It has been a while since I have blogged not because I have not wanted too but because I am not sure what to write.
Our lull ended near the end of June and we are back on the schedule of 20+ shifts a month. It is tough. We are like single parents working a full time job. Compounding this challenge are the cases we face in the hospital. I haven’t the experience for it. I need somebody beside me.
24 year-old male presents with progressive paralysis x 4 days. At presentation he is barely able to move his left arm and leg. Diagnosis: suspected Guillain-Barré Syndrome. Treatment required, IVIG –we don’t have it. We tell him he is sick and that there is not much we can do beyond just supportive care. We explain to him, he may or may not get better. Two days later he dies after we coded him for 30 minutes.
2 year-old presents with malaria and anemia. During rounds he goes into respiratory arrest. We bagged him for 30 minutes and decide to place him on BIAP, hoping he will survive. He survives the night. Follow up exam show fluid in the lung. Chest tube placed drains copious amounts of pus. He is alive today on antibiotics and eating up a storm.
19 year old males comes in because of loss of consciousness x 5 days. When it started he was treated at another clinic with a plethora of medications. We suspect meningitis based on a lumbar puncture and start rocephin and dexamethasone. The following day he is like a new man; however, this was not to last. After completing 10 days of IV antibiotics he is no better than when he came. We are at a loss for his actual diagnosis, but we cannot do anything more for him. We have sent him home to die.
26 year old females present with difficult breathing x 3 days. Work up shows concern for a right lower lobe mass. There is not much we can do for her. I explain to the family that she is very sick and that she may die. I tell them she needs more than what we can provide here. They tell us they cannot afford to go anywhere else. We treat with all that we have – antibiotics, steroids, broncodilators, oxygen, and place her in the ICU. The first and second nights were rough, she became sicker, developing subcutaneous emphysema (air leak in the tissue). But then she started to turn the corner. Five days ago she was discharged from the hospital. Boy were we wrong on that one. Thank you Lord.
On and on it goes . . . the successes put you on a high. The failures put you on a low.
Experience is a funny thing. If you have it, a patient benefits. If you do not have it, the patient does not benefit from it. But you have to go through it to know it. Somebody has to be the “first/test case.” I wish there was another way. I wish experience could be simply observed and taught. I think that is what systems, protocols, and stories are for.
The Bible is just that –it is the story of Christ. It tells us through stories, illustrations, and parables on how we are too live our lives. No, it is not going to be all roses all of the time, maybe even none of the times, but there is hope in the end. And in that we must believe, because if life is just now and for the moment, the stories and struggles over here are depressing. But if there is truth in the Bible, and there is, then the stories and struggles over here are joyful. They are stories –through action and prayer –of love, hope, compassion as we at HBB reach out to the sick and the dying in times of need to show, if only for a second, to a stranger, they are loved and God cares.
“God I ask for your strength and your wisdom in interacting, treating and ministering to the patients here in Togo. I pray my inexperience will not be there burden. I also pray for the future Lord, that if it is your desire for us to remain in the field you will open the doors. Amen.”