WHY ORTHOPAEDIC SURGEONS IN NIGERIA ARE RENOWNED FOR AMPUTATING LIMBS By Alamu Olubola

An orthopaedic surgeon was speaking with some of my colleagues and me earlier today, and though it was a different topic entirely, in the course of the discussion, we mentioned in passing how orthopaedic surgeons are said to be fond of cutting people’s limbs off. You have probably heard it, or even told someone who had a fall or some sort of trauma to a limb not to go to the hospital. It is better for them to go to a traditional bone setter, you say. A traditional bone setter will save your limb, but an orthopaedic surgeon will yank it off. As we laughed over that today, my mind quickly travelled back to my first posting in surgery, settling on a sad incident involving a then eight-year-old boy, whom I will just call Ola; that’s not his real name.

(A quick explanation before I proceed: upper limb is that part of the body from the shoulder to the fingertips.)

It must have been 5 p.m. or so, and my firm had emergency call duty that day; so there I was, trying to learn as much as possible and to be of help even though I was as green as grass in spring. That was when Ola came in, brought by his mother and a relative. His case wasn’t the typical emergency with someone yelling in pain, blood oozing out of everywhere, and everyone running helter skelter. He lay calmly on the couch, actively taking in everything that was happening around him, and if you were only observing with your eyes and focussing only on his face, you would wonder what he was doing in the accident and emergency unit. But if you were observing with your nose too, a terrible odour would soon have your eyes darting around to find what was smelling so, and your eyes would soon find the culprit: Ola’s left forearm was decaying.

So, this was the story. About a week earlier, Ola, being a healthy, rambunctious boy, was playing a bit roughly. He jumped from a wall that was about four blocks high, in a building that was being constructed near his house. As he fell, he landed on his left elbow, and soon enough, he had some swelling and found it painful to move that part of his body. Kind neighbours quickly came to his mother’s aid, telling her to rub mentholated ointment on the forearm and take the boy to a traditional bone setter. “Don’t take him to the hospital o”, they warned. “All that those doctors ever want to do is maim people”.

The worried mother listened to their advice and Ola soon returned home with a tight bandage round his forearm, as well as some drugs. Just as predicted, within a couple of days, the pain was gone. And why not? Dead things don’t feel pain. But as time went on with the bandage still in place, Ola’s mother became concerned. Ola truly wasn’t feeling pain, but he wasn’t feeling anything else either. He also couldn’t use that limb for anything. The worst part: the limb was smelling badly, the fingers had already become black, the flesh below the elbow was breaking down and brownish fluid was coming out. Even his mother covered her nose with the edge of her wrapper as she stood there in the accident and emergency unit.

What the doctors concluded: Ola’s left upper limb was dead from the elbow down. That part was gangrenous and was actually “mummified” from halfway through the forearm up to the tip of the fingers. The other part already had wet gangrene: bacteria were already feeding on the dead flesh, releasing toxins that could eventually claim Ola’s life. But they still wanted to know what really happened initially, so the limb was X-rayed.

I went to the hospital very early the next day to check the result of the X-ray, and when I saw it, I was sad. But beyond sadness, I was enraged. I wanted to hit somebody. Ola had a fracture on the bone of his arm quite alright, but such a tiny one that someone with more experienced eyes had to show it to me. And it didn’t happen in a place where a blood vessel could have been injured. If Ola had been taken to the hospital when he fell, he wouldn’t even have had surgery. The limb would just have been rested and the fracture would have healed in about three weeks. What then killed Ola’s limb, necessitating an amputation to save his life? The bandage that was wrapped round it by the bone setter was so tight that it cut off blood supply from Ola’s elbow up to the tip of his fingers. And life is in the blood: no blood, no life.

Some days later, Ola returned home healthy, except that he only had half of his left upper limb.

When next someone has a bone injury in Ola’s community, the kind neighbours will warn, “Don’t go to the hospital o. See what happened to Ola when his mother took him to those surgeons! They just made the boy handicapped.” But they will not explain that Ola went to a bone setter first, and it was only after the bone setter had killed the limb that Ola was taken to the hospital, leaving the doctors with no help to render; for they are doctors, not resurrectors. No one will remember to add that, thanks to their kind advice, Ola’s limb was actually “brought in dead”.

If you are still certain that surgeons just delight in cutting people’s limbs off, what exactly do you think they do with the pieces? You think they keep them in their offices as trophies? Or they submit them to the colleges of surgeons as prerequisites for induction into the “Surgeons’ Hall of Fame”? No sir/ma; no one gains anything by amputating other people’s limbs (except, of course, your “orthopaedic surgeon” is actually a hungry quack), but sometimes and rather sadly, that’s the only way.

I hope you now see why orthopaedic surgeons are “notorious for amputations”. It’s often because, just like many other things that pertain to our lives, we allow matters to get out of hand before we report ourselves to those who can truly help us. I have no idea why we keep doing that. Maybe it’s simply because this is Nigeria.

The end of the matter: Let us do all we can to stay healthy and not fall sick. If we do fall sick, let us get medical care from the right quarter. If we have any concern about a form of treatment that the doctor offers, let us discuss that concern with the doctor; perhaps, there is an alternative. If we reject the doctor’s advice and listen to other people, that’s fine; but should we develop complications, let us not bother the doctor with our complications too; we should let those trusted advisers deal with the complications for us. If, however, we take the complications to the doctor and he graciously helps us, and perhaps we have to live with some unavoidable consequences, let us fear God and not blame the doctor. Even if someone wants to blame him on our behalf, let us be quick to exonerate the doctor and confess that we are responsible for our own scars.

I shared this solely because I care; because I hope it will encourage people to make better decisions about their health. You can continue the line of care by sharing.

Thank you for reading. I wish above all things that you prosper and be in health even as your soul prospers. Peace.

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