Baby boomers

The welcome home party.

I say it is good to be back, however, it has felt a little as if I have had my head dunked in an icy bucket of water and been rudely awoken to the everyday realities of work in rural South Africa. I felt a little “acopic” at the start of the week with the prospect of having to govern the medical and paediatric ward as well as being the second on duty for maternity. We are trying, but really all we are doing is treading water; dousing the fire.

Why such a step back, when things were so good before I went on leave? Firstly, my esteemed colleague Jelleke handed in her notice after two years of dedicated hard work. She has only been gone a week, but the hospital misses her dearly. I miss her too, as now I don’t really have anyone to sit down and unwind with for a beer or cup of tea after work. I cannot blame her though, without a family or any real ties, it is difficult to work somewhere so far out for so long. Hence, I think I will be following her in the New Year. Secondly, our Dutch couple, who have transformed paediatrics and maternity, are on a well deserved holiday. So, in two weeks, when they’re back, I hope we can start to put the fire out, for a short while anyway.

This old guy couln't pass urine - I popped the ultrasound on his bladder and saw this big old mass in his bladder.



***

So, here I am: back at Holy Cross and on call for my first weekend. September is baby season following all the festive fun and frolics last December. Maternity still scares the living daylights out of me. I have never actually done a job in obstetrics and what I know on the topic has been conjured from a combination of reading, sapping knowledge from colleagues and a very small amount of improvisation.



Babies sharing the sole incubator after being a
 bit lazy to breathe and needing a little help.



Last night I resuscitated three neonates. All of them had managed to get in a bit of a pickle and decided that they weren’t going to breath. Fortunately, we managed to inflate a bit of life into the first two and they were happily feeding by the time I came to review them a few hours later. The third and last baby really tried my nerve. I was in casualty and summoned to maternity after being told: “...the baby isn’t breathing.” I ran. I don’t often run at Holy Cross; rarely is there anything that urgent that cannot wait an extra minute while I walk and compose myself. A baby not breathing, however, that needs a little exercise. To my joy when I arrived, the midwives were bagging (giving breaths with a bag and mask) the neonate – in previous times I have found nurses endlessly suctioning the airway, which isn’t much good. I think we have Femke, one half of the Dutch couple, to thank for that. She has spent months trying to instil the importance of neonatal resuscitation in maternity. I digress. To my dismay, the baby was blue, floppy and not breathing. We continued to breathe for the baby and even put a tube in his windpipe to make this easier. After twenty minutes, with the baby only making infrequent gasps, we stopped. 

After this, I do not know what happened. We brought the baby to the mother and explained the graveness of the situation. Then, as if that maternal touch has some healing powers, the bubba started to wake up. I will admit, I was rather bleary eyed during the whole procedure and maybe the baby was taking very shallow breaths, but still, these neonates, they’re tough little critters. I checked on him this morning, and he was looking well. I wonder how his future will turn out.

***

After two months of neglect I would have thought that my tomatoes would be goners. On the contrary, what is left of my vegetable patch are thirty or so big green juicy fruits ready and waiting to turn red. I’m getting about four a day. Doesn’t that keep the cancer away?

***

The new facial hair has received a mixed reception by my colleagues. For a brief moment, before news spread of my return, a surprising number of staff thought that I was a new doctor. To be honest, I think it is a pretty nasty scraggy piece of scruff, but it has provided me with a lot of entertainment and the names I have been called makes me giggle:  “Hey doc, you look like Jesus;” “Hey doc, you look a Jew,” (another Jesus reference I believe); “Ha, it’s Chuck Norris;” “Are you a Hindu now?;” “Barely recognise you with the Robinson Crusoe look.” I cannot decide whether to grow it out until Christmas – I have visions of dressing up as Santa Clause in paediatrics, but I’m not sure if I have the staying power.



 

This is the young lady with Steven-Johnson's
 Syndrome that I mentioned in previous posts.
 I forgot to upload her photo - bar some scars,
she was happy as larry.



This young guy has shingles affecting his forehead and is at a high risk of damaging his eye without the correct treatment. Unfortunately, our pharmacy is closed on the weekend and the medication he requires won't be available until Monday so we shall have to keep our fingers crossed. It is likely he is also immuno-compromised.