A small dose of hope

Vincent (see post below) pulled through today, barely.  Overnight his breathing became labored and he was moved into our 3-bed High Dependency Unit (the level of care between the general ward and the ICU) for high flow oxygen and monitoring.  Alarmed by his sleepiness and cold skin this morning I asked the nurse to take his blood pressure:  60/20.  Yikes.  Fluids, pressors, warmth, antibiotics, prayer and by afternoon he was up to 85/55 and sipping some milk.  He just teeters on the edge of fighting the bacteria in his bloodstream and the despair in his soul.

The HDU is a 3-bed unit of excellent care too late.  Vincent with his paralysis, chunks of missing flesh, raging infection, all most likely from a disease that was curable for the first few years of gradual symptoms.  Little A in the middle whose minor skin pustule turned into a massive flesh-destroying infection, over a matter of a few months eating its way through his side, his kidney, his spleen, his intestines.  Perhaps if he wasn't an orphan, living in a remote corner of Kenya, he might have had definitive care in time to save his life.  His last surgery revealed we are losing this battle though, and his care is now designed to make him comfortable until his inevitable death.  And on the other side Jonah, still pulling for a miracle, fractionally more awake day by day.

Some days, the burden of sorrow just weighs too much.  My tough can-do wavers at a kind face bringing tears.  The stress of complicated ICU patients, these three heartbreaking HDU patients, the myriad of the malnourished and seizing on the general floor, and the steady flow of outpatients needing assessment or reassurance or more wisdom and insight than I can muster, drains me.

But in the midst of all this a few doses of hope.  

First, we had a lovely graduation ceremony yesterday for two Paediatric Surgeons completing their fellowship.  Dr. Situma will return to Uganda where the ratio of surgeons to patients is even lower than Kenya . . note that all three boys who got too little care too late had problems that were partially surgical . . . and Dr. Lebbie to Sierra Leone where he will be the first and so far ONLY paediatric surgeon in the country.

The spiritual as well as the medical maturity and excellence of these two men was evident in their speeches, and in contrast to so much of what passes for success in Africa.  Really inspiring.

And then I found Acacia and a classmate volunteering to serve meals on the Paeds ward in the evening, and came home to dinner with Jack and three friends from his soccer team, great guys.  These are the next generation of hope, and they lifted my spirits.