Incision
Ministerial Meandering
Incision
The plastic doors slap behind me and the first thing I notice is that the walls and floor are damp or wet. Given all that goes on in this place, they have to be washed often, as they are frequently marked with blood and dirt. And then there’s the smell - and then the cold.
I am in the Johannesburg morgue, where row upon row of fridges contain the bodies of the deceased, and the overflow are laid out in a huge area, containing ten tables with more bodies - the majority of whom were the victims of last night’s violence. Not many will ever be identified, as they have been on the streets for years. My job is to select - with the help of the pathologist - those bodies that I can use for teaching safe surgical approaches to access the different parts of the body, which may have been injured by trauma. I am not alone in this; there is a small faculty of 4 trauma surgeons to assist me, and we will each take a table with its body, and demonstrate the surgical techniques to senior surgeons who are not familiar with treating victims of violence.
In order for this to be of any value to my pathologist colleague, I have also to try and ascertain the reason why the body I am dissecting died; not all of them died of wounds. Some are wasted by malnutrition, tuberculosis, AIDS, alcohol, and cancer. Others are bloated from congestive cardiac failure, liver failure - or have been waiting too long for their turn on the table, and the gases in their intestines have expanded. I don’t want to open those abdomens.
It is a bizarre venue and ambience to be teaching the intricacies of trauma surgery, but a highly privileged one. There is no substitute for operating on the human body in training, and before you have to deal with one that is still alive. One other major difference is the tools I need. They are significantly different from those of the pathologist. My friend, the Professor of Pathology, is a lady - and her instruments would look positively gross and outsized in an Operating Room. Her ‘opening’ scalpel looks something like a knife I would use to carve a side of beef (with only slight exaggeration), whereas my usual scalpel is one I hold like a pencil - though smaller - and I would be even more gentle. I see my work as art; I see hers as destruction. We agree to differ - and remain good friends. Probably because I need to use her ‘carving knives’ on occasion, which makes her smile.
I finish a 4-hour session of teaching, and admit to Jeanine (my pathologist friend) that I had to use one of her knives to find cause of death in one of my allotted bodies. My first was obvious - he had been in an argument with a taxi – a VW microbus with - usually - a drunk driver; the bottle of ‘coke’ he has at his hand is usually 90% cane spirit. The patient had arrived in the ER in ‘kit form’ - a bag of bones, but none in the right place or joined up any more.. His head and neck were intact though, so adequate for demonstrating vascular access to the major vessels from heart to brain and into the arms.
I used her carving knife for my second body; I needed to open his chest to find the culprit. There was a massive cancer in his lung, with lymph nodes filling the centre of his chest.
My career has not been one most people would jump at with enthusiasm, but in terms of a legacy, I hope what I have learned myself, I have been able to pass on. In that way, I hope more people will now survive the brutality of trauma than might otherwise have done.
In the same way, now - as a minister - I hope more people will come to find life in Jesus Christ - through our church, than might otherwise have done. ‘Life in His Name.’
Philip+