I wanted to profile cardiothoracic surgeons because they are rare in Nigeria. There are few well trained specialist cardiothoracic surgeons in Nigeria. Perhaps fewer than even neurosurgeons who are only about 90 for the whole population of Nigeria. If we are as rare as a gold coin, they are as rare as a hen’s teeth! You know what I mean!
Anyway, let us use one as an example. His name is Dr Bode Falase. He is a surgeon that has a leg in both public and private practice in Nigeria. A man who can treat the pauper just as well as the man with gold coins! A gymnast with a heart, you might say. Therefore, he understands the nuances of both types of health care practice and does his best juggling act depending on the case in front of him.
Public practice through our general hospitals is often besieged by the poor who tend to have left things rather late. Yet, they are also the one’s without a penny to their name. They come to the hospital after complicating their situation with visits to the herbalist and prayer houses. At death’s open door, they expect miracles. A miracle from hospitals that does not have the infrastructure, access to the right consumables, support of skilled manpower and even, sometimes, the necessities like common electricity.
The market woman on the street who needs an intervention, may not be able to afford to go to the private specialist for treatment. However, that person still has a value to the society and deserves treatment. Yet, they cannot be treated at many of our public hospitals where the masses throng to.
In the private sector, things are done because there is a pecuniary advantage, and many hospitals in the private sector can meet the demand of the health seeking public. There is now a growing trend that more of the advanced interventions cardiothoracic surgeons can offer are being done more and more in the private sector. The rich can go to these hospitals and expect the same quality of care as they would find outside the country.
On a special level, of course, are the stupidly rich who with the same problem jet out of the country to foreign climes spending exorbitant amounts of money that may have treated tens of other Nigerians. The job is to convince these very rich people to utilize the local services such that eventually the interventions can cost less and become affordable for more people. They would be sowing seeds that may save their own lives in an emergency.
Let me focus.
A cardiothoracic surgeon is a medical doctor who specializes in surgical procedures inside the thorax (the chest), which may involve the heart, lungs, esophagus, and other organs in the chest. As well as performing surgery, they also diagnose and treat diseases of these organs.
So, someone with a hole in the heart or a weak heart may need the services of a cardiothoracic surgeon. They can repair the hole in the heart or give you a new heart. These operations can be done and are being done in Nigeria. But, of course, you hear very little about them as our doctors are not allowed to shout from the roof tops like others.
Coronary artery disease is also one of the major operations managed by Dr Falase and his colleagues. This can cause heart attacks when patients complain of severe chest pains and difficulty in catching a breath. Further, these doctors can look after patients with injuries to the chest from assaults or a road traffic accident, lung and oesophageal cancer among many other problems.
So, what are we really talking about in relation to cardiothoracic surgery? We can use some recent cases as real life examples. To reiterate, Dr Falase manages any problem within the chest region. Such problem may be affecting the heart, the lungs, the diaphragm or even the blood vessels inside the chest.
Recently, he looked after a boy who had swallowed a coin. Not a rare coin! Anyway, the coin was inside his oesophagus (food pipe) such that he could not swallow anything else. He could also not breathe properly. So, the coin had to be removed. The family travelled from one hospital to another till they ended up with the cardiothoracic surgeon. He was operated immediately, and they saved the day.
Another woman had inhaled a pin which lodged firmly in her lungs. Left alone, it would have caused massive infection, a hole in the lungs and possible death. Dr Falase was able to remove this without too much hassle. The sad point of course is that because these types of surgeons are few and far between, many people do not know who or where they are. Worryingly, even doctors confess to ignorance about their availability and resources available to them. So, patients keep suffering and dying in transit from one hospital to another.
Okay, now you know.
Dr Biodun Ogungbo, MBBS, FRCS, FRCSEd, MSc, a Contributor to Newspackng, is a neurosurgeon with Brain and Surgery Consortium at 8 Buchanan Crescent, Off Aminu Kano Street, Wuse 2, Abuja.