The Case Of The Christmas Catheter

 “The only thing necessary for the triumph of evil is for good men to do nothing.” – Edmund Burke.

My name is Dr Sampson Galena. I am not like any of the doctors you have met.No, I’m not your regular doctor. The regular ones  are law abiding, docile, calm ,pacifists, and adjust to situations instead of making their voice heard and making changes for the better. I do not have such weaknesses.Many at times this lands me in serious trouble but I always wriggle my way out, one way or the other , until the case of the Christmas catheter .

The day was Friday, the 25th. The month December and the year, the worst year in all the history of mankind, the coronavirus year.

I was on duty that blessed but accursed day, at the war zone, the emergency.  Being  on duty at the ER on a Christmas Day was as hectic as it was prejudiced. Also the duty commenced as early as 6am in the morning till 8pm in the evening and it was usually meted out as a camouflaged  torture.

I arrived at the emergency at  6am.The place was calm and quiet . There were no patients waiting. This did not comfort me in any way, I knew that  it was the ‘deep breath before the plunge’ and right I was .For the ‘plunge’  that day was extremely turbulent.

At exactly 6:30am a teenage-looking  girl who was probably 19  and wearing a short diaphanous dress that barely got to her mid thigh rushed into the ER supporting a man who I presumed was her grand father or her ‘papa no’ (her glucose guardian).

My spot diagnosis was a penile fracture. I was right but not entirely.He was also in acute urinary retention.His story was simple and straightforward .He had been diagnosed of benign prostate hypertrophy  four  months back and had been put on drugs. His post void residual urine volume was very significant hence he was catheterized and  the catheter was supposed  to remain in situ for sometime, but some birds are not meant to be caged. They are meant to fly free under the blue wintry sky. He refused initially but the threat of kidney failure and possible stones scared him into complying. He had been able to cage his bird  until Christmas Eve when the 19 year old showed up with the keys to the cage.

After watching a few YouTube videos he managed to remove the silicon catheter  himself.The rest of the story needs no telling.

The duty had started on a bad note. The man had a penile fracture with acute urinary retention as well, thanks to his non compliance with keeping the catheter in situ. I silently prayed that there was no associated urethral injury.

In the end I had to do a suprapubic tap to relieve the pain from the acute  urinary retention, I had to leave  the rest for the urologists.The man kept lamenting that he never knew that the penis could break like a bone and make a ‘pop’ sound. That day passed.

A week later I was summoned by the  Council of physicians and surgeons for regulation of medicine and dentistry (CPSRMD).The man had decided to sue on account of a procedure being done on him without his consent, the Suprapubic  tap. I was surprised the CPSRMD had even entertained the complaint and gone ahead to forward it to the high court. I   appeared in court nonetheless.

The trial day came. The courtroom was bursting at its seams with people.The room was stuffy and  hot.The suit I was wearing hid the fact that my long sleeve shirt was drenched in sweat. Sweat from the heat and sweat from the trouble I was in. The lawyers and judges hovered around in their black and white costumes like crows waiting for an injured quadruped to drop dead so that they swoop in and devour its flesh.I was the meal. My chances of winning the case was practically zero, not because I had done any wrong but because I had come to the trial without a lawyer.I could not afford one ,but that was not the main reason. The plaintiff had used his influence to make the trial happen in a matter of days making it impossible for me to get a lawyer in time.

After going through the rituals of oath swearing among other court customs, the trial

“ Dr Sampson Galena! You have been accused of performing an invasive procedure on a patient without seeking consent first.” “I plead not guilty.” I calmly replied. The Q and A went back and forth for some time and the scales seemed to be tipping in my favor but the devil had come dressed as a lawyer that day and he was on my opponents team. One  Lawyer  Richards asked the judge to give him the opportunity to cross-examine the accused, me.

