The invariable Saturday night popular aromas of the perfect blend of alcohol, blood and urine. Bringing another fabulous use for the tight-fitting (somewhat claustrophobic and suffocating) duckbill masks usually used for seeing actively infected and therefore infective patients with TB (tuberculosis).
It was a somewhat insidious night. For us at least. Resus remained somewhat still except for the young man with the sucking stab wound in his back. He was not seen as soon as he should have been because another man stepped in when the man with the stabwound was called and basically pretended to be him...meaning we only realised the real original man with the stabwound needed immediate attention when he made it very clear! The air sucking in and bubbling out and the blood around his lung were pushing the lung into a small area making breathing a bit uncomfortable and largely unsatisfying. Nothing the graceful chest drain can't help! With speed and stealth his lungs re-expanded and he was back to his happy self.
But by far the most heart warming and exciting part for me was meeting these two lovely ladies. The older one is a traditional African healer (Sangoma) who specialises in oncology or cancer patients. She uses the local traditional herbs. Her student, the younger one, explained to me in English. We chatted about the options they use including our local famous Kankerbossie (Sutherlandia). She invited me to her future sangoma graduation ceremony in the Eastern Cape. (It reminded me of when I used to attend these in Khayelitsha so many years ago!)
There was another wonderful connection where a family with an elderly mother were really appreciating the time I took to connect with them. We (EU doctors) tend to get irritated with people that come so late at night with what we think are non-urgent issues (being an emergency unit).
I agree it is confusing to be seeing a person with pain that has been there for 3 months but has decided to come on one of the busiest night at the most remote time to wait in emergency unit for several hours and be seen by a tired doctor. (Yes, we get tired even at 2am because for many of those docs they have been working since 8am..that makes it about 16 hours on their feet.)
But I realised something important on that call. I realised that every patient is a person.
Huh? What? Of cause...duh!?
Nope – it becomes increasingly easy and habitual as well as practically protective coping mechanism (yes because doctors are people as well!!) - to isolate symptoms, apply protocols and not bring the personalism into the consultation.
Anyway – when I was seeing this lovely 82 year old lady – for me I could get her concern. The concern and confusion about the pain she was experiencing was as important to me as her pain. So albeit tired and all from all of us – it was an enlivening interaction. And I found out that she has 9 children and the first 3 were born at home! (Which naturally excites me tremendously.)
The elderly sangoma had 11 children, all born in hospital and the first was a caeserian meaning she had 10 vbacs! I am unsure how I extracted this information on both accounts as the reason they came in had nothing to do with their reproductive history!
The little snippets of person life that keeps me excited and going on an all nighter in trauma.
We have to speak. Writing helps me debrief. It helps me bring clarity to times of need. These experiences are so rich. Community medicine is so full of real raw lives. Connection is simple and vital. The difference between you and me is an illusion. We all want love and connection and health. My role as a doctor / healer is not more or less than yours as a patient. Together we move.
I tasted that respect on Saturday night.