill to get what they want ad if I have what they want, I'll become a target. It's the sad reality of living in South Africa.