consultation

He’s one year, one month old. Runny nose, watery eyes. He’s number 8. Mom is 40 years old, but looks much older. The mountains have not been kind to her old, worn-out body.

___

Can you go to the hospital? Can you drive the car? A patient needs a referral. We need to get more blood. Can you get us an x-ray?

Going to the hospital is always tremendously frustrating. Such a beautiful campus–a beautiful, thrumming, $5 million hive of activity, but with next to no efficiency. Do you really care about your patients? I know that some of you do. A Timorese doctor in Emergency. A Cuban doctor who chuckled at me for being such a stubborn disciple of Dr. Dan’s. A Nepalese woman in Maternity who’s impossibly hard to track down. A British surgeon who looks like a 21 year old professional SC2 player. I know all of your faces, but not all of your names. I know a few of your numbers, but none of your schedules. I wish that we could work together. I wish that we had an x-ray machine at the clinic. I wish you guys had a PCR machine too. I wish that there weren’t so many politics muddling things up. I wish that we could just focus on saving lives.

___

Registration takes forever. “We’re closed,” she says. She doesn’t seem like she’s in a good mood. But it’s only 10:45AM. We were specifically told to come in today. The specialist said so yesterday over the phone. We’re from the clinic.

I’m not some stupid high school dropout, you know. I’m a trained nurse. Even though I’m new here, don’t look down on me.

I don’t know why you’re telling me this. I haven’t even said anything to you. She’s so defensive.

We just want to get a referral, ma’am. That’s all we want. Thank you, ma’am. Okay, thank you.

___

Is this OPD? Is this where we go? I’ve only been to urology before. I don’t know if this is it.

___

There are other kids here, but our kid is special. He came all the way from the mountains–from hours away. He was here last year; he was only three days old. His file is huge, with x-rays and post-op exams. He’s so, so small. How has he been through so much already?

I reach out to poke him, and he grasps my finger. His grip is strong. His fingers are chubby. He smiles at me with those watery eyes—ears sticking out, hair swaying in the breeze.

“Hello, baby. Hello there, baby.”

___

“No, she’s not here yet. Her flight just landed,” they say. “She was a bit ambitious with her schedule. She’ll be a bit late.” From New Zealand, they tell me. A doctor who cares. We could use a doctor who cares—we’ve been waiting here for over an hour at this point.

___

“How old are you?” He replies with a blank stare. “What is your name?” He doesn’t understand. “Do you eat well? You have to eat well. Please eat well. I want you to live.”

I’m singing to him now. His mother rocks him in her sling. The music comes through my phone, soft and soothing. Nothing too loud, but loud enough to sing to. There are three other families here—three other families that have come to a consult. One baby has Hirschprungs. The other has polyps. They’re so damn cute. It’s such a damn shame.

I hope she arrives soon. I can’t sing forever. The longer I sit here, the sadder I get. The mom is sitting beside me, but the baby is slung facing away from me. I’m glad he can’t see my face. I’m not singing happy songs today. It feels like I’m singing a farewell.

___

She’s finally here. An enthusiastic, talkative, grey-haired woman. She’s wearing eyeliner, with a dab of blue by the tear ducts. Her energy is contagious; I shake her hand enthusiastically.

We take our seats, and she begins explaining the nutrition supplements. 24 bottles of 200mL each. They look like Frusion smoothies. 300 kcals per bottle, with four bottles per child. A bit of a bottle every few hours. Drink with a straw, or feed with a spoon. If you breastfeed, then breastfeed first. Do not stop breastfeeding. Do not wean yourself. If you start relying on the nutritional supplement, it won’t work. It’s very important that you don’t stop breastfeeding.

The Tetun rolls off my tongue. It’s been over six weeks, and I surprise even myself sometimes. The families stare at me as I instruct them how to take care of their children. They probably think I’m a doctor too.

___

“Are you from Ermera too?” No, no, I’m just here from the clinic.

“Are you a doctor?” No, I’m just a volunteer.

“Oh, that’s wonderful!” Well, I’m just here for my patient. I just want to make sure they’re okay. I just want to make sure they don’t get lost. I don’t mind staying, and I don’t mind translating for you. The other staff should translate too, though. They’re Timorese after all. This is their language, not mine. I’m just here to help.

___

We’ll come back on Monday. Well, they’ll come back on Monday. I go home in two days. I won’t see it happen. It’s okay, they’re admitted at the clinic. We’ll make special note for them to have plumpynut, since the mom needs nutrients too. Cassava. Water spinach. Corn. Rice. How do you live off of carbs and vegetables? He needs fat. He needs protein and fat. He needs to grow.

___

He doesn’t like the smoothie. The nutritional supplement must taste awful. I feel bad, because the mom is trying so hard. She tries to get him to feed, but he just cries and cries. At least he’s not vomiting. At least he’s responsive. Not like the other baby, the one who came in yesterday. We can’t let that happen again. We need to do better next time. We need to do our best. Because it’s our job. We volunteered to do this, not to have a vacation. I don’t know what I’m doing, but it’s still my job to do it. 

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