Wednesday, October 31, 2007
Tuesday, October 30, 2007
We arrived at the village to find a swarm of people waiting for us. Within minutes of our arrival a torrential rain started, leaving us ankle deep in mud and water and little dry place to set up our examining tables, pharmacy, registration, glasses, and spiritual counseling. But as always we were able to adjust and within an hour we began seeing patients.
By 11 a.m. the drama began.
Kelly our main missionary here, was said to be sitting in the van cooling-off and not feeling well. I went to check on him and found him to be extremely pale, diaphoretic, and slightly incoherent. With backup called, a blood pressure of 80/30 was recorded and I quickly put in a large bore IV and ran 1 L of fluid in as fast as I could. We transported him to the hotel bypassing hospitals as it is said that one goes go to hospitals only to die here in Cambodia. At the hotel with the team now back at the village seeing more patients, I gave Kelly two more liters of fluid and watched him closely. By the time the team returned from seeing about 170 patients for the day, Kelly was feeling better but now complaining of indigestion. It was that very word "indigestion" that was of concern. By now it was clear that we had to move Kelly to a higher level of medical care. But first I needed an ECG. The first hospital we tried sent us away telling us they did not have an ECG machine despite the fact that they were a trauma hospital. We drove into town and found a roadside medical clinic and we rescued in old ECG machine. The primitive ECG that I was able to obtain showed significant and concerning changes. It was clear that we had to move Kelly to Phnom Penh. At 9:30 at night we began the four and a half hour drive in torrential rain to Phnom Penh in order to get Kelly and his wife on an airplane in the morning for Bangkok. By early morning Kelly and his wife were on their way to Bangkok and I tried to get the MAF airplane to fly to Battambang, but it was down for maintenance. So another 4 1/2 hour ride by taxi this time back to Battambang to meet the team for the rest of the day's clinic. We wound up seeing 350 patients today. I just heard from Kelly who confirms that there is a strong probability that he has had a small MI and he is scheduled for a stress test in the morning and that he is doing well and in good care. Grace was with Kelly and still is. There is always grace from He who leads us and directs all that we experience.
But there is another part to the story. This afternoon I saw a 41 year old man with complaints of a fast heart rate for over a year and a 30 pound weight loss over the last two years. He was extremely cachectic, anxious, and sick. His heart rate was 125 and his blood pressure was 160/110. He said he had seen 2 doctors in the past, both of whom said that he had heart problems and that they would not do anything for him since he had no money and told him to go away and that he would die soon. He had no family and lived alone and came to us for reassurance and help. This man was no different than Kelly, entitled to the best care available and an opportunity for cure. But because of what he was, a poor man, he was denied that which is a simple right: compassion. I started him on medication and arranged for weekly follow-ups with the hopes of finding a way to get him the care that he needs. And for all that I'm embarrassed to say that I pretended to be better than those two other doctors simply because I gave him some medication.
I am not a god in a white coat, and for me, kindness and compassion has not come easily. There are many definitions of grace and for me its definition came one afternoon as I cared for a young child in the intensive care unit: grace means simply moments and gifts of kindness. Both Kelly and this man received grace today. But the thing that's missing the most is what happens because of that grace. Kelly will get better because of grace. That man, despite grace, will more than likely die. As I watched him walk away, I saw his hand clutch the medicine he was given and look back just once, before he disappeared. I caught his eye, and gave him a smile, but he looked away. Grace. Moments and gifts of kindness. I pray that where ever he goes that grace goes with him. May kindness and compassion be with him always.
