01 February 2019

WINTER WONDERLAND URBANA ILLINOIS

UNEXPECTED POST

     I had assumed that I would no longer continue this blog as I am no longer working in Kenya.  This picture of Illinois captures the starkness of the brutal winter we are experiencing with the polar vortex this week.  Our record temperatures have hit -13F (-25C) with a wind chill of -43F (-43C).  I dream of sweating in Mombasa!

     But the topic of this piece is a friend who is hospitalized in Nairobi with a serious illness. He had told me the day of his surgery and the plan of treatment.  At 10pm in Urbana (7am in Nairobi) I sent him a text message on the day of the surgery.  He replied that he was trying to understand what the doctor had just told him at 5:30am.   The doctor had decided to do a different procedure which was much more extensive.  I was shocked.  I asked several questions and he didn't know the answers which should have been clearly explained.  He had several serious health problems and all were well known when the plan was made.  I was aghast that a doctor could just walk in to a groggy, frightened patient and brusquely make such a major change.  I told him I would call him back.

    At 10pm at night I had only one person who could help me with an urgent bit of advice.  My sister is a specialty nurse and luckily she answered her phone.  When I presented the case to her she was more shocked than I and started a barrage of questions and vehement concern.  She is the mother of five children but any person with this problem is like one of her own.  She was adamant that the change in procedure would cause more harm than good.

     Next. I phoned one of our lay missioner doctors who was with my friend and we discussed the scenario.  I knew the Kenyan health system and she was on the ground and about to learn a lot more.  She brilliantly took the bull by the horns and was able to find enough evidence to convince the surgeon to return to his original plan and do some extra testing as well.   

     The surgery went well and the treatment plan has progressed with my friend recovering well. There are three important points to make:

1. Even with the finest hospital in Nairobi and well trained physicians it is necessary to follow and scrutinize a patient's care and advocate for evidenced based medicine.

2. The use of What's App, which is free, and a simple text message of support and concern can assist with the care of a person half way around the world.  This is globalization in the best sense of the word.

3. Most of the people in this world will never come close to even getting a correct diagnosis let alone a good treatment plan.  Most of the people in our world with this condition will simply die a long and painful death.

     I am amazed that I am still able to 'practice' medicine and make a difference from half way around the world.

PEACE OF THE NOW GENTLY FALLING SNOWFLAKES TO YOU