Life as a bush doctor is nothing if not exciting.
For years I was the only doctor at our 100-bed mission hospital in northeastern Ghana. And for years there were times when I was as busy as a one-armed paper hanger and as anxious as an old alley cat in a room full of rocking chairs. Having a colleague to share call is a blessing above the price of rubies. But sometimes there are still nights when it’s déjà vu all over again, to quote the famous baseball player Mickey Mantle.
So last Friday night I was on duty when I got the phone call from one ward.
A little old lady had just died from pneumonia and they wanted me to come pronounce the patient. As I was about to leave for the hospital, Dr. Sulemana, my Ghanaian colleague, called to inform me that a middle-aged man had just been admitted after a toxic exposure to herbicide while spraying them on his crops. This poor fellow was now semi-comatose and seizing and had inhaled some of his vomit. I pronounced the lady and handled the paperwork and then moved to the male ward. Our poor patient was still seizing and required more phenobarbital. One dose of phenobarbital later, the patient was better, and I headed for the Kids Ward, just to check on things.
As I arrived at the Kids Ward, the nurses on duty gave me grateful relieved looks.
This is a bad sign! When the nurses look at you longingly as you walk in the door, you are definitely in trouble! One child was very pale and had been receiving blood; however, his IV had blocked twice, leaving him without a line. This child turned into a vein-less wonder. He had NOTHING left in his arms! We shaved both sides of his head, giving him a slightly lop-sided mohawk haircut. Several cannulas later, we got a line…but the blood had been sent back to the lab a few hours earlier. We sent the dad to collect the blood. 20 minutes later, when the dad had not yet returned, I went to the lab myself. Surprise! The lab was locked. One quick phone call later, the lab man on–call came to open the lab and give the man the blood. The line didn’t run well, but the nurses were able to squeeze the blood into the kid.
Meanwhile, there was a new problem.
Two months earlier, we had transfused a young pregnant lady from Chereponi, 35 miles north of us. Finding blood was a major problem because the patient had O Negative blood, and we had advised her to follow up closely with the Chereponi Hospital and to stay on drugs to build up her blood. She did neither. Friday she went to Chereponi, where they found that A) she was severely anemic and that B) they had no O Negative blood donors. Suddenly this young lady turned up in our Outpatient Department, pale, panting, and near collapse. Oh, and she was also in congestive heart failure from her anemia. Unfortunately, all of our O Negative donors had donated recently and we had no blood available. Not only did we not have any blood available, but Yendi Government Hospital, the next hospital up the line, had no O Negative blood either! And our roads were in wretched shape due to heavy rains. All we could do was to load this lady into a pickup truck, send her to Tamale, our regional capital, 110 miles away, and pray.
And then a new problem popped up!
I was in the midst of telephone tag, trying to find a hospital in Tamale that could give this lady blood when I got a call from the MIDWIFE ON DUTY! A lady with twins had just come in in active labor, and the midwife was concerned about the delivery. That’s when I gave up and called my colleague, Dr. Samuel Sulemana for help!
Follow- up three days later:
The PPL (Pale Pregnant Lady) actually made it to Tamale, but she lost her baby and retained her placenta. After 3 pints of blood they were able to remove the placenta, but she remains in ICU due to the heart failure. The twins arrived safely (Thank you, Dr. Sulemana! ) and we got the blood into the little boy and he went home yesterday. In addition, yesterday morning, our herbicide poisoning woke up and demanded food, although today he was hallucinating-something he has never done before. It remains to be seen what kinds of problems he will have in the long run.
So goes the life of a bush doctor. There are nights when nothing happens, but sometimes you hit one gaudy, gaudy night!