Acute appendicitis

The first time I made a working diagnosis of acute appendicitis was in third year, a week after I had read the topic. I remember this topic better than any other surgical topic, not because I am a surgical geek, but because of the events surrounding my diagnosis on that particular day.

There was this evening I found myself at the casualty. It was during that time of the year when the sun was blazing hot all the way to dusk. I was not of the idea of learning medicine that evening but I forced myself to go anyway.

The casualty was not unusually busy. The sweltering smell of blood never seems to change. It has been like that since I started school. A few injured people lay helplessly on their stretchers waiting for their turn to be served. I got into one of the consultation rooms and made myself busy looking at the patients’ files to find a good case for revision. I love cardiology cases. I love listening to diseased hearts.  It does not mean that I love when people have sick hearts. People will be sick anyway.

There was this beautiful girl who was brought in by the mum and dad. Her dad was so stressed about her illness that he left almost immediately. I guess he went to drink it down. I don’t remember the name of that girl but at least I remember she was from The University of Nairobi, school of law, second year. She was Luo and she was beautiful. You know those kind of ladies that you would look at and tell God, ‘God, this is good’, yes, she was one of those ones. She looked rich, I wondered what the hell they were doing in a public hospital. Shit happens.

From her history, ruptured ectopic pregnancy and acute appendicitis were high on top of our list. A pregnancy test done before indicated negative, so we remained with acute appendicitis as our most likely diagnosis. I did pretty well examining her abdomen. I loved the whole process. I picked even the minor details that I usually don’t pick in exams. The doctor in charge was happy but I could see he sensed some overenthusiasm in me and moved closer. He took charge and pushed his stethoscope behind her blouse and listened briskly to her heart sounds. Her breasts stood protuberantly on her chest; a sight that every man beholds. He looked like he want to listen to her heart the whole day. Save for the emergency of acute appendicitis, he would have done it. After he was done, I put on my stethoscope and as I was moving my hands under her blouse in the same manner he did, he slid my hands off, gently though, not to raise any alarm. I knew he did not find anything significant, he saw me as a potential threat to scarce resources that nature gives. To console me he simply said, ‘S1, S2 normal’. I didn’t care whether they were normal or not, I wanted to hear them myself. Like hearing is believing. This guy, I mean this doctor who was meant to teach me was out to sabotage my learning.

My ego was bruised. I felt dejected. This was the closest I had come to getting a learned friend. Don’t ask me how. Where there is a will, there is a way. And that moment passed, I moved on as I have always done. She went to theatre almost immediately, the inflamed appendix had to come out. I found no need of staying behind with a man who would take meat from my mouth when I am just about to bite. It doesn’t make sense. Given another chance, he would do it again and again. So I left.

 

Author: Dr. Kiaye Oliver

I am a dreamer. I love medicine. She is generous. I am also in love with literature, she makes me see the world the way I want to and sometimes the way it is.

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