Monday

Six days you shall labor and do all your work,
but the seventh day is a Sabbath to the Lord your God.
Exodus 20:9,10

Each Monday, I fill in a blank grid to help me keep track of all the women on Salome Ward. With name, file number, diagnoses, medications, and pertinent lab results, I record their progress as we treat them.

During the week, as new patients are admitted and others are discharged, I fill in new entries and cross out old ones. Occasionally, a patient is transferred to the ICU or to the national hospital in Nairobi, and a few pass away from their illnesses.

We’ve been quite busy the last couple months, caring for around 20 very ill patients at a time, and this week we’re up close to 30. The diseases we’re currently managing on Salome are things I don’t deal with much in Snohomish, such as:

thrombocytopenia (very low platelet count) caused by HIV infection
severe anemia (some of the lowest numbers I’ve ever seen!)
stomach outlet obstruction due to cancer
pulmonary TB
TB meningitis
TB pericarditis
advanced AIDS
acute renal failure
gangrene of the foot, leg, or forearm due to diabetes
acute pancreatitis
cryptococcal meningitis
bacterial meningitis
acute pulmonary embolism

And more – it’s challenging work! Questions about the care of these conditions arise every day, so I’m often in our little hospital library, looking things up, finding answers. Though our internet connection is slow, I can sometimes find answers online – a huge help! And I frequently turn to the Kenyan interns and the other senior staff for help – their collective experience and wisdom is amazing!

These women are usually poor and often malnourished, so the burden of illness is high for them and their families. One woman with AIDS and multiple myeloma said this week that she is just tired of being sick and wants it to be over. We took time to pray with her and encourage her. I hope we can get her blood count up so she can return to Nairobi for more chemotherapy.

By the end of the week, the sheet is full and the folds are well-worn. The back is covered with notes about various medical topics as they came up during the week.

And Monday I’ll start a new grid.

- Doug