It's already 10pm, and I haven't journaled, blogged or read my bible. So you can probably guess what kind of day it's been... Full. Not necessarily busy, but full.
I woke up this morning feeling much better than I have the rest of the week so I decided to head to the hospital. I struggle at times at knowing how I much I should push to fit in and help, and how much I should just be observing. So I bounce between observing and asking for tasks.
The language barrier, cultural differences, different policies, and whether or not policies are followed all make it challenging to just step out on my own and take care of patients. If I was at home I can do what I know, and explain to the patient that I need help, advice, clarification or a second opinion... I don't have that luxury here. So I often just find myself being a shadow, which at times can be a little boring.
Today in casualty (emerg) I was put to work in the morning taking the vitals of all the patients - perfect, something I'm comfortable and confident in. I was able to figure out their scoring sheet for early warning signs of patient decline... And managed to keep everyone alive. Most of the patients were very stable and just waiting for rooms on the wards.
One of the most interesting patients was a mad who had been shot in the chest... The left side even... And was perfectly fine. He was dressed in a suit, was sitting in his bed texting and asking when he could go home. Apparently he had been parked at the gate leading into his home, waiting for it to open and some random guy shot him. His wife took him to a local hospital and then they chose to be transferred to Kijabe because of how well known it is. After a few x-rays had been reviewed by the surgeon it was decided that they weren't going to operate, and the bullet would just stay in there. So the guy left, he was back in about 40minutes because he had left with an IV in his hand... But other than that he was good to go.
Death is a challenging thing to know how to deal with. Do you encourage people to embrace it? Fight it? Believe in miracles? All of the above? One of the patients who came in today had been diagnosed with prostrated cancer with mets to his spine over two years ago. Since then he had lost function of his legs, and over the past few weeks his health had seriously declined.
Looking through his chart, over the past few months he had been admitted frequently to hospital and had received multiple blood transfusions on each visit. Again today the family insisted that he receive a blood transfusion and fluids. When the MO (medical officer) on duty, Dr Lawrence, asked me what I thought the treatment should be... I hesitated, not wanting to sound calloused or faithless. "Honestly, I believe God can do amazing things. But at this point I would think that this patient is palliative. If he has mets to his spine that have caused an inability to walk, then my guess is that his body is full of cancer. And that there really isn't much else (medically) that can be done at this point"
He agreed. Saying that he would suggest that the patient be given oxygen and made comfortable. But the family had insisted on a transfusion. So I sat there for the next two hours monitoring the transfusion. For the entirety of the time he remained hypothermic, slightly tachypnic and tachycardic, practically unconscious (not responsive) and a very low BP. It was heartbreaking to watch. His son stood by saying that he's a nurse and knows that his dad will get better. How do you deal with that?! I don't know. I just pray that, no matter what the outcome, that the family will have peace and closure.
A few other things happened today, like treating a very ill patient with HIV... Vomit, blood, coughing, urine... Oh Lord, keep me safe!!!
After a full day there I wandered home to change and then up to RVA and got to skype with my parents (who I woke up early on their last vacation day in Whistler) and with Ferenc, Erin and her brother (totally don't know his name) as they hiked Benson. Made me miss my home, my family, my friends and my mountain.
But three weeks from today and I'll be back there... And will be missing it here. So, although I love and miss home, I'm trying to think about it as little as possible... and just focus on my time here and what God has to teach me, and how I am to bless those I meet.
While I was in the hospital today I met Lucy, she works in ophthalmology. She welcomed me to come ANY time and sit in and watch her work. She told me about how she went to school in India, so whenever she sees someone who is a foreigner (and believe me... I stick out like a sore thumb here - there's no question that I'm not from here) she can put herself in their shoes. She remembers how frustrating and lonely it can be, not knowing the language, culture, policies etc. It was such a blessing to be so well understood. So often I stand there not having a clue what people are saying... because it's all in Swahili, and I know only a couple words, and none of them have any medical relevance.
After RVA it was back down to the guesthouse for supper and a good bye with about half of the Love Africa team. It's going to be weird to have them all away on safari this weekend. Most of them are leaving tomorrow morning, and then only half of them will be coming back. Leslie, Hannah and Krista aren't going on safari this weekend, so we're planning a girls night at some point. It'll be good to have the guesthouse mostly empty, and quiet.
Ok... Typing this up with my thumbs takes a long time, so it's now 10:40, and I really need to crawl into bed. Not that I'll be able to sleep because there is SO much going on here. I think they should make a curfew/quiet time here. Mhmm, that would be nice. There are chairs scraping the flood downstairs, people talking, laughing... being loud, and stomping through the hallways. Man, am I getting old?!! Haha. Ok. Enough of that. I'm going to try to sleep... I've gotta be up early and at the hospital in the morning... And then a girls weekend to look forward to!
Day 19 (Friday May 29, 2015)
A much more exciting day all around. More patients coming into the casualty department, feeling more included as part of the team, I think I may have found someone to take me for a run... And it's Friday!! Even though I took 2 days off from the hospital this week, I am SO looking forward to the weekend.
