Alone

I once tried to run away from medicine. I ran far, for a long while. I never looked back. I thought I had gotten away. Afterall, it wasn’t good for me anymore. I was sinking, on fire, hurting, burning so I selfishly decided to quit, and I didn’t care. I did not want to be a doctor anymore. I could not be a doctor anymore.

I foolishly thought that the powers that be, had let me give up and let go. I thought that I’d revert into my old carefree, well-slept self who could calmly eat croissants and fuss about the small things in life. For the first few days, as expected, I would still think about medicine, work and illness. But I was surprised at how quickly I became a normal person again. That revelation came to me when I found myself sleeping without any haunting-sweat-drenching nightmares. I even found myself having the energy to be upset about bank ques and sold-out watermelons at woolworths. I was normal again! Damn, that excited me.

My excitement was short-lived as medicine eventually did find me, and it wasn’t pretty. It was horrific. Bloody and tragic, and ironic, as always. Writing this story makes me realize I have never actually relayed this story to anyone before, further affirming the manner in which it broke me. I couldn’t possibly say it out loud, ever.

It was 5:30PM in 2016. I was driving alone on the N2 admiring the sunset whilst listening to east coast radio, slightly panicked to get home before dark. I had been up to normal people errands like visiting the dentist for a check up. I had 3 meals that day, no anxiety and I had even washed my car; a great day in my books.

That’s the thing about medicine- it steals the little things in your life. Instead of enjoying your morning coffee, your mind is racing about the number of theatre cases to be done today. Instead of enjoying the morning news, as depressing as it is, you’re fretting over the baby in casualty who is in shock and has no bed in the ward. Instead of fussing over what to wear for the upcoming family wedding, you’re just trying to keep your eyes opened long enough to greet the person next to you. Instead of planning your free weekend, you’re just concerned about the patient you spent weeks trying to keep alive, who may be gone on Monday.

Anyway, I digress.

As I was driving, I saw the bakkie and it immediately made my palms wet against the wheel. I had always disapproved of the maintenance bakkies who carried passangers on the open back without any safety measure. Irresponsible at best, an obvious hazard. I started cursing the driver under my breathe, when the only passanger, a gentleman not older than 30 turned and looked me straight in the eye, as if he heard every word. He was positioned seated at the back right corner, holding on to the edges firmly.

He gave me a toothy child-like grin and smile and turned away. I smiled too.

It wasn’t long before everything took a turn for the worst. I could have never been ready for what I was about to see. I wish I had blinked, looked away, or been distracted for some reason. But I wasn’t. I saw it, in slow motion. I saw each inch of every moment. And it changed me forever.

All it took was five seconds, a dog crossing the road and gravity.
The driver swerved violently to avoid oncoming traffic and the dog. The dogs small bowel was up in the air. The driver hit the railing and the momentum slapped his bakkie onto its back, rolling, tumbling, breaking, murdering.

I remember braking so hard I knew I had fractured my foot. Snap, crackle and pop. I felt the swelling expand my shoe, and then the pain. I missed the bakkie by a few centimetres and came to an abrupt halt.

I was distracted by the blood scene in front of me. I opened my door and limped out. It seemed like only a second, but it had become dark so fast. If it wasn’t for the throbbing pain in my foot, I would have sworn my nightmares were back. The bakkie was no longer a bakkie. Just shattered glass and a number plate covered in blood.

I searched for a few minutes before hearing a soft groan. I limped quicker and I found him lying on his back, sweating, in immense pain. He wasn’t smiling anymore, he was dying. I rushed by him and made a quick trauma assessment. His head and brain were probably fine. His chest was bruised but no pneumothorax or hemothorax for now. His limbs were also fine for now but his pulses were weak and thready. I lifted his shirt which was surprisingly intact, and It was the abdomen. The blasted abdomen was causing havoc. Between his umbilicus and his left iliac fossa, lay the mother of all wounds. Ragged, ruptured, bleeding, leaking bowel contents everywhere. Eviscerated ruptured bowel with hypovolemic shock.

