Surgery in a Jail Cell
By Gordon "Chip" R. Phillips III 6/23/03
April 17, 2003, Santo Antônio do Içá, Amazonas, Brazil. The policeman called me to the hospital's front door. "We need you to operate on someone at the jail."
"That's impossible," I said, " you have to bring him to the hospital." He was adamant. What was happening to our small quiet rural town along the Amazon River in northwest Brazil?
The day had been fairly routine until 4 PM when I heard a rumor that a nurse from the city's health clinic had been shot. I quickly went to the Amazon Baptist Hospital but found no patient. Could it be that they were trying to treat her at the clinic and not the hospital?
As I rushed to the health clinic on my motor scooter, I knew something was amiss. I had to dodge a man running down the street with a semi-automatic rifle. At the clinic I learned that he was the nurse's brother, patrolling the road in his fury at her death. I found her dead at 20 years old, killed by a bullet that had entered her right chest and transversed her belly. In a jealous rage, her boyfriend had shot at her through a locked door-and found his mark.
A Vigilante Mob
The murderer fled, but the police caught him. They put him in a police car and rode to the jail. As they arrived, relatives of the nurse surrounded the car, armed with various guns. The police retreated from the mob, abandoning their prisoner, who was shot as he cowered in the back of the squad car. Desperate to save his prisoner, the head of the police had called me to the jail to treat the victim. The girl's family refused to allow the man to be taken to the hospital for treatment and were surly when I arrived to treat him.
I found the man moaning on the floor, having been shot from his lower right to lower left chests. The bullet appeared to have passed through his belly just below his heart. Both lungs had been punctured and probably a number of abdominal organs. Without surgery he would surely die. The scene outside the jail was tense and the patient could not be moved. But could we operate in a backwoods jail and have the patient survive?
I met with Dr. Mark Thompson, the other physician at the Amazon Baptist Hospital, and we decided to try it. While a nurse prepared the usual surgical supplies, Mark and I tried to collect anything we might need. We thought we would have one shot to arrive at the jail unexpectedly and enter without the family trying to stop us. We were wrong. As we arrived, they began to seize our supplies and cast them in the road and stole our instruments. Salvaging what we could, we fled into the jail.
Surgery in the Dark
I started treating the patient while Mark and our nurse snuck back to the hospital for more supplies. We transformed the jail into a makeshift OR (operating room). Using a headlamp, we operated in a hot police cell on a wooden table. Both chests were punctured, requiring bilateral drainage tubes. There were powder burns where the muzzle of the rifle had been pressed against his right chest. The bullet had torn through the man's liver, leaving a four-inch laceration spreading out like a star, had torn through the middle of his pancreas, and then exited through his diaphragm.
Twice during the operation to remove half his pancreas and his spleen the lights went out and we kept operating by feel, under the feeble glow of a flashlight held by a prisoner. Both times the rioting family had been trying to burn down the jail by pushing high tension electrical wires onto the jail.
All night long, I worked on the patient. The jail cell, first an OR, now became an ICU. He lay in critical condition, in desperate need of transport to a hospital. Despite deflating my motorcycle tires, the mob stopped short of harming me, and I left the jail briefly to catch some sleep and take a bath. But they would not let us move the prisoner, and their numbers were swelling. As the hours passed, his condition worsened, and he developed respiratory problems, which are common with this type of injury.
Rescue by Airplane
Finally, after 48 hours had elapsed, the governor sent a float plane accompanied by a SWAT team to remove the patient to the state capital, Manaus. When all the preparations were ready, the SWAT team burst out, armed with machine guns and hand grenades, and 200 people surrounded them, screaming "Killer," "Aggressor." I had stabilized the patient as best I could for the transport, and gladly left it to the police to keep him from being shot again as they carried him to the plane.
The plane finally took off, but the patient died in transit to the hospital in Manaus. The delay in transport had cost him his life, and the vigilantes had achieved their revenge.
The Lord's Plan
As I have reflected on this atypical case, I have developed a greater appreciation for the Lord's leading in our lives and the deadly consequences of sin. On the negative side, this nurse had made a profession of faith in the past, but lived a prodigal life, full of partying and many lovers. She never thought the consequences of sin would be so stark and had stated that she believed that she could do anything and nothing could happen to her. She had no fears. But sin, whether slowly or quickly, always kills.
Positively, the Lord used this tragic situation to give a number of people the opportunity to hear the good news of Christ. Police offices from three other counties were called in to help stabilize the situation and all of them passed through the jail. There were many opportunities to speak about spiritual issues and ask the officers what would happen to them if the family attacked them and they were to be killed. None professed Christ, but many heard the gospel.
I also saw how the Lord used my prior training in Trauma and Critical Care Surgery to prepare me for such an undertaking. This case would have been very difficult, if not impossible to do in the dark, if I had not been there many times before. Additionally, I experienced the Lord's protection as any of these enraged family members could have lashed out against me as I tried to help their sister's murderer.
Fortunately, most of the days at the Amazon Baptist Hospital are not so dramatic. The Lord allows us to use medicine to touch people's lives and make contacts to share the Gospel. We would covet your partnering with us in prayer and financially to reach the needy people of Brazil's Amazon Jungle with the gospel.
Read more about Gordon Phillips and ABWE's medical ministry in Santo Antônio do Içá.
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