4pm emergency

Oct. 3
Emergencies are not respectful of person or time of day! I should now this by now but still get unsettled when an emergency case shows up. This time it was a hot Saturday afternoon & i was preparing for the evening's math lesson & game session with the boys...

The woman who called to me from outside my door is a friend from our Friday night home visits so culturally there were a lot of greetings to go through before she got to the point! (Last night we showed the first half of the Mary Magdalene video to her compound.) Her two older sisters are pregnant and she said they were here with their mother. Oh. And the patient? Well, the one you know is bleeding too much. And the other has headache & nausea.

The poor woman on the exam table in my office at the clinic was suffering a miscarriage in complete silence. She calmly told me her symptoms. Not a whimper as i examined her & confirmed her suspicions. This was her fifth pregnancy and her second miscarriage so she was no stranger to this physical pain & heartache. (Later i remembered i should have offered her a pain tablet!)

Teresa and i prayed with her and told her she was bleeding too much for us to keep watch on her here. We took her BP over & over again and it was just too low. She needed an IV and transfer to the hospital for a D&C.

I told Teresa, "It's been a really long time since i've started an IV--as in--- i haven't done it since the learning lab in PA school!" But she replied that her resumé was also bereft of good IV experience... And so it was my turn to bat. Besides, she had to call the ambulance driver and one of our staff members to accompany her as well as deal with the other pregnant sister and the steady stream of neighbors who came with this medical problem or that!

I collected all my supplies from the cabinet and readied my patient. I was sweating bullets!! I put the tourniquet on her arm and said a prayer as i looked for a noticeable vein like i've watched my ER staff do a thousand times before... Then i reviewed the steps of the procedure in my head and warned her of the impending prick. I plunged in the needle and saw the blood fill the catheter--the flash! "Whoa! I think it's in!" I praised God in Wolof and then fumbled with applying the tape and securing the catheter to her arm. I prayed again as i flushed the line with a syringe of saline. "It flushed!" I called out. And again praised God aloud. There was my miracle for the day!!

I finished my transfer paperwork between examining her progress and incessantly checking her IV for signs of failure. She probably thought i was a lunatic for asking her if her arm hurt every two minutes! I tried to clean her up as best i could. When i sat her up to tie her wrap skirt around her, she suddenly slumped forward, passed out! Teresa went to fetch a wet towel for her forehead as i laid her back down. She was alert in a few seconds and after a few minutes i tried again to ready her for transport. Teresa backed the ambulance up to the side door and when the driver came, her family helped us move her to the stretcher in the back. We had to wait for the staff member who was

Then it was time to clean up. There is no janitor on call. And Teresa still had neighbors and staff members coming by for this or that. So it was a full circle day--from consultant to tech to janitor!!

But i missed out on the boys' math lessons. I went to the gate where i could see them playing in the dirt road. I apologized but it was already getting late. We made plans for next week and i headed home across the compound to wash the blood splatter off my feet and skirt...