Hospital work

Well friends. Where to begin. Work. Alice and I are rounding together on the pediatrics ward. There are about 20 patients. Many are children with hydrocephalus (big swollen heads because their spinal fluid builds up inside and pushes the bones apart. To fix this requires surgery to place a small tube in the brain that drains into the belly. It can allow the child to develop normally if done early enough, but often we see children who have already had the problem a long time. One of the saddest cases I have seen is a 1yo girl who weighs probably 10lbs, of which her head is probably 5 lbs. Her little body is the same size as a newborn baby only thinner. A rat chewed on her head an broke the tube that had been put in to drain the extra fluid from her brain. Often the children with hydrocephalus are not fed until after everyone else in the family. I feel like one of the things we can do is touch them and love them to show their families that they are still valuable, but this child is so horribly deformed I find that my natural response is to shrink back. Makes me think of Isaiah's description of Christ, "his appearance marred beyond any man."

I have been working in the outpatient department after I finish rounds in the morning. It is fun to work with the nursing students as my translators, and I am learning a lot about medicine here. So much is different. Different problems, different medicines, different attitudes.

Speaking of attitudes. I was working in the out patient department the other day and running around checking to see what medicines we had or going to do an ultrasound and suddenly realized that when I returned from "tea" (a break from 10-10:30 during which all hospital staff vanish without a trace) I forgot my wrap that I had been wearing over my jeans. It is a very strange sensation to be fully clothed and feel naked at the same time. A friend who has been here for a while told me the only ones I was likely to scandalize were missionaries, but I still embarassedly tiptoed up to the guesthouse to get my wrap. :)

We had a 35yo patient with a snake bite last night while Alice and I were on call. Can't say I've ever treated one of those before. He was in shock with low blood pressures, cold and clammy skin. His pupils were dilated and he was drooling profusely. We don't have any anivenom, so we gave him fluids, epinephrine and atropine. His heart is very irregular, but still beating this morning. I hope that he will pull through, but there is no ventilator to breath for him if his breathing fails.

I also got a 13yo girl who had fallen from a moving vehicle and has a skull fracture we are pretty sure. We can't do x-rays at the hospital right now so we sent her to a town about 45 minutes away, but their power was out, so she was brought back to us. we had no collar to stabilize her neck, so by the time she returned we decided that trying another hospital farther away was more risky. So she is on the peds ward and I don't know what will happen to her.

Surprise twins were born last night. The mother had no idea that there were 2. We delivered the first, reached in for the placenta and encountered another head instead. Unfortunately these little ones were too early. They would have done well in the US where we could give them surfactant to help their little lungs work, but here we have none. They were placed on what oxygen we had and their bodies wrapped in plastic bags to hold in their body heat. I was called later in the night because they needed to turn off the generator, but the babies oxygen was from an electric compressor. They would die. Then the nurse asked if it was ok to turn on the smaller generator. I almost cried with relief as I answered "yes." However only a few minutes later I received word that one of the twins had finally run out of strength to breathe. The other is still alive this morning and we are praying for a miracle for those tiny lungs.

My living situation here is actually really wonderful. My roommate is a blessing and the other couple sharing our kitchen (a med student and his wife) are great fun too. Last night we made an italian feast complete with spiral noodles topped with homemade spaghetti sauce and fresh basil. An appetiser of mozzarella, fresh basil and tomatoes in olive oil and delicious garlic bread. We ate by candle light since the power was out. Amazing!

And, last but not least, my roommate and I removed a 6 inch centipede from our bathroom last night. As first we thought it was one of the harmless millipedes that merely look disgusting, then we realized that it had 2 spikes on its tail and only one pair of legs per segment. Making it both ugly and poisonous. (gulp!) We took it outside and doused it with insect poison.

Please pray for the power to be fixed soon. Please pray for my patients. Please pray that the supplies for the x-ray will arrive, and that God will guide us as we try our best to care for people in horrible situations. Please also pray for a language tutor for me. I would like to be able to talk to my patients or at least respond to greetings from passerby.

Much love! Sorry for the long post. It's been a busy week.