Wednesday, June 6, 2012

Faith, Hope and Love: Conversations from my ward

Some stories from CRH Ward 9...
The author is a medical doctor sworn to protect secrets of his patients even after their death... Nothing shared in this violates this sacred oath.

This is a story about a 26 year old man and his family and of course me, his doctor! It's a story about fighting to survive. It's about Hoping against hope and staying strong despite agonizing reality. When doom looms and hope elopes, when all you do seems pointless and you feel helpless and the odds are against you, it is then that you must have faith and hope! You have to have hope and the courage. 

So I mustered courage and with the diaphragm of my stethoscope placed on his frail chest - barely any skin to cushion my tool, I listened to his chest and the heart sounds and satisfied myself he was not in heart failure. What was intriguing and satisfying was his smile and what came out of his mouth; "What you listened to, is it okay?" Even more intriguing are the next two words and the accompanying smile I'll never forget, "My doctor". 

Here was a man confined to his bed and barely of any flesh. With fistula big enough to admit my glove size 8 fitting hands on his abdomen. Here was a man barely alive yet smiling with pride as he called me his doctor. I can never forget that smile. 

I had been called to see him the night before as he was bleeding from this huge ulcer on his abdomen which communicates with the outside draining faeces and anything the bowel wanted to extrude out. He had a bad enterocutaneous fistula after an operation for perforated bowel from another hospital. His days in the hospital outnumbered my entire stay in Cape Coast. 
It's another day and I had been called to see him again because the nurse on duty who wanted to dress his ulcer saw this huge haematoma that would likely cause profuse bleeding and probably lead to exsanguination should it be evacuated. 

I smile back hiding my disappointment that we had not been able to do much for him. He's so frail he probable wouldn't even last the journey from our center to Accra where he'd probably receive same treatment as we're giving him - Nutritional support, adequate hydration, anaemia treatment and other supportive treatments in addition to the daily wound dressing for the ulcer on his abdomen.

Everything around him seems hopeless and within my heart I feel sorrowful. Sometimes we are reminded of our humanity as doctors by such cases. We are reminded of our empathy, emotional frailty and our own mortality. I laugh uncontrollably whenever the chance for laughter presents itself, ask him irrelevant questions just to take my mind off his sorry state. Yet on this particular day, I'm touched by his smile. As I reflect on him whilst I recline in my bed to rest my hurting back, I feel more touched by the support of his mother and father. This must be the meaning of the expression; 'nothing like a mother's love'. The parents of this 26 year old man have practically abandoned the comforts of their bed for their son. They live with him, watch over him, nurse him and care for him like nothing I have seen before. The will is so strong and hopes high that their son will live. They're illiterate too! They can't understand a word of what the doctors discuss each day; about the dwindling hopes, the frustration and anything dooming the doctors say sometimes. probably a blessing to be illiterate on such occasions because in their 'ignorance', they have kept this boy alive in hope and in enthusiasm and a joyful expectation that he'll soon get well and be out of the place. Such is their blessing - an unwavering faith and an expectant heart. 

I comfort myself with the words that in his misfortune, he's been blessed with such loving parents. In his misfortune, he's enjoyed a mother's love and a father's care as I have never seen before. 
I'm also encouraged in my faith and in my profession - give your best no matter what and you'll be blessed with a smile in the least. How comforting it is to give your all to the patients you have been entrusted with. How fulfilling it is to find that your care and profession is appreciated. On yet another day, this ailing man told his parents in a frail shaky voice, "anytime I see doctor then I get happy". I guess I won your heart with the many smiles and encouragement and the 'conversations' we have. Not so much with the blood samples I take or the Iv lines I set and the drugs I prescribe to relieve your symptoms. 

One night I wrote down these words fearing you'll leave that day; "If you should leave your doctor today, I know you're going to a better place where the Master Physician Himself will be your doctor! I'll comfort myself with the truth that in Heaven, there are no sorrows, no tears, no disease nor death. In His arms you'll be safe forever! God bless you Isaac! You and your family have touched my heart forever!