I decided to carry him to my car and drive him to the nearest hospital. I had no stretcher and a broken foot. I attempted to lift him, but he sceamed in pain, I imagined his wound tore a little more, blood poured out through the fabric. I decided that trying to get him to the car would cause more trouble so I hopped to my car and decided to drive to him. I put the key into the ignition, nothing. Again, nothing. Again, nothing. Again, nothing. I had never felt so helpless, alone and angry before. I decided to abandon this plan and call an ambulance, no easy feat. Everyone who works in the state knows the constraints with the ambulance services. When patients pitch up in ambulances instead of taxis and borrowed vehicles, I am actually very impressed. At one time, I wandered how people came in with ambulances because it would take me 30 minutes to get a hold of one.

I tried to reassure him but my own voice was shakey. Was this really happening? He answered my mental question by screaming in pain as I poured the little water I had trying to do a makeshift washout and tied the sleeve of my shirt around his abdomen, to prevent any more bowel from seeping out. I took out my cell phone and dialed 10177. My battery flashed: 3%.

At this point I was pissed off. Why would God do this to me?! To them? Shit. Them. The driver. I had completely forgot about him. Where is he?

I limped along and shouted ‘Mr Driver’ as loud as I could. Nothing. This was a bad sign. Afterall, I only found the smiling gentleman because he guided me with his groans.

Finally, EMRS picked up the phone and I quickly spoke in one deep breath hoping all the necessary info would be relayed before my battery died. Sure enough, it died while I was on the call. At this point I was sweating from my ears. I gave them the address and told them if they couldn’t come, to send a private ambulance, id promised to pay. Im sure that wasn’t nearly enough assurance.

I went back to the smiling gentleman and sat by his side. I told him help was on the way (I hoped so). I asked him some questions to keep his brain active, hoping it wouldn’t succumb to the threats of hypovolemia. His breathing became slower. His palms became paler.

My knees were soaked in blood. I cursed myself for not bringing my first aid kit along, not that it would help. No number of bandages could fix this. This needed emergency surgery with Prof, STAT.

I scanned my mind for any useful information. What else could I do? What was I missing? Is there anyway to repair this street-side? What would prof do?

Profs words ringed in my head, “eat when you can, sleep when you can, and NEVER F&*%! With a trauma abdomen”

“you look worried” the smiling gentleman heaved, sadly.

I was more than just worried. I knew this was a time-sensitive problem. I knew this needed surgery. I knew this meant sepsis if he was lucky enough to bypass the wrath of hypovolemia. I knew the possibility of the ambulance arriving and him being driven to the nearest hospital was 30 minutes, to theatre about an hour, which he didn’t have. I KNEW. But i could do nothing. For now, I was a useless doctor who had to watch a person die and there wasn’t a single thing I could do about it.

I used to be a doctor, I told him. I quit a week ago. Im going to be a preschool teacher.
He looked unconvinced by my small talk and my future plans.

We spoke about the weather. I spoke, he groaned softly. Each time, with less energy. A morbid sign. Tjings went from bad to worse to horrible quickly.
He wasn’t sweating anymore. He was pale as a sheet. His eyes sunken, his nose stiff. His breathing pattern was rapid and shallow. He wasnt bleeding anymore. I knew death was close by.

I asked him his name to distract death somehow. Maybe if death saw that there was some life left in this man, he would leave.
Thabani Ernest.

When he didn’t say his surname, I started CPR. I pushed as hard and as fast as I could for 30 compressions. When i heard my finger snap as his chest became rigid, and rigor mortis took over, I didn’t care. I welcomed the pain as I cried and carried on, 28, 29, 30. I heard an ambulance siren.

I will never know his surname nor his story. But he changed mine forever.
He will always be Thabani Ernest, the smiling gentleman, to me.

(RIP. )