Taco Tuesday

Tuesday, September 3

This morning the air in the ward was pungent with many people sharing the same space and air. The buzzing of flies is constant and yet not monotonous enough for you to block it out. Trivial as it is, I hate feeling grit when I wiggle my toes. The start of the ward report was welcome in leading me to a time to pray and listen to Chichewa singing. The chaplain came and spoke out of Genesis 39, Joseph’s promotion within Potifer’s house. His lesson was that if we are doing good work it will bless those around us- like the patients and the hospital.  It was a good starting thought for the day.

Rounding was good. The child with unexplained jaundice has eyes not as bright yellow as yesterday.  We had a normal blood sugar with the child with diabetes. YAY! A few got to go home. Unfortunately, one with a severe pneumonia who we then started on TB treatments had a positive HIV test today. So sad. This will be a life long struggle now and probably end in a much shorter life. 

NICU rounds are always a little inspiring. These itty bitties are so tough. Three were sharing the warmer.  All under 2 pounds but off oxygen and tolerating their feeds like big kids. I also saw the baby whose mom died with the liver tumor a few weeks ago. She has been vomiting and lost some weight but still seems okay. Hopefully feeding adjustments will get her on track. I did have to seek out her sitter at the orphanage to get details. I guess it was my first official house call in Malawi.

The best part of the day was that it is Taco Tuesday. They have started a small cafeteria to help raise funds at the hospital.  This description may be deceptive-there is a small room with a stove that holds 7 people cooking food you can buy. They are serving tacos on Tuesdays and I was excited and bought 2.  I was not disappointed! Yummy! Hopefully there will not be any gastric details to report later.

I sat at lunch contemplating how much of my day conversation is circling around me but in a different tongue that I can’t comprehend.  The Dutch have similar voice inflection such that I can understand the tone of the conversation. Truthfully, they are sweet to speak English as much as they do. With the Malawians, the tone and rhythm is so different that it makes me feel paranoid. Like they are talking about me. I know it is likely not true but in most conversations, it starts in English, transfers to Chichewa, and if I want to know the conclusion I have to ask. The funny part is that to add clarity sometimes they spell things-SO NOT HELPFUL! I cannot make out any of the letters they say- T, C, V -I don’t have a clue!  Everyone is sweet and patient with the language issues, it just feels oddly lonely in a crowd at times.

I headed back after lunch and found our lunch blood sugar for the diabetic to be good as well.  We gave his mom a glucometer and test strips to learn how to use today. I also had a few minutes to write up a protocol that hopefully will prevent the spread of Hepatitis B from moms to newborns.  We had one admission with bronchiolitis that was struggling some.

I then attended a doctors meeting.  I really didn’t have much reason to be there but was asked to attend so I did.  It is really more for the faculty of the hospital but I enjoyed just watching this small group around a conference table that is facing giant sized problems with limited resources.  It was kind of a “well, what’s plan B. There isn’t one, so let’s stick with plan A” type meeting. These people are heroes and saints. I feel terrible that in my head I am just thankful that these burdens are not on my shoulders full time.

I headed home but went through the ward and found the bronchiolitis kid not doing very well. There is some frustration in nurses being on phones while kids in distress are not being tended too. I discussed him with the nurses, ordered some treatments, and checked his pulse ox which was not stellar.  Then I got texts from Nicole and found that the little one I saw before lunch was still vomiting and now being admitted. I did her admission workup and got IV fluids and medicines going. I left prayerful that all would have improvements overnight and if not that the oncall clinician would be called as I instructed.

I headed back after a long day.  It is great to have a guesthouse family that had included me in the dinner count and let me vent a little about the day.  Again, so many people suffering, my life even on a tough day is so easy and blessed.