The Heart-Ache
At the start of the shift there were 12 pending cesarean sections. Two patients had three previous uterine scars and were now fully dilated and pushing against their weak uterus. A first time mom had been pushing for five hours- the fetus had a face presentation and was stuck deep in her pelvis. Two women had severe vaginal bleeding with the clinical diagnosis of placental abruption. No doctor was in sight. Thanks to a great team, we worked fast and efficiently, triaging the patients as quickly as possible and begging the nurses to open a second operating table. One uterus ruptured but the mom and baby were saved. So far, so good.
At the peak of the chaos, the intern comes to get me from admission. He has a patient who is 36 weeks pregnant, has severe pre-eclampsia, asthma, and HIV. She came in holding the left side of her chest crying of severe crushing pain. I happened to have nitroglycerin tabs on me. Her pain was relieved for 5 minutes and then returned with a vengeance. I gave her another tab. Her heart wasn't getting enough oxygen. I listened to her abdomen- the baby still had a heart beat.
She needed a STAT EKG. The patient was crying from the pain, now breathing rapidly and in acute distress. I was told that in order to get this simple test, she had to go down four floors to the cardiac department and pay 50,000 Shillings ($20). When she heard this, she said “I have no money. I’ve been waiting to be seen for two days and I haven’t eaten. I’m all alone. There is nobody with me.” I gave her the money for the EKG and a nurse quickly wheeled her down to the cardiac unit.
Fifteen minutes later she was back in triage still grasping her chest. “The results?” I asked. The nurse responded “They wanted 70,000 Shillings so they refused to do the EKG.”
The patient’s heart was dying. Nobody seemed to care. How did these health care providers get to the point were they no longer see value in human life? I can't imagine what they must have to make them so disconnected from their brothers and sisters.
The more I experience of this system, the more my own heart hurts.
At the start of the shift there were 12 pending cesarean sections. Two patients had three previous uterine scars and were now fully dilated and pushing against their weak uterus. A first time mom had been pushing for five hours- the fetus had a face presentation and was stuck deep in her pelvis. Two women had severe vaginal bleeding with the clinical diagnosis of placental abruption. No doctor was in sight. Thanks to a great team, we worked fast and efficiently, triaging the patients as quickly as possible and begging the nurses to open a second operating table. One uterus ruptured but the mom and baby were saved. So far, so good.
At the peak of the chaos, the intern comes to get me from admission. He has a patient who is 36 weeks pregnant, has severe pre-eclampsia, asthma, and HIV. She came in holding the left side of her chest crying of severe crushing pain. I happened to have nitroglycerin tabs on me. Her pain was relieved for 5 minutes and then returned with a vengeance. I gave her another tab. Her heart wasn't getting enough oxygen. I listened to her abdomen- the baby still had a heart beat.
She needed a STAT EKG. The patient was crying from the pain, now breathing rapidly and in acute distress. I was told that in order to get this simple test, she had to go down four floors to the cardiac department and pay 50,000 Shillings ($20). When she heard this, she said “I have no money. I’ve been waiting to be seen for two days and I haven’t eaten. I’m all alone. There is nobody with me.” I gave her the money for the EKG and a nurse quickly wheeled her down to the cardiac unit.
Fifteen minutes later she was back in triage still grasping her chest. “The results?” I asked. The nurse responded “They wanted 70,000 Shillings so they refused to do the EKG.”
The patient’s heart was dying. Nobody seemed to care. How did these health care providers get to the point were they no longer see value in human life? I can't imagine what they must have to make them so disconnected from their brothers and sisters.
The more I experience of this system, the more my own heart hurts.