
“Gaza is now the world capital of child amputation. And that doesn’t even cover the true horror, because Israel blocks any anesthesia from entering Gaza as a means of imposing further agony on the population that they are subjecting to genocide.” – Former senior United Nations human rights official Craig Mokhiber
For a month after a third joint replacement (this time a second knee), I went through excruciating pain that even mouthfuls of opioids did little to quell: one consequence of their overuse, or “abuse” in today’s vernacular, over several years.
I wasn’t a junkie (“they always say that”) or addicted (“they always say that too”). But for a while I found the high they gave me increased my creative powers. I could write articles and chapters in record time, and if I was mathematically inclined (I’m not) solve quadratic equations in the blink of an eye. The opioids didn’t let me sleep and, because I didn’t increase the dosage, they gradually ceased to be a stimulant or effective in pain relief.
Nevertheless I was sent home from hospital three days after the joint was replaced with widely prescribed opioid analgesics: Targin 10/5 mg and Endone 5mg x 2 (10mg). These had little or no effect on the pain in my knee especially at night when it was horizontal, preventing me from sleeping.
With growing concern about my lack of sleep, I limped into my GP’s surgery and was prescribed a minor variant: Palexia SR 50mg and Palexia IR (tapentadol) 50mg. Though they are supposed to work on different receptors, this opioid cocktail was equally ineffective in curbing the pain, let alone inducing sleep.
My chemist suggested I was no longer metabolising opioids in the way most people do and had become resistant (or “tolerant” in pharmacology speak) to their effects. I had suspicions of this after an earlier medical “episode” when morphine proved to be ineffective and fentanyl was required to kill the pain associated with an attack of colitis (not recommended).
I also began to think my prothesis was plotting against me. It was the product of a 3D printer, jointly made in Belgium and the US from MRI data, then assembled in Melbourne: custom-made as they say, not off the rack as in the past. Perhaps I had got caught up in some trans-Atlantic conflict? The aim was to walk in a perpendicular fashion for the first time in 15 years.
My aim, at least in the short term, was to get some sleep. I was close to delirium by this stage. After a month of annoying pain and sleep deprivation, I was getting desperate. I then suddenly realised that in the internet age, pain “management” had switched to a new modality: DIY.
This was a light bulb moment for me, much like Marie Curie felt when she discovered radium or proved the existence of polonium. It was my responsibility to research the problem and come up with an alternative treatment, then present it to a doctor and get a script for the medication. In other words, reverse the doctor-patient relationship.
After some web searching and a chat to a tame rheumatologist, I suggested Pregabalin (Lyrica) 75mg x 2 which helps to inhibit pain reaching the nerves around the knee joint. It works in a similar way to the local anaesthetics that are given by needle straight after the procedure in hospital, but which are impractical to administer at home, and raise the prospect of infection. Little did I know that Pregabalin previously featured in post-op pain management protocols for total knee replacements, but had inexplicably fallen from favour and been replaced by opioid treatments (or “agents” if you want to sound medical).
My GP thought it was an excellent suggestion, even though he didn’t make it, and did not seem in the least embarrassed or surprised that his patient was now advising him about pain relief. It was like an episode of Larry David’s Curb Your Enthusiasm, lots of “huhs”, “why nots” and shoulder shrugging. I was soon on my way to the chemist with yet another prescription to fill.
It did the trick. I got sleep and the main side effect was head cloudiness that could be attenuated with several cups of strong coffee and a glance at the ghastly morning news.
During my convalescence, I indulged in several bouts of regret and self-pity until I was disabused of such a self-indulgence by heartbreaking photos I saw of kids in Gaza being amputated without any serious anaesthesia at all. I got Propofol, they got Panadol – if they were lucky.
Children who were denied the basic medical treatment I took for granted, had been bombed only because they were Palestinian: the wrong nationality. These kids from under the rubble survived when so many members of their extended families did not. But are they any less fortunate than their brothers and sisters who are being systematically starved to death in northern Gaza right now? Whatever the gruesome answer, the pictures of these children are soul destroying. They certainly put one’s own good fortune in its proper perspective.
I am mobile again and thanks to the miracle of modern medicine I can walk freely without pain around one of the world’s safest and most liveable cities. For the children of Gaza, their survival will be a much greater miracle than mine.
So much power, greed and fanaticism occludes their chances of enjoying any future at all. Their path forward is blocked by zealots, many of whom live in the same safe and liveable city that I do, with no connections of any kind to the land which they claim is theirs by Biblical entitlement. Many of these extremists openly cheer the wholesale slaughter of Palestinian children, something I have never seen before in any other conflict. And I am in my 60s.
At the same time, they are claiming to be the real victims of rising antisemitism which they mistakenly say is unconnected to events in Gaza: meanwhile a number of academic studies closely map incidents of antisemitism with the one-sided slaughter in Gaza. Cynics might say this victimhood is a convenient distraction from the genocide with which the mainstream media is only too keen to play along.
Until now there has been offensive graffiti and the appalling fire-bombing of a synagogue in Melbourne, but thankfully no serious injuries nor deaths. To compare this situation with the purposeful slaughter of innocent civilians in Gaza is absurd and offensive.
According to the Zionist Facebook brigades (the most fanatical would not even visit Israel, let alone volunteer for the IDF now), these poor benighted children are uniquely without the right to live in their own homeland and their suffering is either imaginary or deserved.
Imagine confronting this violence as a penalty for being born to the parents of a nationality without global influence, wealth or international support. Watching family members murdered, your house destroyed, your land stolen and the hospital which removed your arm without painkillers — if it is still standing — being raided by men with guns trained on you. Imagine for a moment what these horrors are setting up for all our futures.
It is often too disturbing to watch, but there it is on video feeds for anyone to view, hour by hour, day after day, month after wretched month. The savage reckoning will come eventually, of course. It won’t be pleasant. And most of us will scratch our heads amnesiatically and wonder what is happening and why it has occurred to us.