July 10th

So… the big surgery that I mentioned above was on a premie that had an esophageal-tracheal fistula.  In the U.S. this wouldn’t be such a big deal, but here even figuring out a diagnosis was a dilemma.  We also found that she had a popped lung during that surgery. So she came out with a stomach tube for eating and a chest tube for her lung.  The parents are from Ghana and speak English, and seem very literate and involved in the baby’s plan of care (unfortunately, not something that happens very often around here). So I really enjoyed working with and teaching them.  That night I left the baby with who seemed to be a very competent nurse (perhaps I’m being biased but I like a lot of the male nurses and PA’s more than the women staff) and I knew the baby was in good hands.  The nurse was worried about her and asked me to pray for her that night, so I knew he’d be watching her closely haha. To make a long sob story shorter, the baby had to have a second surgery the next night, was more difficult to breathe on her own after (I spent some pretty late hours into the night serving as a human ventilator and making sure she was stable enough to leave with the staff… they don’t have any sort of ICU and some of the staff don’t really understand the difference in the criticalness of one patient’s care versus another’s), was still doing well the next morning, and then she died late that afternoon.  I guess this can be considered the first patient that I lost.  Dr. Bryce’s (he just graduated from med school as a surgeon, and he has done an incredible job jumping in and running the OR!!) first patient to die here too.  Part of me was disappointed in myself because I can say that maybe if I had just stayed and given her 24-hr care this wouldn’t have happened- we are assuming she aspirated and nobody noticed for a while, it didn’t matter if I told someone to check her oxygen every 30 mins or to suction her every hour (which by the way nursing friends they don’t ever use a suction tube down the nose or throat, and some of them thought I was crazy for using the suction bulb syringe in her mouth they thought it could only go in the nose… you can imagine how frustrated I am here)., this is their hospital, they have an established staff that has been hand-chosen and trained by ABWE, and it’s just the way things are here.  It’s easy to say TIA (this is Africa) in regards to something funny I come across, but it’s not so easy to just say TIA and brush off a baby dying that really would have been just fine and healthy back home.  So every day in the hospital I just do what I can.  Obviously it would be wrong to push my way in and want to run things a new way, give my own care to every patient.  But if you know how hard-headed and abstinent I can be it’s really hard not to!

Hopefully in another few days I will be completely over my whining so you don’t have to endure any more of my sob stories.  It was really funny- yesterday two of the boys were absolutely terrified of the Yovo doctors.  Their eyes would get huge as the doctor got closer, and then once the doctor actually touched them they would just start screaming.  The entire room full of family and staff was just laughing at the boys, who were plenty old enough to rationalize with but they were just too scared.  It’s a good sign when the kids start crying as a Yovo goes to touch them- means they are getting stronger J