another story of the futility of trying to get it right in kalafong happend to a friend of mine.
the patient was stabbed just outside the hospital at the taxi rank. his friends immediately carried him into casualties. my friend and colleague happened to be there at the time. he immediately saw that the stab was probably to the heart and the patient was in trouble.
my friend grabbed the gurney and charged off to theater. amazingly enough he got the patient onto the table almost immediately (very nearly unheard of in kalafong). similar to my previous story, by the time he put knife to skin, the patient was in exitus.
the surgeon ripped his sternum open at double quick time. the pericard was a large sack of blood. the heart just couldn't compete against this and had stopped beating (this is not good). the surgeon opened the pericard and drained the blood. this allowed the heart to start beating again. unfortunately with the first contraction a stream of blood shot out of the left ventricle.
a steady hand and a few stitches later and the heart was no longer leaking. all that was left was to close.
the next morning, when i heard the story i was pretty impressed. a general surgeon had moved into a domain that he was not fully comfortable with and managed to pull a patient through that had actually been stabbed in the heart and that in the left ventricle. when he presented the next morning, once again the professor ripped into him.
it seems, according to the professor that the correct entry should have been a thoracotomy (between the ribs) rather than a sternotomy (through the middle chest bone). the small matter of getting the patient on the table literally about 10 minutes after the incident and pulling a guy through that had received an essentially fatal wound seemed of little concern. at a stage the prof even attacked my bewildered friend personally. as usually we all sat in silence. it was not the first time and it would not be the last time that this happened. we had all at some or other stage experienced the wrath from on high and it was just his turn.
at a stage my friend rose from his seat in a seething rage. he stood for a moment. he then seemed to realise that the safest move for his career would be to just sit down again. this he then did, but i'm sure i saw steam rising from his head.
after this fiasco, i went to him and said that despite what anyone says i thought he had pulled off something amazing. i even wrote a message on the tea room notice board saying that he was the man. he laughed at this and all seemed better.