I know many people turn to alcohol or drugs, or adventure sports, to get that elusive feel-good factor in their lives, but I’m fortunate enough to be able to get it from my job. Working as a surgeon here at Kiwoko Hospital, Uganda, provides many opportunities for frustration and tiredness, but at the same time, there are often priceless moments when you know you’ve done a good job, and someone’s life has been changed as a result! What a privilege.
Two patients over the last couple of days have delighted me in this way. The first was on Friday afternoon - a Musee (Elderly Gentleman) was admitted with a story of two weeks of a tender swelling in his abdomen next to his liver. He had been seen the previous weekend and ultrasound by one of my colleagues had suggested a liver abscess, for which he had had some pus removed with a syringe, and had been placed on antibiotics. He had not improved, and had come back. I decided to operate so that I could drain the abscess and place a drain for irrigation, but when I opened his abdomen I found that the problem was actually a very inflamed gallbladder, with an adjacent abscess. It was a simple matter to remove the problem gallbladder and wash everything out, and I expect that he will be on his way home in a couple of days. It was great to do an old-fashioned general surgical operation, and the procedure was quick and straightforward. I removed over 130 gallbladders last year, but this was my first in Africa, and the theatre staff had not seen such an operation before.
The second patient was this lunchtime. A Ssebo (man) was admitted with half of his lower lip missing – his “friend” had bitten it off while both were drunk last night! I wasn’t sure how to replace the missing tissue, but hoped to be able to make a skin flap of some description. I was pleased to discover that he had such large lips (common in Ugandans!), that I was able to trim the edges of the defect and close the gap without difficulty. The end result was a neat line of sutures below the lower lip, and he was able to go home later this afternoon.
I’m sure that the feeling of taking a patient with an illness or injury, being able to do something to help in a practical way, and ending with a successful, aesthetic result, is one of the main reasons that I’m a surgeon. If you could bottle the sense of achievement gained, I’m sure I’d be a millionaire by now. Its funny – I’ve often said, ever since I started working as a doctor, that I enjoyed what I do day to day so much that getting paid for doing it was a bonus! Well, I’m putting it to the test this year – I don’t get paid a salary for working here in Uganda!
Having said that, I had a nice weekend away from Kiwoko last weekend. I ended up in Jinja at the Source of the Nile on Lake Victoria for the night on Saturday before dropping a visitor back to the airport on Sunday night. It was relaxing to go to a really decent, and cheap, restaurant, have a couple of nights sleep away from the possibility of being called to operate, and enjoy both the company of friends and some peace and quiet! Its important to remember to take time out to rest, and that can be forgotten easily when you live and work in the same place. I’m looking forward now to the beginning of July – I’m taking a couple of weeks holiday to go on safari, see various parts of the Ugandan countryside, and catch some adrenaline going white water rafting on the Nile. I think I’m about due a break!
No gross medical pictures this week. The child above is one of our adoptive Ugandan family who came to lunch with Rory and myself last Saturday. I don’t know what he was meaning by this pose, but it’s a cute photo!
Steve
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