I usually participate in Medicine Ward Rounds on Saturdays when I'm in Chogoria. This past Saturday, during rounds, we saw a patient sit up in bed, gasp for breath, then collapse. When we hurried over to assess him, we found him to be pulseless. Dr. Juliet started chest compressions and I hustled to my office and retrieved our only well-broken-in defibrillator. When we attached the defibrillator pads, we saw ventricular fibrillation, which is a fatal heart rhythm. We shocked him and saw a return to a more normal rhythm. Not really normal, but not fatal. His heart rate gradually increased and even became a ventricular tachycardia, nearly pulseless. Juliet shocked him again and ultimately his rhythm became normal and his breathing resumed.
The man didn't wake up, though. His primary illness was heart failure. We had ultrasounded his heart a couple of days prior, and we were compressed with how poorly his heart was contracting. Now, after being in a fatal rhythm, requiring CPR and two shocks, his already-underperforming heart was pretty beat up. His pulse was barely palpable, and very little blood was going to his brain. We ultrasounded his heart again, and it was barely squeezing. At times, the squeeze didn't even produce enough pressure to open the aortic valve. I honestly didn't expect him to last very long, even an hour or two, and strongly recommended that his family transfer him to a hospital with an ICU. And, of course, we prayed.
|Dr. Juliet after the successful defibrillations.|
Surely, this was a man who must have some unfinished work. He collapsed during one of the few hours of the week when he would have been directly observed and we could have intervened. The defibrillator is not often available. People who are defibrillated do not often survive the "code." And his heart is badly diseased.
Further, we left the defibrillator on the ward that night, which is not our usual practice. And Juliet was called by the nurses later that night. The nurses were performing chest compressions on him. And Juliet defibrillated him again.
So during rounds today I called Chaplain Roy for a consult. He came with Evangelist Mbae. I explained the situation, and they engaged. It turned out that our patient needed to reconcile with God. So they all prayed. Fervent, active prayer.
|Evangelist Mbae and Chaplain Roy in action|
Hopefully, our patient will live on and his family will be able to afford a transfer to an ICU. But even if not, I think he has had the immeasurable gift of some days to reconcile with the King.
I am so grateful to work in this Mission hospital. My intern colleagues are compassionate and learn skills quickly. And my Chaplain colleagues are also compassionate and can engage in the Great Work freely. How could it be better than that?