Not all days can be great and today was supposed to be one of them. I was scheduled to travel to a warehouse 90 minutes away and conduct an inventory of their new medicines from the WHO. I am unsure if I could create a more boring job description if I tried, but I do what I am asked.
Before traveling to the warehouse, I stopped by the local health facility for one last goodbye. The medical director asked me to give a parting lecture. I excitedly thought of a topic and decided to make a game. I would pick two practitioners from the audience and have them sit at the front of the room. I would then present a quick pediatric emergency case and asked them questions. The winner would get a prize!
The first case involved intussusception, an intestinal emergency. Two physician assistants immediately volunteered. I asked questions and they eagerly answered. Sometimes they were completely off target and the room erupted in laughter. Other times, they were perfect.
At the end, we had a vote of who won. There was a heated debate and we determined it was a tie. When I handed both participants a bottle of soda, there was a collective groan among the crowd. They all wanted a drink too.
I presented two more cases with the same response. It was a fun, exciting way to start the day.
As I was leaving the facility, I received an urgent phone call from the County Health Director. She wanted me to consult on a “very sick” patient who happened to be in the same town as the warehouse with the WHO medicine. I grabbed my driver and raced off.
When I arrived at the hospital, I was greeted by the maternity staff with open arms. They showed me a newborn with an abdominal wall defect called an omphalocele. His guts were in a clear sac outside of his body. I talked the team through his treatment options and the likely outcome of each plan.
As I was preparing to leave, the midwife asked me to consult on two more neonates. One had a horrible skin infection over his entire body and the other had a neurologic abnormality. We spent an hour discussing the cases and the staff had many good questions.
As we were winding down, the pediatric nurse shyly approached me and asked, “can you see another one?”
When I walked in the door of the pediatric room, I found a tiny, completely lethargic five month-old girl on the bed breathing at a lightning fast pace. After a quick history and exam, it was obvious the patient was in shock, likely hypovolemic. I told the nurse “I do not have a Liberian medical license, but if you want to keep this patient alive I would…”
I wrote a detailed road map for the treatment of shock. It was a lot of “if this, then do this”. After an hour, the patient was looking better.
As I left the hospital for the warehouse, I was on an emotional high. I remembered what it was like to love my job and not count down the hours of the day. If I didn’t know it before, teaching medicine and caring for patients is my passion.