We walked into the Salles de Urgences to check on our patient from last night. The young girl with 4+ cerebral malaria who has been seizing, the one whose blood sugar has been hard to control and whose airway was difficult to control and give her adequate oxygenation. We walked in after our rounds, and Jason and I noticed she wasn't breathing at all. We ran over to check and Dr. Wegner fired up the ultrasound to check for a heart beat.....there was none. I started CPR and Dr. Wegner started bagging. Jason drew up epinephrine and glucose, and we kept CPR going for about 20 minutes or so. Sadly again there's just too much we don't have here in the Congo. We can't intubate, we don't have pressors, we hardly can keep a pulse-ox let alone get regular blood pressures and glucose checks, we don't have potassium....you get the point. So we gave what we could and tried, but pretty much the rule here in the Congo is if you are doing CPR, they aren't likely to live. In general, if you're doing CPR, it's not a good sign. But in the states I've gotten people back, though I'm not sure how long people live after being resuscitated in general. Dr. Wegner turned to the family and told them that their child was gone. Each of them started wailing loudly and ran over to hug her one last time. The news spread fast and there were cries for quite a while. Dr. Wegner explained that they do have a cemetery nearby, and she would likely be buried by the morning. Depending on whether the family was Christian or not, tonight would vary a bit. If not Christian, lots and lots of drinking, and lots and lots of drumming. If Christian, less drinking and still lots and lots of drumming.
The rest of the day was pretty good. Since it's a weekend the hospital functions differently. Dr. Wegner was on call, so we met with him at 7am to round on the patients. Most of the patients were doing pretty well and some were recovering better than others, but nothing too major or exciting other than our one code blue. We took a short break to go and drain some abscesses (more pus, yay!) that a 3 year old had. Bilateral anterior thigh abscesses. You could feel it, so when I stuck the knife in and nothing came out, I was kinda sad. Then Dr. Wegner suggested really jabbing it further down to the bone and seeing what happened.....ahah! There it was. 40cc's of pus spilling out. Always love some good pus drainage. The other leg had a bit less, and we used the ultrasound to guide me right into the abscess pocket. There's not much more satisfying than watching a whole lot of pus drain out....that's weird I'm sure, but when you are going into ER where pus is abundant, you might as well enjoy draining it.
We went back to rounding and had one patient who they were treating for pulmonary tuberculosis. Jason and I first listened and percussed his lungs and determined that his left lung sounds were severely diminished and dull to percussion. So we ultrasounded and...well yeah no wonder it was such an easy physical exam. Basically the guy had so much fluid in his lung space that the left lung was collapsed and his entire mediastinum (middle part of his chest) was pushed to the right, including his heart. His IVC was also compressed which was backing up flow as well. Well that explains why he's short of breath. So we broke to eat lunch and then met up to put in a chest tube. Jason did this procedure. Since I did the last chest tube, AND he said I did the abscess drainage that morning....though I argued that he did both exploratory laparotomies....but ya know, there's plenty to do. We both like procedures a lot is all. Anyway, success....chest tube went in (with some makeshift tools) and we drained about 2000cc of fluid from his lung cavity. The guy felt a lot better after that.
Rounding took a long time today. There's like 50-60 patients usually here I think they say, and with just the one doctor on duty we round on all of them, so it takes a while. Between the two procedures and trying to resuscitate the girl, we rounded till about 4pm. Jason and I then hopped on the bikes and rode to the market to grab some pineapples and found some cold coke....which really never tasted so good. Probably just cause it was ice cold, but I should have recorded us and sent it to Coke for a commercial.
Oh yeah, we also had a music practice today for tomorrow's service. We broke for about an hour and did that. They met up the other day to work on their intros, so they're sounding a lot better and starting to get a hang of some of the rhythms. I'll be playing with them for the second service tomorrow, the one in French and English. There is a baptism in the river at 8am, then the English/French service at 11am I think. Then I'll be leading them in some worship for Sunday Night Live....and some of them have requested I play "new music," and not old hymns that they always sing. So I'm working on a song set of some good Easter Resurrection songs. There's a lot to choose from, so the hardest part is narrowing it down.
That's about it. We are heading off to eat dinner at the Tropicana, a restaurant that Amanda made dinner reservations for all of us. I guess you make reservations so they don't run out of food. I'll write about that a little bit later if anything super awesome happens, but I'll at least describe the food.
