Nick and Tessa in Kisiizi

With our powers combined, we are… Captain medicine! (yeah right)

There are 2 new medical students here, Shi and Alice from Malaysia. Over the New Year with doctors on leave, we are doing ward rounds with little supervision. Together we nearly make up one “real” doctor, and are certainly not up to the super-sub-specialty medicine we are attempting at the moment. God is with us and the patients though, and is a continual comfort. (Oh dear that sounds bad, “attempting” medicine. The sad thing is the element of truth….)

P.S if you like House you will like this…

“Heart”

“bzzzzzzzz, bzzzzzzz” Oh dear, his chest is buzzing due to a damaged valve, not a good start to our exam. He’s only 60 and usually well, but his heart is failing ‘cause a valve is stuffed. His family says they can afford an operation in Kampala, but the noble patient refuses, saying it would leave his children broke and would force them to sell their small farm. What an awful situation! We do all we can to get rid of the fluid in his lungs so he can at least sleep again. Who knows what will end up happening here?

Water

I put my hand on her tummy and leave a deep handprint as I displace the water under her skin. I have never seen a patient this swollen before. She is swimming in her own fluids.

She came in nearly dead after not peeing for 3 days. Her kidneys had packed up and unless they started again soon, her time was short…

Incredibly she was quickly by the best doctor here, and by the grace of God improved drastically. Her complaint today is that she is still puffed up like a balloon and she wonders why we have not cured her yet? We lovingly explain that she has to gradually pee out the litres and litres of excess water and that this will take a long, long time…

Fire

Thankfully the nurses have managed to take temperatures every 6 hours. Yes, she is on fire. 40 degrees again last night? Dark brown urine? Lost nearly all her red blood cells??? After 20+ minutes of searching I find a doctor who confirms one of our thoughts. She has malaria with the dreaded “blackwater fever”. So many red blood cells get destroyed and excreted, the urine bizarrely turns nearly black. Dr. Patrick shakes his head and labels her a “time bomb”. “The only thing which will help her now is blood”

“What…. No blood at the lab….???”

Mortified, I charge around like a headless chicken. Thankfully she is O+ (extremely common). I track down the lab technician, who helps Shi and some nursing students give blood and become instant life saving angels. She get blood, and is now at home just a few days after nearly dying. Kama Simwe (praise God)

Wind

This man was direct from the village through the hospital doors, not on our “captain medicine” ward round. He was a 20 year old happy guy whose only complaint was a cough for a month. I would have sent him back to his village had he not taken off his shirt. He was wasted and sickly looking and was only 38 kgs!!! I admitted him for tuberculosis testing and it turns out his lungs are infested with the dreaded consumption. Chances are he has HIV this young with tuberculosis. I feel for him but it is awesome that people from all around the world fund hospitals like this so that poor young men like him can get free treatment (HIV and TB treatment is free).

Earth?

“Just a sore leg and a headache?”

“Yes but the leg is so sore I can’t even walk on it, and the headache and leg pain have been getting worse for about 3 months now. The pain is almost unbearable”

“???????”

Bewildered, we tap his knee with a tendon hammer. I have never seen such a big kick. We pull his foot up and are mesmerized we watch it bounce up and down until we release the pressure (clonus). The cogs in our young medical brains tick away slowly. Brain tumor? We decide to wait till Dr. Denise comes before telling the patient and the family to make “absolutely sure”. Bad call. That night after 3 months of gradual deterioration the tumor must have bled and he dies and is taken home before we even see him in the morning. His family will never know what killed their father, their husband. I pray they do not blame the hospital for killing him. I feel pretty awful

His body is in the earth, but I believe and pray for much better for him.

And with their powers combined, they are… captain medicine. Not. And believe me when I say this is just a selection… Pray for me, Shi, Alice, Tessa, the doctors nurses and the patients as we work together in this awesome place of healing.