Thursday, September 27, 2012

Patients this week

I diagnosed my first case of meningitis in a pregnant patient this week. It was kind of obvious by her symptoms, but still I was happy that I knew what it was. As for what to do about it, I read that line by line out of a book to make sure I didn’t get anything wrong. I stuck a needle into her spinal column to get some fluid immediately to confirm the diagnosis. I was proud of myself for remembering how to do that. It wasn’t hard, but I don’t think I had done it since medical school. So, now she is lying in a little room by herself getting antibiotics for a week. She is far from better, but so many die from this by now. I think (and hope) that we got to her in time.

 I opened up another patient’s belly who had undergone a cesarean section a little time back. She was full of pus all in her abdomen. I’d never seen such after a C-section. I was so angry at the medical decisions that put her in this position. I was on fire inside at so many management errors that were made during her hospital course. But I went by this morning to see her and she had her new baby at her breast, resting in bed. Now, she’s not recovered yet, she still has pus draining out of the tube coming from her side, but when I saw her I stopped being consumed so much by anger. I began having hope for her healing and joy at the life she does have.
I have a patient with HIV and tuberculosis on whom I recently delivered a baby emergently. She was so sick and had to be delivered in order to get the treatment that she needed for her disease. She was so sick that I had to do her cesarean section with her sitting up and with local anesthesia to help numb the surgical site because she couldn't have the usual type. The study I got on her heart had less than half of the work-ability that it should have had. She was gasping on admission, and had been ever since. Mothers in the US die from what she has going on in her heart, they have heart transplants and such due to it. Plus, then you add on AIDS and very active tuberculosis, and medically there’s just not much hope. But this morning I walked in to check on her and there she was, lying flat on her back (she has been unable to sleep for days due to difficulty catching her breath unless she is sitting upright), sleeping soundly. She still was breathing a bit fast, but she looked so peaceful and, well, I’m not sure how to describe it, better. Just last night I had given her a little card with a couple verses from Psalm 73 written on it-
Whom have I in heaven but You? And besides You, I desire nothing on earth.
My flesh and my heart may fail, But God is the strength of my heart and my portion forever.
I don’t know if she will even make it. She looks better for the moment, though the road ahead is likely a hard one. But I loved to see her resting there this morning. And I loved to see her smile when I awakened her, not smothering any more. Indeed, for her and for each of who follow after Him, our bodies and hearts may let us down, but God is our strength and forever our portion. 

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