Sister Amen

It is my last day on T ward. The doctor I have been covering for these last weeks is back from the UK on Monday and I will be moving to outpatients. I am working my way around the male half of the ward with Sister Hlabisa. Surnames are often taken from the location and there are a lot of Sister Hlabisas. I call her Sister Amen on account of her involuntary exclamations of praise.

I examine the chest X-ray of a 20-something man admitted with pus in his chest as a result of TB. I put in a drain last week and after the initial 2 litres drained only a few millilitres drain each day now. The X-ray confirms that the pus is gone and the lung fully re-inflated. “Very good,” I tell Sister, “this drain can come out today.”

“Amen!” proclaims Sister. She explains to the patient who grins, gives me 2 thumbs up saying “Sharp sharp!” which apparently means “Cool”.

The next patient has completed 2 months of inpatient TB therapy which required injections – he lived too far from his local clinic to make the daily journey. He speaks fluent English and we have enjoyed our brief daily chats. “Hey doctor, I will miss your rounds when I am gone. I will miss your smiling.” I am wearing an enormous duck-bill like respirator mask and ask how on earth he could know whether or not I was smiling. He grins. “Your ears go up.”

I write up his take-home medication and hand it to sister. “Praise the Lord!” she proclaims.

The last patient is an elderly man, severely confused as a result of high blood calcium almost certainly due to cancer. I have been hydrating him which has helped a little but what would really help are the expensive calcium lowering drugs routinely used in the UK but not available here. Nor will I be able to get a scan in an attempt to identify where his putative cancer is – if I knew what could I do about it? Not much at this stage. I look at him sadly. His wife is by the bed. I ask Sister to explain what is wrong. She does so and the wife nods, saying “Ohhh” in a manner incongruous to my British ear, as if a beautiful firework had just lit the night sky.

“I do not think we can do much more for him,” I tell Sister. She shakes her head and mutters a sombre, “Amen”.