Marilyn and I are halfway into our first weekend on-call and are happy to report that we are still standing! The first part of this past week has been pretty brutal (at least on the medicine service), but things have begun to settle down a bit, and some patients are actually getting better! It's always a joy to see some of our desperately ill people beginning to make progress. The young mother of twins that I reported to you about last posting is continuing to improve and is really looking quite stable - she has a bad bilateral pneumonia (we think), but is requiring less oxygen for support and looks quite comfortable. She speaks pretty good English ( I discovered today!) and is able to report to me that she is feeling significantly better. The Kenyan people are so warm and sincere....I can't count the number of times each day that we are told by family or patients, "we are very grateful".... I think it is part of why we keep coming back here. I am also taking care of another young mother who has serious rheumatic heart disease and congestive heart failure, and she is also steadily improving. She has the most engaging bright smile, and warm, wonderful spirit. It has been so rewarding to see her sitting up in bed in the intensive care unit feeding her newborn infant, and no longer struggling to breathe herself. Both of these young mothers are patients that Marilyn and I have had the privilege of caring for. This evening there were 2 admissions from casualty (what they call the emergency department) who serve to demonstrate how the successes of any given day can be offset by sadness and despair. The first patient was an older man who presented with a huge mass of his larynx, which has grown to the point where he is now struggling to breathe, and is unable to swallow without feeling like he is smothering. He has declined a tracheostomy (which would temporarily divert his airflow below the level of his obstruction) and therefore we have nothing to offer him but morphine or other sedatives to help with his restlessness and "air hunger". My intern and I offered to pray for him at his bedside, and he responded to this with attentiveness and some temporary decrease in his restlessness...He was not able to talk, but his eyes said to me: "I am grateful". My second patient this evening was a young woman in her mid 40's who has had multiple sclerosis and involvement of her spinal cord which has caused paraplegia and a chronic bedridden condition. Consequently, she has developed deep bedsores and ulcerations from persistent pressure to the skin of her back and hips. She had been in the hospital in another town for 6 weeks without improvement and was discharged home today to the care of her family. They subsequently brought her into Tenwek casualty and I was asked to see her there to see if anything else might be done for her. Once again, her situation is medically hopeless as there is no effective therapy here for her MS, and no real surgical option for flaps to cover over her chronic pressure ulcers. As a result, we had to explain to her and her family that we had nothing to offer her. Again prayer was offered and appreciatively received. It always amazes me that these people in such dire circumstances seem to have such a deep faith in God....perhaps because they have nowhere else to turn. It is so sad to me that people in our country, who have so much to be thankful for, typically live with such spiritual poverty, whereas the materially impoverished, often have such rich spiritual lives. I hope that it does not take the destruction of all that we take for granted for our people to turn from sin and back to God...but I fear that that may be our future. In the meantime, the experience of serving in Kenya reminds us of all that we take for granted and all that we have to be grateful for. It also gives me great hope for the next generation of Africans and the health of the world church. I will include a photo of some of these young African children, who represent the hope for the future of this nation. The older of the two children has taken to following us around while we are making hospital rounds....he is unrelated to the child in the chair....he is just using his time to help out his little "brother". Hope you enjoy it as much as I do.
With love,
Randy.
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