Memoirs of a surgeon: An hour late

The day I met Jan, it was a late Wednesday afternoon and he was writhing in agony in the casualty department. It seemed no matter what he was given to ease the pain, nothing worked. When I arrived, he was out of control, begging for us to “end it”. His scared, soft-spoken wife told me she’d never seen him like this before. This wasn’t the Jan she knew. I could see why a specialist who’d seen him earlier thought he may have had a psychiatric illness.

The most bizarre part was, even after physical examination, I couldn’t find much wrong with him. He was just suffering from an indescribable pain. I requested a CT scan to try make a diagnosis, while also allowing me to quickly slip off to my family for dinner, but halfway home I stopped. There was this voice in my head that kept telling me Jan was in serious trouble and I had to do something NOW. I turned around and on my way back to the hospital, made arrangements for immediate surgery.

As soon as I opened Jan’s abdomen my heart sank. I saw nothing but loops of blue-black intestines. He had a very unusual case of bowel malrotation, this happens when the attachment of the small bowel to the big blood vessels is very narrow, allowing for a complete twist, which cuts off blood supply and results in certain death. I thought of Jan’s wife and children, who were sitting in the waiting room, and I dreaded their hearts breaking when I told them their father and husband wouldn’t make it.

Henry van Niekerk
I knew this condition sometimes happened in newborns, so I called my former professor who was a super specialist in this field. He carefully guided me through the complex procedure of detangling Jan’s intestines. Against all hope, I untwisted his bowel and after a minute, and to my amazement, it turned bright pink. I knew the blood flow was restored. Then it hit me, if I’d waited even an hour longer, Jan wouldn’t have made it.

Jan was discharged from ICU and in no time was back to his healthy, happy self. Life carried on and ten months later, I was running the Comrades Marathon. I’d started off running at a pace that would get me a silver medal for sure, but about a little after halfway in, at 60kms, I was suffering. I kept thinking about the crucial long runs I’d missed during my training because I’d worked late in theatre. I thought about how unfair it all was and just as I reached rock bottom of my self-pity, I was tapped on the shoulder by a passing runner. It was Jan. “Come, doctor. Let’s finish this together.”

We crossed the finish line arm-around-shoulder and I realised that perspective often sneaks up on you in your darkest moments. Yes, I’d missed my silver medal by one hour and eleven seconds, but crossing the finish line with Jan by my side, I revelled in the joy of having so much more to be grateful for.