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Cattle Prod

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 When I use the term "cattle-prod" I normally think of the electrically-powered stick some farmers used to guide errant cows - a bit like a mobile electric fence. I am not very up to date with veterinary issues, but I suspect the use of these is now frowned upon due to animal rights issues.  I was forced to rethink this concept however when a Cambodian farmer was brought into the accident department in severe pain having been impaled by a cow's horn a few hours earlier whilst she had been stooping down to pick something off the ground.  She was unable to explain what had triggered the attack from her normally docile cow unless it just couldn't resist the target so presented. The unfortunate lady in her 40's had a deep laceration immediately adjacent to her anus - see photo. (I avoided referring to this as a bullseye) which, on subsequent exploration, was confirmed to extend into her rectum. It had also damaged her anal sphincters. The shock of receiving an injury ...

He wasn't even a Vampire

 In a previous story I related the case of the Cambodian splinter, but now I would like to describe a much larger one I encountered in Newcastle-upon-Tyne very many years ago. The patient was a member of the so-called Newcastle mafia - a notorious crime syndicate family from the Northeast. He had been driving his car at speed, lost control and collided with a stationary wooden picket fence coming in the opposite direction. This resulted in him being impaled through his chest. He was admitted to the emergency department in a state of collapse with the wood protruding from his chest as fortunately the rescue team had the wisdom to not try and remove it at the scene of the accident, electing rather to cut through it in order to free him. The accident and emergency consultant, a dour Scottish man of enormous experience, oversaw his resuscitation and immediately took him to the operating theatre where he found the stake had penetrated his left ventricle but had missed the coronary vesse...

Embarrassing Bodies

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 Social media has many advantages and good uses - but of course, I would say that wouldn't I, using it as I am for this blog. However it is not without it's problems and in a medical context, some people seem happy to share intimate details of their health issues in a way that one might not expect. I suppose I shouldn't be surprised given the popularity of TV reality shows like "Embarrassing Bodies" shown in the UK on Channel 4 and running to nine seasons. However, I still find it extraordinary that people are prepared to send me graphic content of their nether regions, especially anal, to demonstrate the severity of their haemorrhoids or other problems. Fortunately I have a cast-iron stomach so receiving a picture of someone's prolapsed piles whilst eating my breakfast does not phase me unduly. Mind you, it is not just confined to social media - I was doing my weekly shop in Tesco on the Isle of Man many years ago when someone shouted across the busy aisles -...

A Cambodian Splinter

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    I have just moved from Battambang to Phnom Penh – hence the late arrival of this episode of my blog, but it has reminded me of an extraordinary sight I witnessed a number of years ago. Many houses in Cambodia are built of wood and rest on stilts to prevent them from flooding during the rainy season. Imagine my surprise, therefore, when I looked out of my window one day to see a large group of men lifting our neighbour’s house from the ground by the stilts and carrying it down the street to be relocated some distance away. It transpired that the owners had purchased a new piece of land but didn’t want to build a new property. It certainly brings a whole new meaning to the expression “moving house”.   I do not know whether splinters were a problem for those carrying the house, but a splinter certainly caused a major problem for an elderly gentleman I saw with a nasty infected wound on his scrotum. It had been discharging pus on and off for several months by the ti...

An Unusual Sneeze

    Many years ago I, in conjunction with my family, started to grade sneezes on a scale of one to ten according to the noise generated. This quickly developed into a competition to see who could sneeze the loudest. A rating of five or six would be what most people would consider normal with lower numbers reserved for the more discreet. On the other hand, between eight and ten would be considered sufficiently loud to make other people’s ears bleed or to knock over small children.   The sneeze in this story, however, was unusual not because of its volume, but because of the product - I am not talking about snot or blood here, or even a bead previously inserted into a nostril by a small child and subsequently sneezed out. A lady came to one of our rural clinics asking for some worm medicine – we routinely prescribed this to young children as hookworm infestation is common in Cambodia as a result of them walking barefoot on contaminated soil. The larvae penetrate the s...

A Shot in the Dark

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      The purpose of this blog is to provide some intriguing and, at times, amusing medical cases that I have encountered over many years of clinical practice in Cambodia, the UK and on the Isle of Man. I hope that they will be of interest to both medical and non-medical readers and I have pitched them primarily at a non-medical audience. Please feel free to leave comments and suggestions as I am new to the blogging community! Just to reassure you that any photographs I use have been taken with the consent of the persons depicted and do not allow their identification. Continuing from last week’s theme of weapons, my story this week concerns a slightly more conventional one, albeit rather more old-fashioned, in the form of an arrow. As before, the circumstances surrounding the injury were unusual and took the form of an accident rather than a deliberate attack. In Cambodia it is not uncommon to find home-made arrows being used for hunting rats, frequently fired from some s...

Unorthodox Use of Chopsticks

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 I don't know whether you have watched Jackie Chan in the film "The Legend of Drunken Master"  but there is an entertaining scene involving a fight over food using chopsticks.  I worked until recently as a surgeon in a small hospital in Northwestern Cambodia. A number of years ago I dealt with a case in which a chopstick had been used as a weapon during a family dispute resulting in the patient being stabbed in the back with a metal one. The initial story given was that he had fallen over and landed on the chopstick, but as is so often the case, this did not hold up under closer scrutiny as a chopstick does not normally balance on it's end! The family initially wanted to fly back home to South Korea for treatment, but this was not an option and eventually they agreed to him staying at our hospital. The patient himself had a punctured lung and, ironically, needed a larger metal object to be inserted into his chest (trocar for a chest drainage tube) in order to treat th...