High and Low

High of today had to be assisting in the delivery of a baby in the front seat of a matatu parked in front of the hospital . . alerted to the evolving scene as I saw another patient in casualty but heard the screaming mom outside, who just couldn't make it those last few yards inside. I took the blue baby girl and RAN all the way to the nursery, but by the time I got there she was crying, and all was well.

The rest of the day blurs together: rounds, teaching, notes, labs, run home to start some bread dough, consults. The usual, as Kijabe is a mecca for the floppy, the weak, the neurologically devastated, the wasting away. More seizures and poor growth, calculations and xrays. Low is that Scott is on call for ICU, but all 4 patients there are pediatric, so when he got called in the middle of dinner I ended up leaving our 7 guests and 4 kids to fend for themselves and joined him for a few hours, as he intubated two critically ill babies and we sorted out their therapy. Then the real LOW came in precisely the same spot as the high, 12 hours before . . standing by the same bed . . admitting an 8 month old with intractable seizures, maybe a viral encephalitis. As I talked to the intern the nurse said "Doctor!" and we looked at the baby, who had been in respiratory distress, and now completely stopped breathing. Flat. Still. Nothing. The intern reached for the ambu bag (ventilating equipment) and I reached for the baby and at that very moment the power went out. Completely. Pitch black nothing. I fumbled in my pocket for a tiny flashlight I carry, tried to get the mom to hold it so I'd have hands for the baby, she was in hysterics and unable, I grabbed the dad's hands and showed him what to do, and at that moment the power came back.

High number two: came home just now to find the girls had washed all the dishes and put everything away. I love boys, but tonight I have to say, hooray for girls.