July 30

30 Jul 2009 – Day 50

Greetings in the name of Jehovah, the LORD who heals us! (Ex 15:26, Ps 103:3, Ps 147:3)
We pray that all of you are well, and walking in the knowledge and strength of the LORD.

Today was one of those days. Some days I wonder about Psalm 84:10. Who did I pick medicine? I wonder if David might have been having a day like mine. Of course, no one has with vengeance sought my life the way Saul chased David. But today was one of those days…….

Call was long, but God was watching over (was someone praying specifically for me last night around 9-10pm?). The late afternoon was filled with odd patient after patient (involuntary sticking out of the tongue?). I arrived late for Cari’s special African missionary dinner. Then I was called back before it was over. Around 1am a difficult pregnancy came in and at the same time I was also informed our 28-30 week twin mom was having early labor. But before I knew it the difficult pregnancy was delivered and the premature mom was settling down and not progressing! I slept a few half winks and woke up in the morning to a zoo……..

Walked in on semi-comatose 70 year old abdominal pain, distention, small bowel obstruction, difficulty rehydrating took to OR to vomit and aspirate, pus in the abdomen, coding during recovery now on Dopamine. 6 month old with incarcerated hernia. Sent home the 70 year old with prostate hypertrophy/urinary retention who got knocked off his moto trying to get here, femoral contusion, pelvis xrays negative, sent home to rest and follow-up. Also sent home the 70 year old chief of his village whose best friend/secretary died, had dysarthria after returning from the funeral home (and a few drinks), rehydrated, told to rest (does one rest if you’re chief and your best friend is dead?); And the 40 year old encephalitis NG feed dependent lady in infection. Heart failure lady was better, as was 20 year old HIV pneumonia lady, but SI2 old man with wicked pneumonia was still touch and go and getting a standing CXR was an experience not just once but twice (first no good, did they really try three times?). One of our 30 weekers was vomiting blood. Then 20 year old in coma, completely unresponsive and breathing 6 times a minute (not good), he died while I was away at lunch.

Russ let me away for lunch. We all hiked to Jeremy and Elise’s in Tsiko. FuFu and chicken in a peanut sauce. Cari took a (short) turn at the FuFu pounder. (Have we mentioned FuFu is eaten by hand?) Washed down with sweets and a Coke. Very proud of Drew who tried it and found he liked the sweet biscuits best (ate 4). They explained that inviting us into their home to eat African was their way of accepting us! It was very sweet and VERY much appreciated on our end. And so different from eating Western food at the Guest House surrounded by typical Western amenities. Of course, found out later we were almost African, they set us each plates and true Togolese dip into a community pot of FuFu. (As I watched John, their 3 year old son scoop and slurp his FuFu down with not quite clean hands, I couldn’t help but think about Amebiasis and all those other fecal-oral infectious disease and said a quick prayer of thanks that our hosts were so thoughtful. Then a pang of regret and self-criticism as I realized how far from African I still am). A lovely time of fellowship …..shattered by the piercing screams of a 2 year old boy splitting his lower lip open …..followed by gurgles as the blood poured down his shirt and legs. At first we thought it was the darn nose again but a quick exam by Doctor mom (confirmed by a pediatrician) identified a GAPING lower lip. He had fallen onto a big wooden FuFu pounder of all things. Long hike home considerably shortened by a fortuitous encounter with returning missionaries in their Land Rover. So the afternoon started with 2 stitches, Tony papoosed between two parents. Fortunately the surgeon was still waiting for his next case so Andy didn’t have to gown up!

Cari took the boys home….. I turned back toward the hospital……And the next thing I knew I had entered a zoo. The afternoon went all to pieces. The first 70 year old’s surgery went all to pot, then the 28 week twin mom went into real labor and delivered, one vaginally, the other by C-Section. Meanwhile the 20 year old died. And another 20 year old who had severed off the tip of his finger waited patiently for an open OR as arterial blood continued to pump out of his finger. Another 20 year old with a fractured clavicle and small holes in his side waiting in the hall for someone, anyone, to be free to patch him up so he could go home. He must have wondered why I passed him >20 times without ever stopping to fix him. We played musical isolettes without the music for the ever-increasing number of premies in our “NICU” because now we only have two functional heater units; and with two new 28 weekers, three (four?) 30 weekers, and a (I can’t believe he’s still alive) five week old former 28 weeker – well, sorry but sickest baby gets the working unit. If you’re unlucky enough to be doing well you get a broken down unit with a hot lamp and a few extra blankets. Did I mention we only have four functional IV pumps? Yes, we still count drops per minute here! Here come some more……..Kid with typhoid, 4 weeker with fever rule out sepsis, boy with hemoglobin of 4 (thank goodness for something simple!), 8-10 getting-more-frustrated-ladies waiting (with their angry husbands) for pregnancy ultrasounds (most come 3 hours from Lome, where wealthy people are used to demanding and getting, and they come up here because we’re cheaper and offer better quality, but their lack of patience really gets to Russ sometimes, and this was one of those times!). Then the family of the really sick man in SI2 asked to be discharged so he could die at home. Another man (where did he come from?) asking Russ then me to sign an insurance form (are you serious? Right now? Can’t you see I’m coding a 28 week twin here and that man over there is dying, too? Please come back later!!!!). And all the family members, friends, and general rubber-neckers inching closer and closer to the chaos around the nurses’ station/makeshift NICU. At one point we had to yell to get the 15-20 some people who didn’t belong there to step outside (only kinda worked), reminding me how lovely those NICU double doors were, you know, the ones with the big sign NICU -- NO ENTRY PAST THIS POINT, next to the security guard, the big sterilize-up-to-your-armpits-like-a-surgeon sink, and the ONLY PARENTS ALLOWED sign. At one point Russ turned to me and asked “What are you still doing here? Aren’t you post call?” But I know he’s exhausted. He’s trying to schedule umpteen ortho and complicated pediatric surgery cases for September before leaving in 3 days and has been up til 3am several nights in a row. Am I really prepared for him to leave? Then I remembered I WAS post call and it would all start again in 14 hours. So I left the zoo………

I found out later they also found a scorpion in the pharmacy……

I want to talk about the persecuted church….I read Tortured for Christ by Richard Wurmbrand…..no time to think today……

Tony’s doing well.
I love that they feel free to run around the compound – the whole place is like a big backyard. Drew even bikes the loop and they both ride down to the tennis court to play. But the downside – we have no idea where Tony scraped up his face.
We’ve moved into the Guest House apartments now as the DeKrygers return tomorrow. Sad and happy – it’ll be different but there will be four more young boys. Bye to the toad and tears for the former farm mouse. And unfortunately we’re now quite some distance from the (4am) crowing roosters.

May you seek the LORD while he may yet be found. And mawu ne no kpuli wo (May God go with you).

Yours in the service of our LORD,

CADT (The Robertsons)