10 DEC Enough to eat
There are a few children who are side by side in our hospital ward. I think it is good that they have each other. It must be frightening being in a big hospital with lots of people who are bigger than you and don't speak your language. Add to that the pain and discomfort of recovering from surgery and it must be a terrible experience. It might take away a little of the terror to see that there are some other children around who are going through it too. Maybe if they see someone else getting better, they will be able believe that they can get better too.
We are treating one boy who was shot through the heart a few days ago. Kind of reminds you of the Bon Jovi song. Thoracic Surgeon J. did an amazing job repairing the two holes in his heart. After a few days in the ICU, he has grown strong enough to make it to the patient ward. He has had all of his tubes removed and is able to walk around. We are encouraging him to eat a little better so that he has enough protein to heal. His older brother, who is an adult, was also injured in the same suicide bomber attack. His older brother has been hanging out in front of the wide screen TV on the patient ward, watching movies. Translator N., a young man who goes around in distressed jeans and a Yankees hat, is our resident style advisor and picks out all the cool movies for the patients. They boy whose chest is healing asked us today why he couldn't hang out with his brother and watch TV. This sounded familiar! It's not fair! I want what my brother has! Of course we could move him into a chair by the TV. A friend from home sent some wonderful plush teddy bears that were perfect for cuddling. One of them had a heart sewn on his chest with broad stitches. It was perfect for the boy. I gave it to him and pointed to the stitching on the heart. He looked, then pointed to the incision healing on his own chest and took the bear with a smile. When I left the ward he was clutching the bear tightly to his chest as one of the nurses started a IV in his arm. With a little luck, both he and his brother should be ready to head home soon.
A boy we treated a few months ago for a gunshot wound to his aorta has come back. He was very seriously ill and we didn't think he would make it. He fought off infection after infection and went to the operating room for procedures more than ten times. Eventually he was well enough to head home. His mother took him home. Our translator M. tells us that the region of the country in which he lives has a reputation. The people there are proud to think of themselves as simple farmers. They do not value education so much as the ability to successfully farm the fields. They are also known to be quick to fight in defense of their opinion, right or wrong. This description reminds me of a few places in the US. Translator M. told me the story of one of his friends who was from that region. He was the only one in his family to go to college. Upon returning home, he saw his brother driving a truck of grapes to sell at the market. The two men recognized each other and stopped their vehicles to talk. The brother returning from college told his brother who farmed that the grapes looked excellent. He responded by thanking him and said that he was happy to see that he was home from school so he could help on the farm. They said goodbye, and as the farmer was climbing back in his truck, he noticed his brother taking some grapes to eat. He told him to put them back because they were the best grapes and they needed to stay on the top to make the produce look valuable. The student said that the least he could do was to give his brother returning home some of his delicious grapes. The argument elevated and the brothers ended up drawing guns and shooting each other. The student died.
The boy we are treating is one of six children. In addition to caring for her children, his mother works in the fields. When she brought the boy back to us, he had lost nearly 20 pounds and was skin over bones. He tried to eat, but would throw up what ever he put in his mouth. He told us that he didn't want to live because he would never be well enough to work. His mother said that she wanted her son to be well, but she understood her son's point of view. He is 11 years old. After a long time talking, they both agreed to come into the hospital to try. We admitted the boy to our hospital. After staying a few days, the mother returned home to care for her other children. She visits as often as she can. It is difficult to feed him. He has many internal scars so his digestion is poor. When we feed him with a tube, he cries piteously about the pain in his nose and pulls the tube out. An infection in his belly had eroded through the skin and some of the food he eats leaks out with his digestive juices. We try to feed him more, but then he leaks more. He won't heal the hole in his belly until he gets more nutrition. It is a tough predicament. He used to cry a lot when he was in a room of his own. Now that he is in the company of other children, he seems to show a little more interest in his world. It is frightening to look upon him and see the bones of his skull and each of his ribs starkly outlined under his paper-thin skin. I'm very worried for him and it will be a challenge to keep him from starving to death. We have to start first by helping him find the will to live, and I hope that the children around him will teach him that lesson better than we have been able.
Also on our ward are the two children who were injured when an explosive was detonated in their back yard. They are a brother and sister, and they are neck and neck in the race to see who gets better first. Each morning we round on first the girl and next the boy. Their father sits between them and smiles as he listens intently to our conversation and then turns to the translator. Each morning he thanks us in English. He seems so calm, but then again, he has 16 children so probably very little fazes him! Both children are taking small bites of food. So far I thin the sister is winning, but really likes to lay in bed all day so her brother may still have a shot.
Tonight has been calm so far. Two men came to us, both shot in the head. One lived and one didn't. After dinner I went with one of the quiet professionals to the range and shot at steel targets in the dark. How different their job is from mine. How similar is the feedback loop from eye to hand to target and back to eye. We'll both work hard at what we were trained to do.