Wednesday

Today was both swelteringly hot and exhaustingly busy. It was one of those days where a distinctive temperature shift can be felt as soon as the sun rises over the horizon, and you wake up sweating. Hours before clinic even started, we were greeted at the hospital entrance by a large congregation of people patiently waiting to be seen at some point much later in the day.

Many patients were admitted from clinic. Two were dead before evening rounds even started. Brett successfully resuscitated a neonate! He used two fingers to do chest compressions until he got a pulse. Then he switched to bagging until, as he says, the baby took one deep breath and raised a defiant fist in the air! 

I was called to the bed of a 4 year old patient who was struggling to breath with oxygen saturation levels in the high 80s. After arguing with the nurses that she did, in fact, need supplemental oxygen (nurses here instinctively ration supplies for when the need is dire, as you will soon understand why), yet another small child was admitted with a saturation in the low 70s. 

I heard the nurses telling the latter child's doctor that all of the remaining oxygen was being used already on two babies. "Is there anyone who doesn't need it?" she asked. I sighed. I went to unhook my peacefully slumbering patient from her oxygen. I watched her nostrils begin to flare with air hunger and her breaths become shallow and rapid as the nurse wheeled away the oxygen to the sicker child. I anxiously watched her oxygen saturation drop back into the 80s, until I became both satisfied that it was stable and scared that if I continued to watch her it would drop even lower. Then I unhooked her from the pulse oximeter and gave that to the sicker child, too.