Thursday, June 26, 2014

Sad Update - Traveling With Kids in Kenya

The baby died two nights ago.  Last night another patient who I'd be hearing about for weeks also died.  He had super complex problems, even in the US it could have happened but it means that in the last two days since Dr. J started working on peds he has had five patients die.  Five patients!  Each one I shed a tear for.  I can't help it.  I don't know if it is the pill or just the fact that I'm an emotional being but I just feel like each child deserves their own moment of sadness.  Dr. J told me he allows himself to feel sad while he is standing there with the parents but then he has to put it behind him for the day because there are so many patients on the wards and so few doctors and nurses and he needs to focus on the patients he still has living.  Right now he has a great intern and that guy is a gift to work with.  He has a great nurse as well but she is currently covering 32 patients...some of whom at home would be sick enough to be in the PICU where the ratio at most would be 3 patients to 1 nurse, at most!  His registrar, his Kenyan resident counterpart is ok.  Personality wise he is fine but he's been cutting out every day at noon.  It drives J crazy.  When Dr. J told him they'd lost three patients over the night he said, "What can we do, they were sick enough they should have been in the ICU."  (I mentioned before there are only six beds in the ICU, all of which are filled).  It is as if he's washed his hands of the responsibility.  It is sort of a common problem here but it is difficult to know what drives it.  A lot of the Attendings (Dr. J's Attending is not actually not one of these...he rounds in the morning, goes to clinic, but then he actually comes back after clinic to make sure things have happened while he was gone, so that is actually really great) only do morning rounds a few times a week and spend the rest of their time in the clinic so it is definitely something modeled from up top, but I'm just looking at this system from the very outside, (not even working in it from the outside like Dr. J is) so I have no idea if it is money thing (I've heard they only make money working with their private patients), just a what you do thing (sort of grandfathered into the system), or just a frustration thing (because honestly I think it would take a special kind of person to have patients dying at these rates because of lack of beds, nurses, resources, ICU slots and stay positive and invested over the long term).  I don't know.  I keep praying every night for the patients in the ward.  I keep praying for the doctors and nurses. I keep praying for doctor J.  I even keep praying for the relationship between Dr. J and the Registar.  Yesterday Dr. J told me he's going to invite him out for lunch.  It can't hurt to make friends and maybe he can get him to stay a little longer each day to help if they are buddies.

Sort of on a weird side note, tomorrow we are on lock down in the compound.  There is a political rally scheduled by the opposition party in town so they've asked all the IU house people to stay at the compound at least for Friday then depending on how things go maybe for the weekend. A bunch of people are bummed out because it means they might have to cancel their weekend plans and for the pharmacy students who had to cancel last week because the lake they were going to had had some tribal violence at it, it is a double blow.  We'd already intended to stay close to town this week because we spent a ton of money on safari last weekend but we were hoping to do some things in town so fingers crossed the rally stays peaceful and we are off lock down Saturday.  Dr. J will probably be late tonight trying to get all his patients set for the possible long weekend.  Maybe if things are good  he can check on them sometime after Friday since I'm pretty sure he was going to be getting a new Intern this week as well.  Seriously Kristin I wish I would have given you more than that one weird awkward hug when you left.  How were you doing this everyday?  I don't know what we are going to do if we get locked in the compound for the whole weekend.  We have a bunch of dental students here with us, pretty sure I've mentioned them before.  Last night they had a wild late night drinking party, but I think if another one of those breaks out Adrian might clear the kitchen with a broom.  Our window faces the back of the compound and we heard dogs all night but Adrian's faces the dining hall and he thought the party was from a bar up the street.  Now that he knows it was here I'm sure he won't stay silent.  Our weekend saving grace, yesterday we had Indian catered in from this super yummy place Jill took us to before she left and the pharmacy students told us they've been ordering take out from them on all their weekends stuck here and that there is no delivery charge.  So there you go.  Indian for the SAVE!

5 comments:

  1. wow...rough stuff going on there. I feel so blessed to be able to count on the Doctors here in the USA. It's great that Jason has this opportunity and that the whole family get's to be there. Be safe... <3 Rachelle

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    1. I should say more than just Doctors...just the organization over all of US medicine is such a blessing. NAs, RNs, PAs, Drs, Specialists...we are blessed.

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  2. I think you are coming up with some good ideas on why this happens. I know that it must be so very difficult to stay emotionally connected when you see patient after patient dying. And that can even happen here in the United States depending on the physician's specialty...

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  3. Please pay attention to all the lock downs... it's hard to stay home but I'd much rather you avoid any of that tribal violence we keep hearing about back here on the news...

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  4. Sorry things are so crazy over there. I'm not sure I could do a job like this. :/ That's why people like Dr. J. exist. :)

    Hopefully they won't get so riled up and you'll be able to go out.

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