Now I'm beginning to have a strong feeling that you'll live through this and get out of the hospital soon. Today you asked me if you can start taking soup and fish cos' you miss it so much. Of course anything you want Isaac! I'll be praying for you.  I have faith in a God who heals. I'm hopeful you'll get better. And that God loves us all so much that he answers us!

Two weeks after, you are gone to your maker and I know you are in Heaven. God bless and keep you Isaac. RIP.

Wednesday, May 30, 2012

Houseman on call; Life at the Regional Hospital, Cape Coast

Maybe I'll summarize earlier weeks and add it later but for now, I'm just itching to let this out in my third week as an intern at the Central Regional Hospital in Cape Coast. Here it goes...

Yesterday (Sunday, 27/05/2012) I did my first suturing! yay! I'm obviously excited about this cos' it gives me hope that I'll be justified in my decision not to stay in Korle Bu for my first year in House job. Having hid behind numbers most time (cos' we had a large class in Medical School), I decided it was time I stood on my own. A hard decision that has seen me even part ways with my best friend from school even though he also opted to stay outside Korle Bu for first year. 
Anyway, I have to get that off my mind and simply focus on gaining as much as I can gain from this experience.
It's now 1:48am on 28-05-2012 and I have a crazy schedule ahead of me;
- I'm the only house officer on call 24 Hours at the Department of Surgery here in CRH. That means I'm in charge of both male and female wards, I review cases on both wards every morning, I do OPD work, prepare patients for surgery and also assist in theatre, sometimes review surgical cases at the ER and in addition, do ER work almost every other day! That translates into about 15 hours of work/ day every other day and also means my short sleep hours can (and actually is) interrupted at any time of the day! 
So much for my personality which is the kind that wants to do things at its own pace, be in charge and control how events unfold. Not anymore! The times are set for me and I must follow through and come out clean if I am going to be a good doctor (or so I have come to believe).

As I realized, my day typically begins few minutes before 6am and by 7:30am, I should be by my patients side and reviewing cases already. By 9:30am/ 10am, ward work including reviews and taking samples and doing other procedures should be done. Then depending on the day, I set off for the OPD to see patients. 
By 2pm/ 3pm, I should be done here and really my day should end there if I don't have ER duties. But no! Theatre calls and I must answer. Emergency or elective cases, I must answer the call.
As I have realized also, there are good sides to being an overworked intern;
I get to do so many things that I would have otherwise missed. I get to be more responsible and also get more opportunities at practice.
But later today as I would realize, my responsibilities just got a little bit overboard! I will be running the department of surgery alone tomorrow the 29th of May 2012!
None of my 5 superiors will be around in the day and the onus lies on me to keep the department sane and running smoothly. God help me.

So it turned out I have worked for 20 hours non-stop! I had duties at the ER and my night started at 10pm on 28/05/2012 and ER duty ended next day at 7am. So much for the night already and I must get ready and move straight to the ward and review cases. Little did I know know I was going to be in the hospital premises for the next 11 hours or so! Hey! I don't even know if my new American friend was around. I simply didn't notice this. First year medical student from University of North Carolina here in Cape Coast. So much for the girl in my opinion. I had a good time at the ER with my colleague and classmate helping me out. The only problem I had with the night was this baby with Malaria and gastroenteritis with dehydration. I had a hard time finding an IV line for him to get the fluids in. He needed these IV fluids and his inexperienced doctor couldn't find his tiny little veins buried in his thick skin. Days you wish not all 14 months babies were not that well fed and dehydrated with collapsed veins. There was also this teenager who for strange reasons had drank some liquid soap and fallen unconscious! Thank God he was revived after a lot of IV fluids! I guess it was a good experience for me. I'm learning everyday and I count myslf blessed under these circumstances. Today itself would have been a good one if not for the emergency cases we had to operate on. I had anticipated it to be a crazy one cos' I was going to be alone but the H.O.D for surgery at the UCCSMS came around to do the emergency cases. So I reviewed all the ER cases, and the ward cases as well and did the labs for the patients whiles I waited for Prof. to prepare for the cases. He let me do my second skin suturing! The case we did in theatre included a 9 year old girl who was initially thought to have perforated her bowel from typhoid fever. It turned out to be a perforated gallbladder! Cholecystectomy it was then. The youngest Prof. had done in his many years of work both in the UK and in Ghana.

