Hospital in a 3rd world anyone?

It was only as I was waiting for my last wave of the session that I noticed the scalpel blade sticking out of the nose of my board. Lying prone, I rubbed my finger back and forth across the leading edge, marveling at how sharp and lethal it was. The day before I’d dinged my board on the rocks coming in and did a home-made repair job, leaving it to dry overnight. As dawn rose and the surf looked perfect I’d dashed into the water, forgetting to inspect the damaged part of my board.

Using a square of matted glass fiber, epoxy resin and catalyst, like a mad professor, I’d concocted a classic botch job. Five or six strands of glass had detached themselves from the patch I’d cut and were sticking straight out from the rail. The resin had been pulled along with it, creating a web, from nose to the point of the fibers and hardened. The leading edge was extremely sharp and the fibers acted as a backbone to the knife-like protrusion.

Ouch, that’s nasty. I’d better break that off and sand it down when I get in. How had I not noticed it until now? Well, good thing it’s my last wave because something bad could have happened. Prophetic thoughts, indeed.

I caught my last wave a little too late and fell, from top to bottom, followed by my board. The wave powered the 6.8 into my leg, hitting the shin bone and raking itself along it’s length to my ankle, where the leash was strapped on. The nose buried itself for a second and then flipped out, leaving me in some pain. If you’ve ever cracked your shins on a low bench or table then you’ll know the pain. It’s heavy to begin with, subsiding slowly over time to leave a dull ache for a fair while afterwards.

It’s a funny thing in surfing that, when you injure yourself, instead of paddling for shore, you always head back out to sea and then inspect yourself. As well, last waves are a sacred rite, in that you have to at least ride a half decent wave in. So it was that I took a few strokes for the horizon and sat up, cursing like a well versed sailor, trying to get to grips with the pain.

I lifted my leg out of the water and saw the livid pink welt already showing that ran from just below my knee down to my ankle. Aieee, no wonder it hurts so much. There was nothing else to do but wait for the level of agony to deteriorate. But as it did so I began to notice a different ache emanating from a spot under the leash, sending strange signals to my brain of a kind I’d not really experienced before. So I raised my injured limb up once again and this time noticed a trickle of blood coming from under the strap and running over my heel.

Why I didn’t just take the strap off and have a look, I’m not sure. Instead I gripped the shin with one hand and lifted the upper edge of the tight velcro band with the other, so that I could have a look underneath. This action had the effect of pulling the flesh in two opposite directions and with some force. What I saw still shocks me today.

Perhaps a miniaturized version of the grand canyon would be an apt description. Two walls of blood red flesh with a frayed tendon stretching from one side to the other, almost like a tightrope you wouldn’t want to risk crossing for fear of it snapping. While one end of the slice was a nice clean cut, the other shone white with bone. As I was pulling with such strength the wound was opened up to it’s maximum extension and I could see straight into the inner workings of my leg.

Sometimes when you inspect yourself you expect the worst, such as after scraping across rocks or hitting reef, and find that there’s nothing but a bunch of scratches. Other times something innocuous might happen that you’re not even sure is worth looking at, but when you do, you find a hole. It’s never really the pain that bothers you, but the question of stitches and how long out of the water you’ll have to spend that’s the issue. Only occasionally does something gruesome happen that threatens you with shock, and it’s at these times that you really need to keep a grip. This was one of those moments, made worse by the fact that I really didn’t think anything too bad had happened. Which was when I remembered the scalpel blade…

I paddled in and let some white water push me the rest of the way to the beach. There’s a path through knee-high length grass that I never take because of the number of lethal snakes in the area. The other route is across slippery rounded stones, smooth as pebbles and the size of an Olympic discus. If you’ve ever been to Brighton beach you’ll know what I’m talking about; no sand at all, just giant sized pebbles. Because I’d got up close and personal with that tattered tendon, I was in fear of it snapping if I walked on it, and so I found myself crawling for 20 minutes up the coast on hands and knees, slipping and falling on these bloody rocks.

Fortunately, the owner of the empty camp where I was staying had turned up for the afternoon in his pick-up truck and Roberto was able to drive me into town to see the local doctor for some stitches.

