Gorilla Doctors

Category: Field Procedures | Date: May 02 2008 | By: admin

Nyiramurema and others groom Umoja.

We gave up after three hours. The group stayed together, and the opportunity to dart never came. We did watch Umoja nurse, and we photographed his wounds. We could see holes in the exposed intestinal tissue, and interpreted them to be in the omentum, the fatty tissue that covers and protects the bowel, rather than the intestinal wall. Had his intestines been punctured, we didn’t think he’d still be alive, let alone have an appetite. At one point, three gorillas gathered around the infant and groomed his wounds, licking and picking at bits of dead tissue. We could only hope we were right about those holes.

Umoja with Nyiramurema; parts of his small intestine protrude from a wound in his abdomen.

Magda, Elisabeth, and I returned to the forest first thing the next day. After spending another hour and a half in cautious pursuit, I finally had my chance. Nyiramurema sat down to eat a bamboo shoot. Umoja lay at her side. There were other gorillas nearby, but not Chiri. All were busy eating. I darted the mother. She pulled out the dart, dropped it on the ground, got up, and walked away to the next bamboo shoot. Five minutes later she wobbled to her knees and fell asleep, anesthetized. I darted Umoja while he clung to her side. He too was unconscious a few minutes later.

Umoja anesthetized, ready for surgery.

My job over the next hour or so was to keep the two gorillas safely under anesthesia, with Elisabeth assisting, while Magda did the surgery. Our operating theater was a tiny clearing surrounded by bamboo and vine-covered trees. I felt a bit trapped, but also sure that none of the other gorillas in the area knew anything out of the ordinary was taking place. If we tried to move to a better site, they might hear us. The trackers stood quietly thirty feet away, listening for the rest of the group, ready to chase them away if necessary.

MGVP’s Dr. Magdalena Braum prepares Umoja’s injured abdomen for surgery; he had several loops of bowel protruding through two puncture wounds.

Magda zeroed in right in on the surgery. On Umoja’s right side, she found not one but two gorilla canine-sized punctures through the skin into the abdominal cavity with several short sections of bowel protruding through each one. Umoja’s intestines were intact, but the skin had begun to heal around them, constricting the herniated tissue. Magda removed small bits of unhealthy tissue, rinsed all with sterile fluids, released the pressure on the bowel loops, pushed them back in, and then closed the wounds with buried sutures.

ORTPN vet tech Elisabeth Nyirakaragire treats Umoja with fluids and antibiotics.

While Magda worked, Elisabeth gave Umoja subcutaneous fluids and injections of antibiotics. I collected blood samples from him and Nyiramurema, satisfied that the anesthetic drugs (Medetomidine and Ketamine) were working well, but not entirely comfortable with the situation. It’s challenging enough to anesthetize one mountain gorilla, never mind two at the same time. I kept my focus on anesthetic depth, frequently checking both patients for an increase in muscle tone. If Umoja began to wake up, surgery would be disrupted. If she woke up too soon, we’d all be in trouble, given our cage-like OR.

Umoja lying next to his mother the day before surgery, favoring his injured right wrist.

Umoja’s right wrist was badly damaged by a deep gash, more severe than we’d anticipated. One of two major flexor tendons running along the underside of the arm was severed, and the joint capsule was torn open. The end of the ulna, one of the two bones in the lower arm, was exposed. Magda sutured the tendons and a piece of muscle, knowing the repair might not hold but hoping to protect the tissue temporarily. Umoja may never regain full use of the wrist, but the wound should heal eventually. At worst, if the bones become infected or necrotic, he could lose his hand.

Umoja’s right foot is curled as he guards the break in his leg above the ankle; his left foot is uninjured.

We palpated Umoja’s lower right leg and confirmed a fracture of both the tibia and fibula, midway between the knee and ankle. While this injury is the least worrisome in terms of healing (young animals heal major bone fractures quickly), it is clearly the most painful. Umoja will not be able to walk, climb, play, or feed normally for weeks. While waiting for a chance to dart the day before, we’d watched as one of the other infants tried to start a game of rough and tumble. Umoja pushed his former playmate away, tucked his head, and curled up in a ball.

MGVP’s Dr. Lucy Spelman administers the anesthetic reversal to Nyiramurema at the end of Umoja’s surgery.

The scary part came at the very end of the procedure. As mother and infant recovered from anesthesia (I gave each a reversal drug), Nyiramurema started moving away in search of the group, stumbling a bit as she struggled to burn off the remaining anesthetic. Umoja rode on her back. In her pursuit of a gorilla trail, she had to make her way through a dense thicket. Our patient hung on—at first. Unfortunately, Nyiramurema headed downhill, the wrong way. The trackers quickly fanned out around her, forming a semi-circle to encourage her to reverse direction.

To be continued…

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