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DISSECTING ROOM
LIFELINE Sahin Aksoy Sahin Aksoy qualified as a medical doctor from Ankara University, Turkey. He was a general practitioner for 3 years and did a PhD in bioethics at Manchester University. He is now an assistant professor and chair of the the department of medical ethics and history of medicine in Harran University, Turkey. Which research paper has had most effect on your work, and why? The book entitled Should the Baby Live? by Peter Singer and Helga Kuhse. Because I am amazed by how such an immoral practice can be defended in the name of mortality. What would be your advice to a newly qualified doctor? See your patients as if they are your relatives, and behave accordingly. What part of your work gives you the most pleasure? Teaching medical ethics. If you had not entered your current profession, what would you have liked to do? I would like to have been a secret agent. What apart from your wife is the passion of your life? To eat baklawa with ice-cream. Describe your ethical outlook. I would describe my ethical outlook as a consequentialist with some spiritual overtones. Have you ever broken one of the ten commandments? I am not sure but most probably, yes, maybe in my childhood. But knowingly and intentionally, no, never. What is your worst habit? I think my worst habit is to trust people very easily, which very frequently leads to disappointment. Do you believe in capital punishment? Yes, if it will decrease the crime rate in a society, which it certainly does. Where are you in your sibling order, and what did you gain or lose as a result? I am the second of three. It was an advantage to be both older and younger brother of two sisters. Do you believe in monogamy? It is the ideal, but some certain circumstances may justify polygamy.
2022
On a jab ife is a potentially lonely business, as you realise when you run short of people to worry about you. Getting a needlestick injury in Africa was not, of course, on my list of travel plans. But it is in strange new circumstances that accidents happen. It was surprising to find that Vacutainer barrels were not automatically thrown away after use, but were treasured as reverently as expensive stethoscopes—lent only reluctantly and supplied initially from some secret source. I had to continually restrain myself from throwing mine away, instead of carefully discarding the needle and slipping the barrel back into my pocket. Still, it wasn’t resheathing that got me, but a needle I’d used for an ascitic tap and carelessly kept hold of while adjusting a drip. That gloves are irrelevant when it comes to needlestick injuries was brought home to me as I washed the powder off to look with disbelief at the slow ooze of blood beneath. I wanted to hide my hand in shame. In hindsight the saddest thing about the young woman was not that she was an inappropriate referral, not that she looked so much worse than most cadavers I have seen, but that she was unaccompanied. Pseudomonas had infected her right eye, which had ruptured. I had never seen anything so rotten. The fish I buy are better: their eyes are opaque from death, but have not putrefied. Her right eye—which was low in her list of problems—was a gaping gluey mess. Her left eye was gorgeously clean and a bright, healthy white around a lovely brown iris. It was alone. When left undisturbed the patient became Burch’s sign positive: she pulled the blanket weakly over her head and hid herself completely underneath, like a child scared of the dark. I found this hiding beneath the covers pathognomonic of people who knew they had AIDS. When I had filled in a mountain of
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incomprehensible forms and been allowed to progress to the occupational health doctor’s door, I was yelled at. “Can you PLEASE wait outside!” she screamed in harsh tones, “I am listening to something VERY IMPORTANT!” I had no idea what it was, and was not thinking very straight at that point, so mutely I did as I was bid and sat myself down amidst all the AIDS awareness posters. I stared at the one of a coffin being lowered into the ground, felt isolated and far from home, and waited. She turned out to have been listening to the latest news about the national cricket scandal, which she retold me in urgent tones—assuming it would also be foremost in my mind—before discussing my needlestick in a generous and patient manner. Eccentricities, in retrospect, are charming, and I remember her fondly now. Later, last thing on a Friday, I was left a message that one of my test results was “alarming”. The department was closed for a long weekend when I rang back. I had expected that not everyone in South Africa got highly active antiretroviral treatment (HAART), but my naivety seemed monumental when I discovered that it was not a case of being denied a full range of antiretrovirals, it was an absence of any that was the standard treatment. No viruses entered my bloodstream from the needlestick (my hepatitis B antibody titres had turned out to be a little low), but the image of the young lady with the rotten eye hiding beneath her blanket inoculated me. In Africa, I too was short of people to worry about me. But the thoughts of those at home who I love, and worry over, were never far away. That they lived in a different world, the first world, seemed the greatest possible blessing. It is a surprisingly effective therapy for loneliness, to worry about others. Druin Burch
THE LANCET • Vol 356 • December 9, 2000
For personal use only. Not to be reproduced without permission of The Lancet.
