On defeat

A month ago, I hit a big blood vessel.? The surgery ended at that moment.? Yes we kept going, we stopped the bleed in the long run, but the battle was lost.? I rounded on him daily? in ICU over the next 8 days. I prayed. We pushed. I had almost daily meetings with the family.? They asked me questions I just could not answer.? Neurosurgery is an ancient science in some respects.? We still have no idea what happens when the brain really starts the journey of no return. There are some tests, but all of them really complement each other, and sometimes in death as in life, consensus among doctors is needed, to make a valid diagnosis. We lost him on the 9th day.? ?

Everything had started well.? We had gone through the nose to take the tumor at the bottom of his brain.? Its close team work with an ENT surgeon.? This surgery demands small instruments, small movements and a tolerance for high stakes.? It took me years to be able to learn this approach, and I have to alert every client about this risk… of hitting the big blood vessels that carry blood to the brain.? In this case, it happened as I tried? to bite off some tumor to take to the lab.? It was a big tumour, with big blood vessels stuck to tumour tissue. ? This vessel happened to go all the way back to the big artery that supplies half the brain.? The tumor came off with a bit of the vessel wall, and the gush of blood was as final as death.

It was difficult for the family to understand that what we had discussed before as a rare possibility, was now an unfortunate reality.? And the thing about bad news in surgery, is that one has to tell it to different people every time.? And bad news is so difficult to take.? It does not matter how many times it is told… sometimes its almost as if the family is waiting for something right in all the wrong.? A shining star in a collection of black pebbles leading nowhere good. Its my responsibility to ensure that the order of the pebbles stays the same.? One cannot change the order of events in such stories.? One cannot thoughtlessly pierce the heart in a different trajectory every time.? Death is a horrible thing, but witnessing the tragedy that plays on the relatives’ faces every time the story of inevitability is told, is heartrending. The hospital is a place of healing, but sometimes death comes knocking, and it is difficult to ignore the terror of its sound.

The family must move on with the loss. But I must move on with the healing.? I must mourn the loss of one who could have been saved, but not forget the many who will come.? I must turn the procedure round and round in my head and think how I could have done it differently, so that when death comes knocking again on the front door, I will at least know which back door to use.? A week later I was back at the same surgery, in another client.? The memory of the previous defeat hung over me.? And when I saw him going home a few days later, the taste of victory was bittersweet.? Sometimes the fire of achievement burns bright, but in the rising tendrils of jubilation, one can see the vistas of previous failures.

Last week, alongside a team from George Washington University, 11 complex neurosurgical procedures were performed in Accra Medical Centre. And all the patients made it through. And almost all have gone home, and I do not take this for granted.? I have seen enough defeat, to treasure the victory.? I thank the team of the Global Brain Initiative and the indefatigable Operative, Perioperative, Intensive/High Dependency Care Unit, Ward and Rehabilitation teams of the Accra Medical Centre for the amazing work done over 5 intense days. We thank God

It is only because we push on, that we are assured of rising above the challenges ahead.