We have many successes here and more lives are saved because of the work being done each day. But the deaths are surreal & painful in ways we don't experience each day in the U. S. so I find I write about suffering to unload my emotions & to report how hard life is for others in this world. Count your blessings & hug your children tonight.
When I arrived this morning to set up the OR & arrange the surgery schedule there was a young girl already on the OR table. She's maybe 16yrs old & pregnant & her baby is definitely dead. The mom may have a ruptured uterus (labored for days--not at our hospital). A forceps delivery of a dead baby is really tough to watch. The scent of death filled the OR immediately & left a permanent scar on my heart. I felt sick with grief. Frequent death is still new to me. They closed up mom with no rupture but things just seemed "off" with large belly & pain after delivery but she was stable & not bleeding.
An hour or so later we were called to the OB ward to see her again. She looked bad-- like sepsis creeping up. We hand carried her to the OR just a 100 feet away. Definitely septic. Ketamine anesthesia. Not bleeding, normal hemoglobin, but laparotomy found lots of fluid, swollen bowels, no perforation but her tissues look bad. Did I mention we could not obtain her blood pressure for probably 5 minutes? We were pretty sure she would die in the OR. I found some Levophed in the drawer (one of only 2 bottles in the country), mixed my own drip and titrated the medication with no pump, just a roller clamp.
I kept her in the OR for hours as our mini-ICU. We cancelled elective surgeries & I stayed with her all day until I was called out to see a child gasping for breath in pediatrics. Actually he was laying on a mat by the fence outside-- kind of near pediatrics. He was maybe 8 yrs old & struggling for breath. I had them carry him to preop so I could give oxygen, medications, &monitor him. He struggled for breath as we treated him for maybe 20 minutes, working through treatment algorithms & working out why he was so ill. I held his hand & stood beside him the entire time. For a few minutes he looked like he was slightly improving. That sweet boy died literally right in my arms. One moment struggling & in the blink of an eye he was still & silent. I was shocked by the speed that death occurred & I saw it coming. His eyes & face changed & he was gone. As I confirmed with my stethoscope what I already knew, I felt the now familiar sensation of my tears rolling. We called in his mother & grieved with her, choking back my own sobs that tried to break through. It honestly tore my heart apart.
We ended the day with another C-section--but with a happy ending. Strong baby boy & healthy mom. We debriefed a bit afterward to help the team cope with the boys death just an hour earlier, I cleaned up & walked home. It's 530pm & I haven't had anything to eat or drink since 7 am. I stripped off my scrubs, stepped into the shower, & cried again.
This is "slow season" in Chad.
-Mason
P.S. I really, truly love it here.
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