24 hours

24 hours ago I was at a dinner party.

 

S&S invited me out for dinner 2 weeks ago, and then I had dinner w/ them again last week, and they decided then to have a dinner party last night. I walked into their home. They have one of those homes that I think I had probably dreamed about owning at some point in life. There's a small courtyard, a small pool, a fireplace, a gorgeous dining room, and a very chic kitchen. At some point in life, I think I wanted a home like this. Or like the home B&B have in CT, or the home H&R have in Boston (and the cape). A sort of elegant sanctuary. Now, I'm just happy to have friends who have these gorgeous retreat-like homes, and would rather just show up and enjoy their homes from time-to-time, rather than the thought of ownership. The thought of owning a home gives me a choking sensation. The thought of having friends who own nice homes, makes me smile.

 

It was such a stimulating night, I didn't want to leave. And when it was 2am, and I knew I had to be up in 4 hours, I decided that I really had to leave!

 

People I met last night:

 

V: Who was at the dinner 2 week ago. A lovely Belgium pediatrician who has been working in SA for the past 3 years or so. I've made a mental note to ask him how he became licensed in SA. Nice guy. Very humorous.

 

D: Fascinating! UK Doc, who works more in the microbiology aspect of the STD world. SMALL WORLD HERE! My boss from Denver Public Health was here a few months ago working with D!!! WHOA! And, D is good pals with all the head honcho Docs of DPH! Everybody I worked with back in 1998-He knows, and works with some on international committees, etc. This is just exciting. I'll at some point mention my other small story world.

 

T: Is a college prof, who works with Human Rights Watch, and has done most of his work in Rwanda. Stayed in a certain hotel before it became famous. Lives part time in Cambridge, MA with his partner. Use to live next to a certain famous sex columnist-who actually wrote a great book about 8 years ago, which I have read. Fascinating guy!

 

D: From western Pennsylvania, who has lived in London, Sydney, and now Jo'burg, works in business, and had some of the funniest stories!

T: Cute, but not really worth mentioning. Mostly smiled the whole night, a little too young to be at the adult's table.

 

S&S: Elegant Hosts, who have been so generous the past few weeks.

 

Fast Forward to 6am. I'm wrecked.

 

I'm on the road to Bara, and for the second morning in less than a week I see the cops pulling people over. I notice a car pulls away from the road check. Cops are indicating for random cars to stop, and then it happens, they point AT ME!! I'm scared, but also really excited. I have my R 100 bill in the ashtray, and am FINALLY going to get to bribe a cop. Unless something goes wrong, and then I may end up with a fine, but who cares.

Cop: Drive's license please.

Me: (There is a slight pounding in my temples-my issues with authority trigger massive epinephrine releases from my adrenal glands).  I fish around for my wallet and grab my MA license, the cop is looking into the car as I open my wallet. Of note: there is about R300 sticking out of my wallet, and now it is going to be sooooo obvious when I go for my R100 bribe from the ashtray and try to tell the cop that I don't have any more cash--- he's just seen my loot.

Cop: Doctor? Are you on your way to work. (He saw the stethoscope on the passenger seat).

Me (aka Doctor-thinking it not wise to be a smart ass): Yes, I am (and there are sick babies that I need to perform emergency life-saving surgery on in the next 5 minutes, and I'm late, tired, and maybe have a slight titch of hang over).

Cop: Ah, sorry Doctor, you may go.

Me: (Membership, again, has its privileges). Thanks.

 

 

I arrive on the ward. We had a day off..

 

The night nurses like to play this game called patient shuffle. There may be rules, but I haven't figure them out yet. There are roughly 10 cubicles that have the beds/cribs in them. Generally the first two cubicles are freed up for the new admissions, which in part, lends shuffling of kids, but oddly enough, kids have been moved into these cubicles. There's also really no list to where the kids are, you just have to wander around and look for familiar faces.

 

I'm sitting at the computer checking labs. And I glance over to cubicle 3 to where two of my kids were, when I left on Friday.

 

My cutie jaundiced biliary atresia baby is there. But in the other bed, where of one my kids use to be is a now-unfamiliar face. So I get up and walk and peek into the other cubicles.

Death #5.

 

Damn.

Damn.

Damn.

 

I owe Indian food to my coworkers.

 

Sister (aka nurse), when did KM die? (Because it is obvious, to me, that he died, I don't see his face anywhere, and there is no other possibility of where he would be).

Oh Doctor, early in the morning yesterday morning.

 

I'm fairly sad. Then it dawns on me, that I didn't see my 3 month old who had a congenital heart defect, who was getting a sepsis work up on Friday, and had a horrible looking chest xray. (Though, who knows what her baseline CXR is).

 

Death #6.

 

Well, that's the only thing that made sense to me. And I'm taking this a bit personally.
 
Sister, what happened to KP?
Oh Doctor, that baby was discharged home yesterday.

 

Interesting for a variety of reasons.

 

Sister, there is no way he was discharged.

Oh Doctor, he was, I am sure.

Sister, was he discharged home, Alive? (Now I'm thinking that discharge may, in fact, include expired).

 

KP is dependent on supplemental oxygen (which appears to take about a month to get home oxygen sorted), can't bottle so gets fed through a feeding tube, was looking septic so was going to get at least 48 If not 72 hours of antibiotics, and we didn't work yesterday, so there is NO WAY he was discharged.

 

I let it go. He will show up somewhere, or I'll hear the story later. And it turns out he got intubated, and is being a bit of a pain in the posterior! Well, just refuses to be oxygenated.

 

He is not, #6.

 

I admitted 2 kids before I left this evening.

 

One is a 4 and a half year old who is heart failure, HIV positive, started anti-retrovirals earlier this month. Lives with grandma who is raising him and his 14 year old sister. Mom died of HIV when the baby was 2 months old. Grandma is a champion. She knows his antiretrovirals, give a great history of his illnesses recently. Is basically the one who took this kid from Dad because he isn't such a great parental unit, took the kid to get tested, and has been the motivating force, and the stability needed, for the kids to get meds!

 

Anyway, this kid is a cutie. He's in a little too much heart failure right now to smile and be interested in anything other than breathing and staying alive, but I bet when this kids feels better, he's going to be running all over the ward giggling and bringing joy to others. You can tell this kid brings joy to grandma. And hopefully in a few days, to Ward 18.

 

Good night.

I'm tired.

 

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