Comatose

 As I was rounding today, I experienced a miracle.

The young man arrived at my hospital sometime during the nights couple of days ago, not speaking and comatose. The nurse on duty prescribed the usual typhoid and malaria treatment, and I didn’t see or hear of him until the next morning.  

His father said he had fallen ill 3 days prior and had sat at a “Centre de santé” (local ill-equipped clinic) until comatose and then sent here.

During rounds, he was stiff and didn’t even flinch with my firmest sternal rub. But his eyes dilated very well with light—that’s “un bon signe” as I told his father. And when I pinched his thumb with my pen, he moved his hand away. There was hope, although not much. (I considered performing a lumbar puncture, but he had received IV antibiotics already and I wasn’t sure my management would change with positive or negative results.)

We don’t have an ICU. We don’t have fancy monitors in the medicine ward. But what we do have is IV access and a handful of medications. We have dexamethasone (our only injectable steroid), IV quinine, IV glucose, and IV ceftriaxone. That’s not much. I would have loved IV acyclovir and a million other medications, diagnostic tests (our chemistry machine is broken), and monitoring. As I sat there trying to communicate in French and bemoaning all I didn’t have, I remembered the one “thing”I always have with me. I have access through prayer to my Heavenly Father. The family and our rounding team surrounded his bed and I prayed in English.

The following day, the patient could open his eyes and became somewhat agitated. He wasn’t able to eat and I ordered a NG tube (feeding tube to his stomach). He hadn’t eaten or drank anything in 4 days and we don’t have TPN.

Then, this morning I walked up to his bed and was about to admonish the nurse for not placing the tube as instructed yesterday. I leaned over and greeted with a loud “bonjour! Comment ça va?” I was not expecting an answer. He opened his eyes and said “ça va un peu mieux.” He could speak! He had drunk some water and milk.

He still has a long road to recovery and is not yet out of the danger zone. But he is improving and I’m thanking God for this blessing.

~megan