LIFELINE Sahin Aksoy Sahin Aksoy qualified as a medical doctor from Ankara University, Turkey. He was a general practitioner for 3 years and did a PhD in bioethics at Manchester University. He is now an assistant professor and chair of the the department of medical ethics and history of medicine in Harran University, Turkey. Which research paper has had most effect on your work, and why? The book entitled Should the Baby Live? by Peter Singer and Helga Kuhse. Because I am amazed by how such an immoral practice can be defended in the name of mortality. What would be your advice to a newly qualified doctor? See your patients as if they are your relatives, and behave accordingly. What part of your work gives you the most pleasure? Teaching medical ethics. If you had not entered your current profession, what would you have liked to do? I would like to have been a secret agent. What apart from your wife is the passion of your life? To eat baklawa with ice-cream. Describe your ethical outlook. I would describe my ethical outlook as a consequentialist with some spiritual overtones. Have you ever broken one of the ten commandments? I am not sure but most probably, yes, maybe in my childhood. But knowingly and intentionally, no, never. What is your worst habit? I think my worst habit is to trust people very easily, which very frequently leads to disappointment. Do you believe in capital punishment? Yes, if it will decrease the crime rate in a society, which it certainly does. Where are you in your sibling order, and what did you gain or lose as a result? I am the second of three. It was an advantage to be both older and younger brother of two sisters. Do you believe in monogamy? It is the ideal, but some certain circumstances may justify polygamy.
2022
On a jab ife is a potentially lonely business, as you realise when you run short of people to worry about you. Getting a needlestick injury in Africa was not, of course, on my list of travel plans. But it is in strange new circumstances that accidents happen. It was surprising to find that Vacutainer barrels were not automatically thrown away after use, but were treasured as reverently as expensive stethoscopes—lent only reluctantly and supplied initially from some secret source. I had to continually restrain myself from throwing mine away, instead of carefully discarding the needle and slipping the barrel back into my pocket. Still, it wasn’t resheathing that got me, but a needle I’d used for an ascitic tap and carelessly kept hold of while adjusting a drip. That gloves are irrelevant when it comes to needlestick injuries was brought home to me as I washed the powder off to look with disbelief at the slow ooze of blood beneath. I wanted to hide my hand in shame. In hindsight the saddest thing about the young woman was not that she was an inappropriate referral, not that she looked so much worse than most cadavers I have seen, but that she was unaccompanied. Pseudomonas had infected her right eye, which had ruptured. I had never seen anything so rotten. The fish I buy are better: their eyes are opaque from death, but have not putrefied. Her right eye—which was low in her list of problems—was a gaping gluey mess. Her left eye was gorgeously clean and a bright, healthy white around a lovely brown iris. It was alone. When left undisturbed the patient became Burch’s sign positive: she pulled the blanket weakly over her head and hid herself completely underneath, like a child scared of the dark. I found this hiding beneath the covers pathognomonic of people who knew they had AIDS. When I had filled in a mountain of
L
incomprehensible forms and been allowed to progress to the occupational health doctor’s door, I was yelled at. “Can you PLEASE wait outside!” she screamed in harsh tones, “I am listening to something VERY IMPORTANT!” I had no idea what it was, and was not thinking very straight at that point, so mutely I did as I was bid and sat myself down amidst all the AIDS awareness posters. I stared at the one of a coffin being lowered into the ground, felt isolated and far from home, and waited. She turned out to have been listening to the latest news about the national cricket scandal, which she retold me in urgent tones—assuming it would also be foremost in my mind—before discussing my needlestick in a generous and patient manner. Eccentricities, in retrospect, are charming, and I remember her fondly now. Later, last thing on a Friday, I was left a message that one of my test results was “alarming”. The department was closed for a long weekend when I rang back. I had expected that not everyone in South Africa got highly active antiretroviral treatment (HAART), but my naivety seemed monumental when I discovered that it was not a case of being denied a full range of antiretrovirals, it was an absence of any that was the standard treatment. No viruses entered my bloodstream from the needlestick (my hepatitis B antibody titres had turned out to be a little low), but the image of the young lady with the rotten eye hiding beneath her blanket inoculated me. In Africa, I too was short of people to worry about me. But the thoughts of those at home who I love, and worry over, were never far away. That they lived in a different world, the first world, seemed the greatest possible blessing. It is a surprisingly effective therapy for loneliness, to worry about others. Druin Burch
THE LANCET • Vol 356 • December 9, 2000
For personal use only. Not to be reproduced without permission of The Lancet.