Welcome Aboard!

Good Evening Everyone,
I know Jeremy wrote earlier this evening, but I just returned from hospital night rounds and thought I, too, would give some updates.

The title may have you a bit curious. Well, we are happy to be joined by another pediatrician, Michelle, from Kansas City. Today was her first day on wards and in clinic. She was paired with me for the day, so we were able to share the shock of being a pediatrician who also sees some adults throughout the day. I think it went well though, because clinic wasn't too busy today, so she had some time to adjust and bring back some old med school memories about treating adults. It is a wonderful blessing to have another person who will share call and help divide up the patient load at the hospital.

The week otherwise has been quite busy. Jeremy had posted about a few of the patients earlier. I, too, have patients who need prayer. It seems the peds ward is now with less patients, but not because of discharging them home. Already 5 patients have died since Sunday night this week. 3 of them were a complete shock to me, and a couple of the others were expected. The three that were surprising were children who had typical viral gastroenteritis with dehydration, 2 of whom were very close to going home, but during the night the past 2 nights have passed away. I don't know if something else went wrong suddenly or if there was another illness that we were not able to recognize because of the symptoms from dehydration. They all had some component of malnutrition, however, so I am sure their immune systems were weaker than normal, and they had no reserve to help fight an infection or acute bodily stress. Some of the others had respiratory illnesses and little hope of survival from the time they were admitted, because they were very ill before they got here, and honestly the antibiotics probably never had a chance to work.

Meanwhile, there are a few new kids on the ward who are very ill right now, one, maybe two of whom I expect to pass very soon. One is a little boy with a respiratory illness that looks like pneumonia and maybe bronchiolitis, but he also has some large tonsils and is having a lot of trouble breathing. He is on oxygen (via NG tube in the nose), but is working VERY hard to breath. Unfortunately we only have bulb suction available at the bedside, so some of the routine treatments we would do at home are not available. Pray for his recovery, because if we could get him through this acute phase, he probably has a chance, but he is really in some distress tonight. The other one I expect to die is a little 4 day old who likely had a hypoxic brain injury during birth, who presented with seizures soon after birth. I was able to get the seizures to stop with meds, but the child is not at all normal in regards to a neurologic status. I had the chaplains come spend time with the mother today to help her prepare for the reality that her child will likely not survive. In the meantime I am treating with antibiotics for the slim possibility that the child has a severe meningitis picture that is complicated by the long birth history.

This evening on night rounds I also had a few sad cases. One is a young man in his 20's who drank car battery acid this afternoon to try to commit suicide. He said he had an argument with his mother and wanted to die. He would not answer when asked if he still wanted to die or if he was wanting to live. He appears well currently, but anything is possible with acid in the gut. Another is a younger man who apparently had a bicycle accident today. He seems very intoxicated or encephalopathic one of the two. I think he most likley is intoxicated based on my exam, but I am testing for malaria tonight, in the case that he has cerebral malaria. Either way they both need prayer as the outcomes for both could be good or poor. I also had 2 children who had fallen out of trees and had leg injuries. I suppose today was a great day to climb a tree. Since we have no x-ray film, we will likely take them to the procedure (theatre) area in the morning, sedate them, and exam them better so that we can reduce any fractures or dislocations they have. Pray for us to have wisdom as we do this.

On a more positive note, today the wife of one of our workers here came by this evening. She is a seamstress. She is going to make us some African clothing from the fabric we purchased on our trip the market a few days ago. (No, in case you are wondering, there was no Obama fabric. Those are all manufactuered clothes.) I am excited to see how the clothes turn out. The best part is the whole thing, fabric, sewing and all, are going to cost less than $30.

I suppose I should conclude for the day. I need to take a quick shower, and get some rest in case I get called back to the hospital tonight--several women are currently in labor. Please keep us in your prayers. We are learning a lot here, and enjoying our time to the best of our abilities. Please keep the comments coming, we have a lot of fun reading them.

Love always,
Steve