For many times in my life I have believed that there was an essence to prayer and that prayer works. Some experiences in the past year since I started practicing medicine have however at times thrown some sprouts of doubts about the same. It is at times thought provoking to see a mother realize her baby is walking on the edge of death, being resuscitated by doctors, and her earnest prayer in her most vulnerable time of need is met with the very worst outcome she willed against with her prayers. Deep within, as a doctor, whiles running helter-skelter, with inestimable rushes and flashes of neuronal activity, attempting to save a life, the part of you that acts on faith will be praying for the best for this life, and it is at times very disappointing as well, though the profession makes you not show such when the unfortunate ensues.
Another duty day at the accident and emergency center, Volta regional Hospital. “Doc, are you the surgical house officer on duty? Please there is a call for you.”
“Hello. This is Dr. Benyin-Mensah, Volta regional hospital, accident and emergency, surgical unit. Please who am I speaking with? The voice on the other side of the connection also made a good introduction and went ahead with her intent for the call. “I am calling from Hohoe Municipal Hospital, surgical department. Please we have a case of a 32year old who presented with duodenal perforation which we repaired but we are thinking the repair will break down. We therefore want to refer to you for further management.” Not the best of news I had wanted for the day. Especially knowing it was our elective surgery day and my bosses were in the operating theatre, for which reaching them was going to be a bit herculean.
“Please, is the patient stable for referral?” I asked inquisitively, knowing very well how the referring hospitals can at times be furtive with the information they provide before referring a client. “the vitals are all stable and the patient is not oxygen dependent currently.” She replied confidently.
“Alright, my boss is currently not available, let me get in touch with him and I will get back to you with what he says. Thank you.” My exact words.
Upon discussion, with my boss, he gave the confirmation that the case could be sent. The 12hour duty for the day ended at 8:00pm without a hint of the client anywhere near the facility. Passing through the A&E the next day, I saw a man on intranasal oxygen in one of the cubicles with a plaster patch on the abdomen. Then I remembered the case that had been called earlier.
“Charlie, Nketiah, wey case this” I asked a colleague Dr. who was in the same team as mine. “ohh… some referral bi oo…from Hohoe…dem say them call…be like the guy get some perf wey them repair but dem dey fear say the thing go perf again so dem refer come say make we monitor see.” The usual pidgin dialect we spoke. “Ooh ok…so why he dey on oxygen then?” as he come na ein SPO2 dey low so I take am put oxygen top… the bosses no see yet” “ok… all the best then, I dey go do my reviews for the ward.” I responded as I took leave of him.
Fast forward, two days after and I was on duty. My boss required that he be sent to theatre for a re-laparotomy and repair of bowel perforation. The content of the discharge on the wound dressing showed very well he had had another bowel perforation. It had now become my duty to prepare him for theatre. After going through the process of counselling the relatives and getting all processes due and ready for the client to be sent to theatre, I came across one of the very phenomenal things. All the relatives, about four of them, had knelt down around this man, laid hands on him and were rendering fervent prayers unto the heavens. Then he opened his eyes and asked me, “Am I going to make it”. One of the most challenging questions I’ve always had to deal with. All I could say was “God is in control. You are in safe hands”
Later in the day, I passed by the theatre when my duty was over to check up on the case and they were almost at the end of it. A posterior duodenal perforation which was repaired had re-perforated again. So I wrote the operation notes.
Post-op day three, naïve as I was, client reviewed, Nasogastric tube had drained nothing over the past 24 hours and but had passed stools and was looking generally improved with a clean wound. Client had been nil per os for the past fifteen days. The order was simple, NG tube out, start graded oral sips, continue on other medications, keep abdominal drain in-situ, remove urethral catheter. Only on the next day did I realize the havoc caused the day before.
Examining the amount of fluid emptied from the abdominal drain and the content confirmed the earlier stated. All things were pointing out to another perforation. My boss came in, I told him about it, and we all sensed the difficulty ahead. Some very terrible days I had, bearing the guilt of having given a plan that might have rather gone wayward. So… a few days after, I had left general surgery, the client needed another laparotomy. Now I couldn’t even give the procedure a name.
It was an evening on that Tuesday, I had closed from the urology clinic, the call came in from Dr. White. “Charlie, we dey come start the case. Boss say make you come theatre rydee”. Tired as I was, I knew there was a responsibility to be at the theatre.
Getting to the theatre, the sleep on my will was apparent from miles away, there they were, client on table in supine position, surgeon and assistant in place with scrub nurse busily about their business. Intra op findings showed some adhesions actively ongoing which needed strategic removal. Nothing in the abdomen showed that the area repaired previously had perforated again. But leaving it like that without any intervention was not an option either. The crossroads had been reached with little known to be done as my boss stated.
My faith was called to test. The next moment, I found myself in one corner of the theatre, speaking in the language of the spirit. Immediately, the way was made. A divine area fresh and free of any the inflammatory process that had encroached on all areas of the abdomen was discovered together with the area of leakage. The plan and way to go was a gastrojejenostomy with a repair of perforation. This was carried out and patient was sent back to the ward. Once in a while, pull over at the ward on which the client was to have a peep at him. He had been kept nil per os for days only the spirit could tell. I asked him if he was feeling hungry. His response was splendid, “I don’t feel hungry anymore. I know I am getting better and whatever you guys are doing for me is working, I feel like I can go without food forever” at that point, I could see light.
Fast-forward some days after, I asked Dr. White about how he was doing and his response “oh… he’s fine. The abdominal drain fell off on its own. He is currently passing stools and on normal diet. His abdomen is still as flat as it had been.
So this client, had in two weeks, undergone three laparotomies on account of one of the most difficult surgical abdominal emergencies to manage. Whatever the negative lot was, he had survived it. One thing I always noticed about him and his family was prayer and love. The two greatest things I think. His wife and brother with him and willing to do all they could in prayer and in kind to save his life.
Only one thought lingers … when men pray… there is a release of the impossible.
GLORY IS TO GOD