Christabel Iyinoluwa Akerele
400-level Medicine & Surgery
University of Ibadan
Sunday, 15th November ’20.
My entire body hurts. Oluwa!
Today felt quite slow, almost like nothing was going to happen. Three surgeries were supposed to hold today, all orthopaedic surgeries. The first was a combination of Plate and Screw and Internal Fixation (fixing a segmented fracture of the Ulna and Radius — the two long bones in your arm), the second was fixing a patellar fracture and the third was a minor one — biopsy and skin graft.
I had arrived a few minutes past 10 am, only to hear that the surgeries had been rescheduled to 1 pm. No wahala! I spent the time catching up on my new found love, Naruto! On my way to work, I had spent all the time wondering if Sasuke would beat Gaara. The hours raced by and soon enough, it was surgery time; Naruto would have to wait.
The second surgery was somewhat frustrating, but it had an interesting story behind it, involving police brutality. Mr X seemed, to me, a fragile, middle-aged Muslim. As he lay there on the operating table, I kept wondering why he seemed so afraid, despite reassurances from the two anaesthetists that he would be fine. He was placed under spinal anaesthesia, but it didn’t seem to work. I saw why as I scrubbed.
You see, for anaesthesia (causing loss of feeling in a person’s body or part of the body through the use of drugs) given to only segments of the body, there is still a possibility that the patient would feel pain. The reason for this, amongst others, is psychological. Though spinal anaesthesia (anaesthesia given through the spinal cord… yeesh!) is an excellent way to ‘deactivate’ the pain receptors from the umbilicus to the soles, fear can still increase one’s consciousness of pain.
Despite efforts to calm Mr X down, he remained very agitated. The slightest touch received an exclamation from the patient, and it was only a matter of time before everyone became irritated. At last, we had no choice but to sedate him and dampen his consciousness.
I learnt that Mr X was the way he was due to the truckload of trauma he had experienced over the past months. He had lost his wife early in the year — she had died of kidney failure — and his superstitious Yoruba in-laws had him arrested, jailed and interrogated with brutal force (Police reform? Urgh! If I hear!) He had had to deal with the grief of losing his wife, a false allegation that he was responsible for her death and physical injuries sustained during the interrogation. One of the injuries was the fractured patella for which he was now in the operating room. Very sad story, yeah?
“Doctor! Swab! Doctor Chris o! Haha!” My consultant’s elderly laugh brought my mind back to the operating room.
“So ti re e ni? We just started o, Dr Chris. Hahaha!”
Lol. His laughter makes me laugh — not the laughter itself but the things he laughs at, and that includes everything! LOL.
Time for some medical jargon so you know I’m not a fraud.
We made a nice incision from the Tibial Tuberosity to the dorsal segment of the Quadriceps Femoris Tendon (QFT). The Tibial Tuberosity is the swollen bony part on the front part of your leg, just below your knees, while the QFT is a cord that connects all the muscles on the front part of your thigh to your knee cap.
Skin. Subcutaneous tissue. And then blaaaaahh! Blood everywhere! My favourite part of surgeries! Blood everywhere!
I hurried to mop up the blood (I hate messy surgical tables) so we could see the exposed fracture site well. My consultant pointed out the synovial membrane (a tissue in some joints that produces lubricating fluid) and the tissue and all…or something like that, I don’t know; I just know the stuff felt fluffy.
There it lay, separate and distinct, the two halves of the patella separated by the Quadriceps Femoris Tendon and Patellar Ligament. The police lied about the fracture time; it was well over one month old, evidenced by the soft tissue that had grown around the fracture surfaces.
Now, to the frustrating part! What was meant to be a 45-minute procedure took over two hours! We were to use metal wires to sew and hold the two halves of the patella together with just four puncture sites, but we used 16 puncture sites! Sincerely, it felt like something was really following that man. Either the wire cut or the instruments couldn’t penetrate the patella or the knot wasn’t taut enough. In my mind, I was thinking, “Shey we won’t pray for this man like this?”
I checked the time; I had been standing since 1 pm, and it was 6:45 pm already! Lord! I needed a warm bath, jeez. We finally got it to stick but not efficiently. Then, we began to stitch, and the stitches were just randomly coming undone; I could not cope.
At 7:30 pm, we finally finished stitching. My consultant decided to put him in a full leg Plaster of Paris (POP). I guess he feared that the wires wouldn’t be efficient enough. Either that or he too felt like something was following this man. For me, between the leg pain and the backache, I had no doubt it was the second option.
Now, I’m home and all I can think about is if the battle was even won. Maybe we will have enough strength to fight again another day, to protect people like Mr X.
Signed,
The Unmedical Medical Student.
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😄😄😄. Such an interesting read. I hope you gather more strength to save other men like Mr X.
Thank you!
I love this