New Patient

Abu Hayat arrived yesterday at the Spinal Cord Injury house. A man in his 30s injured in southern Syria, paralyzed from his belly-button down about three months ago. He was treated in a field hospital, transferred to a higher level of care in a nearby city where he had two surgeries: one on his back, and one in his belly. The patient isn't clear why he had either, nor if they took anything out of his belly, like his spleen.

Unfortunately, this is about the 4-5th patient I've seen after a laparotomy (open abdominal surgery) who has no idea what was done in his belly, if anything, during the surgery. This is important because if his spleen was removed, he will be at greater risk for certain infections, particularly pneumonias. And with no records, clinical notes or ability to communicate with those who did the surgery, unless we do another CT or MRI, we're not going to find out.

Its been three months since his injury, and he's learning for the first time about he needs to change positions every few hours or he'll get bed sores. Paralysis 101, but he hasn't yet had the course. Which means his 8x10in stage 4 decubitus ulcer will require a skin graft for any chance at healing.

I can't blame the patient. He's just been through a near-death experience. Plus Abu Hayat is lucky to be alive since the bullet (which is still in him) is only a few millimeters away from his aorta. I don't expect him to know all the details of his surgeries. But this means that by the time they get to us at the SCI house they're already doing poorly.