Life in the hospital

Sorry it’s been so long since I’ve written anything on here, it’s hard to find the combination of time and energy.

This last couple of weeks has been really challenging, both academically and emotionally. It’d be very easy to come on here and say what an incredible time I’m having and how I’ve been able to do so much awesome stuff. That is true… but it wouldn’t be a very genuine representation of my trip.

For example yesterday I got to put my first chest drain in (w a lot of guidance) – awesome experience, something I’ve never even watched in England, let alone been able to do myself. (It’s a tube, about the thickness of a finger, that you place between the linings of the lung to drain pus/fluid/leaked air).

The other side of the story, that doesn’t make for such an upbeat blog, is the reason I put the drain in in the first place. The patient was a muscular 30-something year old man with AIDS pneumonia. He had such damaged lungs that a leak had formed, leading to air filling his chest and crushing his lung. For about 6 hours after I put the drain in and released the air he looked great; he was breathing much better and he would thank me + Jim (who did it with me) whenever we went to check up on him. I was feeling so pleased. I thought he would live long enough for the antibiotics to have a chance to kick in. In the evening however he was looking as sick as he had that morning and when we went for rounds this morning his bed was empty – he died in the night.

Every morning I check certain beds to see if they’re empty, looking for patients who the night before have been on deaths door. About 50% are still there the next day.

For every tragedy though, there is the other 50% who make it through the night, and have time for the antibiotics/blood transfusion/fluids to kick in.

One of my favourite patients is a little 3 year-old boy on paeds. He saw our surgeon in clinic with a bulging fluctuance on his chest that felt just like an abscess. We took him to theatre and Lisa talked me through my first ‘I&D’ (incision and drainage). This is normally a very straightforward procedure involving a small incision and squeezing the pus out of the abscess. Once he was anaesthetised I made the incision and the pus came flowing out, and kept on flowing. In total we drained about 500ml from this tiny guy's chest. When the flow had slowed a bit it began coming out in little bursts as he breathed – it turned out the collection was coming from the lungs and had eroded forward to the skin. This was pretty unexpected, and he now had a sucking chest wound. Luckily Lisa managed to put get a chest drain in quickly and suture him up – so glad I wasn’t doing it on my own!

The next morning I went to paediatrics, half expecting to see an empty bed. Instead I found a well looking baby and a happy dad. As soon as the kiddy saw me he started screaming cos he thought I was coming to do another procedure on him. His dad thought this was hilarious, so now every time I go into paeds his dad always gets his kid and shows him to me. The poor little kid hates me, but me and his dad always laugh so much when we see each other. Draining the pus and fitting the tube saved that kids life, so I don’t feel too bad! (Having said that he’s definitely not out of the woods yet, but doing well considering)

There have been so many times over the last two weeks when I’ve really question all that is good in the world. There’s so much suffering here, so many young patients dying. But as Jim always says, you’ve got to remember the patients you have helped as well as the ones you couldn’t.

I’ve seen some pretty horrendous things here, but I’m not really sure how much you guys want to hear about that kind of stuff… As well as being a staff + resource poor hospital, it’s the only hospital for about a hundred mile radius, and so often only the really sick ones will travel that far, giving a disproportionate picture of health in northern Ghana. Before coming here my (half) Ghanaian friend Marie kept saying ‘why do you want to go to the North, healthcare is rubbish in the North’. Well that’s why I wanted to go to the North, and I’ve really experienced that, and some. Maybe that's not fair, but it's certainly very different.

The choir at First Baptist Church, Nalerigu

My friend Hamsa

All the women carry their babies like this and little kids carry the even smaller ones