A day in the surgery room

I have covered health for a couple years. I have written about almost every major existing health condition, interviewed nutritionists about food and diet, interacted with patients, their caretakers, doctors, and top health officials (including ministers) in different fora. One moment, however, stands out, and it will always be memorable: “Please be here (at King Faisal Hospital Kigali) at exactly 8:30am tomorrow,” read the message from Diana, the hospital’s public relations officer. Finally my request to be allowed to be present during a surgery procedure had been granted. The one-month wait was worth it.The changing room When I reached King Faisal, the first thing I was shown was a bathroom. Despite having taken a shower at home, I was required to take another shower, after which I was given fresh disinfected clothes. “Hang your clothes there and leave everything here apart from your valuables,” one of the health officials whispered to me before leading me to the theatre. Florence Furaha, the theater supervisor, was at hand to receive me. Her warm smile quickly erased the feeling of anxiety that had suddenly taken control of me. It was at this point that my nose realized that the air and environment in the theatre was different from many hospitals – it was fresh and inviting. The neat and spacious rooms also impressed me. Health officials adjust the position of the patient before the operation. Enter the patient As I was still trying to fully adjust to the new ‘world’, a 12-year-old girl, lying on a hospital bed, was brought to the theatre. This beautiful girl, whose problem was congenital scoliosis, needed surgery. And I was going to be part of it – at least by observing. I was interested in seeing how they would ‘trick’ this alert girl into ‘surrendering’ her life to the medics. But Esperance, the anesthetist, was there to ensure that the young girl cooperates. I watched keenly as Esperance gently turned the patient, making her lie on her belly before sending her to sleep with complete anesthesia. Meanwhile, a group of doctors – Prof. Alex Butera, together with Germany medical experts Prof. Thomas Neimeyer and Nils Rudoff, a clinical specialist – also joined us in the surgery room. Their appearance caused me some excitement and my mouth began itching to say something so I approached Prof. Butera. “Solomon we shall talk after the operation,” he said. The response showed me how much these medical officials valued the young girl’s life, and understandably so. As Esperance continued to attach tubes from the ECG leading to the arms and chest, doctors scrutinised the X ray films. An electrocardiogram (ECG) is a test that checks for problems with the electrical activity of your heart. It shows the heart’s electrical activity as line tracings on a monitor. We were about 8 people, with no one blinking. Everyone wanted to save the young patient. In fact when Furaha asked us to exit the theatre for a few minutes, I grumbled quietly since I was determined to be by the patient’s side all through the operation. She even made things worse when she said the atmosphere was becoming sultry. What was that supposed to mean? “When there are many people inside, the microbial safety of the room is compromised and the risks of contamination are higher. Just go observe from outside, when the incision starts, you can come inside,” she explained. So I was in-and-out of the room every five minutes. Just when I thought I had fulfilled every requirement, Dr Emmanuel Bukara arrived with a special jacket to shield me from the X-ray radiation since they were about to take another X-ray shot. Medics disinfect the area before incision. Shortly after, Prof Nemymer inspected the knives, screws and pins that would be used during the operation. “I don’t need very big ones because the bones are too small,” he said while pointing at the screws. It was now time for serious business. The girl’s lower part of the body was wrapped in a white cloth and taped it tightly. The area in question (the back) was then disinfected with a mixture of iodine and alcohol; they rubbed the body with soaked wool. The patient’s position was further adjusted and she was made comfortable with cushions of the cotton wool. Soon the incision started, the knife was being used gently and slowly. After the slit, the skin gave way to the deformed bones. Finally the screws, nuts, and metallic supports could be brought in. The medical officials officially started correcting the bones by putting them in the right direction. By then I had lost my appetite, and I don’t know how many times I had excused myself from the theatre. The four hours had felt like one week. As the patient was being led to the recovery area, I, too, nearly asked to be taken along. Both of us needed to recover albeit for different reasons. And while some of us left the theatre, a few others remained behind to observe the patient. The experience I went through in the theatre will forever stick in my mind. It was such a unique and enriching experience. I learnt to appreciate life better and respect the work of health officials even the more. It is an opportunity I will always embrace whenever I get it. Prof Butera (right) and Prof Neimeyer making a slit in the back before corrective sugery. (All photos by Solomon Asaba) What is congenital scoliosis? Congenital scoliosis is a deformation, which is a sideways curvature of the spine caused by a defect that was present at birth. It occurs in only 1 in 10,000 newborns. Degenerative scoliosis may result into a hunched back. Dr Butera says that complex cases of spinal deformities like scoliosis are operated to improve the lives of people living with spinal deformities. “Patients benefiting from the exercise of surgery are those with the worst conditions and in need of immediate attention. Most of them have been admitted through the referral system from district hospitals,” Professor Butera said. Over 10 cases of spinal deformations were corrected in a workshop organised between St George Hospital in Germany, King Faisal Hospital, University of Rwanda and Medtronics.