Being a south African to me, mean many things. To name just a few; our beloved Braai’s, boerewors, biltong, eskoms loadshedding, car guards, burglar guards, electric fences, our infamous home affairs que, ‘the system is down’, corruption, taxis, bunny chows, pap n vleis, cricket, and a sport in which many men run with a ball in their armpit, I believe its called rugby.
Over the years I’ve come to appreciate the uniqueness of our south African folk in all our glory. Afterall, I deal with people when the proverbial sh*t has hit the fan and someone is always injured, bleeding and distressed.
It happened during my community service year. I was placed in a busy (read:violent) rural area. The mixture of patients included the old grandmas and grandpas with their chronic diabetes and hypertension, often uncontrolled and complicated, but chronic nonetheless. The other part of the population mixture involved their delinquent children who were part of notorious gangs and spoke of prison sentences proudly and waved weapons in peoples faces on the daily. Needless to say, the drama that followed me was usually bloody, gruesome and often ended badly.
When cases other than blood and gore found me, I was usually excited and my step got an extra bounce. Getting to examine a patient from head to toe without any life-threatening bleed to contain first, was a real treat I only saw once in a while. Toward the end of the year, there wasn’t much that could phase me. I had gone through the motions of every emotion, and plateaued into one of a quiet neutral apathy. I was fatigued to my core, nearing the deadly rims of burn-out, a common medical problem.
A stabbed abdomen? Eh, okay. A gunshot neck, well that’s nice. A chopped ear? No problem. A fractured femur? Let me get my plaster of paris ready. Basically, I was used to the chaos of trauma. What had once stressed me out and cause my blood pressure to hit the heavens, had become a natural way of life. After all Where there is booze, there is always blood.
But theres one thing I could never get used to. More unnatural and abhorrent than any other mechanical injury; burns. Out of all, I hated the smell, it grated my last nerve. The complete concept of it bothered me. Firstly all superficial burns cause an indescribable pain I would never want the displeasure of feeling. Every single skin particle is, well, literally on fire. Every intervention inflicts even more pain. How can I help someone I cant touch?
I was called to casualties to assess 2 new patients. Walking down the hall, I could smell the familiar odour of parched flesh. Instantly, I knew there was going to be trouble.
The story made no sense to me. Their over eager exclamation of “it was an accident!” before I even asked what had happened, obviously meant they were both lying.
The males genitals were covered in a towel while he whimpered in pain. His upper thighs and hands were also affected. He could still urinate well but the damage was there.
The female was flopped on her abdomen and her back was covered in linen while she screamed in pain. I ordered some painkillers and a IV fluid for them. Thankfully, the extent was not as bad as i’d imagined. Id seen far worse on a bad day.
I began the slow process of peeling away the covers carefully, to avoid any further damage to the already irritated skin. I concluded that the damage was superficial and needed religious dressing and it should heal well.
During my history taking, I had to enquire about what had happened. They exchanged glances and began their song of “it was an accident”. I noted this down, unconvinced.
I proceeded to take the female into the wound dressing room. I decided to use the privacy to probe. At first she was adamant it was freak accident in which her back and his genitals got burnt with hot water while making tea. Her shaky voice gave the plot away. She was lying through her teeth.
I questioned the male when it was his turn and got a similar reply. I told him since his burns involved his genitals he would have to be referred to hospital. He immediately looked alarmed.
“Doc, wait, are they going to um, you know, amputate?!”
“Amputate what? ” i chuckled.
“You know, chop it off, the sausage and eggs because it’s burnt??” He was so alarmed as he clutched his package tightly.
I couldn’t help but wonder if this would happen in any other country. South Africa , the land of endless possibilities!
I laughed for a long while that day!