A Surgeon in the Village: An American Doctor Teaches Brain Surgery in Africa

by Tony Bartelme with Catharina Hoek-Ellegala (Beacon Press 2017)

Dilan Ellegala is a Sri Lankan-American neurosurgeon. In this engaging narrative, Tony Bartelme tells how Ellegala escaped the craziness of an academic superstar neurosurgeon career to spend six months in a small village hospital in Tanzania. What he finds there changes his life, his career focus, and his priorities. He realizes early on in his time at Haydom Lutheran Hospital that the constant stream of visiting foreign doctors and medical students has the unfortunate consequence of teaching the Tanzanian staff to doubt their own abilities, to depend upon outside help to do their jobs. Ellegala had an idea: he would teach one of the staff, a young man named Emmanuel Mayegga, how to do simple brain surgery. Mayegga was not a doctor, just an Assistant Medical Officer (AMO), so this might seem overly optimistic, but in fact, he did learn to do brain surgery from Ellegala, and he later taught a young Tanzanian doctor fresh out of medical school what he had learned. The young doctor, who eventually became the hospital’s director, taught a second young doctor. Ellegala had not only succeeded in replacing himself; he had launched a chain of teaching surgeons at the hospital, where surgery had never been done before except by visiting “medical missionaries”. He then became infused with the desire to start an NGO devoted to sending Western surgeons to teach African doctors to perform surgery, rather than sending them to do the surgeries that the African doctors were unable to do. Thus was born Madaktari Africa. Hundreds, then thousands of babies, children, and adults, who would have died without surgery, could now be saved.

This forced me to think about the down side of modern medicine. It works too well. People who would have died instead survive and go on to have children. Earth’s population explodes. People accustomed to having large families to ensure that enough children would survive to adulthood to carry on their genes (and farm their land and take care of their elderly parents) now find themselves struggling to support all those surviving kids. Food, water, and jobs are all in short supply. Of course, I speak from a position of huge privilege; who am I to say that I should live and Tanzanian children should not have the same chances that I had? I cannot say that, yet whenever I read or hear of how many deaths have been averted by this or that medical technology or wonder drug, I cannot help but think that what seems like a good thing can have unintended negative consequences. Sure, if modern medicine went away and antibiotics no longer worked (something that is already happening anyway as bacteria become resistant to the antibiotics that we have) and surgery were no longer an option, we would all live shorter lives. As it is, we are crowding out other species (both plants and animals) and are already starting to see the effects of over-population: wars and massive refugee crises.

What is the answer? Is there an answer?

 

Struck by Genius: How a Brain Injury Made Me a Mathematical Marvel

by Jason Padgett with Maureen Seaberg (Houghton  Mifflin Harcourt 2014)

Jason Padgett was a mediocre student and a 31-year-old party boy who went to a karaoke bar with some friends one night and was violently assaulted by several thugs hoping to rob him. The traumatic brain injury (TBI) that he sustained that night left Padgett with obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), synesthesia, and savant syndrome. It took him ten years to really understand all of these diagnoses; that journey is the subject of this book. But immediately following the attack, Padgett already experienced the visual “disturbances” that were to change his life and how he sees the world: “The world looked different: off-kilter, dreamlike. Everything that moved had trails of colored light following close behind it. There were triangles and squares in repeating patterns wherever I looked, from the windows to the lampposts to the street signs. . . . The glow of the streetlights seemed amplified. I could see the cars going by, little chipped shapes bouncing off their hoods.” Padgett never stopped seeing the underlying geometry of everything, even after his brain had healed. But he suddenly found himself fascinated by, and good at, mathematics, although he did not have the vocabulary to discuss it. Instead, he learned to draw exquisite copies of what he saw–pictures that helped him to understand and explain mathematical and physical concepts.

After a 3 1/2 year self-imposed exile from society during which he confined himself to his home, Jason Padgett bravely returned to the world and to school, taking classes at the local community college, where he was viewed as an eccentric. Little by little, he met people who recognized his newfound genius, and he learned about synesthesia and savant syndrome. He learned, among other things, that being born with one of these abilities, though rare, is more common than acquiring them, as he did. Jason Padgett is the only person in the world known to have acquired both synesthesia and savant syndrome as an adult.

It’s a fascinating story. You can also watch Padgett’s two TED talks: How Math Saved My Life and Alternate Realities from Relativity (TEDx Tacoma).

The Brief Wondrous Life of Oscar Wao

by Junot Diaz (Riverhead Books, 2007)

This is one of those novels which does not unfold chronologically. Instead, the story of Oscar, his sister Lola, his mother Beli, his grandmother “La Inca”, and Yunior (Lola’s sometime boyfriend and the narrator of most of the novel), is spun in a haphazard way, as if the chapters had been thrown down the stairs and then organized according to which step they landed on. It’s not always obvious who is speaking, or about whom. The reader needs patience to figure it out. Parts of the novel take place in New Jersey, other parts in the Dominican Republic. There are voluminous footnotes to explain references to DR history that a non-Dominican reader would not know. The language is a combination of Spanish (a lot of slang) and English; I studied Spanish in school for many years (many years ago, too) and could understand enough to keep going (even if the slang expressions were beyond me), but I’m guessing that a reader with no knowledge of Spanish would be flummoxed. (Example: Her advice? Forget that hijo de la porra, that comehuevo. Every disgraciado who walks in here is in love with you. You could have the whole maldito world if you wanted.) And there is a lot of bad language and an obsession with sex, asses, and breasts. (One of the principal conflicts in the story is Oscar’s inability to get laid.)

That said, I kind of enjoyed it. It wasn’t boring, I learned a lot about the DR, and I got to use my poor Spanish.

By the way, the author has been accused of sexual harassment; he has denied the allegations. It wouldn’t surprise me; the treatment of women in the novel was pretty sexist. They are tough and smart, but they are also sexual objects.