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Elizabeth Molyneux
DISSECTING ROOM
LIFELINE Elizabeth Molyneux Elizabeth Molyneux is professor of paediatrics in the College of Medicine, Blantyre, Malawi, and was formerly Clinical director of the Accident and Emergency unit at Alder Hey Children’s Hospital, Liverpool, UK. Her interests include meningitis, tropical oncology, and paediatric emergency care. Who was your most influential teacher, and why? My English teacher, E Pike, whose enthusiasm for language was contagious. What would be your advice to a newly qualified doctor? Don’t keep worrying about the next step; enjoy the present, do it well, and the rest will follow. Do you believe there is an afterlife? Yes. What are you currently reading? On my bedside table are Vikram Seth’s An Equal Music, Susan Greenfield’s The Private Life of the Brain, The Bible, a book of poetry By Heart, and a Guardian Weekly: I dip into some and ponder others. Do politics, spirituality, or religion play an important part in your life? Politics reluctantly and religion wholeheartedly. What do you think is the most exciting field of science at the moment? Nothing beats good clinical medicine for challenges, stresses, glorious successes, and miserable failures. What do you think is the greatest political danger to the medical profession? Talking and thinking about medicine in business terms with business models and outcomes that are not always compatible with good medical care. What part of your work gives you the most pleasure? Being part of a well run, happy and cohesive team. Describe your ethical outlook. Do unto others as I would have done unto me. What is the least enjoyable part of your job? The constant presence of poverty, malnutrition, and AIDS—I sometimes feel that I am drowning in other people’s sorrow. Where were you in your sibling order, and what did you gain or lose as a result? Third of three and as far as they were concerned I was spoilt rotten.
596
A titbit manating from some hidden source, on a sunny Sunday, there was the unmistakable smell of barbecue in our backyard. Smell-induced imitative urges in children, fortified by a mother-instinct in midsummer, was all that was needed to persuade my wife that the time was right to have a barbecue in our garden. Once the barbecue had been successfully lit, we all began to enjoy the different features that are part of the ritual of this genuine outdoor feeding experience. So, momentarily impressed by its perfect cubed shape, I swallowed my first piece of roasted meat of the day. Having swallowed thousands of pieces of meat in my lifetime, I was definitely disturbed by the unusual discomfort of this particular act of deglutition. After I had repeated the same physiological procedure a few times, I became aware of the fact that to swallow is a very personal and intimate activity. Unable to speak, I jumped from my chair and tried another swallow. It dawned upon me that the chunk of meat was stuck. With a frowning look, my wife observed my rather curious behaviour. She quickly got the message by the uncivilised inspiratory noise that I was making, tried several unsuccessful Heimlich manoeuvres, and then ordered the children to stay with the neighbours. Remembering that there are some 13 deaths from obstructed airways per million population every year, I was alarmed by the thought that I might be next. Meanwhile, I had noticed that, with my head somewhat flexed and turned to the left, I was still able to breathe, albeit with difficulty. So I decided to assume that particular position in order to postpone my death, and decided to drop the idea of doing a needle tracheostomy on myself. As one can see, impending death can provoke bizarre ambitions!
E
The rush to our hospital was an epic journey of 15 km of heroic driving— my wife violating all traffic laws. I constantly felt the blocked vomiting reflex, resembling hiccups, and produced more saliva than Pavlov’s dogs on the day he forgot to switch off his laboratory chime. At the hospital, none of my consultant friends were present to prove their fondness—they were probably somewhere enjoying a barbecue. However, despite my grey cyanotic colour, I was instantly recognised by the hospital staff who, while preparing for an emergency tracheostomy, empathetically commented on my stridor and shock-like state. I was told that a week earlier someone had died in the same way, though the bearer of this news quickly added that he was dead on arrival; probably to cheer me up. Eventually, under local anaesthesia, the piece of meat was dislodged by a friendly locum anaesthetist. With a rebound facial flush (proving optimum reoxygenation), my first words uttered concerned a bottle of champagne, as a reward—a promise that I kept. Back at home, alive and well, our neighbours informed us that when our then 10-year old son, in tears, told them that his father was dying, his younger brother had protested, saying “Liar! Daddy is only suffocating”. At last, when in bed, my wife admitted being impressed that, although facing death, I had managed to stay calm and to show no signs of panic. I explained that God, as well as I, knew that I must not die before I had completed some great task. If not, I should have been dead. “Ha,” she said, “a great task! Like what?” “Like writing for The Lancet”, I replied. “Boaster!” she scoffed, “they’d kick you out”. “Do you really think they would?” I murmured. Joris Nauwelaers
THE LANCET • Vol 358 • August 18, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.
