An awesome and harrowing responsibility

SHERIDAN GRISWOLD
Correspondent | Friday January 16, 2009 00:00

From the title, The Karma Suture, you may have guessed that this book had to be written by a medical doctor. If you are squeamish at all, you need to think twice before starting to read it. It is a first person account, a continuous flow of words on the true-to-life agonies of a medical doctor in a second-rate hospital. The author is from KwaZulu Natal, but the story takes place in one of Cape Town's overcrowded hospital wards.

Dr Sue Carey is a highly motivated young GP or general practitioner. Struggle and survival are the order of the day. She has finished her medical training and is now, at 24 years old, embarking on her 'community service' (a bit like a form of Tirelo Setshaba (TS) for medical doctors in South Africa). She tries to find ways of saving patients under conditions of desperate pressure-too many patients, too few staff, inadequately equipped, a shortage of medicines and everyone is overworked. She can't stop thinking about her patients at night and tries to decide whether she has given them the best she is capable of. Her own emotional well-being often determines whether she can think clearly and coolly about the speedy choices she must make on the job.

''Do you mind coming with me?' I grab the dead patient's folder, quickly check his name and then lead the mother and fianc to a small waiting room next to the sisters' office. It is a dingy, windowless room, the floor lined with the standard-issue grey hospital linoleum. There are dried blood splatters on one wall and a faded oil painting of a church and a cemetery on the other. I don't know which is worse, the blood or the cemetery' (page 69).

Dr Sue Carey's journey through the trials and tribulations of Cape Town's largest hospital is a frank exposition of all that a young doctor in her twenties faces when confronting the realities of medical care in South Africa. Her personal life includes three roommates, two of whom develop medical problems, causing her to have to make decisions about whether to enter into their medical treatment as well as being their friend - generally doctors are advised not to make relatives or close friends their personal patients because they may lack objectivity in making decision about their treatment.

Kendal makes it all a very good story, as long as you can stomach medical issues described in considerable detail. She is taking a philosophy course to give her some help with making decisions about the priorities in her life. She is also trying to find a partner instead of a series of one-night-stand lovers. It's a hectic life, full of harrowing experiences, especially in the emergency ward, a place that is most challenging to a doctor's sanity. When she does find a man that we think might be reasonable, we feel greatly relieved.

Dr Carey's assistant, Justine, 'is already panicking that I am not coming in. I ask her what she will do if I'm actually sick one day. She doesn't answer but my question disconcerts her: she drops her precious green folder. It splays open and blank X-ray request forms, discharge pages, prescription charts and referral notes scatter across the floor, underneath patients' beds and out of the ward into the corridor'.

Decisions have to be made in split seconds and we sympathise with Justine ... it's an awesome responsibility constantly being on the spot with life and death issues. It's surely a great book for those who are faced with making decision about medicine as their future career. A tense time occurs when a doctor accidentally sticks himself with a needle from a patient with HIV and AIDS. This has happened to doctors I know working in Botswana and it is a harrowing experience.

On the days she has to take the interns around the teaching rounds Dr Carey is frustrated with the time taken from her emergency patients who are waiting for her. In an amusing tale of confusion over her part in implementing a new policy on preventive medicine, she is giving a class in a health club on diet for diabetes prevention. Having lost the venue and room number, she ends up with a group of Alzheimer's patients.

Juggling her various roles is well done and also makes for interesting reading.

Rosamund Kendal's lively humour and her open hearted care for her patients, her entertaining dialogues and the fast moving pace of this novel make it a good one. It makes you aware of the realities of a doctor's dilemma: that they can't be perfect, they can only do their best and they have their own lives to lead. People must seek out advice from doctors,  but it would also be best of they could be in the position to make their own  informed decisions about their bodies-this is best done working together with a medical doctor.

Father Michael's Lottery (Mmegi, November, 25 2005) is a novel by Johan Steyn about a young doctor practising in government hospitals in Botswana. These two novels could be taken together, as both paint a picture of adversity and human perseverance in difficult circumstances. The Karma Suture is a long way from Mary Chi-whi Kim's Karma Suture: Poetry, Prose and Creative Writing and has nothing to do with Ray Larabie's font of the same name, or the lyrics Karma Suture sung by Monochrome Set or the song launched on March 21 last year by AdAbsurdum. This variety of surprising uses for the words 'Karma Suture' is purely coincidental!
e-mail: sheridangriswold@yahoo.com