Perspective on Assault from Kla

Hello and Greetings from Kampala (it is often abbreviated kla)!

I've been back in Uganda working at Mulago hospital for almost 4 weeks now.  As usual it has taken me a while to find a chance to write a post, but I'm hoping to put up a few in the coming days to catch everyone up.

At some point I'll put together a post on the Ebola outbreak here (spoiler alert: I don't have Ebola), and another on the Quality Improvement project I'm working on putting together.  First, though, I wanted to write about some events that happened just before I came here to Kampala.

About a week and a half before I came back to Kampala, I was the victim of an assault in New Haven. It was midnight, and I was walking from a friend's apartment to my car in one of New Haven's nicer residential neighborhoods. I was walking with a friend of mine (also a resident). Although our cars were only about 2 blocks away from our friend's apartment, as we walked we crossed paths with a large group of adolescents.  There were a lot of them - probably 20 or more - all looked to be teenagers (from younger to older), and the group consisted of boys and girls, some walking, some on bikes, and all talking, chattering and interacting amongst themselves as the walked down the street.  Although it was an odd scene, they were not overtly threatening.  We had actually walked through the group without incident (they were heading one way down the street, and we in the other), but moments after we had passed them a smaller group of about 5 boys, mostly wearing ski masks, returned and assaulted us.

I didn't really see my attackers because they ran up from behind me and began hitting me in the head. I didn't realize it at the time, though in retrospect, and given the degree of the injuries they caused, we ultimately think they were hitting me with rocks. While three of the boys attacked me, another two snatched my friend's purse, shoving her to the ground and hitting her once (without causing significant injuries). They made no effort to rob me (my wallet and phone were in my pockets).

I was dazed as everything occurred, but as I was receiving repeated blows from behind, I decided to try to turn around to face my attacker, in the hope that a face to face confrontation might dissuade them.  Frankly, at the time, I didn't realize the gravity of what was happening, and I half thought that I would turn around and see one punk kid who had punched me a few times and gone running. Instead I saw several adolescents in ski masks standing behind me. I think the fact that I did turn around and face them was unexpected, and everyone stood still for a moment.

I saw that my friend was okay, and was not being pursued by anyone, so I kind turned around and sort of jogged and stumbled off into the adjacent city park (a few blocks of lawn and trees in the middle of this generally pleasant neighborhood). I could see that my friend was moving off in the same direction, and seemed okay. I could also see that one of the assailants followed me into the park, and I thought I saw him stoop to pick up a rock (or perhaps he already had one in his hand). I was not moving very fast (as you can imagine), so he was quite close behind me. I thought he was going to throw the rock at me (not realizing that they had already been hitting me with them), so I tried to bob and weave a bit, though lost my balance and fell to my knees. I expected another blow, as I tried to stand up, though I never received one. My friend later told me that the final attacker left me in part due to the shouted warning of one of the other assailants - something along the lines of 'what are you thinking? let's go!'

Although we were left alone at that point, moments later the same group attacked another resident just down the block who was heading to the same apartment we had just come from.

I only realized the degrees of my injuries as we waited for the ambulance. I had large lacerations on my scalp, my right forehead, and my right eyebrow.  My nose was broken and somewhat crooked. My most significant injury was to my left ear. A decently sized piece (about 1-1.5cm wide and about 2-3cm long) of my ear had been avulsed, and remained attached only by a sliver of skin near the very top of my ear. I have some great pictures from the ER, though even for a blog where I photo-documented cutting a parasite out of my own toe, they are a little much.  If you want to see them, email me.

As I write this, 5 or 6 weeks later, my injuries are all but healed.  I will have bit of a jagged Harry Potter-like scar on my right forehead, though the one in my eyebrow is largely hidden.  I went to the operating room about 5 days after the event to have an ENT doc straighten my nose, without complications.  And my ear, the survival of which was initially in question, ultimately regained its blood supply and has healed well (though the avulsed portion remains numb and there is a large scar).

I don't have too much to say about the higher meaning of the events at this point, in part because I'm tired of talking about them.  But I think I summed it up well, a day after the event, when I said: Random Violence is Bad.  I don't mean to say that all of this doesn't tell us something about the underlying problems of our society, but for those of us who are confronted with the results of poverty and hopelessness on a regular basis in the hospital, I'm not sure it tells us anything we didn't already know. Sure - I won't give large groups of adolescents in New Haven the benefit of the doubt on a dark street anymore, but I don't think that is a widely applicable lesson.

And what does this have to do with my trip to Kampala?  Well, in a way, coming back to Kampala rescued me from the aftermath of this event, in both a practical, and a philosophical sense.

After the assault, I spent about a week milling about at home, supposedly resting my brain after it was concussed -- which I am quite bad at -- and feeling generally restless. Even after the immediate medical issues were taken care of, it was difficult to overcome the inertia of the event - it had stopped my life. Every chance meeting with an acquaintance required another retelling of the episode, and my email inbox was backlogged with correspondance related to the assault.  Kampala, in that respect, was an escape. And while a quick trip to Uganda probably doesn't seem normal to many of you, I have done my best to make international work a regular part of my life, and so making it here was part of making it back to my normal.

And certainly, I did have to tell the story to a few Ugandans when they inquired about the wound on my forehead, though here the incident was largely forgotten.  It goes without saying, of course, that Ugandans are uniformly shocked that something like this could happen in the US. Interestingly, I found that Ugandans often had more difficulty wrapping their heads around it than Americans. While saying something like 'teenagers looking to wreak havoc' was generally enough of an explanation in the US, it is not sufficient here. Were they on drugs? Were they psychologically disturbed? A robbery would be one thing, or even a rebel army kidnapping children and raping and killing civilians - those are somehow more familiar here. That is not the case for truly random violence; in that category the US seems to stand out.

But Kampala rescued me from the implications of my assault in another way as well -- by putting them in perspective. I began this period at Mulago hospital working in the Intensive Care Unit. The difficulties of this work would fill a blog entry on its own, but suffice it to say that the ICU is full of unlucky people - victims of motor vehicle accidents (mostly from the motorcycle taxis), victims of assault (though rarely random), and victims of disease - people whose injuries are far worse than mine, who receive far less support and care, and many of whom don't survive. Walking past the emergency department, at any given time, you are liable to see a few patients far more disfigured than I was on my worst day, and who are unlikely to be helped to heal as much as I was.

It is easy to say to yourself "I'm lucky it wasn't worse" and then to go on feeling sad at just how bad it was. Living and working in a place where you are regularly confronted by "worse,"however, illuminates that type of sorrow in a harsh light.

Thanks to EgyptAir for having a pre-arranged tour to Giza for those of us with a few hours to kill in Cairo en route.