“Dr Sampson Galena, you are a medical officer at St Theresa’s hospital right?” I answered in the affirmative. “You are well-known as a reckless, ruthless and merciless medical man. You once locked the parents of a 6 year old in the  toilet at the emergency and nebulised their  asthmatic child against their wishes. True or false?” I did not utter a word, the question was obviously a rhetoric. “You also forced oral anti hypertensives, specifically tab nifedipine 60milligrams down the throat of a 60year old university professor who had refused to take them because he preferred herbal medications for his high blood pressure. As if these crimes are not heinous enough you once did a tubal ligation for a 30 year old lady who had just delivered her tenth child , without her consent.”

“Your honor, Dr Sampson Galena has no regard nor respect for human life . He does not seem to grasp the importance of  seeking informed consent  from your patients as a doctor, before performing  your ‘experiments’ on them. Like a mad dog he has been set loose on the innocent citizens of this country for far too long. It is time for him to be put down! I rest my case.”

Lawyer Richards went back to his seat with a broad smile on his face and looking pleased with himself. He was a smart lawyer , I could see that. A very smart one, having been able to dig up so much ‘intel’ about me in such a short time, but he was not a doctor. Hence he was unable to see all the sink holes in his arguments.The judge called my name and asked if I had anything to say about what had just ensued.

“I will like to face my accuser.” I said. Mr Kanes was asked to come forward. “Mr Kanes  kindly explain the exact crime you believe I committed against you to this court.” “Dr Galena, when I came to the emergency I made it clear that I do not want any catheter to be inserted in any part of my body again. I only came for emergency treatment so that I can go back and continue with my herbs which has no side effects unlike your catheters. You helped me a little but you ended up putting a catheter in my lower abdomen while I slept.” 

This man had gotten it all wrong and his legal team in their haste to put me down had not gone through all the intel they gathered about me thoroughly. I had only relieved this man of the painful acute urinary retention he was in coupled with his penile fractured. What he was suing me for was a suprapubic cystostomy the specialist team did for him when they came around. His penile fractured involved a urethral injury and he was already in retention. His best chance was a suprapubic cystostomy to prevent accumulation and back flow of urine in his urinary system which might result in sepsis and kidney failure later on. I was around when the team came. They administered some  anesthetics to take care  of the pain from the fracture and the procedure about to be done. That may have addled his memory. He must have woken up later at the ward and asked about the catheter, only to be told that it was done by the doctors at the emergency. To him that meant me. I could see redemption swiftly coming my way and maybe some compensation.  It was time for my counter attack , my rebuttals.

Lawyer Richards had revealed a lot of skeletons in my cupboard. Apart from the fact that they were irrelevant to the case at hand, they were actually trophies. I had made the hard decisions to save patients when everybody including their families and  even the system had turned their backs on them. The parents who got locked in the toilet were not the biological parents of the child  so they did not even care if the child died from a severe asthmatic attack  or not. Also the toilet door was faulty, I did not lock them in. I only allowed them to stay locked in. The elderly professor  too had been brought in delirious. His blood pressure was at the level considered hypertensive emergency. I had to do something fast and he was too aggressive to allow for an intravenous line to be put in. With the help his daughter I was able to convince him to swallow some of his own medications. Yes he did not want to, he preferred  herbal medications but his life came first. 

The ‘tubal ligation’  was a far cry from a tubal ligation . The lady had suffered from post partum haemorrhage . Her uterus did not contract after she delivered . She was given a cocktail of drugs but it did not help. The uterus was ‘tired’ from having carried ten children in such a short time interval. The only way to save the woman was to remove her womb. I made the  decision to remove it to save her. No child deserves to grow up without their mother even if they have nine other siblings. Lawyer Richards did not seem to understand these  ‘trivial’ things.

I was practically the savior of the world to the judge after I explained all these circumstances  to him in detail. The jury which had no medical doctor on board had no choice but to clear me of all charges. The CPSRMD seemed to be more interested in regulating medical practitioners who did their job  instead of going after those who did the real damage, most of whom were hidden in the alternate medicine business. They look on unconcerned as many lose their lives and livelihoods as a result.

Mr Kanes really deserved canes . He had wasted my money and time ,suing me for something I did not even do. The initial plan was to sue him for defamation, time and money wasting if I won. Now that it was all over I decided to do something unusual, for once  be a good doctor and let it slide.

E.Y.