Our fist weekend on call got off to a wild start. at around 3AM John and I were called in for an emergency C section. The lady had labored for 19 hours or so at a "nearby" district hospital 50 km from here. We stumbled out of the house, sleepy, and into the OR for the cesarean. We've been doing such late night stumbling together, just to back each other up. We figure it's better to do the late night surgeries together just in case we get into a bind. It's funny, the referral pattern is supposed to work in the opposite fashion- the bush hospital transferring to the district hospital and then on to the big city hospital and so on. However, the medical system here is so dysfunctional that we get people from the capital city, driving 2 1/2 hours out into the bush for their medical care here. It is said that last year at this time, many hospitals didn't even have an aspirin on the shelf.
Anyhow, where was I... Oh, yes, The C section went off without a hitch. As we walked out of the OR a woman lay on a cot covered by a blanket, obstructing the exit into the labor and delivery ward. My sleepy mind thought little of it until the clerk announced to me in a flat tone that the woman had been in labor for 2 days in a far off village. A policeman had found her walking along a dirt road, trying to get to help, and had brought her to us. She died as she passed through the hospital gate. It was then that I noticed her blood, pooling below me on the floor. It was an such a paradox- elation and life in one room, sorrow and death in the next.
After a glass of cold water, we went to sleep, but not for too long. Rounds began at 8AM. We had to see all of the patients in the Male, Female, Pediatric, and Maternity (plus neonatal) wards. We were unfamiliar with two of the wards that we'd not been seeing regularly, so this took quite a while, as many patients needed procedures done and medications adjusted. After rounds, John took to the OR to take care of a few items that needed doing. I headed to the outpatient department to tie up some loose ends. It turned out that the loose ends were several dozen people who seemed to be falling apart at the seams. I admitted many of those people to the hospital and sent many to the OR. After wrapping up the outpatients, I headed to the OR to tag team some items with John. Aside from seeing all of the patients in the hospital and seeing all of the patients in the OPD, we got comfortable with Ketamine sedation, reducing a dislocated jaw, setting a complicated fracture of the forearm in a child, did two lumbar punctures, two paracentesis, debrided a child with second degree burns, and performed several other procedures.
We then headed to a celebratory lunch for Dr. Roland Stephens, who turned 80 on Sunday. The festivities were nice. We enjoyed a wonderful sense of community with the long term misisionaries on the compound. One of them even brought fireworks in honor of the day. It turns out that none of the locals have ever seen fireworks and some of the patients just didn't know what to make of the loud, beautiful balls of fire in the sky! Some watched in amazement, some hid under their beds.
Early Sunday morning, the Drs. Stephens as well as their brother, Mark (who grew up here and is now visting from the states for the first time in 30 years) took us for a "hike" at a place called "Pulpit rock." It turns out that this "hike" was more like a 200 foot vertical ascent up a huge piece of rock sticking out of the Zimbabwe bush. It was fun. I made it to the top. I mean, I really thought I might die at points, but I made it. Dr. Stephens got out some ropes for me to use that he says he has used "for women and children" making the climb in the past. I guess this was the climbing equivalent of bumper bowling.
Of course, we rounded after the climb.
Overall, the entire weekend was very good. The missionaries brought us lunch on Sunday, cementing within us a strong feeling of belonging to the community.
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