DAWOOD: A case of man’s innate goodness

The usual question from Mwendwa was, “How is Yvonne?” My reply. “Getting better.” His next question, “When can I see her?” ILLUSTRATION| JOHN NYAGAH

What you need to know:

  • When I saw Yvonne, I realised that if anything, Dr Muturi had understated the damage to Yvonne’s pretty face.

  • Her nose had caved in, splaying her eyes wide apart. Her upper and lower jaws were broken and her teeth were protruding out as a result.

  • In addition, she had multiple irregular cuts on her face; obviously the windscreen had shattered on it. On top of that, she was deeply unconscious.

“I have a couple here with me, badly injured in a car accident,” Dr Agnes Muturi was phoning me from the Accident & Emergency Department.

“The girl has serious facial injuries and is also deeply unconscious. The man has sustained multiple rib fractures, a dislocated right hip and fracture of his left tibia,” she continued.

It was obvious from the phone call that Dr Muturi had collected all the clinical data, had done the necessary X-rays and was now seeking my help in the management of the cases.

I hurriedly drove to the hospital. It was just past midnight and the roads were relatively quiet allowing me to put my foot on the accelerator, without causing yet another road traffic accident! On arrival at the hospital, I was met by Dr Muturi who handed me the files of the two patients.

“She is the one more seriously injured,” she said picking up the file of the girl and implying that she wanted me to give priority to the young lady. As I perused her file, the name on it caught my eye.

“Yvonne Mwaniki, the name rings a bell. Isn’t she a fashion model or a beauty queen?” I asked. The doctor was amused at my question. She did not think I could be interested in such mundane matters.

As she raised her eyebrows higher, I added.

“I never forget a pretty face. Marie and I were invited to a charity fashion show recently and her name was written prominently in the programme.

That and the fact that Yvonne is an unusual name caught my attention. Finally her catwalk was superb: she did it with such provocation and resilience that I thought she had more joints than described in Gray’s Anatomy. She modelled some stunning dresses that evening and so naturally her face and name have stuck in my memory.”

“You will need a lot of imagination to recognise her now,” Dr Muturi challenged me.

When I saw Yvonne, I realised that if anything, Dr Muturi had understated the damage to Yvonne’s pretty face.

Her nose had caved in, splaying her eyes wide apart. Her upper and lower jaws were broken and her teeth were protruding out as a result. In addition, she had multiple irregular cuts on her face; obviously the windscreen had shattered on it. On top of that, she was deeply unconscious.

As the doctor led me to the man’s bed, she acquainted me with the details of the accident. “According to Mwendwa, the young man, he was driving Yvonne home after a fashion show and a party which followed the show. On the way, he suddenly came across a stationary lorry as he turned a corner and collided with it head on.”

After talking to Mwendwa and examining him, we went over to the viewing box where X-rays of both patients were laid out. Dr Muturi detailed me on them.

“While all the injuries of Yvonne are confined to her head and face, Mwendwa’s injuries are all below the neck. He has multiple fractures of his ribs on both sides of his chest,” she added as she pointed at the chest X-rays.

“He has dislocated one hip and has fractured the other leg.” The splints on his lower limbs testified to her statement. We then moved to where Yvonne’s X-rays were placed. “She has fractures in her mandible, maxilla, orbits and zygoma.”

Dr Muturi was using surgical terms for lower and upper jaws, eye sockets and cheek bone. “Plain X-rays of her skull do not show any bony injury but because of her coma, I have ordered a CT scan of her head.”

LIGHTEN THE ATMOSPHERE

Having looked carefully at all the X-rays, I said. “My job here is like that of a sorting clerk in the post office,” I tried to lighten the atmosphere, which had turned gloomy in view of the serious injuries sustained by the young handsome couple.

“Both cases need multi-disciplinary teamwork. We need to call our brain surgeon to manage Yvonne’s head injury and the maxillo-facial and plastic surgeons to deal with her face.” The former means a jaw surgeon.

“Mwendwa can be taken care of by Prof Ndonga, our orthopaedic surgeon, who will need to come now to reduce the dislocation of his hip under general anaesthesia and will probably plate the fractured tibia tomorrow. Though his ribs are fractured on both sides, there is no injury to the lungs, except contusion so we can treat the broken ribs with pain killers and our chest surgeon can review him tomorrow morning. There is no need to disturb his beauty sleep at this time of the night,” I concluded, still trying to lift the gloom.

