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Something interesting I learnt in the operating room…a deliberate twist of fate.

Authors: Enoch Toluwani Owolabi; 5th year Medical Student; Obafemi Awolowo University Teaching Hospital Complex; Ile-Ife, Osun State; Nigeria; Twitter: @OwolabiEnoch1

The feeling brought a flash of nostalgia as I pushed through the doors, realizing it had been two years since I last set foot into the operating theatre. Taking a deep breath, I filled my lungs with the chilling air mixed with antiseptic. My immediate alarm was evident from the scowl on the consultant surgeon’s face, peering through his mask. His piercing gaze sent a surge of adrenaline through me, causing the hairs on my body to stand on end. The bustling scene unfolded before me: intern doctors hurrying to ensure everything was in place, perioperative nurses exchanging medical jargon with the resident doctors, and the absent-minded anaesthetist occasionally checking her iPhone, ensuring equilibrium. They all continued their work, oblivious to the student’s presence. Once I successfully appeased the surgeon’s gaze, I embarked on witnessing the ongoing procedure.

The day’s surgical procedure aimed to stage ovarian cancer in a 65-year-old woman through a diagnostic laparotomy. It was evident that the cancer had advanced well beyond Stage 1, given the presence of ascites. Initially, I doubted the value of such an intricate diagnostic procedure, feeling that the patient needed therapy rather than an elaborate examination. Confined to the ward, the woman was on a compulsory fast due to discomfort while eating. Her state could make even the most hardened human shed a tear. Unfortunately, urgent care in Nigeria is an echo of history.

Nigeria’s healthcare system is notorious for its challenges, known to both medical practitioners and the general public as a daunting mountain to climb. Those needing emergency intervention often face hours of waiting before receiving help. Many prefer to seek solace in prayer clinics or turn to herbalists, discouraged by their faith in conventional institutions. Consequently, patients arrive at hospitals as their last resort, carrying a tinge of negative sentiment. It is no wonder that surgeries of such high calibre are hard to come by. The patient scheduled for surgery was already weak, clinging to whatever fragment of strength she had left.

By the time I could observe, the doctors had begun draining fluid from the woman’s abdomen. The volume of fluid collected was enough to fill an 8-litre container, providing insight into her constant discomfort. My inexperienced mind struggled to comprehend how an elderly woman’s fragile biology could accommodate such a surplus of fluid. At that moment, an intern doctor whispered into my ears, “At least she’ll be able to eat.” It felt like a divine revelation, a Eureka moment, realizing that this diagnostic procedure also provided some therapeutic relief. I couldn’t help but admire the ingenuity of the surgeons, who, despite the challenges and patient superstitions, found a way to show empathy through their craft.


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