Monday, June 25, 2007

i made a difference

most of the time you do your job. sometimes it means something.

when i was still a registrar, rotating through vascular we had an incident that meant something in my life. i'd like to think it meant something in the other guy's life too. yes, i'd like to think i made a difference.

it was early one saturday morning. a cop came out of his office in plain clothes carrying a laptop. 3 guys asked him if they could have his laptop.
he said no.
they asked again, this time brandishing their knives. the old saying about not bringing knives to a gunfight became appropriate in their lives at about that point.

exactly how the next few moments played out i don't know. what i do know is he shot them all. one guy he winged in the hand. i briefly saw him in casualties. not because he was my patient, but because the story interested me. (as usual he swore he was out selling bibles. a very dangerous passtime if you ask me). one guy he shot through the chest. intercostal drain and the guy was ready to steal again.

but my guy... he got it bad. this incident happened within spitting distance of the hospital. (admittedly the wind would have to be behind you and you'd have to put your back into it.) yet even though my guy was in casualties within ten minutes of the incident, he had bled to shock and was quickly progressing towards death. he took it through his common femoral artery just below the inguinal ligament. (for movie buffs, roughly where hannibal lector stabbs the cop's informant).

without going into too much detail and without even touching on the point that my consultant wasn't available for some reason, we took him to theater, patched him up and pulled him through. of course he did the obligatory icu time, due to massive blood transfusion. (i've seen enough of these to wonder if it could be employed as a cure for aids. bleed out the infected blood and replace it with uninfected blood. wait, i didn't say that!!!)

and then i got to thinking. you see in the state, most of these gunshot wounds are criminals, but this one was brought in by the cop. he was caught red handed (when i saw him, almost everything was red). the others deny everything. this guy could not. i felt a strong sense that i had a chance to say something that might change the course of his life. i might indirectly save some other guy's life a few years from now who would otherwise take a bullet from my patient. i decided i must.

when he came out of icu i approached him on rounds. i meant to say something. i'd even thought about what to say. i couldn't. i thought of my car that was stolen. i thought of my house that had been broken into. i thought of being robbed in town. i was too angry. this guy was the representative of the men that did those things to me. i walked on by. the next day was the same. the following day i realised the guy was going to go home soon and the opportunity would be lost. i had to try.

in the morning i did my usual evaluation of his leg and pulse etc. then i turned to him and started speaking. i spoke fast and almost aggressively, my anger lying very close to the surface. i told him his life was no longer his own. he had been shot dead and yet he was alive. he was alive because a stranger had saved him. (i never told him i was the one that operated on him and he never asked, so the concept of a 'stranger' hung meaningfully in the air...i hope). i told him therefore his life belonged to a stranger and he had to now go into the world, find a stranger and repay the debt. he listened. he said he heard and he would turn his life around. i wanted to say "yea right!!" but i kept quiet. i was still angry at him in proxy.

he went home.

some time later i followed him up. i was surprised to see he was not in prison (ok south africans...i wasn't surprised...shees give a guy a break). i asked him why. as it turns out he listened to my words and decided to make something of his life. he turned state witness and swore to me he was also going to go back to school to get matric.

he was probably lying, but, often, when i'm alone with my thoughts, i like to think he wasn't and that i did in fact once make a difference.


Jeffrey said...


please visit

Surgexperiences - where we share our surgical experiences.

it is a new blog carnival i, a medical student, and an aspiring surgeon, am setting up.

thank you.

Anonymous said...

Great story, I loved the little gems as well in your post. I.e "admittedly the wind would have to be behind you and you'd have to put your back into it." and the bit about hannibal.

Bongi said...

jason, thanks. i enjoy the input. sometimes i wonder if these posts get read or do they sort of hang around in cyber space.

Dr. A said...

Great story! I appreciate you stopping by my blog and leaving a comment. Thanks! I add you to my blogroll.

Sid Schwab said...

Nice. Had you not done it, I imagine he'd have carried on as before. I wonder if culture plays a role: meaning that some believe more than others that having one's life saved obligates one to the saver...

Bongi said...

thanks dr a.

sid my take on it in africa is that here, life is cheap. i think here there is very little feeling of obligation to the saver as the value of the thing saved is viewed as cheap, even by the guy whose life it is.

a cuban friend of mine (the one in witbank for those who have been following my blog for a while) tells a story that demonstrates this. one day a guy stops him at a shoping center and lifts his shirt, revealing a large lap scar, saying that he was one of his gunshot patients and that the cuban had saved his life a year previously. the cuban was just getting his memory in line when the guy said he needed x amount of money for whatever (transport home etc). now in cuba as far as has been shared with me there is a strong feeling of obligation to the saver by the savee. the cuban was first dumbfounded, then shocked, then angry. when he told me i laughed. the saver it seems owes a debt to the savee.

Newscoma said...

yes, I did read your post and my throat tightened.
Keep educating us with your experiences.
Hi from Tennessee,

Anonymous said...

I love your blog! I lost it for a while because I accidentally deleted a part of my bookmarks, but now I've found you again! Yay!!

I don't remember where I read it or what culture it was about, but in some if you save a person's life you are responsible for him forever! That would be pretty overwhelming for the good doctors!

Bongi said...

thanks anon. much appreciated

Refinedone said...

you would never realy know if he changed his life by your words...but i think you should be rest assured that it had dropped in his heart like a seed..

...nice blog, i realy dont know how you doctors it!
I love ppl but there is no way I could do what you do... :)

Bongi said...

thanks refined one. each to his own. i'm sure i can't do what you do.

Anonymous said...

now, mr bongi.

(mister out of respect.)

you only have to write more of such stories that provoke much thought, you could even publish a "Tales of Surgery in Africa" by Mr Bongi.

I would be the first to purchase it, or, one of the first. i can assure u that.


if u dun mind, some Christian fact. Christians owe to Christ that He has saved our life from eternal damnation. (John 3:16-18: which are unexpressed conditional statements in reality if u looked at them in Greek).

This is the reason why u might see Christian evangelists around. They feel it is a privilege and sometimes even, out of extreme gratitude (one that moves you to tears), burden that they share the Gospel, which they believe to be life-saving.

Now that's food for thought. Hopefully, not controversy.

This is in response to mr. sid. 's query on culture playing a role on obligation and life saving.

more on that at my blog.