The Lasting Lessons Learned in Lashio
Dr Maung Maung Nyo
Preamble
I enjoyed my stay in Lashio as I was in town enjoying the city life like others and at the same time doing my doctor’s duties in a normal way. Besides I could refer some serious and emergency cases to the Lashio Civil Hospital (LCH) as it has more qualified doctors and facilities. E.g. we had to refer our orthopaedic cases to the LCH for radiography as we did not have the X-Ray machine and radiographers. Of course, we had to provide them with new radiographic plates and developers.
(A Panoramic View of Lashio, Northern Shan State)
And I had friends in the army and civil service as well as in the populace. I was also getting regular mail and I continued writing my short stories in the Thwe-Thauk (Comrade) mothly Magazine. I therefore learned a lot in Lashio and I like to share my lessons learned in Lashio. Enjoy.
Simple Wrist (Colles’) Fracture
At about 9.30 AM one bright day in Lashio a young stout man in tennis shorts came to my OPD with a complaint of severe injury to his right wrist. “I salute you, Captain. I just have a fall on the tennis court and I have severe pain on my right wrist now. I may have fractured my bones,” he said. He was holding his right hand flexed at the elbow by a handkerchief sling. ”OK, I’ll examine and take a radiograph right now. What’s your name?” I asked him. ‘I’m Lieutenant Aung Win from the Artillery. Major Hla directed me to go to you at once,” he replied.
(A Radiograph of the Colles' Fracture of the Wrist)
I examined him and found the following signs of fracture:
(1) Swelling of right forearm just above the wrist joint
(2) Tenderness in the area (Pain felt on feeling)
(3) Inability to use or move the wrist joint (loss of function)
(4) Discontinuity of the right radius (lateral forearm bone)
(5) Jutting ends of the fractured bone
“Yes, Bo Aung Win, you have a Colles’ fracture, Simple one as there is no open wound and protruded bones. I will send you to the LCH to take an X-Ray for confiemation of my diagnosis and then come back to me. I’ll do what I can,” I told him. Then I asked Corporal Sein Tun to take him to LCH for immediate X-Ray and wet film. They came back after an hour and the radiograph confirmed the Colles’ fracture on his right radius. “It’s a simple fracture of lower end of the right radius bone. I can reduce it now under ether anaesthesia, apply a POP and retake the X-Ray for check whether I did it right. Or I can refer you to the BMH, Maymyo where you have to go by train and stay there for at least a few days. Choose your choice because you’re an officer. I won’t tell these options if you are an ordinary soldier,” I explained to him. “I would request you to do by yourself, Captain, I trust you,” he replied.
(Pete Sampras Playing Tennis at Wimbledon)
So, I put him under ether anaesthesia, reduced the fractured segments for normal alignment and applied the POP (Plaster of Paris) bandage supported by a shoulder sling. “You go for another X-Ray and come back,” I told him when he recovered consciousness. The post-POP X-Ray showed I did it fine. So, I told him,” You stay like this for 6 weeks. I’ll check the healing then.” “OK, Bogyi. Thanks a lot,” he said.
“In the mean time you practice your right hand to move and grasp as exercise. That will keep your hand functional,” I explained how to do the hand exercise.
(Labamuni Buddha Image, Lashio, Northern Shan State)
After six weeks, I checked him with another X-Ray and it was found to be OK, the two bone fragments had united well in normal alignment. So, I removed the POP and asked him to move his right hand. He could move well. “It seems OK, Bogyi. Can I play tennis again?” he asked. “Yes, Of course. But wait for about 2 more weeks to make the muscles concerned get back to normal,” I told him.
“Thank you very much Bogyi. You are so kind and efficient. I’m a nephew of Colonel Hla Han, your Director. I have written to him about this fracture and he was pleased with your efforts. I’ll write to him again. Thank you, Bogyi,” he said. “My pleasure,” I replied.
(The Chinese Temple at Lashio Where Fortune Telling is Available)
Major Htwe commented,” You are courageous and kind. If I knew he is the nephew of our Director I would have sent him to the BMH, Maymyo or DSGH, Mingaladon to prevent consequences if any thing untoward happens. But, congratulations for your success.” Lieutenant Aung Win later became a Brigadier-General in the Artillery Corps and he had won several Tennis Championships.
Acute Abdominal Pain
At about 10.30 PM one night Major Maung Htwe sent a soldier to me with the request that I went to the residence of Colonel Min Maung to relieve him of acute pain in the upper part of abdomen he was suffering just now. He wrote it’s not an order and it’s just a personal request by him and Colonel Min Maung as they knew that I refused to go and treat at the senior officers’ houses. Colonel Min Maung was a personal friend of mine as he was the Column Leader for two major operations in Kokang and Wa States when I accompanied him as a medical officer. He was kind to the soldiers, but strict with military discipline and preparations so that he was successful in most operations and his forces suffered few injuries. His soldiers loved him, but his enemies hated him. He treated me like a younger brother during operations protecting me and explaining me what he was doing all along.
