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Thursday, June 21, 2012

A day in the life of Mister Mom

Five days down, 58 days to go until I see Jennifer again.

Joni Mitchell sings "you don't know what you've got 'til its gone…"  Well, I had a pretty good idea of my blessings, but the reality without her is pretty brutal.

No snoozing after the alarm yesterday.  Hopped out of bed - still dark.  Set the table, mix the pancakes, grind the coffee, rouse the kids, feed the dog, cook the pancakes, read the Jesus Calling devotion for the day, shave, hug the kids and and then I'm out the door for a Medical Staff meeting at 7:30am.  Lots of good discussion about the Kijabe Hospital Big Picture.  Our Medical Director is a fantastic BP guy, leading, modeling, exhorting, and delegating.  Then we transition to debate the details of new Transfusion Protocols.  There's some painful but good transition going on as KH becomes more organized, methodical in the delivery of health care, partially because the Govt of Kenya is demanding higher standards in the way transfusion medicine is practiced.  It's hard work, but good.

Rush back home.  Another hour to invest in the Malaria Lecture I must deliver for the Intern Core Internal Medicine Lunchtime Conference at 1pm.   The details of the parasite's complex life cycle and cunning pathophysiologic designs are so colossal it's hard to know how to approach the teaching of the topic.  Do I focus on the basic biochemical facets of the surface proteins which underly the sequestration that leads to seizures and coma, or the controversies regarding artesunate versus quinine for severe cerebral malaria?  Or perhaps the critical need for better prevention strategies such as improved bednet coverage or intermittent preventive treatment in pregnancy?  I compromise and close.

Out the door to round on the inpatient women's ward.  Twenty seriously sick women admitted to the hospital.  The diagnoses range from tuberculous meningitis in an AIDS patient, to severe hyponatremia, to stroke, to asthma, to diabetes and hypertension.  We agonize at the bedside of a woman who at the tender age of 39 looks like she has hours or days to live.  She has cancer which has spread to the liver - incurable in any hospital in the world.  So, we try to comfort and pray, but the pain of loss weighs heavy.

I get a call from my Team Leader of the WHM Uganda Team in the midst of rounds.  I promise to call back within a half hour.  I rush to the Intensive Care Unit where I am backing up the Kenyan Medical Officer posted there.  Our ICU consultant is away for two days for a conference.  I hear some details about a selection of the five patients there and then call Uganda.  There appears to be a cholera outbreak in Nyahuka.  We experienced several of those in the late 90s - but we had the assistance of MSF (Doctors without Borders) at the time.  The Ugandan doctor of Nyahuka Health Center took the keys to the Health Center and fled to Kampala - in protest that he hasn't been paid by the district his salary due.   Not sure if I should laugh or cry.  In the middle of the call, my airtime runs out, because it costs about 50 cents a minute.  So, TJ calls back and we finish strategizing about cholera. 

Rush downstairs to the conference room to set up for my lecture.  The computer won't recognize my flash stick.  Call IT.  IT agrees - the computer won't recognize my flash stick.  We search and find for a different laptop.  Success. My PowerPoint is up and running as the interns start to trickle in.   There is no real sense of urgency in our discussion of malaria, because we hardly ever SEE malaria at Kijabe.  The elevation (7000 ft) makes life inhospitable for mosquitoes.   But after I remind everyone that in one short year, any of them might be posted by the government to rural government District Hospital where they might be inundated by malaria - they seem more engaged…

Not much time for questions….I'm out the door and hurrying and huffing up the hill to RVA Student Health Clinic where I have about eight kids to see for a variety of issues ranging from basic exit physicals, to acne, to pneumonia, to diarrhea.  We love RVA and the opportunity to be part of the community there is a tremendous privilege. 

Home by 5pm.  Had hope for a chance to go running with Star, but can't now, because there is a long Choir Rehearsal at 7pm in preparation for the Big Weekend Tour.  So, dinner needs to be ready by 615pm.  The fridge is full because I stocked up at the grocery when I went into Nairobi for Jack's rugby game on Wednesday.  I scored in the produce section - a nice bag of fresh broccoli.   So, I plan for oatmeal muffins, broccoli and beef on rice and a lettuce salad with feta, cashews, and sliced grapes.  I get the muffin and broccoli recipe from  The batter goes into the muffin tins effortlessly.  The beef fillet looks tender as I slice and toss it into the soy-and-wine marinade.  I begin to saute the beef and move onto salad prep.  I'm on a roll.  I can do this.  I move back to the beef.  I want a little more sauce.  I add more soy sauce, wine and corn starch.  The gravy is turning to glue.  I add more liquid.   Too watery….more corn starch…too sticky….smell burning….the muffins!!  I never set a timer!!  I look in the oven and see every muffin is dark brown with a black circular edge.  Bummer.  I pull 'em out and try to salvage.  Now the rice is boiling over on the stove…I take the top off…I go back to extract these crispy critters from the muffin tin.  I cut the charcoal edges off and cover them with a towel in a basket hoping they will soften.  Somehow, I manage to get the right amount of liquid and corn starch for a nice salty coating on the broccoli and beef.  We dine by candlelight which helps hide the imperfections.  No one complains -except me.  Tummies get full, the kids go out the door, and then it's time for clean-up.

The evening is spent plowing through emails.  Our Google Report says we received 1262 emails in the last 4 weeks.  That's more than 40 per day.  It's pretty rough to keep up.  I try to deal with the flagged messages until my energy flags.  Then I look over and see that there is two days worth of clean clothes which have been folded and stacked by Abigail.  Hey, that's Jennifer's job!   I don't know which clothes belong to which people!  I give a half hearted effort, knowing that Acacia and Julia will be able to re-sort the girl clothes which I pile into one big girl stack.

I crawl into a cold lonely bed.

58 days. 


Mike said...

I'm exhausted just reading that.

Sakura Sojourn said...

Okay, Scott, this should motivate anybody and everybody to be praying for you and Jennifer both, during these long two months! I know you've gotten my attention.

harryk said...

Hi Scott,

I saw Jennifer and Caleb at church last night. How wonderful that he's going to the Air Force Academy and can be another Christian witness there. She asked prayer for you so a lot more folks should be asking the Lord to get you through this. A few thoughts on your remaining 57 days:

1) Lord willing, it will get easier - not easy but easier.
2) I'm thinking that Jack, Julia and Acacia will find ways to help.
3) The reunion with Jennifer will be very sweet.

May God be with you and be your strength,