Bittersweet

Wednesday evening, February 1st.  In my cave (Sarah and I switched bunks).

I just got back from the hospital.  Not because I'm a superstar medical student who likes to go in at night to admit patients, like my roommate, but because I had locked myself out of our room and I needed to track down a set of keys.  Keys in hand, I decided to do another sweep of the pediatric ward.  (I switched to Medicine (adults) this week, and have been periodically visiting the kids and patients on the pediatric side throughout the week...I can't let go of them!)  Bittersweet: My favorite family is gone.  I have mentioned them to a lot of you, and the kids made it into a picture on my last post.  This family has defined my experience thus-far, so I think it's time I share a little more of their/my/our story.

Week 2, when I switched to a new pediatric team, I was still trying to figure out how to be helpful.  The strategy I employed was to pick up the sickest patients and do everything I could to make sure they had the best care possible.  Jo was one of those kids.  The 3 year old malnourished boy looked near-death when I picked him up as a patient.  He was on oxygen, his skin was pealing off, he couldn't keep feeds down and he couldn't hold his head up.  The initial perks of this patient were (1) the very friendly mom who spoke a good amount of english, and (2) her healthy 9 month old boy who was an adorable package of giggles and smiles.  It was after few days of checking up on them that the mom told me her whole story, which was briefly touched upon in my last post.  Basically, she was run out of her house and was only able to take 3 of the 4 children with her.  She returned 2 years later to find her son severely malnourished.  She had to leave 2 of her children in the care of neighbors while she essentially lived in the hospital with her youngest and her very sick 3 year old.  Jo had a very long, hard road to recovery.  After initial improvement, he began to decline.  Cue MY entrance, the enthusiastic muzungu come to save the day--only to realize that there was very little I could do to reverse the damage of chronic malnutrition.  What I could do was keep the mom hopeful and keep the little brother smiling.  So that's what I did.  With some additional medications, mom's dedicated care, a little prayer and a lot of God's grace, little Jo started to perk up.  He came off oxygen.  He started making eye contact with those humongous brown eyes.  Eventually, he started to reach out for a daily mazungu handshake.  The morning that I saw him sitting upright and feeding himself porridge, I knew he would make it.

There are so many side stories to my experience with this family that I don't know where to start.  Watching Jo transform into himself was amazing.  That first smile he showed me, man, I about ran down the hall shouting with excitement!  Finally seeing LIFE behind those big brown eyes!  His smile got bigger and brighter as he continued to improve.  Eventually, he would smile so big that I could see the two dimples high on each cheek.  It wasn't until my last visit with them that I heard him laugh.  (I had to look away to allow the insta-mist in my eyes to resolve before I continued my play-session.)  And then there was Jay, the little brother.  He was so joyful!  Always smiling and laughing so hard that he would loose his balance and collapse onto the bed.  However, it seemed that as Jo was making a turn for the better, Jay started loosing his energy.  He eventually developed a cough and began spiking fevers.  He was "admitted" and treated for, you guessed it, hospital-acquired pneumonia and tuberculosis.  Turns out that if you stay in a hospital long enough, you will get sick.  Shocker.  He quickly turned around and returned to his joyful self, but not before adding a good chunk to the bill.

Priority #1: Get all members of the family healthy.  Check.  Priority #2: Get all members HOME!  Difficult.  Frustrating.  Lead to my first breakdown during this experience.  I went with the mom to go speak to social work to figure out the plan for discharge (payment, timing, transportation, whatever).  The always brave-faced mom broke down into tears as she pleaded with the social worker to allow her to leave the hospital, that she couldn't afford the bill, that her children were getting sick and her OTHER children needed her.  I learned that there would be a "committee meeting" to decide upon her case.  I offered to attend this meeting and speak on behalf of the family, but the social worker seemed confused and eventually responded with, "They will just ask you to pay the bill."  I held back my own tears as I wound through the hospital and back across the street to my tiny hostel room.  We had done everything medically correct, but the social red-tape was preventing the final step.  I made a plan to go over the social worker's head the following day, if necessary, while in the back of my mind I calculated how much money it would cost to get this family reunited and back home to Uganda.  The following day, we were all pleasantly surprised when the decision was reached that the bill would be waived in total.  That was my last official day on pediatrics.  It was the day the family gave me an orange and I became the afternoon entertainment for my firm as I repeatedly squirted myself trying to peal and eat it.  It would still be several days before the family was allowed to leave the hospital, which is why I continued to visit.  When I went to see them this evening, I found an unfamiliar child in their bed.  Good news.





Jo and his classic reaching hand.
My usual handshake became tickle-fingers during
my last visit, which is how I got him to laugh.
Looks like he's saving his orange for later.