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Wednesday, February 02, 2011


Scott here. Being “on-call” is part of the life of a physician. Last night, at Kijabe Hospital I was “on” for Medicine. Thankfully, though, because of our age and experience Jennifer and I are never the “first call” – that burden falls to our Kenyan Medical Interns. My front line warrior last night was Issac, a quiet diligent and quite competent young doctor. He called about 10pm last night for help. He was trying to clear the Outpatient Department so he could get some sleep. A dozen or so patients who had clocked into the OPD in the midafternoon were still waiting – and their patience was wearing thin.

So, braving the howling gales and pitch dark, I trudged over to Outpatient. I found a sleepy group of patients waiting for their turn to tell their stories to a doctor. None were critically ill, but obviously all felt ill enough to wait for hours to get an evaluation – and hoped for a cure. I sent a 6 year old for an elbow x-ray, admitted a 50 year woman who was scheduled for elective thyroid surgery tomorrow…and then came to W., a 55 year old woman with an “something in her stomach”. This lady stated she had a mass in her abdomen which had been moving around for the past FIVE YEARS. “Ma’am,” I said, “why have you decided to come to Kijabe Hospital TODAY – at 3pm in the afternoon – when you have been having this problem for FIVE YEARS?”

“Well, because my neighbor came to Kijabe and she got treated – and she’s better now,” she said.

“Where do you and your neighbor live?” I queried.

“Mombasa. I rode the bus from Mombasa early this morning.”

Yikes. That’s easily an 8 or 9 hour bus trip. This lady spent a considerable sum of her small savings, invested an entire day, and trekked halfway across the country, and ended up seeing me – hoping for a cure.

I’ve heard this type of complaint scores of times. “The worms are eating up my insides…the worms are moving around inside of me…there’s a stone growing up in this side of my belly…” Frankly, it’s a tough type of case to treat. Sometimes there is a diagnosis to be made; giardia, enlarged spleen from malaria, dysentery…and sometimes I can’t identify an explanation of the symptoms. In Bundibugyo, without any diagnostic tools, the latter was often the case. I began to feel a bit nervous – what if I can’t do anything for this lady? That will be horrible.

Well, I thoroughly examined her abdomen – no small challenge since there was about 6 inches of adipose tissue between my hands and her innards. I did detect a slight firmness and tenderness in her upper abdomen – so I decided to send her for an abdominal ultrasound, but that couldn’t be done until tomorrow.

“Ma’am, I want you to come back for ultrasound in the morning. Do you have anywhere to stay tonight? Do you know anyone around here?”

“No. I’ll just sleep here on this bench. I got no where to go.”


So, I handed her a requisition for the ultrasound – and prayed that somehow she could be satisfied – with her care, with the outcome, with whatever diagnosis she ended up with.

I don’t know what happened. But I do know that I need to have that kind of hope, that surety that somehow God can make things all right – and I need to have a similar willingness to sacrifice all that I have in order to allow Him to do so.

1 comment:

Anonymous said...

Solid. Praying for you all.