house of pain

someone brought up the house of god the other day, describing it as a somewhat exaggerated account of medical training at a certain boston hospital. well, yesterday, as i left la pédiatrie, it felt like the house of pain without exaggeration. i, along with several patients, patients’ parents, nurses, and a doctor, had all been drawn to the wails of a small boy with a broken leg elevated in traction. the tramadol just wasn’t doing it for him. the cries were pure agony. pain control is difficult here. when the tramadol runs out, there’s tylenol. i just turned around and left. sadly, everything we could do was being done.

all things being relative, the wails of this unfortunate little boy did not hold a candle to those of the young mother who lost a baby yesterday. pediatricians often describe crying in terms of consolability. well, this crying, sobbing, screaming was inconsolable in a way that tears you up inside. you know that even after the sound ends, the wound remains incurable.

the baby lived six days, not even a week. i remember how happy everyone was when the proud new mother on the maternité ward was given the green light to head over to la pédiatrie. family members in brightly colored clothing gathered her bags and made the move en masse. i’ve never had a patient die before, but this little one never really looked so good. she was working too hard to breathe. her white count was sky high (62) and platelets subterranean (11). we gave her practically every antibiotic we have. her breathing became less labored which may initially seem like a good thing, but then she stopped breathing altogether. diagnosis: overwhelming neonatal infection. i take back all the times i was bored to tears ruling out sepsis. i’ll take those tears over these any day.

that was actually the second time i wanted to cry yesterday. the first time involved a six-year-old girl who was accompanied by her mother, an aunt?, and the mother of her accused rapist. this was actually the second time such a scenario had unfolded during clinic. i’ve been here less than one week, but they say it’s actually not that common...anyway, we had to examine the child to see if the accusation was true. sadly, it appeared that the girl did fall prey to this 25-year-old man. i don’t think the girl really understood what was going on. she was happy to get a new doll. we have some in the office. the mother of the child was as enraged as the mother of the rapist was nonchalant. the 8-year-old who had found herself in a similar situation earlier in the week was thankfully intact, as they say.

at least yesterday’s house of pain can be juxtaposed with today’s preventative medicine. two days a week, there’s a traveling clinic that goes to neighboring villages. today, we made two stops to weigh babies, check vaccination records, offer consultations, and educate mothers on nutrition. we bring medications for common illnesses as well as regular anti-worm treatments. the system is well-organized and was the perfect antidote to yesterday’s dose of helplessness.