A guest blog by Christine Goodall, co-founder of Medics Against Violence
When we founded Medics against Violence (MAV) I remember someone saying to me 'you'll do yourselves out of a job' and I replied 'yes that's the idea' somewhat flippantly but really, that was the idea.
In 2008 I had worked in Maxillofacial Surgery, a speciality dealing with diseases and injuries to the head and neck, for 12 years, had just finished my higher specialist training and got my first consultant job. During those 12 years I saw thousands of facial trauma patients, mostly young men from deprived areas, involved in interpersonal violence, usually while drinking; that's your typical facial trauma patient. Many were quite big characters with colourful language, but some were wee boys, separated from their gang, no longer the big hard man, worried about the wrath of their mother, the prospect of an operation, the involvement of the police, scarred, scared and sore. Being admitted to hospital as an emergency is a great leveller and the 'Badge of Honour' thinge is rarer than you might think. We are really good at patching them up, Scotland has some of the most experienced facial trauma surgeons in the UK, but the trouble is some of them are never the same again because it really is more than just a sore face.
You face is a great thing, the home of all your senses, it is also a fantastic crumple zone, like a series of matchboxes, and the fact that it is, often protects the brain from more serious injury during a fight. But there is something really personal about hitting or slashing someone's face and something really traumatic in more ways than just physical about being on the receiving end.
When I give talks about MAV I always show some photos of patients because no matter whether the audience have inflicted the injury, work in violence prevention or are just interested, most have never really looked at the damage done by violence and many flinch and look away when I show these photos. But this is the reality of life in hospitals and the reality of life for the victims of violence and it's important to see that because these horrific images are what one human being can do to another, and for what? The one thing I can't bring into the room is that smell of blood and alcohol mixed together, it's a really evocative smell and one you never forget if you work in a hospital, the smell of trauma.
Many facial trauma patients require surgery, to fix broken bones most often, and a straightforward operation will cost about £4.5K and take a couple of hours. The other extreme are people who need very extensive surgery and can spend up to eight hours in the operating theatre having all the pieces painstakingly put back together and then often a period of time in intensive care until the swelling goes down, the cost of that, both financial and human, is much more. We fix fractures with titanium plates and screws and even a simple fracture can need two metal plates and up to eight screws, something more complex can require many more.
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