Today ranks among my sheistier days here in Lambarene. There were some really sick kids in the hospital today and some terrible outcomes. The first thing that happened was a kid who arrived with tetanus. Straight out tetanic spasms, sardonic smile, lockjaw, arched back, and lack of proper vaccination (only one of three DPT vaccines). It was awful to see. The kid seems super sweet too. He kept telling his mom not to cry, that she shouldn't worry about him. But then when we gave him medicine and he went into deeper spams he started whimpering “je vais mourir, je vais mourir” which means I am going to die. Too freakin depressing. We looked up the dosage for tetanus immunoglobulin and then went to see if the pharmacy had some. They did. So I mixed up a big syringe full of immunoglobulin and adminstered it. Yes, that's right. Today I adminstered tetanus immunoglobulin. Never in my life did I think I would do such a thing. He is hanging in there for now, but we will see how it plays out. I am not too optimistic.
The other maddeningly depressing event today was the arrival of two day old twins in septic shock. We couldn't figure out a source or a causative bacteria so we put them on amp and gent, which is the standard when you don't know the source of infection. Then we waited. Within a few hours one of the twins went into arrest. By the time the mom alerted us, the baby was cool and very dead looking. We did CPR for 10 minutes while the mom and grandma cried beside us. It was so sad to hold a tiny dead baby in my hands and try to pump its heart and lungs back to life with no effect.
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