"Your reason and your passion are the rudder and the sails of your seafaring soul." - Kahlil Gibran

Saturday 20 April 2013

Damn the torpedoes!















Damn the torpedoes, full speed ahead! - Admiral David J. Farragut

Flies have infiltrated the squeaky clean fortress that is theater. You'd be in the middle of a laparotomy, when, in your peripheral vision, you'd notice their slow, calculated circling. Every turn brings them closer to their ultimate goal: touch down in your open surgical field. The nurses zap them with lignocaine spray. This technique basically anaesthetises them in mid-flight and they spiral to the floor. We can't use Doom because of the potential toxic risk to the patients' tissue.

Theater is a supremely clean place. These filthy critters are, however, attracted to the smell of dead tissue which is unavoidable in a theater where wounds are debrided. If they can find a way in they will penetrate the ranks. We think they're entering through the air-conditioning system.

There has been ongoing lamentation in theater about how unhygienic and completely unacceptable it is to have flies in a theater. If any of our patients should develop a maggot-infested wound post elective surgery, it would naturally be as a result of the resident flies.

The other day, theater staff were once again complaining about how nothing is being done about the flies. One of the senior members of the theater complement was saying that someone needs to inform the hospital's top management. He would not be that person though because bonus time was coming up and if he were to report the fly problem he'd be seen as a trouble maker and would not be considered for a bonus.

The first and most blaring question is why hospital management would consider recognising the obvious truth, that there are flies in theater, and the reporting of it to the authorities, who can bring in people to clean out the aircon vents and solve the problem, as making trouble. Ignoring the problem does not make it disappear. Saving the hospital from potential law suits once patients do develop wound sepsis by the pre-emptive management of the problem is surely the only correct procedure to follow.

Whether the particular doctor had an accurate view of the hazards he would face if reporting the situation, I cannot say. It only makes sense to assume that he spoke from previous experience of dealing with "the system".

Everything about being a doctor tests our commitment to putting our patient' needs above our own. Working 30 hour shifts without sleep because there are patients who need our help is an obvious example. If we are not prepared to be advocates for our patients, who will be? The system may support ducking our heads and smoothing over the creases but being a darling of the system doesn't make you sleep at night. 

Thank you to the man who has stuck his neck out for that which he believes to be right. Thank you to every person who has fought for a society that advocates freedom: freedom to health care, freedom from persecution, freedom of expression.




1 comment:

  1. Wahahahaha lignocaine spray... brilliant!!! I had a good chuckle with that one. I'm going to use it on the next bloody cockroach the cat decides to bring home as a gift; we try very hard not to use bug spray as we worry about our kitty and doggy babies. And the stuff makes me wheeze. (I might do a randomized controlled trial of bupivacaine vs. lignocaine, being an anaesthetist...

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