Anxiety

Monday, September 16

I want so deeply to be able to say that this morning I awoke excited about the ways in which I could be the hands and feet of Jesus.  I truly desperately desire that to be the truth. But I woke from fitful sleep, with worry and dread about the day. The lack of control I have.  The shortcomings of my experience laid upon the reality of Malawi. All born out of a real drive to help and not hurt my patients and the people I work with. I know the scripture verses.  I am aware of the greatness of my God. I know that He can use the most frail and incompetent. I vulnerably admit that sometimes what I know and what my adrenal glands do just don’t sync up.  The verse that comes up in my head. “Lord, I believe, Help me in my unbelief.” 

So I start the day trusting that God knows the desire of my heart and I let my footsteps to the hospital be a testimony of my desire to exercise that faith.  Morning report was without incident. We went to the ward straight away. Lisa and Rinske, the two Dutch students I have traveled with, are on their pediatric rotation now.  So that was enjoyable to have them around. Changing to the teacher role was a little different but no big deal. After waiting for the mopping crew to finish, which is a thing that you wait for here, we started rounds.  Sam joined us for a little bit and the other clinical officer saw a few. We did some discussion on some of our most difficult patients which was good.  

A couple who serve at another hospital here in Africa were visiting today. They were coming around the wards as we were having some of this discussion.  I have had some concerns about one of our babies and some possible anomalies. They were quick to dismiss it as malnutrition. The clinical officer had stated that he was running fever and that led to a long discussion.  I asked about the possibility of him having developed malaria even though he was negative at admission. The kids don’t have mosquito nets in the pediatric ward which wears me out because then we lecture the parents about having them at home.  The group thought it was low possibility and recomended some other lab test. Funny thing, his malaria test was positive and when I scoured the chart I found that he never had fever-the number had been wrongly copied. AGHHHHH!

We had several admissions over the weekend mostly with respiratory symptoms.  I think everyone had what I had. We also got yet another puffy kid. His blood pressure is also elevated so I find myself giving medications I am just not familiar with.  We finished ward rounds right at lunchtime. My resident was also back with us today which is nice for me to have some thinking help.  

Lunch passed quickly.  Melissa had arranged for some meetings this morning in regards to documents for her USCIS case to be done.  We talked through those and at the end of lunch she went with me back to the hospital to pick up the documents and drive them into town.  

The afternoon was spent just rechecking patients and tracking down lab.  I asked Catherine if she would come and talk through a few with me. I just want to ensure with the cases that are unusual to me that I am not missing anything and that dosing is good.  We made plans for the hypertension care and one with severe malaria. I felt scattered and unfocused as we talked through these patients. There was much going on when she walked in and it was just not the calm and controlled presentation you would desire with a colleague.  Oh well, that is one of my areas of concern at present.  

We then had a baby come to the NICU that the clinical officer wanted me to see.  It is a five day old with a distended abdomen and it has not stooled. We started investigations and treatments but it looked pretty good.  It was the end of the workday when we finished. I did go back to my room think of one thing to add and ran back to the hospital to add orders.  It is nice to have a three minute walking commute.  

The evening had me talking too much about the patients and hospital.  I need to keep it in check or it could easily take up the time that could be used building relationships or lead me into areas of complaining.  It is just that my mind continues to dwell on and try to solve the puzzles of patient care. I will continue to try to capture my thoughts and lay my burdens down.  I continue to pray that I will have peace and calm in a setting that feels very stormy.