La Libertad is considered to be some kind of jewel of El Salvador’s countryside. Mainly because the only road from the capital to the coast winds down a valley and ends in this squalid shithole. While the beachfront cafeterias, bars and restaurants are picturesque overlooking the bay, two streets back you’ll find a post-apocalyptic scene straight from a Romero-inspired horror movie. Crazed crack heads, eyes wildly roaming, mouth foaming and dressed only in ragged shorts, stumble and stagger across the road, like zombies, looking to hustle something, anything to buy their next rock. And gringos are their target.

Before finding my epic spot to surf and stay, I spent an afternoon in La Libertad weighing up my options. I found the one and only place to stay for westerners, took in the barbed wire, gate, armed security guard and hippy collective cowering inside the compound and thought, “there must be something better than this”. There’s a great wave there that was having an off-day when I looked at it and when I took in the broader picture I decided to bail, not least for the out-flow pipe sticking ten feet high above the ocean depositing this sickly looking brown froth into the water (much later on, I traced the river and sewage back to the shanty town that lay half hidden by the jungle far back in-land).

The drug addict collective hovering around the gates of the camp was disturbing, too. The second you stepped outside they were on you like vultures, pecking at each other for priority, offering coke, weed, women, anything, even their grandmother. Every one of them would be desperate in their quest, pleading and screaming. The idea that I could stay here and enjoy my time in Salvador, surfing the waves, eating Latin food, meeting the locals and having a sunset beer was ridiculous if, the moment you stepped outside at night, some lunatic would shoot and rob you for nothing.

Much later I was told an apocryphal tale of a surfer who’d taken the short cut through the cemetery to get to the famous point beak and returned fifteen minutes later having been robbed of his board and the surf shorts he was wearing.

And so I asked Roberto if he could wait for me, as I didn’t fancy my chances hobbling around trying to get to the bus stop. Something I learnt in one of San Salvador’s shadier districts was when to run. Given I wouldn’t even be able to walk, pictures of an ailing wildebeest falling back from the pack with a pride of lions closing in sprang to mind. He was cool with it and in I went to meet Doctor Death.

The Doc led me straight into his ramshackle ‘operating theatre’ and got me to lie down on the bed. I’d already cleaned and dressed the wound as best I could so when I took the bandages off he said, “ahh, yes. Five stitches”. His English was pretty good and gave me renewed confidence. Noticing my accent he said, “where are you from in England? London?” and he raised his eyebrows in hope. “Ohhhh, Bournemouth-ish. South coast”, I said lowering a hand to let him off not knowing where Bournemouth is. I mean come on, I don’t even know where Bournemouth is, so how could I expect a Salvadoran to?

He’s a little disappointed and replies, “do you know London?” “Yeah, sure. I’ve been there a few times”, I say smiling and thinking, “where is he going with this?” A broad grin appears on his delighted face and he disappears out of the room leaving his two nurses behind. They already have their surgical gloves and facemasks on so I can’t read their expressions, but they do look like extras from the Rocky Horror Picture Show, which entertained me. Almost immediately he’s back with a couple of ‘Hamleys’ toy cars and places them triumphantly down on the bed in front of me. I emphasize ‘Hamleys’ as they’re the best toy car makers in the world and nerd-like train spotters go to great lengths to collect these things. My doctor is one such geek, it appears.

How bizarre. A jet black London taxi cab and a blood red double decker bus. I’m even a little stoked with how events have just unfolded, here in the armpit of some third world backwater. Good work, fella. London.

I’ve been lying on my side with the wound on my left leg face up and, as I’m inspecting the cars, a little amazed, the doctor begins giving me anesthetic injections. I think to myself, “ahhh ok. We’re off…” So I roll my upper torso over, to place the cars, ever so gently, on the cushioned seat to my right. They’re obviously precious little things and I’m more concerned that they don’t roll off the chair and hit the floor than I am of my imminent stitches.

When I return to my original position, propped up on one elbow, all three members of the medical team are staring at me, I think, incredulously. I can’t tell because of the masks they’re wearing, but the vibe is very definitely there. I say that their gaze was one of amazement, but there was also an element of threat mixed in somewhere. A kind of, ‘how dare you commit such sacrilege in this chapel of righteousness’ look. Anger and awe brewed and exploded in a nanosecond. “What?” I shrug innocently and, while the doc keeps his eyes firmly fixed on mine, the two nurses turn their heads towards the cars on the seat and then, ever so slowly, return their focus onto me. Withering.

