Scott is managing the men's ward this week (with the able partnership of a family medicine resident). He was nearly in tears over a sweet older gentleman who was slipping away before their eyes, and decided to just pray for him at the beginning of rounds. Within two hours he was markedly improved, and may now recover. I've been keeping to the periphery on pediatrics, for many reasons: to not quash the recently-arrived Kenyan paediatrician, to observe and get a feel for how things are done instead of pushing my own way, to give space to a visiting brilliant American military academic pediatrics guy who is here for a week and has way more to say than I do . . . but mostly it's not so noble, I'm just in over my head! Medicine in Bundibugyo is circa 1960's. Medicine at Kijabe is circa 1990's at least, possibly 2000's. It's a big jump. But sometimes no one else is around, and I remember that I do love this stuff, even when it is intimidating. My first semi-solo responsibility was to call in the parents of a newborn named Eugene admitted to the ICU over the weekend, explain his poor prognosis, and get their assent for the plan of trying to wean him off the ventilator. There are only five ICU beds, and if a severely asphyxiated brain-damaged baby takes up one, others will die. Sounds harsh, but the reality of limited resources means not using a ventilator for a baby with little chance of survival. The young parents actually affirmed their thanks for the staff who had done everything possible, and agreed with the plan. It was a good meeting, they visited Eugene then opted to wait outside while we tried him off the ventilator. And amazingly, Eugene, who had shown no signs of spontaneous breathing up to that point, decided to breathe. We wheeled him back down to the nursery on oxygen, where he remains, floppy and unconscious, but alive, his quiet mother lingering, little hope, waiting. And tonight my first real call night started with an urgent call to the OR for a baby about to be delivered by C-section for fetal distress. Only by the time the intern and I wandered through the eerily empty theatre area, we figured out that the mom had delivered the baby naturally in the labor room, and there he was, massive, squalling, and vigorous, leaving us nothing to do but enjoy him.
(Me, trying to be a good culturally sensitive language-learner: I need to learn the proper greeting for a new mother. What do you say? In Uganda we say webale kwejuna.
Kenyan Intern: Oh, here we say "congratulations". )
(Oh, and did I mention, it was the same bed in which I delivered Caleb, same baby-warmer, same everything?)
Today Scott and I left early in the morning for an ambitiously long list of errands in Nairobi, which we quickly pared down, and then down again, as nothing is as quick or straightforward as one might hope. First priority was our car. YES WE HAVE A NEW (to us, used actually) LANDROVER DEFENDER 110, white, "ambulance" style (enclosed not a pick-up). Only it took a couple of hours to tidy up the paper work and insurance and install a new radio and generally take possession. Then we hit the stretch of road where carpenters and welders have shed after shed after shed of locally made furniture. And in the space of an hour we ordered two couches, six beds, a table and 8 chairs, all for less than half of the cost of buying similar items in a store. Then we found the row of fabric shops and chose 5 different curtain materials for the 12 windows in our new house. Then varnish for the floors, and more paint. Now Scott and I have never owned a house, never chosen colors, and hardly ever even bought any furniture, so it's partly fun and partly way over our heads to make this many decisions in a few hours, and partly a learning experience to realize we don't always see things the same way. The furniture area is dusty, loud with hammering and sparks, crawling with young men who want to sell you their particular items (we were glad to realize the store we chose was named "Faith-based Furniture"), catering mostly to Africans who like heavy large impressive furniture. The fabric and hardware are run by Indian-origin Kenyans, emphasis on the plush heavy draperies, tassles, damasks, florals. I think we did OK, but we'll see what it all looks like.
So a full day, I'm heading back to the hospital now. Thanks for the many shouts, and keep them calling.