Ash, and ouch!

Ash! From Eyjafjallajoekull! Which is in no way just a random mashing of letters on a computer keyboard.

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Today's topic is self-surgery, (thanks to ThereIFixedIt.com), which is not a topic for the squeamish. I was amazed at the case of Leonid Rogozov, a doctor on a Soviet Antarctic base, who managed to perform a successful autoappendectomy.

The operation started at about 22:00 on 30 April with the help of a driver and meteorologist, who were providing instruments and holding a mirror to observe areas not directly visible, while Rogozov was in a semi-reclining position, half-turned to his left side. A solution of 0.5% novocaine was used for local anaesthesia of the abdominal wall. Rogozov made a 10-12 cm incision and proceeded to expose the appendix. General weakness and nausea developed about 30–40 minutes after the start of the operation, so that short pauses for rest were repeatedly needed after that. According to his report the appendix was found to have a 2x2 cm perforation at its base. Antibiotics were administered directly into the peritoneal cavity. By about midnight the operation was complete.

The same feat has been performed by Dr Evan Kane, to prove the efficacy of local anaesthetics. And more to the point, because he was a bit of a nutter.

But even more amazing is the case of Ines Ramírez, who despite no medical training whatsoever, managed to perform a Caesarean section on herself, resulting in the survival of both herself and her baby.

Ramírez was alone in her cabin in Rio Talea, Southern Mexico when her labour started. The nearest midwife was more than 50 miles away over rough terrain and rough roads. Her husband, who had assisted her through her previous labours, was drinking at a cantina. Rio Talea has 500 people and only one phone, but it was not nearby. Ramírez had given birth to eight children, seven living, at the time of the pregnancy in question. The last pregnancy, three years prior, had ended in fetal death during labor. Rather than experience the loss of another child in the same way, Ramírez decided to operate on herself.

At midnight, on 5 March 2000 — after 12 hours of continual pain and little advancement in labour, Ramírez sat down on a bench, drank from either a bottle of rubbing alcohol or "3 small glasses of hard liquor" (accounts vary), and assumed the traditional Zapotec birthing position, sitting up and leaning forward. She then used a large kitchen knife to cut open her abdomen in a total of three attempts. [...] After operating on herself for an hour, she reached inside her uterus and pulled out her baby boy, who breathed and cried immediately. She then severed the umbilical cord with a pair of scissors and became unconscious. When she regained consciousness, she wrapped clothes around her bleeding abdomen and asked her 6-year-old son, Benito, to run for help.

Despite bearing many of the hallmarks of an urban legend, it does in fact appear to be true — it's been written up in the International Journal of Obstetrics and Gynecology. Utterly astounding.