Fear not, for I am with you;
be not dismayed, for I am your God;
I will strengthen you, I will help you,
I will uphold you with my righteous right hand.
Isaiah 41:10
be not dismayed, for I am your God;
I will strengthen you, I will help you,
I will uphold you with my righteous right hand.
Isaiah 41:10
I had my first night on call last week. Dr. Charlie Besley, the Medical Director, had been merciful in allowing me 2 or 3 weeks to get acquainted with the hospital before I took 
call. So Friday was my first night. I would be responsible for pediatrics, internal medicine, ICU, newborn ICU, and Casualty (“ER” in America). Everything but obstetrics and surgery.
Bob Carter, another family physician, graciously gave me an afternoon orientation as to what I might expect. Gary Finke assured me that there were no pressing issues in pediatrics. I went up to ICU, where LeeAnn Finke went over each patient individually, and gave me a quick rundown on how to manage the ventilators. LeeAnn spends her entire day there, managing these very sick and complex patients; I silently prayed that she’d done such a good job that day that the nurses wouldn’t have to call me. Three patients were being ventilated, and the other two were close to needing it. I think the last time I managed a ventilator was in 1984 – goodness!
Then I walked down to newborn ICU, where Stephany Hawk spends her entire day managing a cluster of tiny newborns clinging to life. A couple of them weigh all of 800 or 900 grams, and another is recovering from his initial surgery for gastroschisis – he’d been born with his intestines spilling out of his abdomen. There would be a hemoglobin report later in the evening for another newborn who had received a blood transfusion in the afternoon. The newborn ICU is an intimidating place, where the temperature is kept at 85° for the benefit of the newborns, and where some babies miraculously survive and grow, and others just don’t. I admire Stephany and the others who serve there.
Casualty was very busy on a Friday afternoon, but the interns and Clinical Officers would handle things, calling me when necessary. So with two pagers on my belt, and feeling rather overwhelmed with it all, I walked home to change into greens and await my first call. We’d been invited to go with some others to Mama Chiku’s, a local restaurant. At home we’d call it a dive, but here it’s our restaurant – Kathy and I were going to nickname it Anthony’s, but we think Denny’s would be a better fit. (You won’t find a health certificate posted, and you might have to swat a cockroach off your table.) My stomach was in knots, so I told Kathy to go on without me, and I’d stay by the phone.
Funny thing – the pagers were quiet for quite a while, because someone had forgotten to post my pager number! Bob finally called and we got that straightened out. Rachel, our Kenyan intern in Casualty, called me several times for help with some sick patients. I went up and helped her out, reviewing a chest Xray and helping her manage a child with a seizure, an old man with heart failure, and a woman with AIDS and painful genital sores.
A nurse in the newborn ICU called; the baby's hemoglobin was satisfactory. I’m glad the newborns remained stable through the night – I told Stephany next morning that I’d kept all her babies alive and well overnight!
I was summoned once to the adult ICU, where a tragedy was unfolding. A 12 year old girl had come in from western Kenya, with a longstanding problem with her chest. Kijabe was the last resort for her family. The surgeons had removed an enormous tumor – called a hamartoma – which had filled the left side of her chest. She had suffered a brief cardiac arrest after surgery, and wasn’t doing well in the ICU. The nurses were concerned about her increased respiratory effort, but with a little repositioning, she settled down. The troubling thing was that as I observed her, she began to extend her arms and legs in a fashion that indicates severe, global brain damage. LeeAnn would be facing some tough decisions in the morning, for this unfortunate young girl.
After that, I got to sleep and the rest of the night was quiet. I was glad to pass off the call responsibility in the morning, and was thankful that for my first night, there had been no catastrophes and no ventilators to fiddle with. There will be more nights on call, and more complex situations to handle in the future. Kijabe has given me many challenges, and there will be more to come. I am grateful for the offers of support from the other medical staff, and glad that the Lord will be there, walking with me.
- Doug
call. So Friday was my first night. I would be responsible for pediatrics, internal medicine, ICU, newborn ICU, and Casualty (“ER” in America). Everything but obstetrics and surgery.Bob Carter, another family physician, graciously gave me an afternoon orientation as to what I might expect. Gary Finke assured me that there were no pressing issues in pediatrics. I went up to ICU, where LeeAnn Finke went over each patient individually, and gave me a quick rundown on how to manage the ventilators. LeeAnn spends her entire day there, managing these very sick and complex patients; I silently prayed that she’d done such a good job that day that the nurses wouldn’t have to call me. Three patients were being ventilated, and the other two were close to needing it. I think the last time I managed a ventilator was in 1984 – goodness!
Then I walked down to newborn ICU, where Stephany Hawk spends her entire day managing a cluster of tiny newborns clinging to life. A couple of them weigh all of 800 or 900 grams, and another is recovering from his initial surgery for gastroschisis – he’d been born with his intestines spilling out of his abdomen. There would be a hemoglobin report later in the evening for another newborn who had received a blood transfusion in the afternoon. The newborn ICU is an intimidating place, where the temperature is kept at 85° for the benefit of the newborns, and where some babies miraculously survive and grow, and others just don’t. I admire Stephany and the others who serve there.
Casualty was very busy on a Friday afternoon, but the interns and Clinical Officers would handle things, calling me when necessary. So with two pagers on my belt, and feeling rather overwhelmed with it all, I walked home to change into greens and await my first call. We’d been invited to go with some others to Mama Chiku’s, a local restaurant. At home we’d call it a dive, but here it’s our restaurant – Kathy and I were going to nickname it Anthony’s, but we think Denny’s would be a better fit. (You won’t find a health certificate posted, and you might have to swat a cockroach off your table.) My stomach was in knots, so I told Kathy to go on without me, and I’d stay by the phone.
Funny thing – the pagers were quiet for quite a while, because someone had forgotten to post my pager number! Bob finally called and we got that straightened out. Rachel, our Kenyan intern in Casualty, called me several times for help with some sick patients. I went up and helped her out, reviewing a chest Xray and helping her manage a child with a seizure, an old man with heart failure, and a woman with AIDS and painful genital sores.
A nurse in the newborn ICU called; the baby's hemoglobin was satisfactory. I’m glad the newborns remained stable through the night – I told Stephany next morning that I’d kept all her babies alive and well overnight!
I was summoned once to the adult ICU, where a tragedy was unfolding. A 12 year old girl had come in from western Kenya, with a longstanding problem with her chest. Kijabe was the last resort for her family. The surgeons had removed an enormous tumor – called a hamartoma – which had filled the left side of her chest. She had suffered a brief cardiac arrest after surgery, and wasn’t doing well in the ICU. The nurses were concerned about her increased respiratory effort, but with a little repositioning, she settled down. The troubling thing was that as I observed her, she began to extend her arms and legs in a fashion that indicates severe, global brain damage. LeeAnn would be facing some tough decisions in the morning, for this unfortunate young girl.
After that, I got to sleep and the rest of the night was quiet. I was glad to pass off the call responsibility in the morning, and was thankful that for my first night, there had been no catastrophes and no ventilators to fiddle with. There will be more nights on call, and more complex situations to handle in the future. Kijabe has given me many challenges, and there will be more to come. I am grateful for the offers of support from the other medical staff, and glad that the Lord will be there, walking with me.
- Doug
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