Diary of a Tsunami Doctor |
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January 30th, 2005 - 07:15AM |
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Photo: The IRC Hilarie Cranmer, M.D., is a physician at Brigham and Women’s Hospital Department of Emergency Medicine in Boston. On only a day’s notice, Dr. Cranmer departed for Banda Aceh, Indonesia, on January 7 to join the IRC’s tsunami relief teams there. She has been sharing highlights of her travels and observations in a diary. Only one more week left. It feels like I've been here for months. Things have been crazy, but nearly routine in its craziness. I’m trying to get the clinic to have a triage system—it seems like if you are an aggressive person, you or your loved one will get seen first. First come, first served. So what happens is that the sickest are seen later, and you end up finding them instead of them finding you. But today it was different. A man was standing there and he had his son in his arms, who was looking at me very guardedly. Most kids aren't quite sure about me/us just yet. So I asked why he was here and he said that his son had been having some black bowel movements, but that he hadn't had any in about 3 weeks. But he was eating and drinking okay, seemed to have no pain or weight loss. So I asked, “why did you bring him today?” “Well, I wanted to be sure he was okay.” So I examined his very healthy son, who, very appropriately, did not want anything to do with me. He is about 14 months old and slightly clingy with dad, but not abnormally so. Normal exam except for his ears, which had black wax in them, but his hearing was okay. So I asked about it and then the dad told us that he wanted to make sure his son was okay because he was the only one left. He had watched his wife drown, and saw this son go underwater and grabbed him, and held him upside down to get the fluid out of him, while holding onto a log with the other hand. And here they were, in clinic a month later and I said he was the best kid all day and the dad was ecstatic. So every day, when it's like pulling teeth to get vital signs, humble pie happens. I am feeling overwhelmed at how resilient everyone is and how they have picked up and kept on moving. Another of my patients is getting better. He had an infection called pyomyositis, and we've been giving him antibiotics and finally drained all his abscesses 2 days ago. It’s basically a condition that causes balls of pus all over your body. He had them in his elbow and his thigh. Today he gave me the thumbs up and managed to not have a fever for a half a day. The nurses now are able to give him his antibiotics round the clock, and to give him Tylenol when he has fevers. I hope he can get out of the clinic before I can. Today we had training with nurses both from my clinic and my colleague Rachel’s clinic. It was great to see so many, and they took very detailed notes about how to make clean water using Pur packets, how to wash hands, how to dispose of needles, how to chart, how to take a blood pressure. I had several consults about really high ones and low ones—blood pressure, that is. The one that was too high I think had white coat syndrome (fear of doctors/clinics), which was universally understandable, and a couple of women with low ones. Turns out all of them were pregnant, so I got to do a little ultrasound at the end of the day as well and counsel them about hydration... Food is not a problem here. Many supplies as well as local produce, very rich growing environment. But I had a little malnourished baby, 2 months old, and found out that the mom had had 2 other kids with the same condition prior to the tsunami. The department of health knew about her but didn't know she had another kid. We wanted to have the department of health workers come, but no such luck. The baby was so hungry. So we fed her, watching her grandmother take care of her, powerless to help, gave her antibiotics, and let the department know which camp she was in. She didn't come back in today, so we'll head to the camp to find her tomorrow, along with the local health authority. Frustrating, terrible. So many things to do, so little time here but so much to do for the teams that follow. So much to do, so hard to focus. Okay, don't mean to be a downer, just thoughts from patients today. Hilarie Posted By: Dr. Hilarie Cranmer | Asia, Diaries & Journals, Health, Tsunami Relief Permalink |
