Monday: today was a good day… just kidding. I will save you the day to day details of the past week. Let’s suffice it to say, it was a similar play with a new cast of characters. There was a huge team here from Clarksville, TN doing dental, eyeglass and school visits, and our MVP is Dr. Jim Howard, an ER doc from TX.
Frustration. Jim is on his seventh visit to the BMC. Walking back from clinic on Monday he says, “we just have to focus on what we can do.” It sounds so simple yet so impossible. It is extremely easy to become frustrated here. I often feel like half the patients I don’t really need to do anything to help. They complain of headache; I determine they carry heavy items on their head and send them away with Tylenol. Even worse are the patients that come in and I can’t do anything to help: a young woman with ascites and likely liver disease, melanoma and the like. I would like to share a few stories of patients with you. There are patients everyday that will break your heart. Everyday kids die that wouldn’t die in America.
Burns. First, was a man who came in a few weeks ago. He had a seizure and fell into a fire. Third degree burns extended all the way up his legs. After fluids, fasciotomies, and debriding, the man was stabilized. Over the coming days, his legs were full of contractures and lacking any form of blood supply. What next? We are here to help and serve, but taking both his legs would be death for someone in Africa. If he cannot walk, he cannot eat. Any of our efforts to prolong his life here may only cause him more pain. He has gone home early this week to pass. I asked myself if we did him any good. What if we had never stepped in and brought him back with fluids and care? What if bringing him back gave him the opportunity to pray with the chaplin? Was it worth it?
Rupture. Greg, James and I were out on a nice morning run…until we arrived home. Maternity ward had been looking for Greg to come see a patient who presented with a hand out of the uterus. There were no heart tones, and mom’s uterus was ruptured. Medicine is difficult when ‘interesting case” often also means “bad outcome.” When the baby came out, they say, “put it in the bucket.” The mom’s life was saved that day. She is still on maternity and we have been very concerned about her. Following her section, her hematocrit was very low and there was no family to give her blood. (I can’t remember if I have written about that before, but the lack of blood bank means that blood must come directly from the patient’s own family). She finally did get blood, but has been spiking fevers every day since her operation. Today, another woman on the ward was translating for her. A nurse finally translated something back to me, and said that the lady was telling our young patient that she is lucky to be alive. God saved her life and she needs to go to church. My patient looked down and had tears on her face. I pray for this patient. I pray that she knows Jesus or that good will soon come from her sad situation.
Pus. Last one. There is a 8 year old girl that presented septic a week or so ago. We were certain she would die during the night and her extremities were already cold. She did not. In the coming week, her right leg appeared swollen despite a normal x-ray. She was taken for debridement…I have never seen so much pus in my life. I’ll spare the non medical crowd any further wound description, but the infection is now in her knee and she has already been drained twice. We clean, drain and pack, but it breaks my heart to see this beautiful young girl with such a big problem. In the states this infection would have been caught by CT long before it got this far. In the States, we treat people for 6-8 weeks with IV antibiotics for osteomyelitis…not in Ghana. This poor girl may not walk normally ever again. Her knee might be frozen and she very well could lose her leg. We saved her from sepsis, but she is not healed.
This post is not supposed to be depressing, but I wanted to share my heart. This is a sampling of what we see. It is hard. It can be frustrating. Nonetheless, we have to focus on what we can do because there is an ultimate healer, and we are not Him.
Photo of boy with burkitt lymphoma. Our team raised funds to send him to Accra for chemo (a very chemo-sensitive tumor).
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