It Just Gets Worse

I had originally prepared a post for today though somewhat grim still had the upbeat sort of attitude that I have managed to maintain during my visits here. The last 24 hours has taken the wind out of my sails and left me thoroughly discouraged.

A young boy, horribly sick was brought to the hospital the night before last. He had peritonitis but his blood count was so low and he was so dehydrated that we postponed surgery until the morning so we could resuscitate him. He had been treated by a local witch doctor (I am no longer going to use the polite term - traditional healer) for ten days and it is only the strength of youth that permitted him to survive this long.

At surgery we found a hole in his stomach about the size of a quarter and the medically trained among you can imagine what the inside of his abdomen looked like. We got through the surgery with the anesthesiologist pushing us to finish because he was RUNNING OUT OF ETHER AND THERE WAS NO MORE TO BE HAD! The patient was literally awake as I was closing the skin. There had not been time to adequately irrigate the abdomen so the job was incomplete. I did manage to place drains appropriately.

Overnight the nurses had let his IV lines dry up so he did not get the needed fluids and blood. The dressings were soaked and unchanged and antibiotic administration had been incomplete. In the morning he was a mess. I spent the morning starting new lines and cleaning up but it does not appear that he is going to make it.

This incident is representative of the problems here. There is simply not the will to do things right nor the capacity to teach people to change. The bottom line is that no one except Grace or me cares whether the patient lives or dies so there is no support to our efforts. Oh, and speaking of Grace, she did a fabulous job 1st assisting in a very difficult situation.

To compound the situation my local counterpart, Dr. Nduasinde, left us on day one for a "few days" and has not returned nor do we know when he will. He was supposed to be my interpreter and was to have pre-scheduled cases. He has done neither. I have considered him a friend but now am quite suspicious of his motives.

I will persevere for the week and then go to the lake for a long weekend. Things have to get better.

Comments

[MedStudent]

You're amazing. It's nice to know that after all these years of being a doctor, these things still get to you. Not that I expected any different from a physician such as yourself. But you really do give someone like me something to look forward to.

[GABRIELA]

DEAR SKIP,
... I KNOW THAT WORDS (MORE OFTEN THAN NOT) COME SHORT OF EXPRESSING WHAT'S REALLY FELT IN MY HEART... BUT I WILL TRY REGARDLESS, SO YOU MAY KNOW THAT YOU ARE SUPPORTED & APPRECIATED BY ME...AND ALL OF US WHO KNOW YOU!

IN MEDICINE, AS IN LIFE, WE HAVE TO PERSEVERE ....IS SPITE OF WHO IS WITH US, OR GAINST US SKIP!
YOU KNOW YOUR MISSION AND WHY YOU'RE THERE! THE PEOPLE WHO NEED YOU MOST MIGHT NOT BE ABLE TO FIND THE WORDS TO PROPERLY EXPRESS WHAT YOU MEAN TO THEM SKIP;
I FEEL FOR THEM, AS WELL AS UNDERSTAND WHERE YOU'RE COMING FROM!

REMEMBER THAT GOD IS SEEING ALL OF WHAT YOU DO, AND IS USING THE GIFT OF YOU, YOUR SKILLS, HEART AND SOUL! ALSO, REMEMBER THAT NO MATTER WHAT HAPPENS HE IS IN CONTROL - TRUST THAT!

THANK YOU FOR BEING HONSET AND CALLING IT AS IT IS!!

AND ALWAYS BELIEVE IN MIRACLES SKIP!

[Yo, Yenta!]

Oh, Dad, you must feel so disheartened. You must know that no matter what others around you are doing, you ARE making a difference. We - me, your son-in-law, and especially your grandchildren - are so very proud of you. You are setting an example for all who know you, even as you have to process the incompetence and unreliability of a culture that doesn't seem to value what you have to give. We love you!!!

[Cori]

Skip,

I am a friend of Jessica and Mark's and I have been reading your blog. I can not begin to imagine what you are experiencing, but I know that you are making a HUGE difference. I wish things were better and I hope that you are able to see your efforts through our eyes. Take good care of yourself.

[Kate]

Dear Dr. Skip,
My name is Kate and I am a friend of Jessica's. You are a wonderful person to do what you are doing despite the disappointments you are facing. Both my kids have had some hard surgeries. One had heart surgery and the other almost died from a septic hip. I was so thankful to be at Stanford and UCSF for the care we got. My mind would often flash to a helpless mother in Africa whose child was suffering from some condition without decent care. You must provide some kind of hope to these mothers. There is a reason why you are there although you might not see it. Someone greater has a plan.. Thank you for doing what you do.

[Amy Glor]

Dr. Feinstein --
I am literally crying as I write this. I've just read your blog entries and although I have been aware of your efforts in Tanzania, I had no idea just how bad things really are.
I can't tell you how touched I am by your fight to make life better for those who have no means to improve it for themselves. I know it must be more discouraging than anything I've ever experienced and I want you to know that your willingness to shoulder such an unimaginable task is truly inspirational.
You may not be able to save every patient or improve the overall situation much, but rest assured, you are doing immeasurable good simply by showing up. I am certain that both your medical skill and indefatigable compassion are appreciated more than you know.
Thank you for being a beacon of humanity in a time and place plagued with such turpitude. You are an example to us all.
When you have a chance, perhaps you could give those of us back home an idea of how we can help.
Keep your chin up -- Amy (Maltby) Glor

[Sondra Pariser]

Dear Dr. Skip,

I am so honored to call you my friend! You give me a very literal definition of what Tikkun Olam really means. I can't even imagine (seriously...I can't imagine) what you are experiencing and am looking forward to seeing you and listening to your stories and heartache.
We love you,
Sondra and Alan

[Luahancock]

Dr Skip-

I have spent some time myself in Eastern Africa. A place with such spiritual and humanistic highs and lows. Raw life.

It was interesting that I was introduced to your blog today. I work in higher education and have been trying to make some major changes that I know coudl better help the students. I am met with a system that at times is unable to make change and people disheartened and unwilling to commit. Although this pales in comparison to your current struggles and frustrations, I am reminded about how much fundamental change is needed worldwide to better serve each other as humans and how hard that work can be.

I am inspired by your work. On days that I am frustrated I pray and focus on the reason I do the work and fight the struggle (although it may sound cheesy)- to make teh world a better place and to serve others. For what little it is worth- know that I am on the other side of the world, but holding your hand.

- Lua Hancock (a freind of a freind of your daughter)

[Samuel Feinstein]

Thanks, I needed that.