Though as a primary surgeon I remained in charge of the couple, my  professional colleagues played an active role in the management of Yvonne’s and Mwendwa’s injuries.

The former stayed in ICU for a few days while the latter was declared fit to go to the male surgical ward. CT scan on Yvonne’s head showed severe bruising of the brain and she slowly regained full consciousness under the care of our neuro-surgeon.

Though her face looked grossly swollen, both from the trauma and the subsequent massive surgery it necessitated, I knew that our maxillo-facial and plastic surgeons had done a sterling job on her face and eventually she would regain her beauty.

Mwendwa’s dislocated hip was reduced that night and his fractured tibia was plated the next day by Prof Ndonga. The former required him to stay in traction for three weeks.

It is a contraption consisting of a special splint, pulleys, a stirrup, string, beams and weights to hold it in the correct position until the ruptured ligaments healed. Because of all these attachments, Mwendwa was confined to bed while he was in traction. The chest surgeon saw him the next day as planned and continued on the pain killers we had prescribed and commenced him on gentle breathing exercises.

The contusion of the lungs resolved in time. All in all, both my patients were making steady progress. My main problem was to keep them from seeing each other until the lady was more presentable.

I did not want Mwendwa to be shocked and wanted to keep them apart until the bruising and swelling on Yvonne’s face had subsided. But the better they felt, the more persistent their inquiry and desire to see each other became. The usual question from Mwendwa was, “How is Yvonne?”

My reply. “Getting better.”

His next question, “When can I see her?”

 My answer. “When she is transferred to the ordinary ward from the ICU.”

Same refrain from Yvonne.”Can you take me to see Mwendwa?”

“While you are in the ICU, it is not advisable for you to go to other wards because of the risk of infection.” Here I had a very genuine reason.

One day out of the blue, when I went to see Yvonne, she asked. “Can I see myself in the mirror?” The Sister accompanying me seemed to be hesitant but I nodded my assent. After all Yvonne had to face reality and I did not see the point of delaying the moment of truth. “Is that me?” Yvonne screamed when she saw herself in the mirror. “Surely that’s not me.”

WILL TAKE TIME

“These are early days,” I tried to placate and comfort her. “The bruising and swelling, both from injury and surgery will take time to settle down.” 

“Will I be able to work as a fashion model?” Naturally that was her main concern.

“Let’s wait and see,” I replied with caution.

“Mwendwa and I were planning our engagement,” Yvonne informed us. “I wonder if he will propose now.”

This comment convinced me that the longer I delayed the meeting between the two love birds the better. However, I soon ran out of excuses and succumbed to their mutual demands when we shifted Yvonne from the ICU to the female surgical ward.

I decided that she could go via the men’s ward. Knowing that the reunion could be emotional, I asked the Sister of the ward to put a screen round Mwendwa’s bed. In that brief transitional stop, the ICU Sister who was escorting Yvonne and I witnessed a scene which neither of us will forget.

I had prepared Mwendwa for the meeting but was indeed surprised at how well prepared  he was. I could see the glow on his face as the wheelchair carrying Yvonne approached his bed.

I noticed him foraging for something under his pillow. He brought out a small gift-box and carefully opened it. Inside was a diamond ring. As he put the gleaming ring on Yvonne’s left ring finger he said.”Amidst the much damage done to our bodies by that lorry, surprisingly this ring was spared. I had planned to go on my knees and propose to you after we reached home on that fateful night and carried this in my pocket.”

Tears of joy flowing from her eyes, Yvonne said. “After seeing the hideous injuries on my face, I thought you would change your mind.”

“It is not only your face I have fallen in love with,” replied Mwendwa.” It is you I really love. Pity I can’t get on my knee as I had originally planned because this surgeon and his colleagues have immobilised me,” he added pointing an accusing finger at me.

Sister from ICU was also emotionally charged and I had to escort her to her ward. On the way, I said to her:“Mwendwa has restored my faith in the innate goodness of man. Like us surgeons, he has come round to the fact that beauty is only skin deep!”