Another Day, Another Frustration

You would think that after all the time I’ve spent here that I would get used to bad outcomes that are beyond my control. Not so. It still hurts to lose a patient that you know would have survived under better circumstances. The first case I operated was doing well until she suddenly deteriorated and died over an eight hour period. She had had peritonitis and that means she was depleted of protein and potassium, among other things and there was simply no means available to replace them. I’m not talking about sophisticated stuff here but rather items that have been routinely available in hospitals since the 1960’s. The hardest part of this volunteer business is not the travel, food, accommodations, etc, but the sheer frustration of not being able to your best and the oblivious local attitude as to why. OK, enough whining.

I mentioned the weird dinner with the regional commissioner. We were invited to meet him at a new hotel and restaurant across the road from the new slaughterhouse of which the locals are very proud. The party was Daniel, the Commissioner, Grace and me, Jasper, Dr. Kabuma and Elizabeth, the regional Director of Education. When we got there the tables were outside on a very cool night and when they asked for our drink order which was mostly beer they had to send someone back to town for it which took about 45 minutes. When we finished our beer we were informed that there was no food so we had to get into the cars and drive back to our hotel for dinner. Total elapsed time about 2 ½ hours and we had not yet eaten. So tired that I could hardly stay awake I was relieved when the evening finally ended. I felt kind of cheated because I was really looking forward to a conversation with Daniel so I told him that I want to meet one on one before I leave. I’m sure it will happen.

I saw some interesting cases today in the office. First was another of those giant keloids on a lady’s ear. We’ll remove that one on Monday. There also was a woman with one of the largest goiters I’ve ever seen. This will probably not be surgical. Add to that a couple of interesting hernias and it was a worthwhile day. Midway through clinic I was summoned to the operating room to consult for case underway. What was thought to be uterine fibroids turned out to be an inoperable lymphoma so I had to suggest that they just go no further and close the patient. Sad but the fact is that this lady should never been operated. A simple ultrasound, which is available, would have made the distinction. The surgery was being performed by assistant medical officers who have as much business being in the abdomen as I have piloting the space shuttle.

At dinner this evening we met Cal, a graduating dental student who is part of our Healthcare Volunteer team. He is a nice young man from San Francisco and will make an agreeable dinner companion for us, along with Nigel, a British road builder in town to finally get the highway done and, of course, Robert, our Dutch internist who is about to leave for Dar to get his girlfriend who is here to visit. Robert will be a separate subject for a post as his story unfolds.

OK, that’s it for now.  Off to bed.

Comments

[Barry]

Skip,I love you for what you are doing, and perhaps more importantly, for who you are. You are doing the best magic possible and you do so never losing your compassion and connection to humanity. I have such respect for you. Barry

[zhang]

Love this new feature! love this page.