“Just how violent can a relative be towards another?” 

“Just how cruel can a human being be towards another?” 

You will end up asking yourself these questions (reader discretion advised!)

For now, brace up and let’s roll, shall you?

I must have met him during one of those quick morning rounds when I review the patients who have been admitted overnight.

Almost every part of his body was bruised. 

This is the profile of injuries that present to me following road traffic accidents, mostly motorbike related. His was different though. 

At the first review I concentrated on looking out for any life threatening injuries in the airway, neck, chest, blood circulation system or the brain. We call them the ABCDs or primary survey in trauma care. 

The casualty in this abbreviated review is usually the fine details about the injury event. Especially if they are social. 

My team of medical officer and clinical interns had the details. But all I needed to hear was “assault by people known to him” under the “mechanism of injury”. The rest of the fine detail remained with them and the documents. 

After all, there was a cervical spine that needed clearance of any injury. Having gone through the ABCDs, we looked at his priority Imaging scans. He bore the brunt of multiple fractures. 

Later on I would slowly go through the file again, checking his next of kin, location, social status etc. 

There was a piece of land in dispute. Obviously it has to be small (or the only one) for people to give it this life and death status. An acre at most, he would tell me later. 

His ‘inheritance’ of that piece was contested. I do not know how or why. But what came up is that on this particular morning, his life was put under threat by his blood sister and father. 

The former held a spade, the latter a sharp panga. With the spade blow aimed for his head, he lifted his right arm to fend off the attack. He could only manage the first blow, but not without suffering a break in his arm, just below the shoulder contour. That meant he could not shelter his head from the next swing of the spade, which caught his right side tearing his scalp and sending him to the ground unconscious. 

In the meantime, the sister, who probably was shorter, settled for the leg. The first blow got his ankle, hacking it and leaving the foot badly damaged. There were several other blows, and the panga must have been sharp going by the aftermath that was evident on the sheen bone. We call it mangled extremity in trauma.

He lay there crippled, several days after a number of trips to theatre. 

All I could ask was, how big was this piece of land again? 

Well, I did not verify the other side of the story. As the saying goes, there is always another side of the story. But, does that side matter now?

Life over Limb

His foot had to be amputated. Right through that initial deep panga cut that had left it unsalvageable. Then there was infection to handle. Some fractures were splinted awaiting definitive surgery. Others were temporarily held with pins and wires in a ‘damage control’ strategy.

It was a clear case of life over limb! The organism will live to fight another day, albeit without some organs. 

I felt triggered to discuss this case with the clinical intern the next morning. I asked for some reading around and some explorative social history.

“For now I have to rush to the surgical clinic,” I announced.

The clinical intern then came up with a thematic request. He needed an off the next day to attend to a family land case. Some step brothers were up against his inheritance too. Whether the urgency and acuity of the matter was heightened by the patient before us, I cannot tell.

“Okay. Please make sure you avoid violent confrontation.” At least he did.

Again I ask, just how violent can one relative turn against the other?