A tough pill to swallow

Thursday, March 15, 2012  Day 7

The days in Kamakwie are long and slow and hard, but the cool breeze of the African nights makes it sooo worth it! Tonight was the most amazing night since we've been here. They didn't burn the fields today, so not only could I actually breathe for once, but there was no thick smoke layer covering the night sky. The stars were so beautiful and bright and combined with the cool breeze through the tall mango trees that stirred the hot night air, the experience was almost indescribable or at least it is a complete disservice to even try. After dinner we decided to out for another walk to try to soak in the night air more fully. When we got to the hospital, we found that the children were showing Harry Potter on a sheet hung against the wall next to the dispensary (where the medications are dispensed...aka pharmacy in US). We stopped and watched for a short time- more to experience them watching the British actors with English subtitles. It was very interesting and we pondered how much of it they really understood and what their impressions of the developed world must be like.

After a while, we decided to move on. We could hear music playing from my living room before we left, so we decided to try to follow it. We walked all the way down the road from the hospital until we arrived at the downtown market area. Much to our surprise, the music was not coming from the local hangout, but rather from several large speakers piled high on the street corner in the center of town. The DJ played more music and we watched as the people danced in the street. It was alot of fun to watch. The music has subsided somewhat now, but they continue to play the drums. I can hear them still in the distance.

Today we lost two patients in the wards- a 35yo man with Hepatitis B virus and a 3 month old baby with malaria who came in with a hemoglobin of 3.0 (for the non-medical people, back home we get worried if it's below 10 and Phillip was once told by a hematologist that no one could live at 4.0)  Both patients were having seizures and with neither did we have a clue as to why they were as sick as how they presented. I watched that baby have seizures for 3 straight days with no breaks in his 104.7 degree fevers. Dr. Tom taught us that if we could palpate the spleen on a pediatric patient that it was a good sign because it meant that the baby had chronic exposure to malaria and was more likely better prepared to fight it off (with help). This child had a non-palpable spleen.

We did the best we could with both patients, but it was still very frustrating for me. I felt very helpless, as if watching someone drown and not being able to reach them to pull them back to safety. I felt like on some level we were being forced to play God, deciding which patients get to use the limited resources that we have available to us. It is a sad moment when the doctor looks at you and says, "we only have so much of this medicine so we need to decide if this is a good use of our resources, so that we don't treat someone who will most likely not make it anyways." I did not feel comfortable answering to that, and it is still very difficult for me to wrap my head around the idea of the limitations that we have to face here. I still deny the fact that there isn't some other way, but I know the reality of it. It is a difficult and unfair decision, but today I realized it happens often here and it is a tough pill to swallow... T.I.A.