Quite a weekend.

Wilsons_2013 Posted by Rory Wilson on Sun, 15 Aug 2010 | 1 comments | Bookmark: digg this Post this to del.icio.us Post this to Facebook

Last weekend I was ‘on call’ with Dr Peter (our surgeon.) It proved to be quite a busy weekend. Not that we had particularly excessive number of admissions – just those we had, were very unwell.
Of course ‘on call’ is obviously a bit of a euphemism for 2 people doing the work which it should take 8 to do. Usually the weekend is reasonably busy, but it’s not unreasonable to have time for a cup of tea between ward rounds to clear the head, and meal times can usually be maintained. Not so this time.
I was just starting the ward round in male ward – I’d seen our first and sickest patient. A severely jaundiced 12 year old boy with liver and kidney failure who, on account of his severe infection was bleeding from his stomach, bowel and nose. It doesn’t take a doctor to work out this is not a good situation. Getting adequate blood with the fresh clotting factors he needed took much effort – including tracking down a willing UK medical student to give us a unit of fresh blood. I had temporarily finished with him when maternity asked for my assistance – a lady with a placental abruption (and thus dead baby) had no recordable blood pressure. The lady’s significant body habitus and untreated psychiatric condition made the vacuum extraction of the dead baby more extreme, though probably not as sombre as it otherwise would have been! Back to male ward, my boy’s nose bleed had resumed and required packing his nasal cavity with gauze in an effort to arrest the bleeding. Before getting too far around the ward, maternity were back asking for help again – our lady was still bleeding – and her blood pressure had disappeared again…..and so it went on. Dr Peter spent most of the weekend camped in theatre resuscitating and operating on sick patients – two perforated ulcers and one piece of dead bowel kept him amused between the infected shoulder joint and fractures. Meanwhile I kept running around the wards admitting and reviewing faster than is clinically advised. In the middle of Saturday night I could hear wailing before I reached female ward and was told a new admission had died in the minutes before I had been able to see them. Disappointed I went to review the patient to see what might have been, had I been in attendance sooner – to find a lady grimacing and trying to speak from under the sheet the relatives had pulled over her face!
Monday morning doctors’ meeting we handed over from the weekend’s activities. We were tired – but what a worthwhile way to spend a weekend. There is no doubt that if it was not for Peter’s patience and attendance to detail (and a unit of blood donated during the night from a nursing student on ward night duty) our lady in maternity would be dead. My boy with liver and kidney problems is now stabilising and will be fit for discharge next week. Our burst guts have all stabilised after theatre and look like in due course they will be ok too.
At the graduation ceremony last week for nursing and laboratory students I quoted from the description of Jesus’ ministry being reported back to John the Baptist – sick healed, lame walking, dead raised….and I wonder how much of that has taken place this weekend. Quite a lot I guess. I haven’t pulled anyone out of their coffin by the hand – but several patients now alive and increasingly well would have been buried by now if it were not for the care they received here.
Having said that, I hope our next weekend has more sleep and less patients.
Lots of love Rory, Denise + Gideon Mugisha


RAUL said Wed, 15 Sep 2010 07:30AM
>hi rory, good to hear that work is not over in Kiwoko. may God bless your work and all the kind people there. Greatings to Peter. We miss you all Raul

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