Thursday, December 20, 2007

When You Are 911

Bundibugyo, Uganda
Volume 2, Issue 25
December 20, 2007

-Pediatric ICU-
…when you are 911…

This past week has been overflowing with critically ill pediatric patients, incredibly low hemoglobins, and lots of “what am I doing” moments. Of the 12 patients I saw today, seven had hemoglobins less than 5.0 (normal for adults is 12-16) and three of those children were on at least their second or more transfusion for the week. Today was one of those days, the type of day in which I am reminded that there is no 911 in Bundibugyo, Uganda. I am 911.

I had three critically ill, severely anemic patients on the ward today. Two brothers with known sickle cell disease had hemoglobins of 2.5 and 2.7, and a third child that looked worse than the first two, who was almost white as snow and barely responsive secondary to anemia, probably had a hemoglobin no higher than 3.0. Over 20 attempts were made to obtain IV access on the third child, but to no avail, so for the second time in three days I had to use an intraosseous needle. Once again I used the large bore needle to go directly through the 9 month old child’s outer leg bone into his bone marrow. I was able to push blood through the canula, and when I last checked on the child he looked much better, though far from complete recovery. In fact, this was the 11th blood transfusion for this small sickle cell child who is only 9 months old!

I often feel very inadequate in my medical knowledge and ability as clinician, but my mantra still remains “I am better than no one” in reference to the fact that if I were not here these very sick children may have no one caring for them. Somehow that comforts me. Even if I can’t safe a child’s life at least I can do all I know how to and comfort the family in the process.

Tomorrow I am planning a mini-Christmas party for the pediatric inpatients, including chapattis, hard boiled eggs, candy, and Christmas music. Even if I can’t completely heal these kids I can at least give them some food and love them.


Natalia said...

Scott, I have been reading your blog for a few weeks, and didn't want to continue without a comment so that I'm not an anonymous lurker. (I found your blog through a tenant of the Chedesters who asked her internet friends to pray for the situation in Bundibugyo; my husband and I also have many friends working in various places in Africa, but not specifically your area.) I'd have thought there must be many more reading here than commenting. I think it's such a special thing for you to have a little Christmas party for your pediatric patients. I hadn't heard of intraosseous transfusions before - it IS a different world when you are 911.

SunnySusan said...

You are very special to these might be the only Jesus they will ever see....praying

Susan said...

Thank you for keeping people around the world informed about what's happening in Bundibugyo. It's exciting reading people's comments from all over the U.S. It appears that most of them know you but very few of them know what Bundibugyo, Uganda is like. I have been reading your blog for the last few weeks. You are in my prayers. It was great spending time with you before this outbreak. Who would have guessed that you'd be experiencing all this three weeks later? Several of the team members have told me that they are reading this blog and praying for you.


Gary said...

Scott, you're such and inspiration to us all! We are so glad you are healthy and God is with you. I feel like what I do is a very meager contribution to helping God's family when I think about the labor of love you are a part of. Thanks for your example. As always, you are in our prayers. You are God's angel of mercy brother. May heaven's light continue to shine on you especially on Christmas. Stay safe.

Love, the Strongs