(Cause of Pain in Upper Abdomen; Epigastric Pain)
So, I went with his errand soldier bringing with me all the necessary medicines. I asked Corporal Than Soe, my nursing assistant, to bring along injection syringes and pain relieving medicines. Colonel Min Maung’s wife welcomed me warmly and said,” Saya’s friend is in severe pain. He is on the bed. He wanted you to see him badly so, he requested Bohmu Htwe to send you here out of protocol.” “It’s OK. I’ll do what I can,” I replied and entered their bed room. I exchanged greetings with Colonel Min Maung and took history and did the physical examination. He showed me his barium meal X-ray recently taken that showed no ulcer.
“I have no peptic ulcer, Bohmu Htwe told me and yet I’m getting this acute pain at night. It has been occurring off and on for about a week now. Tonight I’m having it since I came back from the meeting with the Taing Hmu (Commander of Northern Shan State). I felt burning pain in the upper part of abdomen like a molten solution of iron poured into my mouth and I swallow it. I have not eaten any meal, but I took Gelmag tablets and drank Horlicks that my wife kindly prepared,” he told the history of his present illness.
I said,” Yes, Bohmu, you don’t have peptic ulcer that is a chronic wound in the stomach or duodenum. As shown by the barium meal. But you have increased gastric motility and increased secretion of gastric acid. That’s why you are suffering from acute pain. You may be irritated emotionally or stimulated mentally. That’s why you are having pain now. This may lead to ulcer later. I’ll relieve your pain now by injection. Then I’ll give you one tablet of this drug to relive pain, spasm and mental irritation. You will go to sleep. Continue this treatment for a week and you will be OK.”
So saying I gave him an injection of Spasmo-Cibalgin intramuscularly and then gave one tablet of Bellaneutron that contained atropine, phenobarbitone and magnesium trisilicate. I asked him to take Gelmag Antacid) three times a day with milk or Horlicks, take a tablet of Miltown (Meprobamate tranquilizer) in the morning and avoid spices and fried food. (It was before the availability of Valium drug and other modern tranquilizers). He telephoned me the next day that his pain had gone and he was feeling fine, fresh in the morning. I heard he was doing his job without pain after that.
(The Great Shwedagon Pagoda by Night, Scenic, Serene and Solid )
My treatment was psychosomatic as he was under severe stress for military operations in the
Colonel Min Maung hailed from Gyo Bin Gauk like his classmate U Win Tin of the NLD, Colonel Htoo Myint of BAMC and Colonels Khin Maung Win and Khin Maung Lin brothers. U Zaw Nyunt and Daw Htoo of the Htoo Supplies Co Ltd,
Not Against His Wishes
“Saya, do you have any medicine that can stop drinking?” one day Daw Aye Ngwe asked me. “Yes, we have a drug called Antabuse that can make a person stop drinking if he takes it. It’s antagonistic to alcohol and if taken together patient will become restless, irritated and may vomit. He may not be able to sleep and became angry. But, it only works if the person concerned likes to stop drinking himself,” I explained. “I like to try it to Ko Hla,” she replied. “Don’t do it Ahmagyi if he does not wish to stop drinking. Sometime people drink because they like it. The effect of alcohol soothes them. It makes them peaceful.. It’s their only escape from the stressful or painful world,” I cautioned.
(A Patient With Swelling of the Abdomen due to Ascites
Caused by Cirrhosis of the Liver Due to Drinking)
Yes, a friend of mine Dr Aung Thu was asked by his teacher Professor Daw Myint Myint Khin of
(Three Beautiful Bottles of Rum)
As for Major Hla, he was just over 35 years at the time. He drank Army Rum regularly in the evening and he would give his Rum to any body that came to his house at the time. He did not ask me to drink it as he knew that I was not fond of it and I had patients to take care of all the time. Major Hla was a saint when he was sober, but he was like a tiger when drank. Because he quarreled with people on drinking his wife wanted him to stop it. But, he refused. That was the reason Daw Aye Ngwe had come to me to ask for Antabuse. Fortunately or unfortunately, I had it with me as a sample and I gave it to her.
