A doctor's diary: An unexpected find in a boys appendix

We are sleeping on concrete and use an outdoor tented loo. This is right beside the helicopter landing pad, so it is not unknown for a chopper to demolish the tents with their downdraft. You do not want to be in a toilet tent when a helicopter lands nearby. I speak from experience. The tent flies several hundred yards and you are left sat there, exposed for all to see.

Our pattern of work is beginning to change, too. Right after the event, the casualties are either dead or have major trauma – broken leg bones, broken backs. Now, many of the patients I see have been treated elsewhere. Today is a good example. It has been a busy one. We have completed nineteen operations but only four were untreated injuries created by the typhoon.

All surgeons are allowed to have their favourite operation of the day. Mine is one of the appendectomies. The patient, an eight year old boy, had all the signs and symptoms of appendicitis.

However, when we opened up his abdomen to take it out, the appendix looked almost normal. So what could have caused the boy’s appendicitis symptoms? We scratched our heads, talked and pondered. One of the Australian surgeons suggested we cut the appendix open and take a look inside. How glad I am that we did so.

With a pair of small scissors we slit the thing open right along its length, opened it up and looked inside. Littered around were dozens of wriggly worms. Small, creamy, string-like things. A worm appendicitis, after all, is not something surgeons like me see every day, so the event has gone straight into my diary.