It was a relatively ordinary stable Monday evening in which I found myself on call. Monday calls are usually unpredictable. It can either be quiet because the patient load had been sorted out during the morning or busy in which the weekend patient load had over flowed.
Or it could be my Monday calls in which it would always be busy, either way. This was to be expected as I was cursed during my early days of internship by an unusual character who wore a padlock around his neck and a scorpion tattoo on his neck
, but that deserves a separate blog post altogether..
The call was a steady inflow of patients, eventually dying down until I sat down and popped grapes into my mouth. I was settling down into my broken office chair which offered me comfort after hours on my feet.
I heard the security guard scream for a doctor outside a nearby window so I peeped. The security guard looked genuinely distressed and ran around frantically. I made my way to the gate and found a peculiar picture ; 4 young boys carrying what looked like a 5th. Minus one foot. I looked twice. I wiped my glasses and squinted. The man had no right foot.
This was confirmed by the way he screamed. The echoes of his cry with such genuine pain and unbearable distress which made his entire body quiver while he dripped out his blood volume through his mangled right leg.
I quickly assessed for shock (being a doctor and missing shock is like being a swimmer and drowning). No shock yet but he is getting there. I managed to get a vague scenario of how these unsuspecting boys were walking outside the clinic when a black citi golf swerved and took his right foot with it. The friends were obviously in utter shock. They had never witnessed such a graphic scene of blood and bone , and in all honesty, should never have.
The leg was completely mangled and the foot was no where to be found. The tibial bone was carved into a sharp bone of the outlying compound open fracture with severed skin and dust around the open wound. The wound was pouring blood like an open tap and one rogue artery was to blame.
I consoled the 4 friends as best as I could during that pressing time and felt pains of regret to have to witness such an unlucky event. I ushered them out of the room and immediately realised this wound was pouring.
I recruited 2 nurses to help me; while we got as many iv lines up as we could coupled with some good doses of pethidine; i began washing the open wound with as much sterility as I could offer. The tibial bone was a weapon on it’s own. It cut through my glove ever so neatly and had an unusual shine to it. I triple gloved and continued.
I searched for the tibial artery like a needle in a gigantic bloody haystack. Finally, I caught the little critter and ligated it with extra oomph. It oozed but with no arterial squirters I figured I had some time to buy.
I quickly called the nearby district hospital and explained this situation. The doctor on the other end sounded so unphased and bored. “The foot is completely off. There is no foot. There is 1.5 lower limbs. The limb is mangled. The MESS score is high. The gustilo Anderson score is 3c” . I decided to push the seriousness of the situation to incite some sort of interest. But to no avail. Im pretty sure i heard a yawn and a muffled “yeah sure send him and make sure he has an IV line”.
The nerve of that statement tickled my neck hairs but I kept calm. He Probably thought me to be a hormonal female who was overreacting.
The damn foot was missing. How could he sound so bored?!?!
That’s when I realised that the foot was actually really missing. Where was the foot ? I checked on the young man and was happy to find him fast asleep. I ran outside to find all 4 friends and the security guard staring at the floor in shock.
Where is the foot? I asked. Where is the missing foot? No response. Shocked stares.
“We dont know. We saw the car drive over the foot, his Jean’s got stuck on the rim, there was alot of blood and the foot flew off outside the gate and we ran to you “
I knew I had to go look for the foot. It seemed only right to do so. I refused to allow a stray dog feast on a mans undignified foot. And these 4 friends were in no state to be hunting down appendages.
I ran out the gate and met the stench of clotted a blood. A smell i had become very accustomed to over the years. I switched my cellphone light on and i began the search. The road was a mixture of tarr, dust, streetwise 2 boxes and blood. But still no foot.
I paced up and down and used all my excess adrenaline. Eventually i saw it. Hiding within a white all star shoe. Blood on The rim but the shoe in tact with the ankle joint protruding.
I gloved up, grabbed the foot, put it in a plastic wrapping and ran . The 4 friends scattered as I emmerged. I guess there may be some thing unnaturally freaky about a lone foot.
I carefully wrapped the foot in a bunch of linen savers and pulled my black marker out. I labelled the foot and tucked it gently where it should have been. A gift for the bored casualty officer. I knew for sure there was no way the foot could be reattached or saved as the foot was cold as ice.
It was more of a courtesy to the young gentleman. After he had his amputation formalised maybe he’d like to bury it or dispose of it accordingly in a dignified fashion.
After all, i think everyone deserves to know where their limbs are. Dont you?