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The Tattoo and the Bruised Face

“He disappeared as soon as he had appeared”- this is a quote I have read somewhere but cannot recall where. 

But the one I write about today did not leave that quickly. He stayed around a little longer. Even when he was discharged he still reappeared in my afternoon clinic. Tall lanky and limping. With a walking aid. All the different. 

Securing the Airway

I first met him in the trauma room. 

“There is a patient for your review in casualty,” the nurse had reported. 

I made my way there, excruciating exhaustion threatening to take the better of me. It was one of those days,13 straight hours of operating. 

“Sasa”! I said that word to several people enroute. 

He was among a group of others involved in an accident. 

He had suffered injuries around the face that put his breathing at risk. The anaesthesia team were at hand slide a breathing tune down his throat. 

We call it ‘securing the airway’. If you do not eat you die in days, if you can’t breath you die right now. Never joke with the airway. 

At that moment I was not aware that it was not the patient I had actually been called to review. It was a worse off patient in the next bed. I sped off to theatre, having assessed his injury profile and briefed his family about the outcome. 

When I came to the wards the next day, this gentleman was in the intensive care unit. He still had his tube down his throat, connected to the breathing machine. 

His face was so swollen from the injuries two people could not part his eyelids.  He would get out of the breathing machine in a day or so, we concluded. 

And get out of the machine he did. I met him on a Monday in that notorious surgical cube. You remember the one with the conniving head injured patients? The ones who keep mum when I tell them ‘sasa’ but are quite to answer questions directed at their neighbors?

A Resembling Tattoo

At this time, the swelling had come down significantly. He had also pulled down his hospital gown significantly to bare his upper chest and arms. 

From his left arm I could decipher a tattoo. It is an impression of a person’s head, ordinarily the tattoo could have appeared more rounded and chubbier than the real face of the bearer. Then came the accident and all the facial injuries and swelling and now the real head dares totally resemble the tattoo. The outline for the cheeks, the middle strokes resembling the scratches and lacerations. A coincidence of chaos. 

“The maxillofacial surgeon will schedule his surgery this week”, my team updates me. He has ankle fractures and head injury which have been addressed.  Now his facial bones need to be realigned with some plates and screws. Off we go to the next cubicle. 

He came back to the clinic. The swelling all gone down. The semblance between his head and his arm tattoo no longer there. But now he got a new tattoo. The scars born out of surgery and injury. The signature of every incision and ligation by the surgeons. They are his new tattoos. Exposed for all and sundry. He does not need to pull down his shirt or bare his arm for all to see. 

He struggles through a smile. The scars are a little thick around the angle of the mouth. 

“That is an ephemeral stage, you will get back to your perfect self soon,” I reassure. Surgeons do not just sow tissues. We sow hope. 

Out he goes. Tall, lanky and limping. With a walking aid.

About the Author

Dr. Stanley Aruyaru

Dr. Aruyaru is a Consultant General and Laparoscopic Surgeon and a Healthcare Manager. He has solid experience in managing busy surgical units and leading clinical teams to deliver in the lines of quality health provision and evidence based surgical practice.

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Expect nothing, live frugally on surprise. - Alice Walker

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