(Abdomen of a Patient With Ascites: Water in the Abdomen Being Drained by
After a fortnight, the driver of Major Hla came to me one night to accompany him at once as Major Hla was in temper tantrums and vomiting. I followed him immediately as both our homes were only 5 minutes drive away. I found Major Hla calling names and shouting all nonsense in his bed. Daw Aye Ngwe was beside his bed massaging his legs. I asked Daw Aye Ngwe,” What happen to Major Hla?” She smiled and said,” He drank a few glasses of Rum about an hour ago and now he became so rowdy. He had vomited twice. He is complaining of restlessness, irritability, nausea and vomiting. He likes to walk and shout. That’s why I called you.” “Did you give him the medicine?” I asked quietly. ‘Yes,” she said. “Then, that’s the reaction,” I told her. I examined him and gave him an injection of Largactil intravenously with glucose. I let him take a glass of milk before he went to sleep. I checked his vomit and found it contained no blood and it was not coffee ground in colour indicating there was no bleeding.
I went and checked major Hla the next morning and found him alert and well. He was taking a bowl of rice gravy or porridge containing duck meat. “Come and join me Saya,” he invited me. “Thank you, Bohmu. I just finished my breakfast. How are you doing or feeling?” I asked. “I’m well, Saya. I’m sorry for the last night’s troubles. Ma Aye Ngwe gave me alcohol antagonistic drug without my knowledge and I drank Rum. It made me angry and irritated. I already asked her to discontinue the medicine. I like alcohol. That’s why I’m drinking,” he replied. I checked his physical condition, took blood pressure, pulse rate and noted the nervous functions. His liver was also not enlarged. “OK, then. Don’t take the two together,” I told him.
(Some People Just Enjoy Drinking)
Major Hla continued drinking well into his late fifties. He developed cirrhosis (fibrosis) of the liver and had to be admitted to the DSGH, Mingaladon for several times. He began to develop ascites (Accumulation of water in the abdomen) and vomiting of blood and he died of liver failure later. He was a very intelligent man drinking alcohol knowing its dangerous effects because he liked it.
Menopause
I knew U Ye Myint as the DFP (District Forestry Officer) in Lashio when we accompanied Colonel Aung Pe to Muse and Nam Kham. We came to Nam Kham on our own as the Deputy Commander (Later Commander) of the Eastern Command (
Since the distance from Nam Kham to Lashio was a long one we struck a good friendship and I continued looking after his family’s health in Lashio as he frequently invited me to his home for dinner. His wife Nyo (Khin Lay Nyo?) was also friendly and generous. She was tall, fair and about 40 years of age. They had 3 children, two boys and a girl. “It’s enough for us. Three children are good. I’m meditating most of the time and politics take my free time,” he used to say. He supported the CPB on its peace efforts and blamed General Ne Win for its breakdown so soon. “I’m a Marxist,” he declared proudly. I always found publications of the People’s Republic of
(Injection to Test Pregnancy)
One day, he called me and asked me whether he could come and see me at my OPD. “Come along. You are welcome,” I told him. He came to me at about 11.00 AM accompanied by his wife. I was examining a soldier and he was the last patient to see at the OPD. “Yes. We can talk freely after him,” I told U Ye Myint gesturing them to take seats. They sat and waited for me to clear the patient.
When we’re alone he said,” Ko Nyo, I like to take your opinion. Nyo is not menstruating for one month or more now. I thought she was beginning her menopause, but she suspected another child coming. Can you check for us please?” “OK, I can. By the way, was Ma Ma Nyo taking any pills?” I asked. “What pills? Nothing taken,” she replied. I guessed she did not know the pills and not taking any contraceptive measure. “Let’s go to the operating theatre to examine you fully. This OPD is only for the male patients and it’s not private. Other people can see.”
I took both of them to the nearby operating theatre and examined Ma Ma Nyo physically as well as intra-vaginally with her husband looking. I found her genital organs soft and supple. We have a saying in obstetrics that a cervix of the pregnant uterus is as soft as the lips (Hegar’s Sign and Goodell’s Sign) and that of the non-pregnant uterus is as hard as the tip of the nose. I thought her cervix felt like a lip.
(Home Pregnancy Test Kit)
” Ma Ma Nyo, I think you are pregnant. Congratulations,” I told them. “But Ko Nyo, I followed the rhythm method to make it safe. Why did it fail?” U Ye Myint demurred. “Well, U Ye Myint, the rhythm method of birth control is not 100 % reliable. It fails sometime. I can inject a medicine to confirm it further,” I told them and gave her a hormonal injection for pregnancy test. “If Ma Ma Nyo bleeds within 3 or 4 days it’s not pregnancy. If it does not bleed, it may be pregnancy as the physical signs for pregnancy are found in Ma Ma Nyo,” I told them and wished them good luck whatever thy want.
At that time the injection test for pregnancy was just commercialized and doctors were given samples to test it. During our student daysthe test for pregnancy was different. The urine of the pregnant woman or suspected woman was injected to an immature rabbit, rat, toad or bull frog and its internal organs were inspected by dissection after a few days. If pregnant the ovaries of the animal usually a toad or bull frog become enlarged and bleed. The laboratory assistants of the
(The Oxford University Where U Ye Myint Studies for Forestry)
A few days later, U Ye Myint telephoned me, “Ko Nyo, there is no bleeding in Nyo and we’ll take the child.” I replied, “Congratulations to you both. Good for both of you. ” His wife Nyo gave birth to a beautiful daughter.
