Baboons in the Mist

I made an uncanny realization early this morning at 3AM as I was walking home from the hospital down a lonely dirt road past a cemetery in the mist was that what I was most afraid of was not the boogie man or a man at all but a fear that I may have an encounter with a baboon. The males are enormous according to Zach who ran into a pack of them getting in the garbage cans, three times the size of Isis (our dog), and apparently not afraid of women. Great. Of course they were probably sleeping like most creatures at 3AM, but it was definitely a funny reminder of where I am.

I was on call at the hospital, my second call in Kijabe. The first was spent finishing up the out-patient clinic which ran until approximately midnight, then spent hours in the ICU trying to get an IV line on a 8mo little girl gravely ill with cerebral malaria and intubating a women with status asthmaticus who made it a few more days on a the ventilator before passing away.

I got a little more sleep this second call dealing early in the evening with a patient who was unresponsive and trying to work through the work-up etc. with the intern on the phone. It was all I could do not to go up to the hospital and do it all myself but she wouldn't learn anything if I did it for her. I did do some sneak phone calling to the nurse so I could feel good about the situation and did check on the patient after being called up to the hospital for another reason. A difficult reason too. An 11mo little boy was severely dehydrated with fever, abnormal electrolytes, lethargy...sick kid...and the mother was refusing admission. All the nurses, physician assistant and intern (all Kenyan) had spent hours trying to convince her. Apparently they don't have CPS in Kenya. We would have just involved the police in the US. I don't know why they thought I, a white girl with a funny accent, would have more luck convincing her, but luckily I did. She was of course concerned about the cost on an admission to the hospital but most of all that she would lose her job if she did not show up for work the next day. She unfortunately had been visiting her sister in Kijabe when the child fell ill and had quite a distance to travel in order to ask permission to miss work, apparently a phone call by her or by the hospital would not be sufficient. I guess a little coaxing and lot of listening was enough, we agreed she could have her sister come stay with the child in the hospital while she traveled the following day. Not bad for 3AM.