6th aug

6th August

Ah today I really earned some respect. The medical officer and I jointly did a circumcision and midway during this procedure, one of the elderly male patients crashed. The gentleman was quite old and had a really bad chest infection. During the morning ward round the patient had actually been coughing up pus! He was really unwell. In This hospital oxygen is rationed. In the western world we usually give every patient oxygen as a matter of routine. In Dophil hospital, there is only one canister of oxygen and usually, the dying patient is put on it. Also in The Uk the standard flow rate is 15litres per minute, when I tried to put this patient at that rate I was told that I was wasting the oxygen –eek. Anyhow the patient crashed and I ran over with the other medical officer and together we brought the patient back. one could argue that the patient was gonna crash again anyway, but here in Kenya, the medics have to be seen to be doing something by the relatives, just so they know in their mind that all was done for the patient, and usually so the other relatives can be summoned to say good bye. The medical officer was mightly pleased with me, also just to add we only had oxygen, adrenaline, fluid and a bolus of glucose.
The relatives were so sad, the male relatives were so grateful for our help, I nearly cried though, proper holding back tears –seeing grown, egotistic, chauvinistic men crying whilst trying to talk to and shake my hand melted my slightly Kenyan male hating heart.
So the patient managed to hold onto the tails of life –but the OXYGEN TANK RAN OUT! ARRRRRRGH! And so the relative requested that the patient was to be transported to Kisumu (about 45 mins away by car). There was no way that man was gonna make it, in England he would be in ITU! I was put on the spot by the eldest son, he asked me if his dad was gonna make it –yikes. In Kenya, there is a strong believe in god, in the Uk as medical students we are asked to call on a senior member of staff to deal with such questions, here in Kenya, I am expected to break bad news. And so I told the son something along the lines of, we have tried our very best to support your father, but he is very very ill, and his heart has stopped once, we have managed to get his heart besting again, but he is unconscious, and is unlikely to wake from this. He is frail, elderly and may not be able to fight this lung infection. We do not have the facilities to improve his health here. I really do not recommend that he is transported to another hospital, as he may not survive the journey. I then had to include something about god, so I said, god has given your father a long and fruitful life, he has raised you and your siblings and has mourned the loss of his wife. God gives life and god takes away, we have done every thing that we can do in our power to help your father, we cannot offer any more but supportive care. Please consider what I have said and prepare your self for the worse. –wow, dono where the fuck all that came form, possibly ER as oppose to my formal medical training. Anyhow despite this they still transported unconconsious dad to Kisumu via a taxi. And that was the last I saw of them.

Later on in the day, I saw a young female, about 15, proper stunning girl, the women here do not wear make up and have short hair and beautiful skin. She complained of fever, headache and cough –typical malaria, I did a quite examination, expecting not to see much, but as I check her ankles for fluid retention, OH MY LORD, she had massive massive swollen legs, -she had elephantitus. I was so shocked, when asked her if there was anything else that she wasn’t to add to or consultation, at the end of taking her history she said no. When I gasped at her legs, she didn’t even flinch, she wasn’t embarrassed she wasn’t ashamed, she just shrugged her shoulders and said, ive had this for 8yrs and the drs say that their is nothing that they can do. I was horrified this girl was proper proper stunning, kinda janet looking, but had these two massive fluid filled thick ugly legs, she also had what looked like mushrooms growing on her toes. I felt soo soo sorry for her. This condition in short is caused by a mosquito injecting larvae into the blood stream during a bite. The larvae turn into worms which block a fluid transport system called lymphatics. Here the lymph (fluid) carries fluid back to the heart but if block fluid is retained in the distal parts of the body, usually the lower limbs first.
This condition can be treated and reduced, I couldn’t believe she had been untreated for so long. The consultant dr –dr phill was not at all disturbed by my findings and said it is common for such a late presentation. Any how we prescribed a course of meds which kill the worms and reduce the swelling, and the girl was sooo thankful and vowed to come and see me on Monday with her family, im gonna try get a picture of her legs.

Some other things, that happened today, I was at the bus stop waiting for the bus home, and no lie, some Kenyan girl, with facial piercing and boyish clothes stopped by me and stared, im use to the starting now so I smiled and turned away. I kinda felt that she was still staring so i turned back and oh my lord, she was proper eyeing me up like she wanted me big time. I was mortified, proper shocked er im being checked out by a girl and its unnerving me, just cos, if she suspects that im gay, and she tells people, im in the shit, as the consultant at the hospital is really hoping to find me a husband and to be honest as boring and energy consuming that it is too say hello to all the actually fit men that come to the surgery is, id rather that than have no one talk to me cos of the gay thing –although being gay is legal here now! As of Thursday!

Right i wanted to tell you about the hilarious hymn singing that happen here in the morning, some of these women are tone death but are convinced that the louder the sing, the better they will sing. Ive had to stifle laughter so many times. Lol

Im proud of myself today, I work alongside the male medical officers and am treated like one of them. We ask each other for advice, we eat together, joke together and gals happy, just hope they don’t think im gonna marry any one of them.