So couple of updates. For one, WE HAVE WATER AGAIN! I took a 45 minute ice-cold shower last night, and loved every minute of it. I washed my hair and all my lady bits 3 times through. D’leau, I never would’ve thought how much I would appreciate this. Here, my day revolves around d’leau (water). Is the pump on, can I shower? can I flush the toilet? Filling up bottles with clean drinking water at the hospital or at home so I never run out. Scarce. Clean water is scarce. Yesterday during our lunch break, I went to the supermarket with one of the ladies in archives just to fill two jugs of water. Jeez. In any case, I am happy and clean again and love water so so much, I will never take you for granted again!!
In research update news, I am 250 charts in!!! WOOO. 2 weeks exactly left, I am not going to be able to get through a years worth of charts they have over 2,000 deliveries in 2017 but I will aim for 6 months. It is crazy the pathology they see here. In one month I have come across 5 ecclamptics (women who develop grand mal seizures and need to be delivered immediately). It is an obstetrical emergency and in 3 years of residency I have not seen a single one. They saw 5 in March of 2017. In any case, going through the dossiers has giving me a broader creole vocabulary and I can better understand rounds. Even if I miss something because they are speaking to fast. I can glance through the chart and grasp the big picture because of all the time I spend reading through charts.
Yesterday we had a maternal death. A 31-year-old who presented at approximately 30 weeks gestation (unclear the exact gestational age but definitely 3rd trimester on appearance) with her mother. She had been complaining of abdominal pain and first shared she was pregnant with her family the day prior to presentation. In medical school, I had a resident on internal medicine who used to tell me, “I know this isn’t relative to you and you plan on doing OB/GYN, but if you get nothing else from this rotation, I want you to be able to tell ‘sick vs. not sick’.” I didn’t understand what she meant until I went to round on my patient with congestive heart failure and he looked different from the day before. He looked ‘sick.’ I called my resident to tell her. He died that day. This woman looked sick sitting in the triage waiting area. Her eyes were closed and she could barely hold herself up. She was rushed to the salle d’accouchement (delivery room) and everyone sprung into action. It reminded me of home. Pulse ox on, BP cuff on, someone attempting to get history from the patient, someone speaking to mom, someone assessing the fetus. All at once in perfect synchrony. Unfortunately she was DOA (dead on arrival). Then the focus switched to the fetus. You have 5 minutes to get the baby out after mom has died, that’s how long it can survive without blood and oxygen from mom. Unfortunately the baby had already died too. There is some concern this may have been an abruption (placental detachment prematurely) that may have led to DIC but no one has any idea. Another death. It’s all around me. Yesterday as I stood at the front door of the hospital 4 men carried out a dead body on a gurney covered in plastic wrapping. They placed it in the middle of the street. I felt so sick. This is someones mother, brother, child, and they are sitting in the middle of the street for everyone to see. Gut wrenching. TET CHAJE!!