All in a day's work

Wow, what a day.

B-ward is the place where all expecting and recently delivered moms and their babies stay in the hospital.  It is a large room with 19 beds placed around the perimeter, and about 1/2 of them are currently full.  The delivery room and nursery are located at the back of the ward.

This particular morning began at 8:00 with rounds on B-ward.  Upon arrival, I made my way through the double doors and into the delivery room.  Sister Sylvia, the head nurse, pointed to a patient behind the far curtain.  “I think you should see her first,” she said with a touch of urgency in her voice.  I pulled the curtain and found two nursing students cleaning up a patient who sitting in a pool of blood.  She had been about three months pregnant, and was now bleeding heavily due to a miscarriage.  I quickly examined her and decided that she needed an emergency D&C.  Thankfully the bleeding slowed after the procedure.  The patient was moved to the ward in stable condition.

And that was just the beginning...

I made my way around the ward, seeing post c-section and other more complicated patients.  (The nurses deliver, care for, and discharge all of the normal deliveries.)  Bed 19 was the last bed.  Sister Sylvia began by telling me that this patient was complicated.  Uh oh.  This patient was nearing the due date for her sixth pregnancy.  She had been admitted the day before with difficulty breathing, stomach pain, and low blood pressure.  The patient thought that her water may have broken.  I pulled the ultrasound to her bedside to check the fluid level and take a look at the baby.  My heart sank as I realized that this baby did not have a heart beat.

The story continues...

After rounds, all the docs head to Outpatient Department (OPD) and begin seeing the multitude of patients that line up there every day.  People in PNG don't generally know how old they are, and this young woman was no different.  But she looked young, definitely no older than 30s and possibly late 20s.  She had many complaints:  lower abdominal pain, bleeding, right flank pain.  By my exam it was obvious that this patient had cervical cancer.  Oh, shucks.  I took her to ultrasound and confirmed that the cancer had already spread to her bladder and was blocking her right kidney.  Her father pleaded for us to do surgery, but the cancer was too advanced for any treatment.  Palliative care is all that we have to offer.  Scott and I prayed with the family.  Jesus says for all who are carrying heavy burdens to come to him, and he will give rest.  I will continue to pray for this young woman, that God will give her peace and comfort.

Happy ending...

I finished the day with my first solo c-section since arriving here in PNG.  This patient had two previous c-sections and was now near her due date for the third pregnancy, so she was scheduled to come in today for a repeat c-section.  I would do the surgery since I am the B-ward doc of the month.  The patient was taken to the operating room and prepared for the surgery.  My word that is a big belly, I thought as I entered the OR.  The c-section began and as I worked my way through the layers of tissue, I encountered quite a bit of scar tissue.  That always makes things interesting.  I eventually found the uterus, cut into the muscle, and placed my hand through the opening.  Wow, this kid has a large head.  O.K. not just a large head, he came out looking like a sumo wrestler... weighing in at 11 pounds 7 ounces!  I believe that is the biggest baby I have ever delivered.  And apparently this may be the biggest baby ever born at Kudjip Hospital!  I finished sewing mom up without any further problems.  Mom and baby are doing well.  Yeah for happy endings :).

Every morning and many times throughout the day I pray for wisdom beyond my understanding, that the Lord will help me to know how to care for and love my patients here.  He is THE Great Physician.  Thank you Jesus for helping me today.