Busy day, two gun shot wounds and one road traffic accident case in the morning. Still in the Operating Theatre, waiting for the recovery of a young man. Early in the morning, two militants were brought in after gun shot injuries. One was hit on back with spinal injury and could not move and feel in lower limbs. Exploration was performed and waiting for later assessment of degree of injury after the spinal shock. Another young militant with multiple injuries was explored in the afternoon. The operation was going on quite smoothly at the beginning. I first put a chest drain on right side because there was shot on back of chest and pneumpthorax (air in chest) on right side. Later I did laparotomy (opening of abdomen) for buttock injury and per rectal bleeding (blood found on examination of the rectum). Then I explored the neck for neck injury, and lower limbs. Jorg found that air entry on left side was not too good, so he put a chest drain on left side as well. But there was blood drained out later. His blood pressure was always low since then. We wanted to open the chest and see but difficult to get consent from relatives as they were away. Just at this moment, the patient went into shock and cardiac arrest. Immediately, I asked for the equipment and opened the chest. Liter of blood was pouring out. Luckily, I found a lung injury and bleeder which was likely caused by the chest drain insertion. After bleeding stopped, his blood pressure came up again and could breath on his own. Thank God for his blessing. I hope he can make it. Every people in the OT was grateful. I bought them some drinks. Ann was waiting for us outside OT. As there was severe insult to the patient’s brain. It may take time for him to recover. We have no ICU (Intensive Care Unit ) nor ventilation machine here. We have to take turn to look after and observe him in the OT. I asked Jorg to take rest and have dinner first. The anaesthetic assistant, Raffik, and I stay. I hope he can recover in next one or two hours.

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