Month: March 2007

  • Danger in the Night

    The kids are recooperating well. Someone asked Stefan where he was born and he replied, "Disneyland!." It had something to do with a NY Times review about a new family cruise Disney puts out. There was a large photo of a kid about to go swimming in a huge pool that had a screen with a dolphin in the foreground and the disney castle as a backdrop. When I asked him if that’s where he saw it, he said, "Yep! And I read the article too." Dina said, "How can that be? You were only there once when you were 7 months old." To which he replied, "How is that possible that I went when I was seven? I’m only 5!" Wise guy.

    Last night was the silent auction to support the American’s Women’s Club. It was a beautiful spread at the Grand Hotel. There were a few nice items to bid on including one of Dina’s homemade dolls. We won a bid on a nice African painting a la Picasso. I won’t try to explain that.

    We got home late and after I dropped Zuri off for babysitting, we watched a bit of the rerun of American Idol. Dina went to bed and I soon followed around 1AM, only to find Stefan in our bed. Sleeping with him is like sleeping with a breakdancer so I went to his bed and quickly fell asleep.

    The phone rang at  3AM. It was a mother telling me her son was having an asthma attack. She had given him a dose of his inhaler without any relief. I instructed her to bring him to the Health Unit where I would meet them in 15 minutes (Don’t want to scare anyone).

    The roads were surprisingly quiet. I put in a call to my nurse to find out where our nebulizer machine is. She has such bad laryngitis that I couldn’t hear her, especially since the roads are bumpy and the entire vehicle squeeks. The guard let me past the check point when I drove up with my flashers on (Peter is a flasher!).  The boy was sitting on the floor with his parents gasping for air like a fish out of water and his breaths were whistling. We got him settled down on the exam table and I gave him his first dose of Albuterol to open up his airway. It didn’t work so I gave him a second dose with little improvement.

    I started to worry half way through the third dose. I had already loaded him up on steroids but that takes at least 6-12 hours to work. He wasn’t gasping as hard but he was still having inspiratory and expiratory wheezes. He was tired but able to speak in complete sentences.

    He basically had near continuous inhalation of medication from 3:30 in the morning until 6AM. I decided to try my last resort of giving him an Epinephrine injection (adrenaline). Within 5 minutes his wheezing subsided. Everyone was exhausted and after watching him for another hour, I sent him home with specific instructions to continue his care.

    It was a bit strange driving home since I was tired and it was at a time when I’m usually driving to work. Kind of like watching a movie in reverse, backwards. The squatting lady by the roadside cooking benne’s hadn’t flipped one yet. My blind guy didn’t get to his corner. When I got home, the fire alarm was going off in the dining room but everyone seemed to be in bed without worry. It turned out to be a low battery. No cause for alarm!

    I crashed in bed around 9:30AM and had that haphazard sleep when there are noises coming from electronic devises controlled only by your children. I touched base with my patient in the early afternoon and he is doing much better so I pray that we’re out of the woods. Yahoo steroids! He may not be wheezing but I bet he has hair on his chest and speaks in a basso profundo voice (just kidding).

    Now I’m back in the clinic for a sprained foot. Nothing serious. It’s quitting time.

  • Images on my mind

    Driving – Camel crossings while driving over the Kennedy bridge over the Niger River. Herds of goats with kidlettes running out into the road. Pausing with hesitation once nearly across, then running back across as the car nears dangerously close! Shrinking water holes with naked bodies casting fishing nets, washing clothes, bathing babies, and watering livestock. Many species of trees Their large roots with sculpted trunks; some with leaves. Others without. Their silouetted bodies contrast against the bright daylight. One with green leaves turning lavendar. Small clusters of village grass huts with campfires. Hand  pumping water. Women walking along side the road with large pots and possessions on their heads. Scooters and bicyclists. Donkey carts pulling loads of firewood and hay. Children running with sticks and old bicycle tires.

    Work at the Embassy – Teaching the Trauma Course all day. Burkinabes demonstrating treatment of mass casualties on each other: Triage. Stop the bleeding! Applying bandages. Perform the Heimlich maneuver (not Hindlick!). Demonstrate one and two-man carry. Waiting for a "no show". Talking to Paulina about morale and patients. Reading charts. Country team meeting with the Embassador and DCM. Seeing patients. Visiting with Dr. Riese. Hearing a babies heart rate for the first time and the pregnant mom getting so excited. She brought her husband later so that he could hear it too! Joy. Still a "no-show" on the recheduled "no-show."

    Ouaga – Our driver loosing all his money (not stolen). La Palmeriae hotel like an oasis with one story buildings, clean white rooms with African art, and a swimming pool courtyard. Birds cooing in the night. Buffet breakfasts with fresh ginger juice, coffee, pastries, cheese plates, and mangos, mangos, mangos! Walking in the heat for an hour with winey children, looking for FESPACO information, then finding it just around the corner. Swimming and reading. Watching a short film clip on a young boy who lives at the dump. Eating out in fine restaurants. Discovering a French wine shop with temperature controlled storage. Then buying beautiful labels of wine to taste back home! Dinner at Paulina’s Hotel Richard. Good wine and fried fish with fresh steamed spinach! Live dogs and stuffed heads of big game on the walls. Feverish Stefan hallucinating with comical statements. Dreaming of Dyadya Oga. Last minute shopping at Marina Market (a real super market!) before leaving for home. Beefy chicken breasts at $28/pound!

    Headed home – Late start. Crossing rocky hills with thick vegetation. Sub-Saharan desert. More village life. Camille getting Stefan’s illness. Niamey in lights as we drive home in the late evening. Home.