Well, if I am going to have a crash, this is the one to have. My computer crashed a while back and I have had to work at restoring my memory. It is amazing what you can forget when you store it in places that are not your brain. It is not like nothing has been happening. So much has happened. Here is something I wrote a couple weeks ago.
I cut a man’s hand off today. Well, at least what was left of it. It had been cut off by a helicopter tail rotor only days before up at Garamba Park. One of the park’s rangers, Dieu Donne, would have walked right into the swinging blades if the wind had not blown his hat off, causing him to reach up to catch it. The blade hit him at least twice, taking all his fingers and most of his hand off with the first blade and hitting his arm, shattering the ulna bone with the next. A big section of the bone was just missing. He was taken to the hospital in Dungu to get blood and they sewed up the arm, as it looked too terrible to them to leave open. Then he was moved to Bunia to the UN hospital, but when they found out he was not a soldier they would not treat him and, a day later, he was moved to our hospital in Nyankunde. The wound on the arm had now become infected from being closed before being cleaned up properly. It was a mess, but now it was going to be fixed. I asked Dr. Mike if I could watch or assist in any way and he said yes. I was excited as I had not been in theater since Zimbabwe days when I flew Matableland Flying Doctors Service and I’ve been quite missing it.
As Dr. Warren stuck the needle into the nerve bundle above Dieu Donne’s collar bone to block the pain to the arm, I watched on the ultrasound as it entered into the bundle and came to within a few millimeters of the carotid artery. I looked over at our patient who looked on like he was watching a TV show at home on the couch and thought, “Man, this should be hurting more than that”. I asked Dr. Warren….”Does this not hurt that much or is this guy just really tough?” The doctor said “No, this guy is a real stud.” I guess chasing down Sudanese poachers around the bush in the hot African sun for years as they shoot at you and throw grenades makes you pretty hard. And this guy was said to be their best. Through the whole procedure he was stoic and tough as nails. Dr Warren had another operation so we moved to the theater and when Dr. Mike started taking off the bandage that covered the wound the smell of infection was obvious. The hand cut was clean but the arm was not so nice. There was plenty of skin to make a good flap to cover the opening we would leave from removing the arm about half way between the elbow and the wrist. It had to be done. I watched Dr. Mike start getting scrubbed up and he explained how to put on gloves to stay sterile. He did it with ease and said, “There are gloves for you. Put them on like I did. “ I got scrubbed and gloved like he said and then suited up. I even wore scrubs! Blood has always seemed a bit like hydraulic fluid to me and I am just not squeamish when it comes to anything in the operating room. That is nice. And much of orthopedic surgery is like carpentry or working on the plane for me. Being an aircraft mechanic requires schooling in woodworking, sheet metal, welding, hydraulics (plumbing), basically repairing things of all types of materials. We even do sewing in our Dope and Fabric courses to work on mostly older types of planes. But,though we don’t get a lot of info on the human body, still many principles apply.
We worked for what seemed like a couple of hours. Mike saved as much as he could but cut away the damaged flesh and removed muscle from bone and cleaned everything back to where the arm had been sliced through with the tail rotor until finally the bone was ready to cut. Then he looked up and handed me the wire saw and asked if I would like to do the honors. I could not pass up the opportunity. It is like many times in life where I hate to see things like this happen but if it has to happen, I want to be the one to do it. I have felt like that sometimes when an elephant has killed a person…. maybe with good cause, at least in his eyes. But it can’t pass without consequence or it continues to happen and I have been called to shoot the offending elephant. If it has to be done, it is a great adventure and I am happy to be the one who carries out the task.
We got everything ready to close and took the tourniquet off and blood sprayed all over Mikes shirt out of an artery that had not sealed well when we cauterized . He stiffened but skillfully found the bleeder and I dabbed up blood as the good doctor tied it off. I held the arm while Mike closed the flap of skin over the cut area and sewed it neatly up.
Later that night as Cher and I were relaxing, I turned to her and said, “Cher, I cut a man’s arm off today!” It was quite unbelievable.