A two year-old boy came in the other day with severe pneumonia and measles. He had previously been in our hospital for 2 weeks with severe malnutrition followed by 6 months of TB therapy leading up to this current episode. The nurses and I talked about how unfortunate his year has been – malnutrition, TB, measles, pneumonia – not the best luck. We even laughed for a moment about the irony of it all. And then, I looked back down at the little child who might be on his death bed and felt shame for my emotional detachment. Maybe it’s just a protective mechanism.
Here’s a sampling of some of the other interesting cases we’ve seen this year:
- A lady presented with vaginal bleeding. The most common cause of this in a young woman here is a first-trimester miscarriage. But in her case, she had a leech attached to her labia.
- A 5 year-old boy came in after coughing up two big beetles. His mom brought the dead beetles in to show to me.
- A schizophrenic 20 year-old presented one evening after being slashed by his mother with
a machete about 20 times. He was apparently attacking his sister. For four hours, three of us sutured up his tendons, muscles, and skin lacerations. His mother came in with him on a follow-up visit and kissed my hands for taking care of her son.- A man came in with tetanus and died within hours. Later in the year, another man came in with tetanus (up to 60% mortality rate) and lived. Tetanus, or lockjaw, causes your body to spasm so badly that you can’t move. With every loud noise or touch or other stimuli the muscles spasm even more forcefully causing excruciating pain. The man sat in our hospital for 2 weeks moaning in pain, unable to eat, but slowly he got better.
- A small infant came in with a fever and a petechial rash all over his body. As this is an ominous sign of meningococcal meningitis, we rushed to give him the medicine. He died moments before I attempted a spinal tap.
- A few children were found to have an extra digit on their hands. We helped take care of these for them.
- A schizophrenic lady delivered her baby with us, but almost did a back flip off the head of the bed because she was having a hard time pushing. I delivered the baby and ended up sprawled out on her bed trying to catch him. It was quite a scene.
- Several women presented with thyroids almost as big
as their heads, a common finding here. We try to promote iodized salt in the community.- A woman went into preterm labor. Hours later, she delivered a stillbirth with anencephaly. This is a severe malformation where the biggest part of the brain never develops, and is incompatible with life.
- A woman’s baby was in the breech position. She delivered the body at home but the head wouldn’t come. Babies can’t live like that for more than a few minutes. Six hours later, she arrived on a stretcher to our clinic. It took us an hour to get the head out. But the woman lived.
- A woman from the primitive tribal regions to our south came in after being stabbed in the abdomen by her husband. The knife penetrated into her peritoneum (abdominal cavity). She eventually had surgery, recovered, and went home. Her husband went to
jail.-In March, we took 5 women with fistulas to a hospital in Addis. A fistula is a hole between the bladder and vagina that develops when a woman’s labor fails to progress and the baby’s head is stuck low in the pelvis for hours or sometimes days. The women are completely incontinent, and become ostracized in their community. The operations are done in Addis Ababa at the Fistula Hospital for free. They are life-changing for the women.
For some patients, their lives were saved as a result of visiting our health center. For others, there was nothing we could do. What I have learned this year is that we are not going to save everyone who comes through our gate. But, the stories that you must hold onto are the happy ones, the successful ones, the miraculous ones. And in everything, everyday, you must look for the joy and humor of life.
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