One in the crowd...

It’s 4:30 pm. I paid another visit to ward 3. Unfortunately, for some bizarre reason, there is no one to do ward rounds. I tried to get someone to come up but everyone seems busy. It’s unfortunate for the 50+ patients. I can just imagine the uproar that would occur had these patients been on a ward in a hospital in my home country. Parents would have demanded for their children to be seen. But here, the parents seem to have no voice. It is so rare for a parent or caretaker to question the way things are done. Often I wish they would speak up just a little bit and maybe it would get staff moving more quickly. Mind you, with limited human resources (doctors and nurses) things are simply difficult.

Earlier in the afternoon when I was checking if rounds had been done, I recognized a mom and child from the outpatient clinic in Aberdeen. The little boy had been a patient of mine, so had his older brother. I remember them well. This little boy is now three years old and has been admitted for a few days. I am not sure why I hadn’t seen him at the hospital yet. I guess because I am not doing a whole lot of clinical work plus the hospital is packed with patients. Unfortunately he was quite pale and had already been transfused twice. I was worried about him and hoped he would be assessed soon.

By 4:30 pm the boy had not been seen. The only patients that had been seen were 6 children who were well enough to be discharged. I guess the nurses asked a doctor to see those patients to free up bed space for new patients. Worried that it was already 5:00 pm and the night shift had begun with only one doctor on call, I thought I better assess the patient with one of the nurses. By now he was worse. He was obviously unwell, being very pale, with cold extremities and some respiratory distress. Something needed to be done. Now.

Fortunately one of the more senior doctors happened to be the one starting night duty. I told her I wanted to transfer one of the patients down to the Emergency Room/ICU and she agreed. So down we went. Fortunately the ER was not too busy. The patient was seen quickly and blood was drawn. He had a hemoglobin of 4.5 g/dL. Unfortunately he had already been transfused twice since admission and so I knew it would be hard for the family to get yet another unit of blood from someone. The blood bank here is dependent on relatives donating a unit of blood for the patient. I decided I would take the forms to the blood bank myself and plead on the child’s behalf. Thankfully the child had a common blood group and there was a unit of blood in the fridge, ready to be given to a patient. Within about 20 minutes I returned to the Emergency Room with blood in hand.

When I left the Emergency Room at 6:00 pm the boy was receiving the blood. He had also been given a bolus of fluids and put on various medications. When I said bye to him he told me he wants to see his big brother. I sure hope he can see his big brother soon. I hope I see him again tomorrow, improving.

I don’t want to take credit, and I am very thankful to the doctors and nurses who helped with this patient, but I cannot help but think that he would have died tonight had I not picked this very sick boy out of the crowd and transferred down to the Emergency Room. I am sure that I would have gone to work in the morning and heard he had passed away in the night. And that would have been that. I certainly hope the outcome will be different. I hope this little boy really can see his big brother soon. I'm a little anxious about what news the morning will bring...

Note from Wednesday 4:00 pm: I found out today that this little boy passed away at midnight. I'm speechless.