Monday, July 14, 2008 - Part 1
This morning I found out from Gavin how the boy with diphtheria really died. On Tuesday night, he woke up when he was still intubated, and while no one was watching, he took out the tube himself, which caused his airway to shut completely. By the time someone came, it was too late. What a tragedy, and such a waste after all our efforts to save his life. How sad that the boy unwittingly killed himself, and that he died without his family around. It's one thing if he had died of the toxin, but he still had a very good chance of survival. If only he had been monitored or sedated...
We also heard a good news today. Ms. Prudence told us that the man who injured Madelene with a machete had come out from hiding, apologized to everyone at the church, and became a Christian! While he was hiding, Ms. Prudence's husband, who is the pastor of a church up in Souffrier, told him that Madelene is healing well, and that he should repent. It was really cool to hear that something good came out of what seemed to be an unfortunate event.
Most of our regular patients come on Mondays, Wednesdays, and Fridays, so we got to see many of them today. And by regular patients, I mean Madelene (machete wound), Augusma (torn hand and broken elbow), Kettelie (pubic sore), and Acephise (facial abscess). The more I work at the treatment room, the more I become familiar with these patients. It was great to see how each patient was getting better, except Acephise's abscess still seemed pretty bad. She had lots of green discharge which smelled awful as usual. Because the abscess is right on her cheek, she could hardly talk. We're still not sure if she's taking the antibiotics. I think she'll be coming to the clinic everyday now.
We also had couple of interesting cases today. Ms. Prudence brought into the treatment room a 7-month old girl whose hymen was completely closed. She wanted to show Amy how to open it. Basically she gently rubbed a tip of a cotton swab against the hymen until it opened up. It was hard to watch the little baby girl helplessly cry with her weak little voice. Ms. Prudence put some draining strip into the newly formed orifice so that it won't close up again. It looked like such a traumatic event for the little girl, but I suppose the earlier it's done the better. At least she won't remember that she had to get her hymen open. Still, it looked really painful.
Another interesting case today was an 18-year old boy named Eddie with a really high fever (105ºF) who was carried into the clinic by his relatives because he was so delirious and paranoid about everything. Whenever he saw gloves he'd say we're going to operate on him and kill him. He was scared of the thermometer and would try to dodge it. We tied him down on a bed so he wouldn't run away. We had to get three or four guys to hold him down while Gavin gave him shots of lorazepam (my class should know what this is and how it works) to calm his anxiety and sedate him.
We figured that Eddie might not be cooperative enough to take pills, so I ran to the pharmacy (within the clinic) to get some acetaminophen (Tylenol) in syrup form (which comes out to be quite a lot to match his dose). He wouldn't drink it claiming that it's poisonous. So we gave some to his cousin who had brought him in. Even after she took a sip, he wouldn't drink it saying that she didn't sip it. Then after a while of trying to convince him he finally took it and put the whole thing in his mouth. We all stepped back thinking that he's going to spit it out, but he gulped it all down. We had to repeat the exact same thing when we gave him chloroquine syrup (except the syrup was twice as much as the Tylenol) because we thought he might have malaria.
We had to get his fever down quick, so we used cold wet towels to wipe down his whole body. We kept telling Eddie to lie down and rest, but he refused saying that he would die if he lay down. We left him with his cousin while we went to lunch, and when we came back he was much calmer and was even laying down. Eventually his fever went down, so we let him go with an instruction to get sputum samples to test for tuberculosis.
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