rough

Today was kind of a rough day. This weekend I'm on call which means I work from Friday evening to Monday morning. At 7:30am today, I walked into the surgical ICU to start teaching rounds with the residents. Immediately, I saw the charge nurse doing chest compressions (CPR) on a little boy. It was the little boy I had admitted from clinic yesterday afternoon. He was severely malnourished. We had operated several weeks ago and fixed his typhoid perforation. He was discharged from the hospital last week and had been staying close by in the ambulatory care unit behind the hospital. When he came into clinic he could barely open his eyes. His surgical incision had come apart. I wish I had a picture of the boy to show you. But perhaps you would rather not see it. Just picture one of the starving children you see on the news.

His dad said that he hadn't eaten since he left the hospital (one week ago). His father had been faithfully dissolving the pills in water so he could given them through a syringe and had been giving the child water as well. They had been told to come back in a week after discharge. He did. It was too late. I guess he didn't know to bring the child back as soon as he stopped eating. He obviously cared and was trying to help his son.

But now the boy was too weak to breathe.  We helped him breathe for a while...but we don't have any ventilators here so we were unable to keep breathing for him. There was nothing more we could do.

After taking a few slow, agonal breaths he stopped breathing. Then, his heart stopped beating. I said, "I'm sorry, he is dead." The charge nurse translated for the father who was standing by his bedside. The father let out soft, heart-wrenching, sorrowful cries as he covered his son and wrapped him in a mat to be buried.

It is only the second time I've seen a man cry here. Not a good start to the day. But, unfortunately, it was not the end of the sadness.