Friday, August 20, 2010

The Agony and the Ectasy

This morning two striking events occurred in close proximity to each other that illustrate the polar opposite of pediatrics both in the US and in Gabon. In the first case there was a young girl of five who arrived during the night with a peanut lodged in her windpipe. It was a big peanut that she had choked on and it was blocking most of the air in and out of her lungs. At some point overnight she went into cardiopulmonary shock and had to be resuscitated. This morning she was holding up alright on 5L of oxygen until we were about to start rounds. She went into arrest again and this time none of our efforts worked to revive her. It was crazy sad. Her mom, aunt, and GM all started wailing the child's name and other laments. The whole hospital kind of stopped to watch and listen, Just a very very sad scene all the way around for a child to pass away from such bad luck.

Not five minutes later I had one of my greatest successes yet. It drives me crazy when parents seem not to look after their children's health be it back home in Chicago or here in Lambarene. So when a parent really does take a close interest it makes me incredibly happy and thrilled. I had looked up an electrophoresis result for a recently discharged patient and it had come back positive, meaning that the girl had sickle cell disease. I called the mom's cell and she promised to bring the daughter the next morning (ie this morning). Not only did she show up on time, but she had lots of questions about the diagnosis and treatment of sickle cell. I wrote down a bunch of information for her and arranged our first follow-up appointment in a month to monitor hemoglobin and thick smear status. Satisfaction in the midst of an otherwise dismal morning.

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