It's 12:33am on 31/05/2012- Awake and listening to good country music. I really should be sleeping but I simply can't! Not with the thoughts of the demise of my colleague and friend under bizarre circumstances at the Korle Bu Teaching Hospital. I'm starting to have thoughts of seeing a psychologist cos' I simply can't sleep with these thoughts. Sometimes just blank thoughts and at other times, memories of the many nights I walked the lonely dark road to my late colleague's room to play video games with him. I remember the excitement in his eyes, sometimes the shock at my incredible comebacks in FIFA12. Oh, I can remember one game he scored 3-0 in first half and I equalized in second half to 3-3. eventually, he had the last laugh when he won in extra time but he congratulated me all the same. He would really laugh loud and tease hard when he won against me. I had my revenge on some days but truth be told, he won more than I did. Now I remember also one time he had asked me to go for a ride with him in his brand new Nissan Primera. Just so much occupying my mind now. So young, so full of life and enjoying his new status as a medical doctor. Just murdered coldly in your own room at the doctors' flat without a clue. Desmond, Rest In Peace!

Sunday, April 15, 2012

Youth; Gather to work!

So it is that time of your life when almost anything is possible to you. Life is before you like an open book with no prints. What story is told is totally dependent on you. Like a vast fertile land in the forests, so also is the story of your life now. What fruits shall be, is dependent on what is planted today. It is also dependent on how the crops are tendered and cared for. 
So gather then what you have, roll up your sleeves and put your foot to the mud.

"Do not be deceived: God cannot be mocked. A man reaps what he sows." - Gal 6:7
Such is the delicate nature of even a time as this when you have all the youthfulness, energy and passion to make a meaning out of your life. It is the time you'll also face some of the most faith-challenging situations and the greatest of temptations - all of this while you are still in the prime of your youth!

But do not fear. It is a time to prepare you for the greater things ahead the best of times yet to come! It is to prepare you for the time when you shall reap bountifully if you sowed well whiles you labored. 

Gather therefore, the spade or hand trowel, digging fork, cutlass or machete, hoe and rake. It's time to work! What work you do is dependent on what plans the garden owner has and what purpose He called you into this garden for. The garden owner supplies these tools as He knows you'd have need of them. 

Take time; reflect on what gifts you have been blessed with. Thank the Lord for such gifts. If you are finding difficulty knowing what is required of you, ask Him in prayer through faith. Be fervent, persistent and consistent in this matter and He shall direct you.  It's easier said than done I know cos' I experience it too. But consider this; the good book says "If any of you lacks wisdom, he should ask God, who gives generously to all without finding fault, and it will be given to him." -  James 1: 5

It's a great thing to have life and even greater to be young and free. True freedom comes from Jesus who is the only way, the truth and the life. "So if the Son sets you free, you will be free indeed." - John 8:36
Every day is a gift to be a better version of you. Make good use of this gift. Don't live without purpose. If you made a mistake yesterday, now is the time to right those wrongs. You have a gift; Plan, Pray and Play too! 

You shall do great if you learn to live and love what you do. You'll do great if you have faith and hope in God and if you have love for one greater than you who has given you work to do. Don't be afraid to take on the world, the one who created the world is with you!

Note: As a Christian, this short piece is largely influenced by my faith.  I believe what I share holds true for any young man or woman reading this short piece though.