30/01/2023
“Daktari”
“Daktari!”
“DAKTARI!”
The Casualty nurse was shouting at me, trying to draw my attention. I could see her fighting to hold her tears back. She was an experienced nurse, twenty years of work under her belt, but even she was shaken to the core. This was a scene of utter bloody mayhem. Stretchers strewn everywhere, patients gasping for breath, some screaming, some wriggling about, some very still. Some patients had fallen to the cold floor, where a pond of red with tributaries from the various stretchers was steadily forming.
An accident had happened and all the victims rushed to our hospital.
Health care workers we busy stopping bleeding wounds from screaming patients, stemming the lake of crimson from expanding around us. Right where I was standing there was a dried up pool of red, with cakes of clotted blood stuck on my shoes.
Moans, groans, wailings. ……Silence.
Then I saw him, lying still at the corner. His darting eyes the only sign of life. I quickly rushed to him and felt for his pulse. ….rapid and thready.
“Can I get some help here!” I was shouting as I picked his limb body from the floor and placed him on the stretcher.
I quickly checked him for any external injury and there was none, no bleeding at all. His belly however was distended and his palms pale. My years in training told me to suspect internal bleeding, my heart hoped it was not so. Dennis was barely six years old, his boyish face framed with girlish locks of hair,dark and lustrous. His chubby countenance contrasted with his present predicament. For a moment our eyes locked, and in that moment I felt his pain and despair, but more than that I felt his great determination to live. His eyes said so much, they had a depth to them that was truly unnerving, yet strangely warm.
I quickly drew some blood from his arms for grouping and cross match, I knew this little fellow would need transfusion, if he made it to surgery. I put up some intravenous fluids as I asked the nurse to rush the blood specimen to the laboratory. My mind completely shifted from everyone else in that casualty department, I felt that I needed desperately to save this little boy with the soul searching eyes. I was so happy that my colleague Dr. Mbuthia had checked in, I quickly briefed him and left him sorting the horrible scene as I pushed the trolley, wheeling the young fellow to the main theatre.
“This boy cannot withstand anaesthesia, he is in severe shock”
The anaesthetist was adamant, we could not put the young boy under until he got some better reading of his vitals. I knew he was right.
“But we will lose him for sure if we do nothing!”….I was shouting, now tired…desperate. I was not going to lose another little angel…. this was just too much for me to take. I had always struggled to deal with the death of children, still do.
“Where is the blood for transfusion?”, the anaesthetist was asking. My little guys eyes were now shut, his pulse feeble, barely palpable. I jumped out of theatre and ran to the blood transfusion Unit (BTU). It is not the doctor’s duty to get blood from BTU, but I was struggling to wait. I knew my little patient did not have much time left.
“Oh Lord help me”
The anaesthetist hooked up the blood transfusion line as I went to scrub up, quickly cleaning my hands and gowning up ready for surgery. The scrub nurse assisting was the oldest in our theatre, an experienced veteran in the world of open abdomens and squirting vessels. I was glad to have him with me. He handed me the scalpel after my customary prayer and I made a long incision on the little guy’s tummy. I noticed the incision was having very little bleeding, not a good sign.
“DOC STOP!” The anaesthetist suddenly shouted, “the patient has arrested!”
Those are the words a surgeon dreads to hear intra-op. In this case my little patient’s heart had stopped, finally giving up after such a long fight.
We abandoned the surgery and started aggressive resuscitation, no one was willing to give up. Ten minutes in and we had our heartbeat back. Muttering a prayer I got back into surgery.
I opened up the abdomen and found the cause of my little patient’s problems. His spleen, an organ found in the upper left quadrant of the abdomen was severely damaged. Blunt force trauma had left the spleen crushed and bleeding continuously, the little fellow was almost exsanguinated by this injury.
We had no option but to remove the spleen to control the heamorrhage, and the young fighter’s vital signs remained stable albeit barely through the rest of the procedure. I left the hospital after checking the boy into ICU, and as I drove home I kept hoping that I would find him awake the next morning.
I walked into the ICU the next day anxious. I found a young lady seated by the young boy’s bed. She held his hand in hers, stroking his palms softly. I could see a dry tearline that had formed on her face, creating a shallow gulley on her make up.
“Hello, my name is Dr. Dindi”
“Am Diana, This is my son Dennis”, that was all she said before she broke down, sobbing into her already wet handkerchief.
We are told not to get emotionally attached to our patients, but at that moment I felt my eyes moisten up, and I quickly turned away to look at the boy’s charts, and to compose myself.
“He is doing very well Diana”, I said, happy that the young fellows charts were telling me a great story.
As I slowly explained what we had done to Diana, I noticed that my little patient Dennis was waking up. He stirred and opened up those eyes, looking straight at me, deep and serene. This time I didn’t get an opportunity to compose myself. I let my tears flow as I reached out to hold his hands, happy that they were warm.
Dennis survived because we quickly made that diagnosis of internal bleeding.
Many marriages look great on the outside, but are hemorrhaging from the inside. ....dying a slow death punctuated by lack of respect and contempt.
Every lie told is a pint of blood lost. Every grudge kept another punch into the lifeline of the marriage.
That "innocent flirting" is draining the blood of your union.
If you dont recognize this in time as a couple you will soon find you have no more blood to sustain the life of your marriage. That's why people say, "We just grew Apart".
It's the small things folks.
Dennis didn't bleed externally, but internally he was losing all his blood.
Is your marriage dying a slow, quiet death?
Nothing melodramatic. ..no cheating but no warmth of love.
No Physical violence but emotionally beaten up to pulp.
Are you ok on the outside but hurt on the inside?
Take care of the little things, the thoughtfulness, the kind words, the helping hand......the listening ear. Those are the things that will stop the bleeding and bring your marriage back to life.
Over the next two weeks as Dennis recovered we became great friends, his personality warm and exuberant.
“I want to become a doctor when I grow up, just like you.”Those were the last words I heard from him when we finally discharged him. I remember watching him walk away held firmly by Diana.
“Your miracle boy” She said as he turned and gave me one last look with those eyes. I heard everything he didn’t say.
