This is a pic from the day we took S on our tea break. He came in having gotten into organophosphates (an effective, cheap pesticide, which is bad to ingest). He's been abandoned. He's always got this smile and happy-go-lucky persona. Though, we were reminded that he screamed and cried for the first 2 days on the ward, back in early July. He's 13 or 14 months, and there's been a slight rally around him recently, now that it seems he may be on the ward for many months. We've come up with the goal of getting him talking and walking. He's mostly developmentally appropriate, though maybe slight language delay. This morning he was crawling down the hall as we were in the first cubicle on rounds, and I grabbed him and carried him on rounds until I got too tired and had to set him free.The contrasts on the ward are extreme.
This afternoon three of us spent the better part of an hour trying to "drip" a kid (aka get an IV). This kid doesn't need an IV though. What he really needs is some pain control, and to be held. He will be dead by morning.
This morning, I was debating (in my head), whether I should test my 13 day old kid for HIV. Which means test the mom (who has told me she is negative, but doesn't have a copy of her results), or do a PCR on the kid (expensive). And I decided not to. Why, because I trust this mom. Which is silly, because the newborn is my patient, not the mom.
After an hour, and multiple, multiple stabs, I got an IV. Luck. This kid is 2. He's smaller than S. He was past the point of flinching with IV stabs. And he didn't bleed from them, but oozed serous fluid from where the IV cannulas pierced the skin.
What is remarkable, is that this is his first visit to the hospital. This kid has never walked. Can't feed himself. And is wasted. We tried to figure out where to lay the blame. How could this kid, who will die tonight from HIV, TB, malnutrition, end up in this state?!?? This is more a rhetorical question, as this is a complex problem, and blame won't bring about change.
And then I thought back to my 13 day old baby. And realized the answer to my debate from earlier. Yes. Of course, the kid should be tested. Any chance to diagnose a kid with HIV, and get them appropriate medical care for their status, and hopefully prevent them from dying in the hospital at age 2, should be jumped on.
Reality needs to trump Trust.
To end this on a lighter note, S shit on me yesterday. But we're still pals, I just check diapers regularly now.
