Aud’s view.
It’s Tuesday and we only have one more day here. Hard to believe. It has gone by really fast and we have been busy. Last night I actually slept well. I guess my body is finally switching time zones, just in time to return to Oregon, 8 time zones away. I was able to get up this morning in time to eat and go to worship at 7am. It is done in French and Nengere. I understand most of it, but have a hard time concentrating in French so early in the morning. After worship, I made rounds on pediatrics-my favorite ward. Everyone was doing well and I was able to let almost all the kiddos go home.
Next I made rounds on the adult ward. I just have to say that it felt like psych rounds today. The first patient I saw was a 70 some year old fellow with malaria, typhoid, anemia, and a huge scrotumn probably a hydrocele, with the scrotum the size of a basketball. He says he’s weak and wants medicine to feel better. Then he says he wants surgery to fix his hydrocele. When I say I will give him medicine, he says he doesn’t want medicine. I ask how he will feel better if he stays sick. He says he just wants surgery. I tell him he needs medicine to gain strength before surgery. He doesn’t want medicine, he just wants to feel better. And on and on the discussion goes. After I leave his bed to go to see the next patient, his son comes over and again starts to argue, saying that he doesn’t want medicine and can I convince him. This happens as I am at the bedside of each patient. And again when I leave the ward, when I go to the surgey ward, when I go to the maternity ward, when I walk by the pharmacy. Every time I turned around today, the son was there stating the same thing. As of 7pm, I still don’t know if he has any medication. On to bed 2. A young guy with typhoid and no malaria, that has only received malaria treatment, but nothing for typhoid. Ugh! Bed 4 is a young girl who was admitted for vertigo and itching. She was given dexamethasone and vitamins. When I see her she swoons. A true, theatrical fall to the bed. I ask what’s going on and she says she’s fine. Denies, headache, dizziness, vertigo, fatigue, nausea, diarrhea, fever. I tell her we should at least meke sure that she doesn’t have malaria (one symptom is dizziness). She refuses all tests and all medicines. We tell her to walk across the room. She does, then again in a threatrical swoon, lands on the bed. She says she wants to go home. I’m sure I’m missing something in translation but I suspect she is depressed or has some stressor going on in her life. The nurse says we can try to talk with her after rounds in his office. I go onto the next bed. It’s a fellow who has been here for 3 days. Two days ago his labs showed severe malaria. I told him yesterday that he needed to pick up his medicaton. He was going to try oral treatment, but if he vomited, I would change it back to IV. Today I find out that he hasn’t picked up any medicine. He says he wants to feel better but doesn’t want medicine. We discuss the importance of taking medication when you have malaria. We discussed different methods of treatment. Finally after much coaxing, he and his brother agree to buy the oral treatment if I would let them go home. I agree, and write the discharge in their health book (carnet- a portable medical chart that goes with them). I then put the carnet in the nurse’s pocket and tell him that he can’t have it back until he shows the nurse that he has his medicine. As I’m about to leave, the friend of the swooning girl comes over and says that he thinks she is worried about having HIV. Her mother died of AIDS soon after she was born. She agrees to do the HIV test. The nurse will discuss with her in his office after rounds are over. I look at the nurse with puzzlement and he agrees that today was a very strange day.
The rest of my day can be read in Greg’s blog #19 as I assisted him in all the surgeries and the rest of the rounds.
Oh, by the way, the little girl that I hoped had TB disappeared. No one had heard of them or where they went, but she was not admitted and I could not find her the next morning. I don’t understand since they traveled over 10 hours to get here. Bere is a very strange place, but also endearing in its own way. Til next note…