LIFELINE Elizabeth Molyneux Elizabeth Molyneux is professor of paediatrics in the College of Medicine, Blantyre, Malawi, and was formerly Clinical director of the Accident and Emergency unit at Alder Hey Children’s Hospital, Liverpool, UK. Her interests include meningitis, tropical oncology, and paediatric emergency care. Who was your most influential teacher, and why? My English teacher, E Pike, whose enthusiasm for language was contagious. What would be your advice to a newly qualified doctor? Don’t keep worrying about the next step; enjoy the present, do it well, and the rest will follow. Do you believe there is an afterlife? Yes. What are you currently reading? On my bedside table are Vikram Seth’s An Equal Music, Susan Greenfield’s The Private Life of the Brain, The Bible, a book of poetry By Heart, and a Guardian Weekly: I dip into some and ponder others. Do politics, spirituality, or religion play an important part in your life? Politics reluctantly and religion wholeheartedly. What do you think is the most exciting field of science at the moment? Nothing beats good clinical medicine for challenges, stresses, glorious successes, and miserable failures. What do you think is the greatest political danger to the medical profession? Talking and thinking about medicine in business terms with business models and outcomes that are not always compatible with good medical care. What part of your work gives you the most pleasure? Being part of a well run, happy and cohesive team. Describe your ethical outlook. Do unto others as I would have done unto me. What is the least enjoyable part of your job? The constant presence of poverty, malnutrition, and AIDS—I sometimes feel that I am drowning in other people’s sorrow. Where were you in your sibling order, and what did you gain or lose as a result? Third of three and as far as they were concerned I was spoilt rotten.
596
A titbit manating from some hidden source, on a sunny Sunday, there was the unmistakable smell of barbecue in our backyard. Smell-induced imitative urges in children, fortified by a mother-instinct in midsummer, was all that was needed to persuade my wife that the time was right to have a barbecue in our garden. Once the barbecue had been successfully lit, we all began to enjoy the different features that are part of the ritual of this genuine outdoor feeding experience. So, momentarily impressed by its perfect cubed shape, I swallowed my first piece of roasted meat of the day. Having swallowed thousands of pieces of meat in my lifetime, I was definitely disturbed by the unusual discomfort of this particular act of deglutition. After I had repeated the same physiological procedure a few times, I became aware of the fact that to swallow is a very personal and intimate activity. Unable to speak, I jumped from my chair and tried another swallow. It dawned upon me that the chunk of meat was stuck. With a frowning look, my wife observed my rather curious behaviour. She quickly got the message by the uncivilised inspiratory noise that I was making, tried several unsuccessful Heimlich manoeuvres, and then ordered the children to stay with the neighbours. Remembering that there are some 13 deaths from obstructed airways per million population every year, I was alarmed by the thought that I might be next. Meanwhile, I had noticed that, with my head somewhat flexed and turned to the left, I was still able to breathe, albeit with difficulty. So I decided to assume that particular position in order to postpone my death, and decided to drop the idea of doing a needle tracheostomy on myself. As one can see, impending death can provoke bizarre ambitions!
E
The rush to our hospital was an epic journey of 15 km of heroic driving— my wife violating all traffic laws. I constantly felt the blocked vomiting reflex, resembling hiccups, and produced more saliva than Pavlov’s dogs on the day he forgot to switch off his laboratory chime. At the hospital, none of my consultant friends were present to prove their fondness—they were probably somewhere enjoying a barbecue. However, despite my grey cyanotic colour, I was instantly recognised by the hospital staff who, while preparing for an emergency tracheostomy, empathetically commented on my stridor and shock-like state. I was told that a week earlier someone had died in the same way, though the bearer of this news quickly added that he was dead on arrival; probably to cheer me up. Eventually, under local anaesthesia, the piece of meat was dislodged by a friendly locum anaesthetist. With a rebound facial flush (proving optimum reoxygenation), my first words uttered concerned a bottle of champagne, as a reward—a promise that I kept. Back at home, alive and well, our neighbours informed us that when our then 10-year old son, in tears, told them that his father was dying, his younger brother had protested, saying “Liar! Daddy is only suffocating”. At last, when in bed, my wife admitted being impressed that, although facing death, I had managed to stay calm and to show no signs of panic. I explained that God, as well as I, knew that I must not die before I had completed some great task. If not, I should have been dead. “Ha,” she said, “a great task! Like what?” “Like writing for The Lancet”, I replied. “Boaster!” she scoffed, “they’d kick you out”. “Do you really think they would?” I murmured. Joris Nauwelaers
THE LANCET • Vol 358 • August 18, 2001
For personal use. Only reproduce with permission from The Lancet Publishing Group.