HEARTBEAT: Today I have a message for fellow surgeons of mature years, which may be greatly to their benefit as we approach the Christmas. The rest of you can skip the next few chapters as it does not concern you.
Hello, hello lads, this is directed at those of you who can no longer hear the grass grow, or may suffer from the odd bit of tinnitus, or God forbid, have to turn up the telly a bit. What do you mean that these are components of the ageing process? Careless talk like that could damage my project before it even got off the ground. Will you just listen for a minute? All right I'll speak louder!
I am suggesting that we put together a group to advance Surgeon's deafness claims. After all, the army did it and now the telephonists are lining up. Apparently all you do is get your ears tested, mention the bit of buzzing, and say "what"? at appropriate moments and lo and behold the State gives you a bagful of money. Sure half the Ear, Nose and Throat surgeons of our age are probably a bit deaf themselves, so there should be no problems with the medical reports. Remember the deafening noise of breathing in the operating theatre. Remember the clang of instruments being dropped, the screaming of the nurses, and above all the loud moaning of the anaesthetists. You don't? Then you're probably developing Alzheimer's as well. Maybe we can claim for that.
"Yet it was not possible for me to say to men; speak louder, shout, for I am deaf. Alas how could I declare the weakness of a sense which in me ought to be more acute than in others - a sense which formerly I possessed in highest perfection."
(Ludwig von Beethoven).
Pity you didn't live in our times Ludwig. You could have sued somebody over exposure to all those noisy pianos. If you think this will work, contact me by letter or e-mail. Don't ring for obvious reasons.
If by any unlikely chance we should fail in this, I have another string to my bow. Let's see what we could do with Post Traumatic Stress Syndrome. Again look at the army and even the gardaí. They only joined up for the cultural and sporting facilities and in this politically correct era doubtless for the knitting circles also. Then what happened? Along came an assortment of bowsies who frightened them, assaulted them and even killed some of their friends. They hadn't reckoned on anything like that. They had watched TV and been to the movies, but those kinds of things didn't happen in real life. Furthermore nobody had counselled them. Everybody knows that nowadays you have to be counselled to cross the road.
Remember the times folks, when a patient bled and you had great difficulty in establishing control? Remember wondering where to start with the mangled trauma victim, or struggling with gunshot or stab wounds? Remember the patients who died, despite your best efforts? We could qualify for any Post Traumatic Stress Syndrome you like.
Well, I suppose not. Life just happens, your hearing diminishes with advancing age and you did sign up to be a surgeon. Nobody should compensate us or anybody else for doing their job. But this is Ireland, I hear you say. Sadly it is.
At this time of year in my internship I was approaching the end of my surgical six months. On the elective side, there was a gradual slowing down, particularly in surgery. Nobody wanted an operation that would hospitalise them over Christmas. Open heart surgery, for example, came to a halt. Twenty years later, Christmas made little difference to the schedule and despite doing four or even five cases in the day we were unable to satisfy demand. Thus medicine changes over a few years.
Winter, then as now, brought its medical and surgical problems, increases in heart attacks, strokes, respiratory diseases for the physicians; and for the surgical teams, perforated ulcers and broken bones. Rarer and more difficult problems like oesophageal varices and dissecting aneurysms tended to show at this time also.
Believe me, you wouldn't want either of them. Overindulgence was a thread that ran through emergency illness and was also seen in the destabilisation of diabetics and hypertensives. The season commenced later than now and for some reason I always associated December 8th with the beginning of the festive season.
There was a tradition then that many folk used to travel to Dublin for shopping on this religious holiday. Occasionally, some would present at the A&E department either in emergency or sometimes with a problem that had been worrying them and that they had told nobody about. It was almost as if we were anonymous, indeed confessional.
To this day, I remember one such incident. A 17-year-old man showed up at the A&E complaining of a lump under his right arm. His parents were shopping and he was due to meet them at 5pm. One look at the swelling and I knew he wasn't going home that evening. "It's nothing serious?" he asked anxiously. I was dispatched to meet his parents and bring them to the hospital.
Three days later, he lost his arm and shoulder blade, and three years later when I was a surgical registrar, he lost his life. He had a malignant sarcoma - a death warrant. He was 20 when he died. Maybe today, with advances in chemotherapy and radiotherapy, he could have been saved. The deadly serious business of illness was no respecter of our festive season. It had its own calendar.