4/4 – Grosser than Pus

Perirectal Abscess. Even if you don’t know what one is, just the sound of it is still really gross. I helped to drain one today, and it was probably the nastiest thing I have ever seen in my entire life! But it was so awesome.

If you’re squeamish, feel free to skip this part… but I like to record it because I think it’s pretty cool. I feel like an 8-year-old boy who is fascinated with gross slime or something. Anyway, this abscess was about the size of a palm, right on the medial buttock. I was expecting a lot of smooth yellowy pus to come out, but instead, it was a sort of thick, brownish gray chunky solid with tiny white particles all throughout. There was so much that it filled our receptacle–about 400 mL’s. It was so incredibly foul that the first thought that came to my mind was feces, but it definitely wasn’t. Both Alex and I, who were draining the abscess together, couldn’t identify what in the world would cause such a pocket of revolting matter. But the most horrid part was yet to come. There was some sort of fibrous white sac that formed around the thick material that we actually pulled out of the cavity like it was a parasite or something. Ugh, I get shivers when I think about it, but on the other hand, I get really thrilled by any kind of body stuff. It definitely makes for an interesting story to bring home!

Later in the day, Tabi and I examined one woman admitted to the female ward with a distended abdomen. It was possible that her intestines were completely filled with feces, the way her belly was so hard. Tabi said she had never seen a patient more constipated in her entire career. This woman had been feeling this exact way for two whole months, since her c-section surgery in Tamale. That’s a crazy long time to be constipated! We both spent a long time on her, and even ordered enemas to be given to her every few hours by the nurses, all throughout the night. It was our goal to NOT have to do a fecal disimpaction procedures the next day… Neither the doctor nor the patient would enjoy a hand up the rectum!

While we were waiting for the NG tube materials for this woman, Tabi gave me a lesson on suturing, which the other nurses also were looking in on and enjoyed very much! The mango we brought to practice on looked like Frankenstein-mango by the end of the little workshop! I got pretty fast at one-hand ties, but still need some work on making the sutures I sew completely even.

It had been a very long day full of patients already, but after lunch there were even more calling from all sides for attention. I’ve said it before, but I’ll say it again–Dr. Jean is an absolutely amazing woman for being the only doctor at this hospital for around 20 years. I really have no idea how she does it. I would literally fall dead after one week, even if I had all her knowledge and experience. This is only one reason why Dr. Tabi is such a blessing to have here!

For example, she was able to complete a fingertip amputation procedure on a little girl who had stuck her hand in the spokes of a bicycle wheel. Reminds me of my babysitter when I was 9 years old who did the exact same thing! If I had seen this procedure when I first came go Ghana, I would have been completely shocked and a little traumatized, but now after about two months here, these things are just normal to me. Or maybe it’s also because I just saw the nastiest abscess in the world drained, and anything else in comparison would fail to faze me, haha!

After our second “shift” at the hospital, Tabi and I called up Ishmael and we all met at Back Home Spot in Kakpeni, just a few minutes walk from the bungalow. A spot in Ghana is like a bar, but it also sells minerals (sodas) and food. This particular one, if you remember, is Timothy from the lab’s little family business! He was there of course, and I invited him to join us because I hadn’t seen him in such a long time, but the butthead declined. He didn’t refuse my offer of a malt, though! Such a quiet guy! All my efforts have not been successful in getting him to open up.

Ishmael and Tabi, on the other hand, are the lives of the party, if there can be more than one life of the party. It’s pretty entertaining to listen to their quips back and forth, especially since Tabi talks in perfect Ghanaian English, from her almost year’s experience in other hospitals in Ghana. We were just sitting there, taking our Alvaro’s, chatting, and cracking up, when just a few minutes into our winding down, the hospital called. Thankfully, I got asked to watch everyone’s “stuff” at Back Home Spot, while Ishmael and Tabi rode on the moto back to the hospital to do an LP on a 15-year-old boy. The test results wouldn’t be in for a while, so I kind of just chilled there with Timothy, talking to him and catching up, after not having worked the same shift in the lab for quite a while. He introduced me to Rafaela, a little baby girl with hydrocephalus that Dr. Jean and Ishmael had sectioned from the mom several months ago. He told me her story–that after she was born, the family wanted to go and kill her because of her condition. Timothy’s family refused to let that happen, and even sent Rafaela to Tamale for her operation to treat the hydrocephalus. Now she lives here behind Back Home Spot, and is cared for very well. I even got to hold her and play with her a bit. J

Also while I was waiting, I discovered that Patience from the female ward also lives near Back Home Spot! She had been off work because of her severe case of typhoid, but I found her making Ayoyo (hibiscus) soup! I was chatting with her and helping with the cooking when Ishmael and Tabi returned. Soon after finishing up our minerals, Tabi and I headed home to our little room at the bungalow.

