monster

i recently read quite an interesting post on one of my favorite blogs. it had to do with religious zealots. it reminded me of two experiences i had, both of which i found disturbing.

i was rotating through paediatric surgery. the prof operated a 7 year old child for obstruction. intraoperatively we found intussusception in the ileocecal region with a golfball sized leading segment. we did a resection. already intraoperatively, the prof suspected a lymphoma (lymph node cancer). and histology proved him right. the child was referred to the chemotherapists for treatment.

during treatment, the child developed pancytopaenia (all blood products were low, including red blood cells) and became dangerously anaemic. at about this stage i discovered he was in foster care, because his biological parents suddenly crawled out of the woodwork. due to some legal technicality they still had a say over him in the legal sense. they then proceeded to refuse to allow a blood transfusion on the grounds that it was against their religion. i felt like i was watching a horror movie unfold before me. i could watch no more. i left it to the chemotherapists and didn't enquire about the child anymore.

the second incident was in some respects less dramatic. i saw an 8 year old girl who had fallen out of a tree onto a cast metal fence. the fence had sharp spikes and she had been impaled. when i saw her, she had four stabwounds in a row about ten centimeters apart running diagonally across her abdomen. omentum was protruding from one and she had an acute abdomen. fortunately she was stable.

i informed the mother that an operation was essential. she nodded. then she asked,
"will you be giving her blood?"
"i hope not." i replied.
"good, because our religion doesn't allow us to receive blood."
she didn't ask about the condition of the child or the nature of the operation or the chances that it would be successful or anything. she just told me that i was not allowed to give blood.
"i would only give blood if it turns out to be a matter of life or death." i replied.
"no, you may not!" she retorted.

i asked her if it was worth gambling her child's life (not her own life but the life of her child) on a religious ideal. but the blinds had gone up. she wouldn't even talk to me. she just kept repeating, as if in a trance, that no blood was to be given no matter what the circumstances.

the operation went well. one of the spikes had missed the aorta by about 2mm. slightly more medially and she would have been in dire need of blood to survive. while closing the multiple bowel perforations, i thought about her blase gamble with another human being's life. i also thought about the very difficult situation i would have been in had the aorta been injured. maybe the mother was willing to stand by idly while her own child expired, but it would not have sat well with me.

my feeling is that if an adult makes this sort of decision about their own life, who am i to go against it. but the children in these stories had no say. their lives were gambled with by others. they probably were too young to make decisions about religious ideals, and yet they were both being expected to possibly make the ultimate sacrifice in the name of religion. in fact they were going to be sacrificed by their own parents in the name of their religion.

it was monstrous.