Okay, just got back from a night of relaxation and fun. So here's the update (and yes, I realize you are reading this all at once, so no time has really passed). We went to the Tropicana for dinner, which Amanda made reservations for us so that there would be enough food. However, when we arrived we found that Joyce, Henri and company plus the Hong Kong Team were all there as well, and had ordered right away. So when we all ordered lamb, we found out that they were actually out of it. Basically there were three options initially: Lamb, Fish, or Omelet. Most of us ordered lamb, and then found out it was all gone because our other group ordered a bunch of it. So, I called Henri over and asked him if I could make a trade and give hime some fish for some "sheep," because I really wanted to try it. Amanda told him I was joking, and I insisted I was serious and was willing to trade fishes for sheep. He agreed and brought me some lamb. And it was quite good. At least I think it was lamb....someone later said it might have been goat, so I'm not sure. Anyway, then our fish came out. It was a pretty thick white fish, and like all fish here you have to spit out the bones as you eat it, but it was pretty tasty. They had peas/carrots on the side and brought out rice and plantains. Also, ordering big bottles of bottled water, not tap water, seemed to be confusing, but they eventually figured it out. Then, Joyce and Henri surprised us as they were leaving and said that they had went ahead and paid for our meal. They wanted to leave without telling us and have us be surprised, but they weren't sure if the restaurant would double charge us, so they told us then. We were still really surprised and very thankful. Free food always suddenly tastes that much better too.
Afterwards we decided to stop into the Discoteca that is next to the restaurant. Basically there version of a club, which was pretty empty other than two people. We realized when we passed it around midnight it's just cause we were too early, but we were really just stopping in to check it out. We stayed for a bit because it was air conditioned and it felt amazing. They were playing a bunch of American pop/club music, so that was entertaining. The server kept asking if we wanted drinks, so finally we said to just bring us 4 cokes. We were quite surprised when we went to go pay for them.....they spent about 4-5 minutes figuring out our bill and then told us they wanted 18,000 francs....which is like $9 a coke. To that we responded, um no way. I was like the most I'll pay them is 2000 per, which is still outrageous (typically can get for 500-800 Francs on the street), and 2000 is like $3.50. We gave the guy 5000F for all of them and he was telling us we couldn't leave without more, so we gave him a couple thousand more and then just left because it was getting ridiculous. Oh, also, the cokes smelled like someone had vomitted on them, so we couldn't really even drink them....yeah it was that bad....we were laughing a lot because it was so unexpected, and then we tried cleaning it with hand sanitizer, but then it just made the coke taste like bad alcohol....anyway, it was an experience that we can laugh about for a few bucks a piece, so I'm not complaining. They were trying to tell us that there was an upcharge for the weekend, and I assume for being American, but $9 for a coke is ridiculous wherever you are, and I was trying not to laugh and walk out it was so absurd. They were pretty drunk and not really sure what was going on from what I can tell. I hate to hear what a rum and coke would cost at that establishment.
Anyway, from there we headed to Dr. Harvey's house to play games with Noah. Noah is 15, by the way, if I haven't mentioned that. He wanted to play Risk, which I haven't played in forever. It was a lot of fun, and we ended up calling the game a tie between Noah and I because I gathered up a bunch of troops and was getting ready to sweep the board, but it was late and Jason and I had to ride our bikes a couple miles back to the hospital, so I called it. I think Jason wants a rematch, so we'll see if we can squeeze that in.
I have to tell you a bit about these bikes, and I'll snag some pictures later. They need some work, and we did get the one bike working and tightened a few things so it stopped falling apart as you rode it. The other one we had was far too small for Jason and I and the seat was really loose and shoots straight upwards, which you can imagine is not comfortable. I was passing Dr. Wegner on the way to dinner and he agreed to trade me his larger bike since he was just riding around the compound, but he warned me his has some issues as well. The issues are that there are virtually no brakes, which hey, who needs brakes. And it's missing one pedal, which hey, who needs two pedals. And you can't change gears, which hey, spinning really fast is good exercise and gears are overrated. It makes for an interesting ride for sure. Beats walking though, so it's all good.
That's about it. Just prepped some song stuff for tomorrow and I'm really looking forward to celebrating Easter in the Congo. There is the baptism at 8am to kick things off in the Oubangi River, so that'll be fun. I was also able to buy some stuff made by the Aca that Becky Harvey has at her house. She buys it and then sells it to other people to help support the Aca. I'll post some pictures of the stuff I get later, or you can come visit my apartment some time and see them. It will go nicely with the stuff I've collected from the Dominican Republic and Haiti thus far, and I'm looking forward to adding something from Honduras too when I go in June. Some local stuff from the Congo is going to be pretty awesome to have. Thanks again for reading, I'll update you again tomorrow, and sorry that I posted the last two days a bit late. The days were hectic and I didn't have access to the internet in time. Tomorrow I believe we are doing a jungle walk with Sarah and the Aca, so I'm excited for that for sure. Stay tuned, and I hope you have an amazing Easter Sunday!
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