The night was not over yet! Jean and I had to head back to the hospital for a severely dehydrated baby. While we were giving it boluses (large amounts of IV fluids at once) to restore its blood pressure, the poor thing began to seize right there on the table. It was really scary but Jean just kept her cool. Many times she has to tell me to just take a chill pill even though my adrenaline is pumping hard. I totally see what she means, because when I get really stressed out like that, I jumble all my words, can’t explain the patient condition correctly, and may even do stupider, more dangerous things. That’s also one big lesson I am learning to practice here in the hospital. The baby turned out to be ok–the seizure didn’t last long at all. Jean stayed calm and collected, and found pneumonia, which we began to treat immediately.

Before we collapsed in bed for the night, I saw another emergency case of meningitis with Tabi. It was a little girl in the childrens’ ward whom I had to hold down hard in order to help Tabi get the cerebrospinal fluid for testing. PHEW! For a small hospital, there is so much work to be done and a seemingly endless stream of calls! Some supplies would make work here a lot easier–we would love to have a ventilator and a nebulizer to treat the respiratory tract patients, and ones that actually work with the Ghanaian electrical cycle! Little things like this which are so common and taken for granted in the U.S. could really help SMC.

Dr. Jean and the other staff at the hospital have to deal with a huge lack of resources every day. They need your prayers to give these patients the best possible care! I am so grateful that many of you have been reading along and praying for the hospital and for the Konkombas in Saboba! That was one of my goals for this blog–to get the word out about the hardship in this area, and to possibly inspire more volunteers to come serve and come to love the people here. Whoever is reading this, I hope YOU may be next!

-ATP

4/3 – Immediate Friend

I am more behind than ever on these journals, so for the sake of time, I will make this post short! Nothing absolutely spectacular happened today, although I felt so blessed to have Tabi here with me. She’s only three years older than I am but has already accomplished so much, so I feel like I have the benefit of a relatable peer around me, in addition to the benefit of someone much wiser, all packaged into one very cool roommate.

I am definitely way more busy with her around, but I like it because I am learning more and helping out more, which somewhat combats the feelings of ineffectiveness that I feel at the hospital. As a recently graduate medical student, she says she’s like a “fetus doctor,” in which case I would be a “gleam in your parents’ eyes” doctor, haha J But thanks to her, I am really getting to help out with more things, like her STABLE program and nurse’s textbook. I already completed designing the diploma for those that graduate from the course. I can’t wait until she is formally introduced to the hospital, and I get follow her around and glean some medical knowledge… J

Here’s what happened at the hospital today:

– I was able to go back to working in the lab and greeting all my buddies there after my absence.

– Rounds with Dr. Jean were pretty routine–lots of typhoid, but there was one long-term malnourished girl who looked like she was 10. I felt so terrible, because her family members looked like they ate well enough, so why didn’t she?

– Watched a right thumb abscess being drained on a 5-6 y/o girl the daughter of a hospital staff. I think pus is so gross, but it’s oddly satisfying to see it drained out

– Visited the theater guys and talked with them a bit–they were listening to a radio program with a Ghanaian-born American, and they were having the best time making fun of his American accent, like they do to mine!

I left the hospital after my day of work as Ishmael was calling after me, “Yours sincerely!” I just laughed at him because I had no idea what he meant. “I feel like using it that way!” he said, meaning he wanted to wish me goodbye like that! Hilarious. He makes fun of my American accent, and I will make fun of the silly phrases he uses somewhat improperly!

I got to read over Tabi’s nurse’s textbook today, and I am so excited for where it is going! I am learning a lot about patient care as I read it as well, and brushing up on all my anatomy and physiology simultaneously. It’s going to be an awesome resource for a lot of people, and I pray that it’s a successful tool in improving health care here! That would be so amazing. I am really impressed with Dr. Tabi, especially since she is such a down-to-earth woman even with so many great ideas and accomplishments. I love that she talks freely with me, because I tend to be quite shy when meeting new people, but she just makes me feel right at home and equally free. That is sure to produce a good friendship, I am sure, and so I am greatly encouraged for the rest of my time here. It means so much to have a friend so often by your side when you’re far away from home, and I almost didn’t notice how much I missed it until Tabi showed up! Praise God for bringing this lovely roommate!

-ATP