How did that happen?!

Have you ever looked at something or someone and just thought to yourself, “How in the world did that happen?!” Well, I had that thought innumerable times this week as I continued my mission in doing God’s work in caring for the sick at Tenwek Hospital.

The ICU

The most memorable patients were two young ladies in the Intensive Care Unit, both of whom are now in glory. The first young woman had rabies, apparently contracted after being bitten by a rabid dog. This is a condition that carries a 100% mortality. Despite our aggressive care, she would eventually succumb to her illness. She had high fevers and excessive drooling until her time of death.

The second young lady had severe tetanus. She sustained an injury to her Achilles tendon but didn’t report to the hospital until the wound was gangrenous and he was experiencing diffuse spasms. Despite receiving appropriate antibiotics, sedatives, and paralytics, she continued to experience high fevers, respiratory distress, and frightening appearing spasms until the time of her death.

The Female Medical Ward

Performing a skin biopsy.

In my brief time in the field of medicine, I have seen things that nightmares are made of and have seemingly mastered the art of the “straight face” — never letting my internal reactions to putrid odors or skin crawling sights show on my face. However, when I saw this lady’s skin, I know she had to see “What in the world?!” written all over my face. **I will interrupt this message to give you a public service announcement — If you notice a rash that is seemingly eating away at your skin, DON’T WAIT UNTIL IT HAS SPREAD ALL OVER YOUR BODY!** Sorry, that was an aside. Now normally after a physician fully evaluates a patient, he or she makes a mental list of several possible diagnoses before initiating treatment.For this patient, I had a mental list of about 15 potential diagnoses. The good news was that though her skin looked horrific, she was not very ill. This was obviously a slow developing skin condition that she was not a risk of dying from on my watch. I knew that no matter what I prescribed her, it would not go away over night. Nonetheless, I gave her some medicine, took biopsies of her skin, made sure she was comfortable, and sent her home with the plan to return in 2 weeks when the biopsy results would be available and I could tailor her therapy.

Another dermatological rarity--cutaneous anthrax.

Casualty (The Emergency Room)

The following event occurred about 2 weeks ago. Have you ever been busy, totally immersed in something, only to be overcome with a feeling that someone is watching you? Well, one particular evening, I was in Casualty talking with my intern about a patient we had just seen when I felt as though someone was staring at me. I turned around and saw an expressionless young male standing behind me. I looked him over only to discover he was dripping blood on the floor from his right hand. On closer inspection, he was missing three fingers.

Penetrating trauma--arrow in the left flank.

Three fingers! And it seemed as if he was not in any pain. Apparently, he was riding a motorbike, tried to avoid some donkeys in the road, and crashed. Motorbike injuries are extremely common here and usually result in a lot more severe injuries than his. Other peculiar things that I have seen in Casualty include drunk men recently trampled by elephants, men shot with arrows over cattle, and women and men struck repeatedly by pangas (machetes). Again, all I could think was “How in the world did that happen?!”

On a more positive note, I received a scripture last Sunday that I marinated on all week and would like to leave with you. It is from Matthew 25:14-30. It is a very familiar passage of scripture known as the parable of the talents. Its a story of man who was going on a journey and entrusted property to his 3 servants. “To one he gave five talents of money, to another two talents, and to another one talent, each according to his ability . . . The man who had received the five talents went at once and put his money to work and gained five more. So also, the one with two talents gained two more. But the man who had received the one talent went off, dug a hole in the ground and hid his master’s money.” The story does go on to say that when the man returned from his journey, he was able to say “Well done good and faithful servant” to the two servants who had multiplied their money. To the other servant who had hid his money, the man said, “You wicked lazy servant!” As is written in the red letters of the Bible, Jesus says, ” For everyone who has will be given more, and he will have an abundance. Whoever does not have, even what he has will be taken from him.” So I pose the question, what will you do with the talents that God has blessed you with?

Thank you for your continued prayers and encouragement. I miss you all dearly and will return to the states in approximately 3 weeks.

Peace and blessings,

Darrell

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