On beautiful reminders. . .
The past two weeks have brought back so many patients from the past 2 years, and have been an amazing reminder of the beauty in this journey we have been on. . .
Last week, I walked into clinic to see a precious boy that was having trouble breathing. The mom looked at me with recognition in her eyes immediately. . . “Daktari, this is your baby, remember him?” At 8 months, Ezekiel was chubby and growing, but I remembered his mama’s smile. I looked at the file – we had intubated him the day he was born, and he was in ICU for 12 days as we helped him breathe and titrated his medicines meticulously. Here he was, with a minor cold and a small oxygen requirement, but thriving, growing, cooing. . .
The next day, our ENT texted me. . . “I thought you would want to know, we decannulated Joyce today.” When I had been here 4 months, the Clinical Officer has called me to Casualty to see an eight year old, paralyzed from the shoulders down. She had been normal, but then over the previous 8 months she had lost ability to walk, then sit, then move her arms. She was struggling to breathe, and an MRI showed a horrible defect of the spinal cord causing the problem. She was in traction for days still in bed to ease the pressure, then went to surgery, then was in our ICU for almost 2 months – ultimately needing a tracheostomy to go home. She had been in and out of the hospital with pneumonia and her trach every few months or so since I had been here. That day, however, she walked into clinic, used her arms to support herself, and had a strong cough – so he removed her trach and placed a bandage on her neck so she could breathe again on her own, no extra medical equipment. Her journey with us was coming to completion. From a scared 8 year old to a smiling almost 10 year old, She took a selfie with me on the lawn outside ENT clinic, and in the language of smiles and broken Swahili, we beamed together at God’s faithfulness.
That afternoon, I went to clinic to do another consult, and a mom grabbed at the corner of my jacket – “we are back, Daktari, see how he is doing.” A baby I had admitted to the ICU with a sodium of 220 (normal is 140) and kidney injury (Cr of 9 for medical people) was in his mother’s arms, breastfeeding contentedly. “He has grown, Daktari. We are so happy,” mom beamed. I had stood by his bedside that first night, pacing as his heart rate varied and worried that the poison built up in his blood would stop its f. And here, without dialysis but with careful management of his fluids and prayer and his mother’s milk, we slowly brought the sodium back to normal. He was one of 4 babies with sodium nearly that high this month. They are all home with their moms now. I skipped out of clinic, smiling as the vision of his big brown eyes gazing at me danced in my head.
I went to Nursery to check out that afternoon, and saw that a baby we had intubated twice, who had been on CPAP for almost a month, was on just a whiff of oxygen now. His mom walked in a broke into a wide grin when she saw me jump up and down and do my infamous happy dance at the news. . . I hugged her and we rested in the moment of another milestone in his journey.
Even as we review mortalities and analyze battles lost, making sure we can do better – to take our mortality from the 9% it was to lower than the 2.5% it is now, we often lose sight of these other beautiful patients whom we have walked beside. In the smallness of the day to day, we forget the story in which we have the privilege of taking part.
Joyce, Ezekiel, baby of Mary, the twins from South Sudan, the dramatic healings and the small ones. . .they have become part of our family, part of our lives, part of the day to day miracles. And as I giggle with them and celebrate, I am grateful for the team that walks beside me – both here in Kijabe and around the world. . .