Exhibit B was served to me on a cold rainy and dreadful Saturday night in which I was, obviously, on call at the end of the month during a surgery rotation in internship. Month ends in surgery is notorious for trauma gunshots and plain stupidity walking or wheeling through the casualty door.
During this specific overnight call I was pretty relaxed to begin with. Aside from the usual appendix and amputations left over from the night before, the day was progressing better than expected. My medical officer and I decided to take a lunch break(unheard of) and i decided to indulge in a R49.99 margarita pizza from debonairs. I was pleasantly surprised at the ease in which I scoffed these 8 pieces down. I was convinced this would be a good call (unheard of).
Ofcourse this is when Murphy had to rear his ugly head. Dead silence was met with the screeching sounds of the bedside phone ring. The casualty officer was a polite chap. Very helpful and hardly turfed garbage our way like most did.
His voice was panicked. That’s when I knew. Murphy. Had. Arrived. “Err moosa. Im calling from casualty. Come now. Bring your medical officer”. Oh hell. It’s a head injury I thought. The thought of holding on for neurosurgery and intubation and pushing patients to CT scan at 3am was a complete buzz kill.
I ran. I told my medical officer to come. Stat. He was the type of guy who knew everything about surgery and ran the Department like clockwork . he was so inlove with surgery it completely engulfed his life and he didn’t mind. A genuine guy who fought for his patients. He could smell an appendix from a mile away. He once diagnosed a work bolus-a blous of about 1000 worms all wrapped nearly around a 12 year olds lives, merely by looking at him. Vulgar as hell but a heart of a marshmallow. He taught me how to conquer the chest drain and examine anal wounds fearlessly. i usually ended up in those rocky resuscitations with him in which retrospectively , taught me most of what i know. A don.
As I walk into casualty I instinctively look for the sickest most injured and unstable patient(my type). Yet all I saw was the casualty officer standing next to something which made him look puney in comparison . my eyes widened. I could feel the sweat drip off my neck and my tanc scrubs cling to my sweaty back. My jaws tightened. My glasses slid of the sweaty bridge of my nose. No no and no.
My medical officer walked in and immediately started “f#*! What the f@#&* why the f#@*%” that’s when I knew this was going to be a long night .
“45 year old female. Diabetic. Hypertension. Chronic asthma. Now with a bowel obstruction. Constipated for 5 days with an acute abdomen. Oh and she’s 155kg’s. ” the formality of the presentation went over my head like a slick duck on water. All I heard was 155Kgs. Silence. At the back of my mind all I was wishing for was a head injury patient.
“Chronic asthma? What the d#*@! The lungs are being squashed by fat! Squealed my medical officer. Thank god for the language barrier and pain which renders a patient immune to such words.
“Moosa get 2 or 5 iv lines up get this lady prepared for theatre. Ill speak to the anesthetist”. I knew this was going to be a major issue as the theatre bed can only accommodate 130kgs of weight and coupled with all those health risks the anaesthetic was going to be a very tricky one. The don needed to do some excellemt convincing in which he was brilliant at.
I managed to get iv lines up with great difficulty through tons of adipose tissue finding a vein was a mission. and prepped this patient for OT. I waited patiently for the call from the don . “bring her. And call 5 porters to help us” after a long convincing call with porters I managed to get 3(all the night staff) ro help me Take this patient to the theatre recovery room and move her into the theatre bed. It took 5 of us plus 4 bypassing strangers including 2 family members to move her with great difficulty .
The anaesthetist was fuming. “Slightly overweight. U call this slightly overweight. I’m sick of u damn surgeons thinking the airway is a joke. I refuse to put this patient through these doors. Move her back” the don was calm. The porters were furious.
“This is a surgical emergency and I cannot let this patient die of a bowel obstruction in YOUR theatre recover room. What will you say in the mortality meeting?” Don was a master of manipulation and a artist with words.
The anaethtist agreeing was one battle won. Scrub sisters another. Yet the challenge of the OT bed was another. Don pulled me aside. Moosa think. get creative. Get a f#*!@ing crane i don’t care. This patient is going to die”
We decided to roll the patient onto the theatre bed and hope for the best. Any suspicious sounds from the bed and we roll her back. Not the greatest of plans but what could i do?
Pretty soon we were elbow deep in bowel and blood . the obstruction was located and relieved. Now came the messy part.” Moosa there a comes a time when every doctor must face the proverbial and literal shitstorm. Unfortunately this is yours.embrace it ”
milking the bowel of 5 day old faeces was by far the most disgusting thing ive ever done. The smell was so pungent it lingered in my nostrils for weeks there after despite everything I tried. It came by the litres . foul fermented and rotten. I ended up dipping cotton wool in perfume and plugging my nose for the next week.i refused to eat for 2 days I survived on sour worms and diet coke.
The anaethtist was livid. There was faecal matter seeping out of the nasogastric tube. The shit had hit the fan. Literally. He cursed don and dons mother and dons future kin. Don gracefully accepted and thanked the gas monkey for his words.
Finally the end arrived. After 5 full hours of faecal bliss. Our scrubs were stained brown. The theatre was foggy. The anaethetist was pissed of. The Scrub sisters were considering disposing of the instruments as autoclaving may not be enough. I agreed .
The don left me to clean with the scrub sister. There was an immersion of faecal matter on the bed and floor. We cleaned and recruited 4 nurses to help us move the patient.
I left. I scrubbed my body with alcohol solution amd welcomed the sting. I sprayed my nose with cheap deodorant . the smell was still there clinging to my nostril hairs.lingering in my brain. 8 slices of margarita pizza sitting undigested and on the brink of a regurgitation. I swallowed.
Suddenly my phone rang. It was the Casualty officer. 20 year old male, assaulted with a panga blow to the head.. Head injury!
The show must go on… And on it went. 26 admissions later, I left the hospital and marinated myself in savlon for 3 hours. Bliss.