There are some patients you just never forget...
There are two patients in particular who I say a prayer for every night as I switch off the bedside light and turn over...I don't really believe in God anymore if I am to be honest,but bed time prayers are reflexive and still vaguely comforting in the cold and the dark...
If nothing else, as long as I am alive,they are alive as well...they have not gone quietly or gently or forgotten into that long good night.
What prompted these thoughts today?
Partly because its midway through February...the month that's a bit like a Tuesday...surely the dullest , most depressing month in the northern hemisphere...Christmas is a memory...spring is still at least six weeks away...grey-impenetrable-sky-day follows grey-impenetrable-sky-day...people seem tired and beaten...even the beggars just sit mutely on the cold pavements,halfheartedly shaking their polystyrene chain-store coffee cups
Partly because I was at back at the university library today and walking through campus it seemed that every single person I passed was using a call phone...talking, texting,listening to music,playing games,taking photos...and when I got to the library I had to switch off my (personal) HTC smart phone and my (business) BlackBerry.
I also have two other call phones at home...a 'spare' UK phone and an MTN phone that I use in South Africa.
I also have a land line...and of course I use skype all the time.
I think that the cell phone has changed the social world by an order of magnitude similar to the wheel.We are never out of touch...
The Johannesburg General Hospital where I did my training was on a hill in a suburb called Hillbrow in Johannesburg.In the 50's/60's/70's/80's Hillbrow was the place to live and shop and party.It was a 24/7 lifestyle before we had even heard that term.
It was a mix of high rise flats and apartments full of hopeful immigrants,cinemas,theatres,'The Fish Hook' take away, night clubs, 'Exclusive Books',coffee shops from around the world, 'Estoril Books',food shops, Cafe Wien, the original Milky Lane ice cream shop with their "AfwulAfwul" ice creams,bottle stores, MiVami and its shuvarmas ,brothels, 'Bimbos' fast foods,churches,synagogues.
It felt like a mix between Leicester Square and Soho in London.
It was the fashion place...the fashionable place...hip , cool...trendy...
It always seemed to be summer...music in the air...marijuana as well...
It was a good time and place to be young and single and have money in your pocket and be studying...
(Only if you were white of course...)
There was a shop called Fontana in the Highpoint Centre ,-flats shops,cinema,restaurants-which was open all day,every day and their roast chicken was so popular people would drive in from miles around.The notice board outside Fontana was where you could find cheap airplane tickets,rooms to rent, cars to buy,guitars,curtains...there was always a group of foreigners standing around talking in guttural mittel-European accents.
And in the middle of it all was the Gen...the Johannesburg General Hospital...the main academic hospital,always slightly envious that although we had the money and the smartest people,that Groote Schuur had still got to do the first heart transplant.
(There were several hospitals in fact...the 'Non European Hospital' or "NEH",the designated 'Black' hospital was across the road from the "Gen." The 'Fever Hospital' was just across the road from that...and the Queen Victoria Maternity Hospital was just over the hill,five minutes walk away,with the Transvaal Memorial Hospital for Children across the road from it).
Wits Medical School was across the road to the west ,sandwiched between NEH and the SA Institute of Medical Research .The medical library was just north of the hospital and across the road from the SA Blood Transfusion Service which is turn was next door to ResDoc,the doctors residence...that was 2 minutes walk from the Milky Lane.
The main student nurses residence was next to-,almost part of- ,the main hospital;and its dining room was the main one that everyone used at lunch during the week and was mainly used by student nurses at other meal times.
I remember that I had eaten steak and chips for dinner.
I remember it was a Friday evening in spring.
You don't really get a twilight period in Africa...it tends to be day or night...sometimes though,when its warm and the street lights come on a little early,it seems like a benign twilight...I remember it felt like that as I walked from the dining room about 100m down the street to work in the Accident Service (as it was called in those days),just after 7pm.
(I was...I suppose I still am...a nerd and a trauma junkie...and in my training I did about 1500 hours of unpaid time in Accident service which was why I went in a little after 'handover')
The Medical Casualty and Accident Service were down a short ramp,effectively in the basement,with parking for 3-4 ambulances right outside.
You walked in past the porters lodge to the right and a small waiting room was directly in front of you.
Straight ahead was the medical casualty.
To the right, around a corner,were offices and a staff room.
To the left was the Accident Service...a small resus area,a nursing station to the right and then the bigger treatment room to the left,with the x-ray department down the hall.
The patient was in the resus room.
He had been walking home,just across the road from Casualty when he was assaulted
He was hit in the head with a panga...a machete.
It got stuck.
It was still in his head.
When the patient didn't die immediately and because the assailant was unable to pull it out,he ran away...
Leaving the patient to stagger a few meters down the hill and into Casualty.
He was conscious and talking and scared...
I think we were all scared...
He asked if we could phone his family so that he could talk to them...say 'goodbye' I suppose...maybe tell them he loved them...
It was obvious that he was dying and that he needed to go to the operating theatre...the neuro surgeons were desperate to get in there and try and stop the bleeding.
The home phone just rang....and rang.
We tried again in case we had mis-dialled...
It still just rang.
His wife was probably on her way home as well.
The neuro-surgeons felt that they couldn't wait any longer...
They took him to theater and removed the panga.
He died immediately.