halloween, triatix, and lunch in bomet

I've got to admit something: I've been feeling a pretty spectacular lack of desire to do much writing this trip. And I don't know exactly why that is. Perhaps it's because writing is often how I process, and much of this trip has felt relatively straightforward. Perhaps it's because I haven't felt monumentally challenged or unusually encouraged in my faith by anything that's happened so far. Or perhaps it's just because I haven't taken enough good pictures, and I feel like a blog post ought to have good pictures. So anyway. I'm trying to discipline myself to write in spite of those things.

At any rate, I'm mostly through a weekend off, which I've been quite grateful for, as I spent Friday feeling a little feverish and peaked. Not nauseous, exactly, but completely lacking in any sort of desire to eat or drink. Something was definitely amiss, I just wasn't sure what. I remember writing about this when I was here several years ago, and it felt very similar. “Green around the gills” was what I called it then, and that still seems about the best way to describe it. Fortunately, the day was light, and when we finished up around 3:30, I was pretty happy to head home after purchasing some cold fizziness at the hospital canteen.

Friday evening was the Fall Festival (i.e. Halloween), which I was seriously tempted to forego in favor of continued couch time, but it's a big gathering of the community here, and I'm glad I pulled myself together and got up there. The kids (see picture) were ridiculously cute, and judging the costume contest was a challenge. And we wound up with birthday donuts for Julia's tenth birthday... which I ate. Apparently some things overcome green gills.

One of the other things that overcomes green gills, by the way, is adrenaline. I got to test that one out when my on-call intern paged me around 8:30 (at which point I had settled pretty thoroughly into a corner of the couch and was watching The Blind Side with my housemates). When I called back, Betty's voice had a sense of urgency to it, and she had gotten as far as “a Triatix (poison, usually intentionally ingested) patient who isn’t doing very well…” before I was looking for my shoes. She’d managed to get out “satting 45% on room air” when I cut her off and fled the house for casualty. I’ve worked here enough that what I found shouldn’t have surprised me, but when I arrived, I was pointed to a curtained-off corner of the room, where my unattended patient appeared to have a reasonable heart rate, but was barely breathing, and the pulse ox sensor was beeping noisily but not registering a number. Happily, casualty has made strides in having equipment available, and there was an airway basket nearby, though the masks were entirely too small for the large teenager in front of me. I urgently requested a mask from the nurse we’d called for assistance, as Betty was occupied looking for intubation equipment, but when she finally returned, she came bearing a mask for me. Nope. We finally got that straightened out, and with a laryngoscope blade whose light had seen many better days, a lot of suction, and a dose of Valium to assist, we managed to get him intubated.

Of course as the adrenaline wore off, my body remembered that I hadn’t been feeling particularly well and had eaten so far that day a scone, a small piece of banana bread, and… that donut. Which caused me to put my back to the wall and ask Betty to bag for a minute or two while I focused on breathing. Then came the problem of patient placement. Leaving poor Betty attached to the endotracheal tube, I first went to ICU, where all of the beds were occupied. Next, HDU. Same there. Fortunately, there is a nurse in charge overnight - COPP, anyone? - and she understood the urgency of the situation, which became worse when we found out there weren’t any ventilators available, either. She promised to work on it, and I returned to casualty to relieve Betty. Realizing I was potentially stuck manually ventilating for a while, I requested a chair, which the poor frazzled nurse brought for me quite promptly. And I sat there, thinking... this is not my usual. Sitting in casualty, leaning my elbow on the bed of a patient who just tried to kill himself, and from whom is wafting the odor of every body fluid possible, with stomach contents splashed on the gurney and the floor in front of me. Lord, have mercy. On my patient, who considered his life not worth holding onto. On his family, who had brought him to us and was awaiting the outcome. On me, who in spite of good intentions, still got frustrated with staff who couldn't help me care for my patient as quickly as I wanted. Working here is humbling.

Yesterday was my first opportunity to take a nice long trek through the hills around Tenwek, so when friends invited me to accompany them on a walk to Bomet for lunch (three-plus miles away), I gratefully accepted. There's a main road to Bomet, but Jen has discovered a back way that eliminates cars and boda bodas and features equally pretty scenery. It was a lovely hike to town, and we ran a few errands, like visiting Radiant Supermarket, before sitting down for lunch at the one restaurant in Bomet that boasts wooden tables, apparently. The chicken and chips were perfect after a long walk, but the skies had clouded over by the time we were done, and we opted to take a taxi back. I'm hoping for a few more opportunities to walk in the next couple of weeks. Maybe tomorrow evening after work if the weather cooperates.

In the meantime, my housemates are attempting to recreate the donuts from Friday evening's festivities, and I think I'm going to go see if I can give them a hand.