A strange 24 hours

At noon, I sat down in the internet room of Heal Africa to prepare a presentation on mechanical ventilation. Just as I was collecting my thoughts, I was approached by a visiting physician asking for assistance on a difficult case.

Three days prior, a Canadian volunteer was visiting a local “zoo” housing caged chimpanzees. She was perusing the grounds when one of the large animals reached out of the cage and pulled at her left arm. He began biting and tearing at her flesh. She fought valiantly and eventually freed herself.

When I visited her room, she had a fever and looked very ill. She had lost a tremendous amount of blood during the attack and was extremely weak. I then saw horrifying images of her left arm taken directly after the attack. There were a few pieces of skin or flesh attached to fragments of broken bone.

We decided quickly that she needed immediate evacuation. The first organization we contacted was the United Nations. Joe, the director of Heal Africa, and I quickly drove to their local hospital. They were cordial and seemed slightly concerned. However, after nearly 45 minutes, they said a meeting would be arranged regarding the case and that a decision would be rendered within two to three days. My only thought was “F*** Y**!!”

We immediately returned to the hospital. Our options with the Canadian embassy had run dry and we were approaching 2 pm. We decided to transport the patient to Rwanda by land. Loran, Lisa and I quickly returned to our apartment to grab a change of clothes, passports and money.

We returned to the hospital just before 3 pm and prepared for the ride. The patient was placed on a stretcher and a large group of onlookers assisted us in placing her in the back of a rundown SUV.

The ride to Kigali was long. Enormous potholes jostled the vehicle to and fro, and pouring rain alternating with thick fog slowed our speed. Loran, Lisa and I shared the duties of holding the IV bag and securing the patient over the bumps.

As the drive progressed, we were able to learn more about our patient. She is a sweet, caring, friendly woman with a healthy sense of humor and an unforgettable laugh. Her emotional strength and her zest for life are inspirational.

We arrived at King Faisal Hospital in Kigali well after dark. We were greeted at the emergency room by a supportive representative from the Canadian embassy and a wonderful, competent and confident hospital staff (This is a story for another time). Our patient received antibiotics, fluids and a full evaluation by the ED physician, general surgeon and orthopedic specialist within the first hour. Soon after, she was scheduled for the operating room for wound exploration.

We said our goodbyes just after 10 pm and we were driven to Chez Lando, a local hotel. We ate a quick dinner at a local bar and all settled in for the night.

Early the following morning we headed to a wonderful buffet. I collected an assortment of fruit, an omelet and a glass of juice. Just as I sat down, a 27 year-old French man at the adjacent table slumped in to his plate and started shaking. Lisa, Loran and I jumped up and, with the assistance of the entire staff, placed him on the floor. He was pale, sweaty, febrile and tachycardic. After a few minutes, he began to slowly regain consciousness and was able to answer simple questions.

We quickly carried him out to a waiting taxi. I squeezed in to the back with the patient and the patient’s friend sat in front. After we closed the doors, the patient worsened and again became unresponsive. I asked the cab driver to leave immediately, but he continued negotiating with the hotel staff. I lost my cool at that point and yelled at the top of my lungs, “Drive the car now”. The chauffeur got the point and, within minutes, we arrived at the King Faisal Hospital.

To keep a long story short, the second patient had untreated pyelonephritis for multiple days and became septic. He was started on antibiotics and is now doing well.

Just before ten, I visited my new Canadian friend with the bite wounds. She was tired from a long night of surgery, but we had a nice conversation.

At noon I returned to the hotel and had a long nap.


2 Responses to “A strange 24 hours”

  1. Parke Says:

    Man, what a day!

    Thanks for the terrific blog. Terse and exciting.

  2. Kathy Otterson (Kennedy) Says:

    I love this blog. mike sent it to me and I have put my book down to start from the beginning. I am heading to bed now, but this last entry reminded me of some “Africa” advice. In Africa, the only thing they DON’T run out of…….is time. (more for border crossings…but as horrific as it sounds…seemd appropriate here). I look forward to your next few months of blogging…and for as long as you stay on the road! good luck!

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