My Patients

A talented doctor and wonderful servant of the Lord has taught me that we must remember the individual patients who touch us in a setting like this. Now this will be a sad blog, I’ll warn you now, but there are a few patients I feel I need to write about. And there’s a happy ending, I promise. : )

First of all, I have to start with Junior. He is a boy in his late teens who I wrote about in an earlier blog. He arrived in the ER with a horrible fever and had been sick for some time. In the end the diagnosis was endocarditis partly supported by the fact he had a stroke soon after admission. Well, Junior continued on antibiotics in the ward for several more weeks, and whether or not I was rounding on the medicine ward I have tried to visit him when I could. With lots of antibiotics running through his veins and his family by his side, he slowly got stronger. First he would sit up in bed with his mom holding him, then by himself. Soon I saw him out around the hospital in a wheelchair getting some sunshine. He still can’t move his right side, but he has an amazing smile. : ) I don’t know if he will ever recover function of his right side, but the boy who went home a few days ago certainly looks better than the feverish, unresponsive Junior I first met some weeks ago.

Death is as much a part of life here as anything else some days. But it’s been new to me. In the States I never saw children as sick as Melinda and Jack Joes. Melinda arrived in the ER on a Friday afternoon. This child of about 3 or 4 was sick, weak, and cold to the touch. We went to work immediately starting IV fluids, giving her antibiotics, and even putting a warm lamp over her to try to warm her small body. I don’t know what she was like before she got sick but I imagine she was full of energy. The child in front of me, however, was nearly lifeless. We started all the appropriate medicines and lab work and admitted her to the hospital. She died that night.

The next day, Saturday, I was on call and in the ER again. There I met Jack Joes and it was almost like déjà vu. This small child, again around 3 or 4, was limp and cold to the touch. And again we went to work with IV fluids, antibiotics, and admission to the pediatric ward. But that night at around 7:00 pm I received a phone call that there was an arrest in the pediatric ward. The whole way to the hospital I feared it would be little Jack and prayed that it wouldn’t be. However, when I reached the ward I found CPR in progress on little Jack’s now lifeless body.

Two days. Two admissions. Two deaths.

Last night I met Baby of Clement. In PNG parents often do not name their children immediately due to the high infant mortality rate. To give a child a name is to become attached. Little “baby of” was only four days old. He had been born at home in the village with no complications, but the day before he had started having a fever. Tonight in the ER he had already had one or two apneic episodes, short periods where he stopped breathing. When I first saw him he was breathing but struggling for air. We kept him on oxygen and immediately started IV fluids and antibiotics. He was breathing when I left him around 2:00 am, but when I arrived on the pediatrics ward at 3:30 they had already been breathing for tiny “baby of” using a bag-valve mask for at least half an hour. We kept breathing for him for another hour, but he never again took a breath on his own. Four days old and he was gone from this world.

One last story – I met another “baby of.” This one is baby of Maria. He started getting sick the day after he was born. He started having seizures and many apneic spells. When I first met him, he wasn’t breathing. But, within a minute or two of ventilating this baby by hand, he started pulling in wind once more. Over the next few days, that scenario replayed many times. Baby of stopped breathing, he was ventilated with the bag valve mask, and he came right back. Same as the other children, this little one has been on many medications. He has also had the watchful eye of his mother and grandmother on him constantly watching his breathing and calling out to the staff the moment there was a problem. In fact, I don’t think a moment went by those first few days when somebody wasn’t looking at this baby.

And now, for the time being this baby seems to have beat the odds and is getting better despite how very sick he was. He is still in the hospital on multiple IV antibiotics, but he has been free of apnea and seizures for about 5 days now and we are praying for a full and complete recovery! So amidst so many sad stories of lives snatched away by disease when they were just beginning, there is hope in happy stories like Maria’s baby. Thinking about the babies and small children we couldn’t save can be depressing and frustrating. It almost makes our actions seem futile without little ones like “baby of Maria.” I will always remember him and the fact that we must do our best for these little ones even if we can’t save them all.