Skip to main content

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”.

Comments

Post a Comment

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...
3 comments
Read more

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...
3 comments
Read more
The next patient is in her mid-20s. She sits gracefully on the edge of the chair and looks at me. "How can I help you today?" I ask. "It is this," she says, hands clasping her belly, "I look like I am 4 months pregnant!" "And are you? Have you checked?" "Oooh! Yes. MANY times - and always negative. I have been talking to my friends and they say it could be the HIV treatment." "Yes - that is true. You are on one of the older drugs, the one called Stavudine. That can make fat appear in different places on your body, and sometimes disappear from other places. Some people find that it makes their face thin." I suck my cheeks in briefly. She laughs. "I used to have a VERY round face, now it is thin!" "I suggest that we change that drug then. We have more drugs available in the public clinics than we did when you started and the one I will use has less side effects. Is that what you would like?" She nods enthusia...
1 comment
Read more