What you need to know:
- Nothing makes one prouder than the moment their name appears on the list of newly qualified doctors.
- That feeling after the final year medical school examination results are posted by the dean to make the announcement.
- It is with this naive confidence that we are sent out into the world.
- We think we are going to stop death, relieve suffering and put a smile to every face that walks through the hospital doors.
Two weeks ago, in an effort to make a point that I would like to presume was important, a governor came across as callous. Yet despite the public uproar, the good governor had a point that medical professionals never really want to talk about.
Nothing makes one prouder than the moment their name appears on the list of newly qualified doctors. That feeling after the final year medical school examination results are posted by the dean to make the announcement.
The sacred moment when the lot takes their Hippocratic oath to serve humanity without discrimination is far more important than the actual graduation ceremony.
It is with this naive confidence that we are sent out into the world and we think we are going to stop death, relieve suffering and put a smile to every face that walks through the hospital doors.
What a rude awakening when it pans out rather differently.
My rude awakening was barely eight weeks into my very first rotation, the paediatrics department. I thought I had seen it all until this one night when my ward was on call to admit all new patients. It was a freezing cold night with incessant showers. The ward was stuffy with the windows tightly shut.
To say the ward was chaotic is an understatement. The babies were coming up from the paediatric outpatient department in droves.
The porter was escorting them in every 30 minutes in sets of five and he kept at it all night until the wee hours. They would arrive hungry, cranky and sleepy, accompanied by exhausted parents who were wondering if their babies would make it back home.
This was the terror that Wanjugu* was facing. Her five-month-old angel was in the acute room fighting for her life. Severe pneumonia was ravaging her little lungs and she was having great trouble breathing. Her oxygen saturations were in the red and she was already on oxygen support but it was not good enough.
I dropped everything and activated the drill. I took blood samples from her to the intensive care unit (ICU) laboratory to evaluate her oxygenation status. The results were worse than I had anticipated. The little angel needed an ICU bed and this was the worst possible day to need one.
The hospital was holding its annual open heart surgery camp. This meant every patient from surgery required observation in ICU for a while.
Even worse, the ICU was under renovation and dismantling it meant that the patients were scattered across various wards which were donating a room each to set up temporary ICU fragments in an effort to ensure continued care.
The intensivist on call at night, Dr Kerema, spent his time traversing the floors to check up on his patients. Therefore, catching up with him was hard. I waylaid him in the lifts and diverted him to my ward to see my patient. He categorically stated that he had no free bed for her but he would add her to the ICU wait list.
In my naivety, all I wanted was to emotionally blackmail Dr Kerema into prioritising my little patient on his wait list. I thought that maybe, just maybe, if he saw her ethereal beauty, her midnight black shock of curls on the head, he would be moved to want to prioritise her. I was out of options, clinging to hope by a thread.
Crying her heart out
Dr Kerema saw through my desperation but remained gracious. He promised to do all he could to help, but warned me not to raise my expectations; to keep it below ground level.
I kept Wanjugu in the loop but I was cautious not to raise her hopes. We were in for a long night. There is nothing more heartbreaking than watching an infant struggle to draw in a measly 40 milliliters of oxygen to keep her alive.
By 3 o’clock I could not wait any longer. I walked around the freezing corridors looking for Dr Kerema. When I finally found him, he had good news for me.
A patient had been transferred out to the high dependency unit and the nurses were preparing for my little patient. I did not have the patience to wait for the call from my ward. I hounded the ICU team until they called my ward to ask for the transfer.
I sprinted down the stairs, two at a time, to break the good news to Wanjugu. I was not prepared for what I found. The little one was flat out on her back with resuscitation ongoing. Wanjugu was on the bench right outside crying her heart out.
I found myself shouting there was a free bed, but no one heard me. My senior colleague was in charge of the resuscitation with great efficiency but 30 minutes later, she had to call it off and declare the dreaded time of death.
I found a corner to heave my heart out in private. I realised this topic was not included in the medical school syllabus. So yes, when the governor said that patients had to wait for others to die in order to secure a bed, he was not being cruel, he was only lacking in grammatical etiquette.