I met U Ye Myint when he came to me in Mingaladon to see his wounded son at the DSGH, Mingaladon. ‘Why, wounded? Did he go underground to join the Communists as you were a staunch Marxists?” I asked U Ye Myint. He laughed and said,” No, Ko Nyo. I have discarded Marxism after my son attended the DSA. He was posted to the Pegu Yoma and wounded in a fight there with the Communists. Nyo is also no more (She died.). That’s why I was so worried for him as the eldest son.” We went together to the DSGH to see his son in the surgical Ward. His son Maung Tin Aye had grown to be big and he was injured only on the two fingers of the right hand. There was no need to fear for his life or limb. U Ye Myint was glad.
(Aung San Suu Kyi's Family in Oxford, England)
Then, I read a few articles written by U Ye Myint in the government daily newspapers. He wrote about the aloofness of Daw Aung San Suu Kyi in
Circumcision for Non-Muslims
I used to make minor operations after lunch in the military hospital at Lashio. Daw Mya Hnit was the sister nurse assisting me sometime. She saw that I was quick and successful in removing sebaceous cysts, lipoma, foreign body from the eye and ear and in draining abscesses. She noticed that there was less bleeding and trauma than operated by others particularly Major Maung Htwe. Daw Mya Hnit one day asked me,” Bogyi, could you please operate on my son for circumcision?” “Yes, I can. But how old is your son,” I asked. “He’s 7 years old. His prepuce is long. I like to do it when his school I closed,” she said. “But all the children under 12 years and all women and girls are now looked after by Major Htwe. Why don’t you ask him to operate? It’s a simple operation,” I told her. “No, he is rough. Besides he is not as skilled as you are. He is going on leave for one month after 2 days. Can you operate my son, then?” she asked me. “OK, I’ll”, I promised.
(Painting and Hieroglyphics About Circumcision in Ancient Egypt)
On the appointed day Daw Mya Hnit took her son to the operating theatre with ether ready for anaesthesia. “Ether is not necessary. I’ll use a few milliliters of lignocaine and operation will last only a few minutes,” I told her. So saying, I scrubbed and injected lignocaine to her son’s male organ. Then, I cut the prepuce and tied it. There was no bleeding and circumcision was over within five minutes. The child did not cry or complained. “OK, it’s finished. I’ll remove the stitches after 4 or 5 days. Take him to me then.” I told her cheerfully. “No need, Bogyi. I’ll remove them at home. You are so quick and neat. Thank you very much,” she said cheerfully.
“Actually, there is no need to do circumcision if the child can urinate normally. It will not cause cancer of the cervix of his wife if he cleans his male organ at bath. The old theory of circumcision to prevent cancer cervix in women is false now. But for the religious reason like Jews and Muslims, yes, you may need to do it in all the male children,” I told her. “We’re not Muslims. We’re Baptist Chins. But I want my son to be manly and able to enjoin his married life when he marries,” Daw Mya Hnit said. Is it a good reason?
According to the old textbooks of surgery , circumcised males have the following benefits:
(1) The circumscribed males have few occurrence of penile cancer.
(2) They suffered from less genital infections
(3) Their wives have less incidence of cervical cancer of the uterus
(4) Their sexual prowess is maintained longer.
But, recent researchers claimed that those benefits are easily obtained by regular personal and genital hygiene. They found that the circumcised males have constant irritation of the genital organ by the scar tissue and this leads to increased sexual activity lacking in satisfaction. They advised circumcision only for males with phimosis or paraphimosis and pinhole meatus of the prepuce.
(Two Beautiful Chin Ladies)
But I later heard tht Daw Mya Hnit family has migrated to Israel
Kaladan Press.Com, dated Monday 23 February 2009
Israel gives nod to citizenship of NE Messianic Jews
Imphal, June 22: People from the North East India region (majority of them are from the Chin-Kuki-Mizo group) professing Messianic Jews faith, who were once denied citizenship in Israel on the ground of being ?converted’ can now apply for Israeli citizenship as per the green signal coming from the authority of Israel recently after several years of its struggle for it.
Disclosing this information, the United Messianic Youth Council (UMYC),
There are around 10,000 members of the Messianic Jews in Manipur alone, Lienboi claimed.
He further claimed that apart from followers from the Chin-Kuki-Mizo tribes, it has also followers of the faith from some villages in Tamenglong district, belonging to the Zeliangrong tribe of the state.
Dr Maung Maung Nyo
23.02.2009
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