Then I get it. The cab and bus were meant to distract me while they went to work, like a secondary anesthetic. I was supposed to play with the cars, pushing them around going, “vroom, vroom”, while they stitched me up. Are you kidding? I’m ready and keen to watch you guys do your job. So I shake my head and wave my hand towards the cars to say, “skip it” and nod at my ankle in a, “right, let’s go” gesture. Doctor’s having none of it, though. The toys didn’t work so he has to actually tell me to lie down saying, “it’s better, it’s better”.

What gets me a little worried is when he decrees, “I’m going to give you two very special stitches, one at each end. A double stitch, yes? I go under, over and back again, ok?” I reply, “ok”, but I’m running through my mind what he means. There’s a problem with this double stitch in that the knot is going to end up being buried in the flesh. When it comes time to take the stitches out, I’m going to have to go digging deep down to find a thread to cut. But anyway, I just want it closed for now so why not let him go ahead and see what happens?

It’s a funny thing receiving stitches with anesthesia because while there’s no pain you can still feel the progress through the pushing and pulling of the flesh. After the needle’s gone down, under, up, over, back down, under and up, I’m wondering what’s next. I’m guessing a slipknot’s applied when I feel him begin to pull the thread tight. Except he’s pulling so hard my whole leg’s lifting off the table, which, while not being painful, is still uncomfortable as thoughts go, considering that it’s all too clear where all the tension’s coming from. Some thread going through my wound is now bearing the entire weight of my leg. With a “doink” sound the cotton is either cut or snaps. I’m fairly certain it breaks because my foot slams back down onto the table, which can’t have been intended.

At this point he mutters, “mierda”, which isn’t a good sign. With a flurry of Spanish the two nurses are dispatched from the room and it’s just me and him now. With a slight shake to his voice he mumbles, “ok, I stitch the other end now”. Without looking and wanting to keep his morale up I merely reply, “sure”.

And the whole thing happens again. Almost exactly, from the stitching, to the crash landing of my leg back down on the table, to his cursing. Except this time he mutters, “puta!” So I sit up to take a look at how things are going and find that there’s precisely no stitches completed. Instead, there’s some ripped and torn flesh at both ends of my trench-like wound. Hmmmmm. Looking up at the doc, I’m shocked to see he’s sweating like a rapist and dabbing at his forehead with a handkerchief. Now I know why he’s dismissed the two nurses as he obviously humiliated himself medically by failing so miserably with the first ‘punta’. The world turns on it’s head as the patient then tries to calm the professional down enough to get the gaping hole sewn up, with the words, “look, just give me five ‘normale’ stitches, yeah? Take your time, it’s cool…”

Really, it’s not rocket science. Any medical school undergraduate could complete the task. Hell, I could do it if you give me the tools. You couldn’t get a cleaner slice if you used a razorblade. So, stop fucking about and nail it closed. Please. I tell you what, I’ll even lie down again and not watch if that takes a little pressure off. Come on man, get your act together.

For the next ten minutes he’s busy as a bee, whizzing through his work knowing he’s got a lot of ground to make up if he wants his pride restored. Finally, He straightens up exclaiming, “finito!” Under the mask I can tell he’s beaming and when I look down at my ankle, bless his little cotton socks, he’s done a perfect job. Five perfect, cute and exquisite knots have clamped the two walls back together again. What a drama, but we got there in the end. I think.

Upon victoriously completing this herculean task, he drops his tongs and scissors, from a height, right on to the traumatized flesh and shoots out of the room (I guess to show the nurses that he was still roughly on time). He couldn’t have aimed them better if he tried and I don’t know if that was a final, ‘fuck you for tampering with my well established ‘machismo’ reputation” gesture or not. It was so unnecessary as to be ridiculous and, despite the anesthesia, it hurt. I pushed them off my leg and lay back down, digging my fingernails into my knee to distract the pain, and through gritted teeth grunted, “oh, you bastard”, knowing he wasn’t close enough to hear.

I was looking for a moral to this story, but there isn’t one other than, “don’t go messing yourself up in the third world unless your looking for trouble” and, “never test a Latino’s masculinity”. Good luck…

Mr I.

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  1. Great story! Thank God I don’t surf …

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