Troubling Day

Okay, Today has been a very interesting day.
A 10 month old boy who came in in severe respiratory distress. Although we don’t typically diagnose asthma at 10 months of age, that’s what his exam and chest x-ray really pointed to. We admitted him to the ICU and tried aggressive management, similarly to what I’d do in the US. He kept getting worse, to the point that we had to intubate him and place him a ventilator. I know before I told some of you we didn’t have vents, and that’s true for the little babies, but we do have ones for older infants and pediatric patients. The thing is vents aren’t my forte and they make me fairly nervous. But we got him stabilized that night. The problem is the medicines I have available here for an asthmatic on a vent are somewhat limited. I threw everything I could at him and did a lot of praying. As I told one friend, this is a very humbling and terrifying experience. Because last night I knew that he was completely in God’s hands. There was absolutely nothing else I could do for him. This morning he seemed to be doing better and I told the family that he was at least staying with us, but would have a lot of improving to do before we could get him off the vent. Late this afternoon I was emergently called to the ICU because his oxygen levels went way down. The entire ICU team was fantastic and we tried and tried, but it was like trying to push air through a straw into a vat of wet cement. Despite all of this his oxygen levels wouldn’t come back up and after what seemed like forever we had to stop because his exam was indicative of brain death. I think this has been the hardest death for me here, having to say everyone they had to stop because he was already with God was really difficult. The family didn’t blame me or seem angry, but grief doesn’t need an interpreter. I’ve talked with others who helped in his care and they all agree there isn’t anything else I could have done, but it still hurts. There is comfort knowing that God knows all of our days before we even live one and that all is according to his plan. Right now I just pray for His peace with accepting this death.
I know I keep promising tales of safari, but not tonight, I’m sorry. A group of us went last weekend and it was fantastic, but at this moment it almost feels like it was ages ago.
I am praying that I can continue to make a difference here and really make the most of the few days I have left. I’m on-call all this weekend, so please pray for a good rest tonight and wisdom during rounds and in the wee hours of the morning.
Missing you all…
Anne