Not a whole lot to report right now.
Swazi trip was good. Great weather. Camping under the stars was lovely. The "trail" on Sunday was not lovely, and I have the scratches and cuts to prove it. The company was great. I drove through Mbane, the main city-well one of them- 5 years ago. I didn't remember it being so hilly, and nice-appearing. We made it there in about 4 hours, so that was nice.
I am taking care of a patient I admitted at the end of last week. Pretty tough situation. Young woman who has progressive neurological deterioration. She defaulted coming to the clinic in March, and showed up last week emaciated, weak, and with worsening coordination. When I saw her Tuesday, she looked much worse to me than when I had seen her last on Thursday. Yesterday her brother called me, and I asked him his opinion-and the thought she actually was looking better. "Help me, I'm dying" is what she told me today. Sadly I think she is right. I was talking to her main clinic doctor on Tuesday the gist of the conversation being what happens when a patient says they are dying. For on Tuesday-I certainly came to the same conclusion that the patient verbalized today. Our consensus was that, when a patient says they are dying, they're usually right. And the goal is to get her home so that she doesn't die in the hospital. She's booked for an MRI tomorrow. It's quite a tragic story, in this land of endless human tragedies.
Wednesday I saw SM in clinic. He's gained 8 kgs (16+ lbs) since I hospitalized him in Feb. He is back to work. He looks amazing. I've been breaking the news to the patients that I've gotten to know since January, that this is my last month in the clinic. (Though I confess, there is an overwhelming lack of motivation to find the head of ICU to coordinate my starting in the ICU in May). And so I told SM and his wife that this would be the last time I see them in clinic. They were disappointed. "I have my husband because of you." How does one respond to that? Guilt because the work here is endless, and it feels like betrayal to leave patients that I've gotten to know well, in such a short time. And anger-because SM didn't get the care he deserved and that all I did was admit him back to the hospital and literally throw the kitchen sink of antimicrobial treatment at him hoping to kill anything that was living in him, a treatment that should have been done weeks before he ended up in my examination room back in February. Thankfully, one of the consultant/attendings will take over his care when I leave, and they have a great rapport with her as well.
I was going to write a bit more, but there have just been some gunshots in the neighborhood, and it's late, so perhaps it's a good time to turn out the lights and go to bed. Oh, and this is the second time, in as many weeks, where there have been gunshots late at night. I'm slightly annoyed, because I staunchly argue to my friends that I live in a very safe area. And since last weeks gunshots, I've decided that running after 8pm isn't such a good idea now that it is getting dark out.