Today in casualty there have been a few interesting cases. One was a young girl who came in with her parents... Weak, shaking, crying... But all of her vitals stable. When they opened the car door she practically flopped out onto the road, we had to lift her out onto a stretcher and wheel her inside. Once inside though the "no nonsense nurse" Lucy took over. Haha. There is one of those in every department. She made the girl sit up on her own, stand up, made sure that she could move and had feeling in all her fingers and toes.
I got to do my first blood draw, and nailed it! They guy was young and had good, healthy, visible veins.... But none the less I felt pretty proud of myself. Haha. It can be really tricky to find veins on the people here, just another luxury I didn't realize I had with treating mostly patients with white skin.
We had a trauma case come in today... A guy who had been in a motor cycle accident the other day, had been "treated" at another hospital and came here because he wasn't doing so good. He was 22, and a tall guy... Probably 6'5" is my guess, and was brought in my two relatives (I'm guessing) who practically carried/dragged him as he hobbled into the casualty department. He had large blood-soaked bandages covering his right eye and the right side of his face, and was barely putting any weight on is right leg.
Once we got him into a bed the docs pulled the bandage off his face. It was dried/stuck to the wound on his face. As they pulled it off his hand instinctively went to push them away. I quickly grabbed his hand and simply held it. He looked at me with his left eye with what I assume to be fear and pain. I have a weak smile and held his hand tighter. As they pulled it off he squeezed tighter.
His face had been somewhat stitched up, but even I could tell it was crudely done. It looked sloppy and honestly, it looked like his eye had been stitched shut. It looked like he would most likely lose sight in that right eye. A while later the docs from optometry came by to take a look. The gently cleaned his eyelid, and pried it open. Thank you Jesus his eye itself looked good! He was able to move it, his pupil was reactive, and he could see! What a blessing to be in a hospital where the docs and nurses openly praise God when they see these things!!
We took a late lunch today... Around 3 and the nurse I had been working with Fidel invited me to come with him and his friend Sammy to his house for lunch. What a precious gift to get to fellowship with others during my time here. As an introvert, I definitely find it challenging to step out and meet people, but at the same time it is a wonderful challenge and time of growth for me. Fidel lives just past/behind the dukas where I go shopping. The three of us had a wonderful time together, laughing, sharing pictures and stories and listening to music. Then we went back towards the hospital... Fidel and Sammy went back to work, and I went back to the guesthouse where I made supper with Leslie, Krista, Jack and Hannah.
Fidel and I have made plans to go for a run on Sunday afternoon... And I'm looking forward to seeing Kijabe in a different way. Tomorrow I'm going to be joining Hannah, Leslie, Krista and Jack on whatever adventure they have planned... Which will likely be a trip down to Naivasha.
I've totally slacked on writing in my journal the past few days... So my blogging will just have to take its place. I'm going to head to bed pretty soon here, and will NOT be setting an alarm for the morning - although... The monkeys will most likely still wake me up at 6:30.
Day 20 (Saturday May 30)
Today was a very non-Kenyan feeling day. The monkeys didn't even wake me up this morning. I woke up all by myself at 6am. But seeing as I didn't have anything to do... I stayed in bed for another hour.
When I finally did pull my butt out of bed at 7:10 i puttered my way through making a typical Jacquelyn breakfast - hashbrowns, onions, peppers, eggs, toast and COFFEE! One of my patients relatives the other day is a distributor for some pyramid scheme specialty instant coffee... And he gave me a sample. It was actually so good (not sure whether that is because it was act silly good, or because it's been 3 weeks since I last had a cup of coffee). I enjoyed a quiet morning to myself... Eating breakfast, sipping my coffee, doing my dishes. The introvert in me breathed a huge sigh of contentment.
Once the others (Hannah, Leslie, Christa (oops! I've been misspelling her name) and Jack were up and had had breaky... We decided that we would go into Nairobi instead and go to Village Market - which isn't a market, it's a mall.... Like a North American mall. I'll be honest, the change in plans had a lot to do with going to the food court for some good food. I had a plate of delicious chicken cashew Thai something. Yumm!! We did some wandering around, I bought a book and some groceries, and then it was back to the food court for some good coffee (Dormans - the Kenyan Starbucks). I savoured every sip!
Oh.... And did I mention there was free wifi in the food court?! Haha. We were all quite anti-social as we sat there on our phones chatting with people back home. (The rest of them don't know the RVA wifi password, so it had been a while since they'd talked to family back home).
After that we drove back to Kijabe, watched the sun set over Mt. Longonot, and then had supper at the guesthouse. Later we walked down to the Smiths house where we had tea, popcorn and comfy couches to sit on. It's amazing how little things like a couch (which is so common back home) has become such a treat.
Another thing that hit me while We were driving to Nairobi was how I commented on the nice apartment buildings and houses. Back home I doubt I would even notice them - or I might think that they look like a not very nice place to live. But here.... In comparison to the shacks and one-room homes, a (slightly sloppy) brick apartment building with cheerfully painted balcony railing looks like a palace. Coming back home might come as a bit of a shock.
Tomorrow is another "sleep in" day. I'm going to church at RVA, and their service doesn't start until 11:10!!! I'm sure I'll be up early though. My Kenyan internal alarm has kicked in and I routinely wake up at 6... Which is 8pm for all you back in BC... That time difference switch is going to be fun. Haha. Alright. I'm ready to hit the hay... I'll post this when I'm up at RVA tomorrow morning.
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