family

my last post was about icu. while on the topic i couldn't help thinking about family and what that implies.

i was the icu guy. as usual, late at night, i got a message from theater that i needed to make a bed available for a gunshot wound patient. as usual, i pretty much had to stand on my head to do this. as usual, it was a criminal that took a bullet through some organ that he probably needed and nearly died. and as usual one of my surgical colleagues pulled him through.

he came in pretty messed up. he had lost a lot of blood and had gone into coagulopathy (the little bit of blood he had just didn't want to clot any more). then i heard his story.

my patient and three of his friends held up and old couple trying to eek out a living as real estate agents. it was late one afternoon when they found themselves faces by four gun wielding men. this is south africa so they immediately handed over everything they had. the criminals wanted more. they wanted blood. they took the old lady into a back room.

two things happened then. the man, left alone, had a chance to unlock his safe and get his own gun out. the criminals, meanwhile made the woman kneel down and as a sort of initiation type thing, one of them put a bullet through her. they then came out of the room, assumably to do the same to the old man. imagine their surprise when they walked into a blazing gun.

the first one he dropped dead on the spot. the second would become my patient after taking one through the liver. the third picked up an arm injury and got away. the fourth was not hit.

it was the usual story and i didn't think too much of it until the next morning.
the next morning, other than the usual police visitors, the patient's mother came in to see how he was. i have treated numerous criminals, but this was a first. i found it interesting so i decided to chat to her to find out where such a criminal comes from.

the first thing she told me is that she was a theater sister and worked night shift in a local hospital. this took me totally by surprise. firstly i wanted to believe that my patient came from a broken home or had some similar pathology in his past. but more importantly, a theater sister is like family to me. i have spent countless nights across an open abdomen with theater sisters. i couldn't help philosophizing about the fact that while i tried to save the lives of criminals through many nights with theater sisters at my side, was the system i worked in actually creating the criminals by making their mothers not available during their developmental years. such thought literally kept me awake at night.

then i got to hear my patient's story. he was an up and coming in some or other business. then he decided that there was either not enough money or not enough excitement in that venture. he and some friends went into the hijacking trade (good business in south africa). apparently this went well for some time. but soon they felt the need to upgrade. they decided the right business move would be to go into a bit of armed robbery. that's when the whole incident happened.

i spent some time in conversation with his mother. she was devastated. she never tried to excuse his choices. she just cried. one day she said that no one could tell what went through his mind the moment of the tragedy. she meant that maybe he repented from all his sins, so i didn't mention that what went through his friend's mind was a bullet. it seemed inappropriate at the time.

one day his brother visited. he was a lawyer, so i didn't speak to him. but i did find it interesting to see that my patient's career choice was not the result of opportunity.

this was not one of those stories with a happy ending. in the end, after some time and exorbitant expenses, the patient died. when he came in i felt nothing for him and, truth be told, his death is a good thing for south africa, but when he died i was shaken. you see, his mother was like family and he was definitely her family. i couldn't be as detached as all the rest of the icu staff.