'Yes, your daughter has a Patent Ductus Arteriosus(PDA).' “What’s that”,
muttered the anxious Mum. It is a heart defect a child is born with and now
that your child is 13 more technically challenging to close. Imagine having a
big tank with two pipes taking water out of it, and connecting these two pipes
abnormally is another pipe. This abnormal pipe – the PDA takes blood from one
heavily big pipe (the aorta) to the other(the pulmonary artery). Now you know
the danger? The heart has got to do extra work. “Extra work”? Yes, the heart
has to pump more volume through the normal and abnormal paths. This nice
looking girl needs surgery.
"Surgery!" Yes, surgery to separate the pipes or close the abnormal connection. We will be opening the chest, have a look at the heart. Set free the unwanted pipe and close it forever. “Hmm….” . ‘O̩ló̩run á fún yín se’(God will be there with you). The trainee in the same room smiled with the corner of his mouth. Here is the straightforward one. I must be allowed to do this. The master ponders; this is an unusual PDA, big with more pressure in the lungs. Yet we must train the future generation. Here comes the morning of surgery, the messengers of sleep has put the patient to a sleeping state. All set! "We have positioned the child sir." "No problem, please go on…….." The trainee has read the big books, and has assisted the master several times; this is a day to shine.
To shine? It’s a day to respect, fervent in prayer,
meticulous in action, reticent in words. No, not for a trainee – chest opened with glee and surgery pursued like a lady to be won by all means. Does a man in love thinks about caution? Or have you seen a man toasting a lady watching out for missteps? No, the trainee often resembles the exuberant toaster. Here is the PDA – the pipe has been exposed with little effort. Wow… finally in charge he mused to himself. "Be careful, pay attention echoes the master in the background. Maybe I should just scrub in?" ‘Oh here comes this overbearing man again.
meticulous in action, reticent in words. No, not for a trainee – chest opened with glee and surgery pursued like a lady to be won by all means. Does a man in love thinks about caution? Or have you seen a man toasting a lady watching out for missteps? No, the trainee often resembles the exuberant toaster. Here is the PDA – the pipe has been exposed with little effort. Wow… finally in charge he mused to himself. "Be careful, pay attention echoes the master in the background. Maybe I should just scrub in?" ‘Oh here comes this overbearing man again.
Must he do everything?
Let’s move faster and tie this thing up before he comes.’ Hand washing done and
the master about to don the theatre gown. “Sorry sir, we have a problem.” “Hey
what’s that?” “As we were trying to go around the pipe something popped and all
we see is bleeding!” Bleeding!… Ah surgery changed; today is gone again. A life
must be saved. Now the big pipes are pouring and our big tank is emptying. Not water this time around but abundant blood from the heart. How do we go ahead? Shouting or barrage of accusations never
solves this kind of problem. This yam has to be re-pounded while the 'Ẹ̀gúsí' soup need to be redone. However, unlike Egusi and pounded
yam; the current situation is not palatable. Life at stake, careers threatened and integrity at the mercy of murmuring men and women! Apply pressure, yeah clamps there! Give blood and plasma….. Bleeding continue unabated. Let’s try another approach…. Sensing danger students left the theatre one by one. The life of a surgeon - on his own when the going gets tough. Minutes going, hours spent.... 90 minutes surgery transformed to 3 and a half hours. We seem to be in control and the sewing actions continue after an anxious separation of pipes and multiple clamping. Sewing done, bleeding stopping, stopped! Child woken up, full recovery, talking and smiling. Big relief all round! We can’t ascribe this life saved to ourselves – God has used the pencils we are; to draw another miraculous picture. Science or art?
must be saved. Now the big pipes are pouring and our big tank is emptying. Not water this time around but abundant blood from the heart. How do we go ahead? Shouting or barrage of accusations never
solves this kind of problem. This yam has to be re-pounded while the 'Ẹ̀gúsí' soup need to be redone. However, unlike Egusi and pounded
yam; the current situation is not palatable. Life at stake, careers threatened and integrity at the mercy of murmuring men and women! Apply pressure, yeah clamps there! Give blood and plasma….. Bleeding continue unabated. Let’s try another approach…. Sensing danger students left the theatre one by one. The life of a surgeon - on his own when the going gets tough. Minutes going, hours spent.... 90 minutes surgery transformed to 3 and a half hours. We seem to be in control and the sewing actions continue after an anxious separation of pipes and multiple clamping. Sewing done, bleeding stopping, stopped! Child woken up, full recovery, talking and smiling. Big relief all round! We can’t ascribe this life saved to ourselves – God has used the pencils we are; to draw another miraculous picture. Science or art?
Hmm…. Surgery
is not only a science. The science is surely in the books, tidy, neatly explained
and convincing as an ‘I do’ from a joyous bride! However, the art supersedes
the science for we must do! Carrying out the operation, akin to living with
women after marriage; is surely an art. Holding or caressing the instruments,
navigating around threatening
structures enclosing the soul and the fluid of life. Yet training must go on, the torch must be passed on, for as marriage gives rise to new
babies to repopulate the world, does training ensure the continuous sufficient stream of surgeons. The question persists: how do we
superimpose the art upon a solid scientific base for our exuberant trainee?
structures enclosing the soul and the fluid of life. Yet training must go on, the torch must be passed on, for as marriage gives rise to new
babies to repopulate the world, does training ensure the continuous sufficient stream of surgeons. The question persists: how do we
superimpose the art upon a solid scientific base for our exuberant trainee?
That is the
riddle – doing, training, imparting, saving and continuing.
We remain humble.
We remain humble.
DR MUDASIRU
ADEBAYO SALAMI,
Consultant, Cardio-thoracic Surgeon,
Department 0f Surgery,
University
College Hospital,
Queen Elizabeth
way, Ibadan,
Nigeria.
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