Doctor, look!

Yesterday ended on a worrisome note for me. A mom brought in her baby with two days of fever and diarrhea. The baby was lying there like a dishrag and not very responsive - he was (just barely) conscious, but didn't cry even when we stuck his finger to check his glucose, and his tone was very low. I was worried that he had sepsis on top of dehydration, so I admitted him. Night time at the hospital is a scary time for patients, not that any of them know it -- by which I mean that they're in the hands of one intern who is responsible for kids in the ER, all the peds floors, and resuscitation of any babies who get in trouble perinatally at the hospital down the road. There is no sign-out process, so I had no way of letting the night intern know to look out for this baby. I left the hospital satisfied that we'd put together a solid plan, but worried that the baby would worsen unnoticed overnight.

The Browns' church has a women's group, and they went to the hospital today to hand out packages of toothbrushes/soap/washcloths/etc. and to just offer some support to the moms and the kids. The visit was a success on many levels, but I started the afternoon feeling frustrated and more than a little worried - I couldn't find "my" baby anywhere on 8B - the service where he belonged. I feared the worst but couldn't let myself think that that baby had really died, so I waited to see how the day would unfold.

Next thing I knew, a mom walked by the conference room with a perky and very much alive baby in her arms. She stopped me -- "Doctor, look!" It was my baby from last night, doing a thousand percent better than yesterday. "I was so worried yesterday -- I thought my baby was going to die! But he looks so much better today. Thank you, doctor!" I was amazed and gratified to see the child make such an amazing turn-around, and had the good sense not to spoil the moment by admitting that I'd feared he might die too.

The thing is, we have minimal supervision in the clinic - that baby got better because I made good decisions and did the right thing for that child. I didn't have lab results at my disposal, no readily available imaging. The night intern wasn't there to back me up - she probably didn't even know the patient existed. So we made a plan, used good clinical judgment, and made a difference. That's amazing, and as much as I'll gripe about the broken system here in Namibia and the many frustrating things about it, it is teaching me so much. I'm so grateful to be able to have made this trip, and I'm looking forward to another two weeks of it.