Book review: Band-Aid for A Broken Leg – Damien Brown

This is a review of a great book I’ve recently read, and whilst technically not exam-related, I think it’s still worth putting on your reading list – you’ll see why.

Band-Aid for a Broken LegBand-Aid for A Broken Leg (And Other Ways to Stay Single) is written by Damien Browne, a South-African born, Australian raised doctor who I’ve had the absolute pleasure of working with up in Darwin, which is how I found out about the book.  Damien and I were both locuming in the Royal Darwin ED, and as is the tendency when you meet a fellow non-mainstream-medical person, traipsing about the country on the locum trail, you tend to ask how they ended up there.  We got chatting and Damien revelaed his amazing story of travelling to Africa to work with MSF, and his subsequent mission to do locum work in Australia which helped him to be able to take the time off to write the book.

For those who’ve done aid-work, the stories will probably seem familiar, but for those of us who haven’t, Damien’s first hand narrative from a perspective we are all familiar with (being an up and coming junior doctor in the wealthy Australian health system) makes visualising the scenes he describes frighteningly realistic. Imagine being plonked into a small village in rural Angola with the bare minimum of staff and supplies, and having to treat major trauma, undifferentiated sepsis (in a country with more exotic pathogens than you could dream of, and no lab tests!), paediatric resuscitations, obstetric disasters including a ruptured uterus which you have to perform the laparotomy on (with only ketamine as sedation, no suction and your operating light powered by a car battery), and malnutrition.  Add to this the complexity of navigating the cultural quagmire of a country recently devastated by civil war, the local hospital heirachy and learning a new language (and not an easy one like French or Spanish, Damien had to learn medical & social Portugese!), and it makes for compelling reading.

In Australian hospitals, junior doctors wouldn’t be allowed near a lot of these patients, but as an aid-worker, it’s you or no-one, so one gets to practice in the true sense of the word.  Flying by the seat of your pants is the norm, and I have no doubt that doctors who do this sort of work develop skills, confidence, and perspective that  most of us can only dream of. The risks of aid-work are also covered, and there are some harrowing reminders of the dangers involved, not only in the field, but also on return to “civilisation” and the difficulties some face trying to re-integrate back home.

A level-headed, non-judgemental but stark comparison is made to the extreme affulence of our health system, when he starts back at work in an Australian tertiary ICU.  Whilst making no judgements, the book serves as an unsettling reminder of how cheap life is in some places, and how totally over-valued it in wealthy countries like ours, and how much we (and the general public here) take for granted. His description of the resource-intense management required for a drunk violent patient in ED – something we deal with every other day – again highlights this divide, and the fact that a lot of what we do at work is a serious waste of our skills.

I may be biased having met Damien and hearing the background to this book first hand, but overall I found Band-Aid for A Broken Leg a “can’t put down” read.  If you are feeling disillusioned with the drudgery of ED training, studying for the exam or the pressures of the public hospital system here, I’d strongly recommend you read this book, both as a reminder of just how good we’ve actually got it, and as an insight into a way you can actually make a powerful difference into the lives of strangers, should you choose to one day sign up and do some aid work.

For those who prefer Kindle, you can get it here.

For those who like paperback – it seems to be selling out – so try ordering it from your LBS or at the time of writing you could still get it at the ABC shop online.

(Please note – these are not affiliate links – I get no commision – I just reckon it’s a great book that you should buy!)

EDExam Book Rating: 5 Stars!

Oh, and if this has piqued your interest, check out the Médecins Sans Frontières webiste…

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