Yesterday, the head of our household died. She was a dynamic woman, loved and respected by all. There was a quick vigil in the afternoon and then people scattered, seemingly unfazed by the loss. Death is universally accepted and has become an integral part of normal life.
The hospital is no different. My patient who presented last week with the profound weight loss became increasingly ill a few nights ago. The nurse summoned the doctor on-call but he was unavailable. He had departed the hospital grounds to attend a funeral and would return when the services were completed. He said the sick child was in God’s hands and would recover if it was the Almighty’s wish. The inexperienced nurse attempted resuscitation, but the child promptly died. The mother was then instructed to proceed to billing, pay the ICU fees and then return to collect her child’s body. She did so in a business like fashion without saying a word.
The following day I arrived to another sick child. He was six weeks premature, was jaundiced and seemed to be getting more ill. I asked the mother to transfer the child to a nearby hospital for a slightly higher level of care. She pondered the idea but then stated that she could not afford the fees for the other facility. Ten dollars per day of hospitalization was not within her budget. She requested to stay in our neonatology unit and stated that she would pray for recovery. However, if god wanted him, she stated that was “OK”. We had no further therapy and I sat helpless at the bedside. He died hours later.
Today, I had a patient born seven weeks premature with underdeveloped lungs. I used a bag to give oxygen most of the morning but he became progressively worse. The medicines I use so often in the United States are not available. I struggled to keep him alive. I inserted a breathing tube, placed needles in his chest to evacuate air around his lungs, did chest compressions and gave intravenous fluid. Nothing worked and he died just after noon.
As I held the child’s lifeless body, the nursery atmosphere returned to normal within minutes. Everyone accepted the death and proceeded with their day. However, things were different for me. A feeling of overwhelming sadness rushed through my body and rendered me verbally incapacitated. I left the ICU and sought refuge in a small room adjacent to the hospital. Death has yet to become a normal part of my life.