The dust settles

The wards felt strange today, no Cedrik tagging along, Derrik’s bed already occupied with an unfamiliar face. Cedrik, Hilaire, and Derrik are dead, Junior left AMA (I’ll pretend he’s still alive, though unlikely), and now we are left with only one of the five boys I wrote about. Rudolph is looking good, but still unable to walk due to deconditioning. Maybe he can go home on Friday…

I ran into Derrik’s mom today and she said “hello dokitah, good morning” and smiled and shook my hand like it was any other day. This place confuses me so much sometimes.

Cedrik’s mom is still sleeping in his hospital bed.

The ward is full again, with lots of children who came in way later than they should have. There is a 2 wk old baby who has been having bilious vomiting since 3 days after birth and has never passed a stool. She weighs 1.5kg and is so malnourished that she just flops in any position you place her. She’ll need surgery for likely duodenal atresia, but I doubt her little body can take it.

We have a 14yo with huge splenomegaly that we’ve been working up over the last week for TB vs Tropical Splenomegaly (chronic malaria) vs sickle cell sequestration vs malignancy. Today she had a bone marrow biopsy done at the bedside with the biggest needle I have ever seen and the loudest screams that she has ever made. I can guess what the results will show.

The baby who was in a coma for 4 days secondary to severe dehydration and probable cerebral malaria is actually looking pretty great. Mom is begging us to allow him to eat by mouth, but it is still too unsafe. Part of me is thinking you should be happy he is alive, but the other part of me is thinking I can’t stand to hear the sound of another distressed child. But I will stand my ground.

We have a 15yo boy with TB pericarditis, 3 failure to thrive children, another few with sepsis/malaria, a 12yo with horrible looking chronic osteomyelitis of the hip, a 2yo with a facial abscess, a 5 yo with probable Burkitt’s Lymphoma, etc etc etc. Who knows what will come in tonight.

I feel a little numb today and spent most of the night staring at the blurry ceiling. This is what these people endure on a daily basis. Death is so much a part of life here, I can’t believe it. We are so so naïve. I appreciate all the support that people back home and elsewhere have given me, but I am only a tiny window into much more horrible things. In 3 weeks I will pack my bags and be back where the water is clean, the medications are in stock, and where I can continue to take everything for granted.