Thursday, June 30, 2016

Night shift

This afternoon, Bernard asked me if I was available to work tonight. I generally enjoy working nights. I'm naturally something of a night owl anyway. Nights are typically fairly quiet. The crickets sing. The beetles crawl. Wilfred the little rat often pops in to say hi. Generally most of the patients are asleep. I don't even have to pretend to understand Arabic. (Although most of the Arab speaking people who I have met do tend to speak very expressively, which helps a lot.) If there is a c-section or surgery of some kind, I have a good chance at the opportunity to assist with it. Besides the staying awake part, which is really only difficult between about 3 and 5 am, night shift is enjoyable. So when Bernard asked if I could work tonight, I immediately said yes.

As I was walking over to the hospital to start my shift, I met Dr. Bland, who had just killed a snake. It was small, by this time dead, and didn't look too threatening. But I decided to start using my flashlight when I'm walking in the dark.

I had 11 patients. None of them very sick; there were no surgeries today, so there aren't even any new patients. There was, however, a kid over in the bloc (which could very roughly be called ICU on occasion) who apparently had pneumonia. I agreed to check in on him through the night. He didn't look that bad. On oxygen.

A short time later, his nurse came and told me that he had died. Ten year olds aren't supposed to die. Especially when they look healthy. And mothers of ten year olds aren't supposed to lay on the floor in hysteria. And grandmothers aren't supposed to cover up their grandchild and carry him away.

An hour or two later, I wandered over to maternity to observe a woman who was apparently having problems in labor. After Dr. Bland performed a fairly simple and rapid vacuum delivery, the baby wasn't interested in breathing. After the normal suctioning, tapping, rubbing, and pleaded, we moved on to offer him some assistance. He had a nice little heart beat. And we squeezed air into his little lungs, and continued with the tapping, rubbing and pleading for close to half an hour. But no, he just wouldn't breath. And his perfect little fingers and toes slowly got colder. You can't breath for a baby forever, even a cute one. (And this one was cute. Ok, I generally think all babies are cute.) Just to be really clear, cuteness has nothing to do with how long you breath for a baby. Babies aren't supposed to die before they've even taken a breath (or any other time, for that matter).

I was relieved that later, when I sat next to one of my patients and gave her an antibiotic, nothing of note happened. Just the beetle that tried to crawl onto her mat.

For some people, the world feels like it stopped to night. For me, it feels like it should have; kids aren't supposed to die. But the crickets and the bats still sing. And it still smells like flowers outside (Only in certain areas. There are other areas where it smells like other things, believe me). The sun is still going to come up in the morning. And someday, kids aren't going to die.

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