Skip to main content

Pus

There is a satisfying give and I feel the rush of hot brown pus over my gloved finger. I work my finger a little more, widening the hole I have made in the man’s chest. He winces a little but the morphine and diazepam given a few minutes ago have spaced him out somewhat. As I injected them he said to me, “Doctor, what makes this fluid in my chest.” I told him it was the same bug that had caused his TB. “So it is not my food or drink?”

"No," I said, "that is very unlikely." He nodded and dozed off.

As I enlarge the hole the pus runs faster soaking the sheets. Sister is watching and looks a little put out, but says nothing. She hands me the drain tube and I push it through the hole between his ribs until 15cm or so of tube has passed into his chest cavity to drain the TB-infected fluid that has been sitting around his lung. Sister connects the tube to a bottle on the floor. I start suturing the tube to the man’s skin to prevent it dropping out and he begins to wake as the diazepam and morphine levels drop. “Done already?” he asks. I nod. He looks at the drain with interest. “Doctor,” he asks, “What makes this fluid in my chest.” I tell him it was the same bug that caused his TB. “So it is not my food or drink?” No, I say, once again, that is very unlikely. He nods.

Sister returns with the dressings for the drain. I have finished stitching. She looks with interest. “Doctor,” she asks, “What makes this fluid in his chest.” I tell her it is the same bug that caused his TB. “So it is not anything he eats or drinks?” No, I say, once again, that is very unlikely. She nods.

Comments

Popular posts from this blog

Otherwordly isolation

I lean across the reception desk and catch the attendant’s eye. “Sawubona,” I say, dusting off my rusty Zulu. I see you. “Sawubona, ninjani?” she replies. I see you, are you well? “Ngiyapela.” I’m fine. She grins at me. “You must be a doctor.” “I am! How did you know?” “It is only the doctors around here who use Zulu. Even if it is only the greetings.” She arches an eyebrow. “I used to work here, at Hlabisa hospital up the road. I have a few other Zulu words, you know like ‘Does it hurt?’ and ‘Take a deep breath’.” She laughs. And then launches into an excellent impression of an elderly Zulu lady rattling off a series of complaints, waddling across the reception area clutching her back in mock agony. She gets it exactly right. I have come up to KwaZulu-Natal for a few days. Tonight I am staying in the Hluhluwhe-iMfolozi game park, 20 minutes or so from where I used to work. Awarded my entry ticket, I drive into the park. The sun is low in the sky, the kills bathed in amber light. I ta...

10 years on

The door flies open. Lele peers in. "You must come out here and see. They are doing a play!" I finish up my case file annotation and come to the doorway. The waiting area is in chaos. A gang of school children are manhandling a couple of marimba's to the space in front of the consulting rooms, a team of nurses and counsellors are creating a stage area. Patients look on mutely. Some with interest, others - presumably feeling proportionately less well - without. "What is going on?" I ask. "It is 10 years since the clinic started. 10 years since MSF first started the HIV treatment programme and proved that it could be done in Africa. So the staff are celebrating. They are doing a show or something." The sister in charge of the clinic has moved to the front of the crowd of patients. She calls for silence and then gives a short introduction. Lele translates for me. "She is saying that this is a very important day. 10 years ago people were dying. And 10...

The first rule about run club

This is what death will be like. My heart is pounding, chest constricting, I can barely lift my foot from the ground. The sweat pours from me and my head pounds. It is Thursday run club. An hour ago Ibby was rounding us all up, exhorting us to get a move on, and allocating us to vehicles so we could lurch through Freetown’s commuter traffic to Lumley Beach on the west side of town. Half way there, the traffic solid and the heat stifling we hailed a street trader and we bought packets of drinking water (improbably branded “CLIMAX”) and biscuits (incongruously labelled “made in the UK for Aldi”). A King’s Sierra Leone Partnership tradition – started by Ibby some years ago – the whole team go beach running after work every Thursday. “The route’s fine” they tell me. “Flat, and you can 5k or 7.5k”. It started well enough but it’s 28 degrees and my pale body is unprepared. The route is straightforward but weaving in and out of other runners, stray dogs, unexpected ga...