In all things give thanks,
Sunday, October 28, 2007
And of course,there is always a story or two. She is 24 years old, shy, and quiet. I saw her for complaints of headache and menstrual cramps, but knew that there was more to what she was telling me. With a little coaxing, Chhaiden my interpetor and medical student, got her to tell us why she really was there: she had been diagnosed with leukemia 2 years ago, and she was waiting to die. She wanted to know if her death was going to be painful, and if it was going to take much longer. I looked at her and thought no way she has leukemia. She was healthy, not anemic, and had lived 2 years with a diagnosis that kills within months without treatment. In questioning her more, she said that she had had a blood test that showed more white cells than red cells and they said she had leukemia and that there was nothing anyone could do. It had to have been a lab error, or a mis-interpretion of the values. She had lived for 2 years waiting for the end. I assured her that she did not have leukemia, and that she would live a long time. She simply said thank you, smiled, and walked away. I watched her as she went to get her vitamins and some ibuprofen for her menstrual cramps that I had prescribed, no emotion showing in her walk or face. You would think that the news I just gave here would have been joyous news, but after 2 years of waiting to die, I guess one has to take time to accept that life will be around for a while. I wonder if she was a little disappointed. Perhaps she had prepared herself, and now she has to look further down the road to a life that may not be much better than the death she had been expecting. Living in Cambodia is not for the faint of heart. She was ready for death. For you see, she had with her as well, a letter to her mother and father that she was going to give to us to pass on to them when she died. As she walked away, the letter that was clutched in her hand, disappeared into a trash bin and I wondered what she said in that leter to her parents. But on the other hand, I'm glad that they will never have to find out. Not for a long time at least, if ever...
In all things, give thanks,
Saturday, October 27, 2007
We all make it to Phnom Phen, meeting at the airport, and finding Kelly (boy) and Mark Larson, 2 of the missionarys that we will be working with. Luggage makes it, everyone is tired, and it begins to rain. The end of monsoon coincides with our visit.
We check in to the Sunway Hotel which is right across the street from the American Embassy. A short period of rest and a shower, and we regroup for a team meeting with dinner at our favorite restaraunt, the Rendevous. The week ahead of us is full. After looking at the places we'll be going to, we may be seeing over 2000 paitents. The four of us who are medical look at each other and wonder how we're going to manage that. It is clear that the members who came to do some construciton may be working with the medcial team alot more than expected. Here's what is planned:
Sunday: Chruch in the am and clinic for church members in the afternoon: 125-150 patients
Monday: Dambok Kpus village - about 40 minutes by car, isolated, no electricity, bamboo huts: 400 patients
Tuesday and Wednesday morning: Prey Dach school and village: 700 patients
Wednesday afternoon: Salaa Hope school: 160 patients
Thursday: Ang school: 600-700 patients
Friday morning: Battambang AOG school: 50 students
Friday afternoon: flight back to Phnom Pehn
Saturday, Day 2:
The weather is overcast, with a hard rain during the night. I get on the internet and check the aviation weather for our area, and the airprots we'll be flying out of and to. The weather is marginal, but doable. I call Emil our MAF pilot and he has already flown to a pat of Cambodia in the morning and says that our flights today are doable. Becasue of weight limitations on the airplane, 2 members have to drive to BB: Mike and Tim. The rest are going to fly: 5 on each flight. I fly the first flight with a new MAF pilot from Australia, Paul, and we leave a little late. He is kind enough to let me do the flying, and off we go. The ceilings are at 2000 feet so I "scud run" the whole flight: flying just below the clouds. I flew at 1500 feet which gave us a great view of the country side. I skirted severeal heavy rain cells, and climbed once to get over a mountain ridge, but overall, it went well. The second half of the team came later in the afternoon.
We arrive at the clinic at Salaa Hope school to find members of the school and villages bagging meds. The next 5 hours is chaotic organization, with counting pills, labeling, bagggies, putting pills in baggies, sorting, and packaging. We ended up with over 26 suitcases, and rolling cargo cases of meds. By 3 in the afternoon, over 30 people were working on getting the meds ready for our first clinic in less than 16 hours.
A late dinner, and rest at the Golden Gate Hotel, our safe haven for the week: hot water, A/C. a bed, very slow internet, but internet all the same and thankful for it. All for $12 a night. You gotta love Cambodia.
In all things, give thanks,
Monday, October 22, 2007
I leave tonight for our
Be with us….
In all things, give thanks,