Saturday, July 19, 2008


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.


amanzimtoti said...

I must say, while I sympathise with the mother, I have no sympathy for your patient (or his partners in crime). He didn't think twice before taking other people's lives. He chose his lot in life - despite better alternatives. You live by the gun...

make mine trauma said...

I like to believe that the converse is true more often, that children from broken dysfunctional homes grow up to be contributing, successful law abiding adults. (I know of several personally) This story just proves that blaming ones actions on the way one was raised thru their childhood is b.s. We all make our own choices and sometimes parents have nothing to do with it.

Devorrah said...

You have such sad stories, Dr.Bongi.

Anonymous said...

"he was a lawyer, so i didn't speak to him." :lol:

Bongi said...

devorrah, the sad stories are out there. i just see them close up.

roer, ek het darrem 'n bietjie trots.

Karen Little said...

Ugh... Before I studied medicine,I believed all people were essentially good (granted - before I'd studied medicine the worst side of human nature I'd been exposed to was bitchiness at an all-girls high school), but now I kind of believe that, with a few very exceptional exceptions, most of us are just different degrees of bad.

walt dandy said...

Ek het jou site nou net ontdek. Bledie interessant. Ek bly nou al vir 18 jaar in die VSA en is 'n 4de jaar neurochirurgie (sp?) resident (kliniese assistent?). Die snaakse ding is dat ek 3 jaar terug in Nelspruit was, en ek onthou dat ons verby die staat hospitaal gery het en ek wonder toe hoe die ondervinding daar soveel anders moet wees as hier in Amerika. By ons universiteit hospitaal sien ons miskien 20 of 30 skietwonde in 'n jaar. Ek wil ook se dat dit moer noble is van jou om so lank met al die k*k van die regering te gesit het. Dis duidelik dat jy omgee vir Suid Afrika en sy mense. Dit is net jammer dat die staatsamptenare jou so rond geneuk het. Ek sien uit om nog van jou stories te lees.

walt dandy said...
This comment has been removed by the author.
Bongi said...

walt dankie vir jou 'comment'. die woord is kliniese assistent in afrikaans en registrar in engels. ek dink dis resident in amerikaans.

ja ek is lief vir die land en sy mense. die geweld pla my baie. ek wonder of dit eendag my beurt sal wees om 'n koel deur die buik te vat en die gedagte is nie 'n lekker een nie.

by pretoria akademiese hospitaal het ek een naweek 17 skietwonde getel. 17 in drie dae!!! belaglik. ons is soortgelyk aan oorlogs dokters.

interesant genoeg is daar 'n neurochirurg by die staatshospitaal. hy is aangestel deur gauteng. dis goedkooper vir gauteng om 'n ou hier te sit as om al die gevalle oor te neem. hulle het nie 'n algemene chirurg nie. dis hoekom ek en my kollega dikwels daar gaan uithelp.

voel vry om enige tyd op my blog in te loer en nog 'comments' te maak.

walt dandy said...

I agree with Karen. I've noticed myself becoming increasingly cynical as I've progressed through training. I started bright eyed and idealistic, and now find myself convinced that the world is going to hell in a handbasket, and any difference that we make is such a tiny microdrop in the bucket. My cycles of cynicism are inversely proportional to the amount of sleep I've had though.

Charles Gramlich said...

Wow. No such thing as a happy ending here. No matter the outcome.

Anonymous said...

The post really summarize the irony of life. People bump into each others, some good, some bad, and in between, there is a grey area.

I totally understand when you explain you were curious to talk with the mother and to get to know your patient/ criminal's background. And I can imagine you surprise.

I'm glad you told this story. The good, the bad and the ugly in each of us is very sticking. Why some take the wrong path... is a mystery.

Anonymous said...

I love read your post, i will share my history too..