A tough day

So today was a pretty hard day.  Emily, my compatriot in the peds ward, lost a 5-month-old little boy to a central nervous system infection.  As we can’t do spinal fluid cultures or herpes PCR, we can’t know for sure what finally took the kiddo, but with the considerable amount of blood in the CSF, the lymphocytic predominance of the WBCs, and the concurrent seizures, it seems it was most likely herpes encephalitis.  Emily was pretty shaken…understandably so.  The family is from pretty far away from Mbingo, and since they couldn’t transport the body back home, they went ahead and had the burial here today.  Emily went to the funeral.  She said it was hard to see the parents bury their only child only hours after he had died. 

As for my “NICU” kids, two of the three in the incubators are doing pretty well—pretty much just growers now.  They’re feeding both by NG tube and by cup and slowly but surely gaining weight.  The third kiddo, a little boy named Praise whose mom had uterine rupture at 32 wks gestation, is not doing well at all.  His amount of respiratory distress is worsening each day.  We’ve covered him with antibiotics for sepsis, but he has continued to worsen.  I think he most likely has RDS from his prematurity and lack of pulmonary surfactant.  And because mom had an emergent C-section, we were not able to give her steroids to help speed his lung maturity.  I checked on him several times today after rounds, and it’s so hard to just watch him lie there and struggle to breathe.  I checked with the pharmacy and three different attendings just to verify that we don’t have surfactant to give.  Sadly, we don’t.  We also don’t have ¼ normal saline, so figuring fluids for these tiny little babies is a beast.  And our potassium machine is broken, so we can’t monitor K on anyone in the whole hospital!  I’ve oscillated between anger and apathy and awe throughout the course of today.  It’s hard not to get frustrated when you know that if this child were born elsewhere, things could be different.  Then that starts me thinking…why was I born elsewhere?  I didn’t do anything to deserve that?  God, why are some so privileged and others born into destitution?  I pondered this while making several trips across the compound today—between maternity, the lecture room, the pharmacy, and back to my room.  Then in the quiet of my heart, I feel…not much.  I don’t know the answer to that question, and until I get to heaven I’m not sure I will.  But I know I can be at peace, for God has a master plan.  All I can do is use the knowledge and skill and resources the Lord has given me to reach out and meet a need.  Jesus gave that example often.  He met the physical needs of an individual, and that opened the door for him to speak into their spiritual life. 

So, tragedy on the peds ward did not stop today after the passing of the 5-month-old.  This evening, shortly before typing this message, the nurse came to notify Emily and Dr. Jam (one of the senior residents) that another of the pediatric patients, an adolescent girl with Burkitt’s lymphoma, had passed just a short while ago.  I can hear the family crying from outside the ward across the hospital compound as I write this.  Here in Africa, even though death may be more common and more a part of everyday life, it still does not fall easily upon the hearts of family members who lose a loved one.  Pray for the patients here, and pray for us physicians that are trying to take care of them.  Pray that the Lord teaches our hearts to trust Him more.