I can’t believe it is already
April, and our time in Kenya is drawing to a close! Last night, Scott and I
started the packing process, as this evening we will be travelling to a nearby
city to spend the night with some old friends, and tomorrow we head to Nairobi
and board a plane headed for the US. It feels like we just got here, but I also
feel that the relationships we have developed are so deep. Furthermore, I know
I have grown by leaps and bounds as a physician and as a member of the body of
Christ.
Since last I wrote, I have taken a
weekend of peds call and spent the week on the peds wards. It has had some
definite highs and lows, but I just wanted to quickly recap some of the events
of the last week.
On Sunday morning, thankfully,
things were mostly in control. The interns don’t round, and no one officially
sees the patients unless asked by the nurses, so I was a bit overwhelmed trying
to be sure that all of the nursery, floor, and ICU patients were stable. I was
fortunate to have a very supportive US physician as my back-up (someone who I
worked with as a 4th year medical student at UAB…go figure). It took
me the entire day to follow up on labs, discharge any well patients, and attend
a few deliveries.
During my lab review, I
unfortunately found out that 3 new babies were growing gram negative rods in
the blood (consistent with the previous infectious outbreak) in the NICU. Three
others were not clearing it, or developing new resistance even with high dose
double coverage of antibiotics. It was disheartening to realize that despite
our efforts, we were far from having the infection under control. I spent over
an hour talking to one set of parents about why this was happening, and I could
sense some anguish in the air among all those in the maternity ward as they all
feared their baby may develop this dreaded infection.
Later in the afternoon, while
attempting to play with ventilator settings on an intubated child in the PICU
(it felt so wrong to touch the controls after having so many RT’s give me the
evil eye for such back home), I had to call my back up. We stabilized the child
in the PICU (who by the way was from the nursery also growing the resistant
infection), and I talked to her about the continuing epidemic.
Even though she had been on call
the day before and not slept in over 36 hours, she very matter-of-factly stated
that she was going home to change into scrubs so that she could clean the
nursery herself to help contain the infection (something that had been
suggested to nursing staff all week, but had not happened because there were 2
nurses to care for 28 babies). While I attended to the sick babies, she donned
a mask and gloves and went to town on the small nursery. Together with the
cleaning staff, we worked through the night to scour every nook and cranny of
the African dust-filled room. It made me realize that serving in missions as a
doctor means not only working to cure disease, but serving as Jesus did…washing
the feet of his disciples…or the beds of tiny babes.
To my knowledge, no new infections
have occurred since the deep clean. We are still praying for healing of those
already affected…but I learned so much about the heart of Jesus that night
through the pediatrician I worked with. She was willing to do whatever it took
to have compassion on the least of these, no matter what the personal cost.
In the midst of our cleaning, we
received a call from our intern on-call (who had been working since Saturday
morning). His wife was on the other end stating that she needed to take her
husband home because he was sick. For a hardworking Kenyan to leave call meant
that he felt very near death. We let him go home, and the doctor I was working
with graciously offered to take his pager for the night. Again, a great
personal sacrifice.
We had 3 admissions by this time
(around midnight) in the ER and the clinical officer and I worked to get all of
their orders together. They included a 1 month old with fever and concern for
bacterial infection, a child with sickle cell pain crisis on oxygen, and a
child with biliary atresia who had had an operation some months ago now presenting
with likely bowel obstruction.
After getting them all settled, I
headed to my house to use the bathroom and eat for the first time since lunch,
and a few hours of rest before beginning the next work day…my first on wards.
I was grateful that the business of
the night was mostly related to containing infection and cleaning the nursery,
and not with children who were crashing. I was also grateful that I had some
wonderful back up. Together we survived the night, and our poor intern got some
rest.
It was certainly an experience
being on call over the weekend to cover the NICU, PICU, and floor. However, I
was reminded so often that I was not alone. The same is true in life. Even when
you can’t see someone standing right next to you…there are people to call. The
Holy Spirit likewise stands with us throughout all of life’s ups and downs. He
goes with us wherever we go and knows all that we go through. As Isaiah says:
“Do not be afraid, for I have ransomed you. I have called you by name; you are
mine. When you go through deep waters and great trouble, I will be with you.
When you go through rivers of great difficulty, you will not drown! When you
walk through fires of oppression, you will not be burned up; the flames will
not consume you. For I am the Lord, your God, the Holy One of Israel, your
Savior.” – Isaiah 43:1-3
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