Two weekends ago, I received a call from Seno, the surgical resident
on call, who explained that he had admitted a patient with bilateral panga
(machete) wounds to both arms. “It was
pretty bad when we washed them in theatre, almost completely amputated on both
sides,” he said with less jocularity than is usual for Seno. Panga wounds from domestic conflicts are,
unfortunately, all too common in this part of Kenya, where firearms are illegal,
and sharp instruments are usually the weapons of choice. “We will take him back to theatre on Monday
for a second look,” I said.
When patients are attacked with a panga, they usually have
tell-tale “defensive” wounds; i.e. cuts on the forearms and hands when the
upper extremities are instinctively used to protect the more “necessary” parts
of the body, such as the face and chest.
However, when we examined the
patient in theatre, I noticed that his wounds were not the characteristic defensive
wounds we normally see, but rather higher up at the elbow, entirely identical
on both sides, and with multiple skin cuts at the same location. As the wounds were opened again, Seno’s
initial assessment was corroborated. Indeed,
both arms were nearly amputated, but thankfully with the brachial artery and
median nerve to both arms spared, which would mean some function if we were
able to save the arms from infection or other complications. As I contemplated the nature of these wounds, trying
to think like a medical forensic scientist, I said to the team, “These wounds
look more deliberate than normal…let’s investigate further tomorrow during
rounds.”
The next day, I had a meeting to attend, so Dr. Rowe
performed morning rounds, and when I reconnected later with him and the team, Glen
relayed the patient’s horrific story that he had discovered that morning. Apparently, the patient was captured by some
assailants (the details of course, obscured, as usual), tied at the wrists, and
with arms outstretched, had both elbows hacked with a panga, one at a time, in
the attempt to cut off both arms. “I wonder what he did?” I said out loud as I
tried to keep from imagining the sickening events of this scene.
I noticed that Glen was telling the story with slightly more
excitement than I would have expected. He
went on to explain that after the team listened to this patient’s story, he
shared with the young man about Jesus, who loved him despite anything he had
done or any events that had happened to him. “The patient gave his life to Christ right
then and there,” Glen said with the passion that I so appreciate in him. The next morning, the patient’s transformation
was completely evident, as he was no longer quiet and stoic, but rather
smiling, talking with other patients, and exhibiting joy that no solitary human
could muster with a story such as his.
The daily work at Tenwek carries with it a frequent absurdity
as we encounter patients with unbelievable stories such as this young man’s. Just a few days ago, I amputated the arm of
an 8 year old boy whose wrist was wrapped so tightly with leather (by a local “bone
setter”) that the entire arm became gangrenous.
Yesterday, while in casualty evaluating a patient, the nurses hurriedly
rushed a young girl of about 12 on a stretcher into the room for evaluation. She was covered with dirt, apparently buried alive,
and now cold and lifeless. She was the
age of my own daughters. Another man
beat his wife to death before catching himself on fire with diesel fuel. To be honest, the mixture of emotions that I
feel – anger, hopelessness, disbelief, numbness, etc. – when I encounter patients
such as these threatens to discourage and/or cause my heart to harden. But then, God reminds me that even though
circumstances may seem senseless, He is in control, blameless, and so able to
work all things together for good. After
all, His ways are above our ways, and His thoughts above our thoughts. So we continue to serve, believing (often
despite our feelings) that God is at work all around us here at Tenwek, even in the midst of the worst of circumstances, and that Jesus is the answer to what our
hearts truly long for… hope, healing, and forgiveness.
Thank you for your ongoing support of our family…your
prayers truly sustain us in our daily work at Tenwek!
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