Life and Death

Dad says I need to write more positive things and less negative things in my blog.  So I wrote the previous two stories first and I’ll end with this one, which is only half negative.  The problem is that medicine is caring for people, and a lot of times life, death, and pain are involved.  The great thing is that’s when you see God the most.

                So this hospital is more technologically advanced than the rural hospitals I moonlit in.  Usually the equiptment and meds aren’t the limiting resource.  We do try to be good stewards of cost.  Usually it’s the doctors and specialists who are limited.  Here’s an example of the level of care we’re able to give here.  I admitted a 55 year old male with hemoptysis (blood in sputum with cough) and pneumonia—the left lower lobe of the lung was whited out on the chest xray with some infiltrates in the left upper lung as well.  He also had a huge (~5cm) cyst in his liver probably [Ecchynococus is common here.  It’s a parasite spread by dogs and causes huge cysts in their liver, lungs, pancreas, etc.  Treatment is albendozol for months, though usually they need to be removed surgically].  He improved and then worsened and went into septic shock (low blood pressure that doesn’t respond to fluids due to infection in the blood).  The old CT scan broke (a new one is due to arrive in March or April), so we couldn’t see exactly was going on in the chest (whether there was a lung cancer [he had a history of tobacco and alcohol abuse] or lung abscess or what), but the entire left lung was whited out on repeat chest xray (though he was moving area better).  With the major help of the visiting anesthesiologist from Germany he was intubated, placed on the vent, started on Norepinephrine, Epinephrine and eventually doputamine and Amiodarone drips to maintain blood pressure and protect against arrhythmias. These meds and the ventilator are something I’ve never had access to before in all the mission hospitals I’ve ever worked in.

   He eventually went on to be with the Lord.  But on a good note, I got to wake up at 2:30 AM two days ago when I on call and over see Alex, the Peruvian OB/GYN visiting resident, deliver a beautiful, healthy baby girl.  I asked the mom for the name of the girl.  She said they were still deciding between two names.  Alex says in Peru they don’t have to have a name before they leave the hospital and sometimes they take up to 9 months to choose a name.  I told the mom she should name her Ria (which is from the verb “to laugh”), because she kept crying and crying and crying…which is acceptable only at one’s birth since it helps open the lungs up. J