Counting Backwards by Henry Jay Przybylo

Author:Henry Jay Przybylo
Language: eng
Format: epub
Publisher: W. W. Norton & Company

ON THE WALK TO the research center that Tuesday morning, as my mind wandered over the possibilities, I was excited to think that my expertise might be needed to address a research issue.

Entering the animal procedure room, I froze. My expertise hadn’t been requested for a research dilemma. In the center of the room, on an obsolete human OR table repurposed for research, a gorilla lay motionless. She was named Tabibu. Even as sick as she was, Tabibu was stunningly beautiful. Dwarfed by the adult-sized OR table, at less than two years old, she was about three feet tall and perhaps thirty pounds, with intensely dark-brown fur and skin a deep midnight black. I stepped to the bed, and her two handlers shuffled away from her, perhaps accepting the gray of my lab coat as authority. Tabibu’s open eyes were the color of dark-roasted coffee, but they were dull and didn’t reflect my image.

I melted. Before I could kick into detached physician mode, I needed to conquer my empathy—that hug-the-puppy desire. I listened as the surgical fellow and one of the animal handlers, who turned out to be the zoo vet, provided me with the details of Tabibu’s condition.

Three days earlier, my anesthesiologist colleague on call for that weekend’s emergencies, Andy Roth, had received a call from our pediatric surgeon, who in turn had received a call from the zoo. Late the week before, Tabibu had become severely ill with an acute abdomen. In humans, an acute abdomen is severe—an incapacitating belly pain that develops over a short period of time. The patient is bent over in agony, unable to stand straight. Lying flat on a bed, the patient avoids all movement because moving causes the abdominal contents to shift, triggering a pain response.

The zookeepers had noticed that Tabibu had stopped eating, become lethargic, and retreated from all social contact. Concerned, on Saturday morning Tabibu’s keeper had called the zoo vet. In comparison to human medical specialties, the zoo vet is the family doc caring for hundreds of species—from snakes to birds, pygmy shrews to rhinoceroses. The zoo vet’s net of knowledge is cast wide, but not necessarily deep.

This vet understood the severity of Tabibu’s illness and realized that the situation exceeded her ability. She contacted our pediatric surgeon because a juvenile great ape physiologically and anatomically is not too dissimilar from a small child, and a gorilla’s genetic profile is at most a couple percentage points different from that of a human. The surgeon recommended transferring Tabibu to our research facility for evaluation. Our surgeon confirmed the diagnosis of acute abdomen. Tabibu needed surgery. Her abdomen might contain an infection, an obstruction of the intestines, or a disruption of blood flow (ischemia) to an organ.

Andy was asked to provide anesthesia for an exploratory laparotomy. In this procedure, the surgeon opens the patient’s abdomen, exposing the organs to determine what’s wrong. This is a major procedure in elective situations, and in emergencies it is fraught with risk, both from the anesthesia and from the surgery.

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