The Martlet; a newsletter where Surgery, Culture, Innovation, Finance and Informatics cohabitate
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Ready to be a Bullfight Surgeon? |
Spanish Versus Portuguese Bullfighting Injuries |
Here’s what you need to know. By Royal Decree from the King of Spain, the medical preparedness of bullfighting events Spain is highly regulated. On site surgical capabilities are mandatory, and teams must have a general surgeon with trauma experience. |
In a recent study from Spain and Portugal over 7 years, they found 1,239 injuries that required a trip to the hospital. This resulted in 9% of bullfighting events, roughly 1 in 10, having someone that required surgery or admission, with 0.48%, or 1 in 200 events, resulting in a death. 70% of the injured are Matadors, whereas 19% are Piqadors, the assistants, with the remaining being a combination of the public (during the running of the bulls) and horseback bullfighters called Rejoenadores.
Injuries are classified as gorings (exclusive to Spanish Bullfighting as seen in this image) or blunt force (Portuguese style, neck injuries from the landing, or trampling which usually results in closed fractures). Outcomes are related to the age and weight of the bull, penetrating injuries, vascular injuries and the presence of a neurologic injury. Interestingly, 50% of injuries re caused by bulls over the age of 4 and 30% of wounds involve the groin, with 20% of these resulting in a vascular injury requiring repair.
In Portugal, unlike in Spain, the bull’s horns are covered and the team tries to tackle the bull and wear it out (see animated image), rather than stab and kill it at close range (the "estacada"). So, if we’re being scientific about it, it’s best to be a Portuguese Bullfighter, as long as you don’t get trampled.
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Sri Frederick Treves: Surgeon to King Edward VII and The Elephant Man |
Sir Fredrick Treves (1853-1923) was an amazing Surgeon and prolific writer. He came to surgery as a general practitioner, as opposed to the barber pathway as had been customary, training at the London Hospital (now the Royal London). He is known in popular culture because of the the story of the Joseph Merrick, the Elephant Man. Sir Frederick was played by Anthony Hopkins in the film adaptation of the book directed by David Lynch.
He then served in the second Boer War in South Africa, documenting his experience in a book titled The Tale of a Field Hospital, which every surgery trainee should read.
In 1902 he operated on King Edward VII in the Music Room of Buckingham palace, draining an appendiceal abscess 2 days before the Coronation. When the King initially protested to the procedure, Sir Frederick purportedly said that if we don't operate today, then there will be a royal funeral rather than a Coronation.
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Teddy Roosevelt was the first president to survive an assassination attempt |
October 14, 1912, while giving a speech in Milwaukee, President Roosevelt was shot in the chest with a .38 caliber colt revolver at close range.
The President fell back and sat down, then pulled a 50 page manuscript from his inside pocket and showed the crowd that the bullet had passed through the manuscript and his eye glass case.
“The bullet is in me now so that I cannot make a long speech, but I will try my best” he is reported to have said. And in fact the bullet was lodged in his right chest. He was taken to Chicago Mercy Hospital, and observed for several days. A X-ray showed no pneumothorax. The bullet was not removed.
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Cardiac Tamponade: Direct blunt force to the heart can cause a blowout of an atrial appendage. The key is to immediately open the chest, release the tamponade and get a Satinsky clamp over the appendage. Any tie will serve to seal it up. If the heart doesn't restart immediately, wait until the heart is full, ideally with blood products from a large bore IV, give 1mg of epi and pour 42C saline over the heart. You'll be surprised at seeing the heart start galloping and wonder why everyone doesn't know this trick. |
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