Not just ANY kind of medicine...

Late one afternoon a mother walks into our First Aid services with her teenage son. As teens tend to do, he is lounging around nonchalantly, trying to look as cool as possible. He is dressed in soccer team attire, and I assume he has been brought to us from a game injury.

I invite the stressed out mother into the examination room and take all the pertinent information. I quickly read through the boy´s file and see that every single time that he has come to our services has been for a broken body part. I turn to the mother and comment on the coincidence. She proudly tells me that her son is incredibly athletic and give 110% in all his endeavors. He even sticks it out til the end of games before going to get the bones fixed. I am humored by this and turn around so she can´t see my smile. Her son continues to show no obvious sign of distress, as he checks his Facebook on the folding chairs.

The doctor is called in and the mother begins again with her proud recitation of her prodigious son´s accomplishments - every broken bone.

Now, I forgot to mention that on this particular weekend day I have already called the on-call doctor 3 times in one short afternoon. He is not too happy at being called away from his family for the 4th time in as many hours. But being the professional that he is, only I am party to his extra stress-wrinkles.

The doctor examines the young man, hands the mother a box of medicine and tries to send them on their way. The mother is NOT happy. She has driven to our hospital from two towns over with her amazing, super-child and she demands an X-ray done on his ribs.  The doctor tries to reason with her, explaining that fracture or no fracture, an x-ray won´t change the course of treatment. He is given 6 weeks off of any athletic sport to recover. "WHAT?!? That´s impossible!" they both react loudly. They are heading to the tournament finals and her son is a mayor player on the team. The doctor has reached the limit of his pettiness quota and leaves the checking out to me, his nurse.

I´m frantically searching the confines of my intelligence trying to find a way to soothe matters over. I hate having a discontent patient on my watch. I gently remind the lady of the rationality behind the doctor´s resistance to take an X-ray. This being that IF a fracture is detected we can´t just wrap a cast around his ribcage. It´s not an arm or a leg. Therefore the treatment is the same as a non-fracture - rest.

She seems a bit more convinced after hearing my rationale, but is now peering loathingly at the box of meds the doctor has give her. I can tell by her body language that things are not going as she had planned. For sure she had expected us all to be abuzz and over-the-head concerned by her little Sweet Pea; and the reality was another. Out of the blue I have a brilliant idea and ask her permission to see the box. [--To not get all technical on you (the reader), I´m letting you know that the medication is essentially an ordinary extra-strength ibuprofen (Aleve).--] I gird myself with confidence and authority, look squarely at the lady in the eyes and tell her,

"Ma´am, this is not ANY kind of medicine the doctor has indicated for your son. It is a combo medication that is an anti-inflammatory AND analgesic. So, you are essentially getting special meds because it´s two-in-one!"

The lady eats it all up - hook, line and sinker - and goes home a satisfied customer.

¡¡¡…. definitely not just ANY kind of medicine…!!  

Huge Bills

A man was checked in at our hospital with gastrointestinal problems and stayed for 5 days. I come in on the fifth and final day and am given the task of checking him out. He is finally going home. There is much joy and expectation from his wife and himself.

I sit myself down, grab a pencil and a calculator and begin the tedious and meticulous task of figuring out the bill. 5 days is a lot of days to be attended to in the ward. This means 3 meals each day for husband and wife, adding up the liters of IV fluids, ampules of medication, the syringes that correspond to each application, the number of doctor visits, blood glucose tests, other external lab tests, etc. For a regular one-night stay the numbers are already daunting. Imagine 5! I dutifully punch in the numbers, erasing sometimes and starting again when needed. After what seems like hours I finally have a final sum of Gs. 1.450.000 to be billed to the patient. My hands feel sweaty because I now need to give this bill to the patient - and the number makes me nervous. In Paraguay, minimum wage is Gs. 1.890.000. (approximately $400 US dollars). This man is going to receive a bill for almost his entire monthly paycheck.

What I didn´t mention before is that this man was once diagnosed with Leprosy. At our hospital anyone who has been diagnosed with Leprosy receives free care for any conditions related to the disease. Many people affected by Leprosy take strong medications similar to a chemotherapy combo. These meds irritate the gastrointestinal system and this is how our patient came to be check-in at the hospital. As an institution we are grateful to many NGOs that make it possible for us to be able to offer free care to our special patients. Because without this free care they surely would not seek out the treatments they need.

The man´s wife takes the bill to the Administration and returns to me with the receipt. She has tears in her eyes. This is not the first time she has had to go to the Administration to settle a bill. She knows that once she gets to the cashier´s window the accountant will quote the figure to her and remind her that she owes nothing. Others have paid for her husband. It is all free. She puts her hand on my arm and whispers her thanks.

        "Thank you for taking care of my husband. There is no other place like this hospital. You truly 
          care for us. Thank you! God bless you!"

There are no words to describe the feeling you get when you realize you are a part of something that´s huge. You are a tangible part of change in this world. It´s been 5 years and 4 months at this hospital and my everyday encounters with these Special People still give me goosebumps.

It´s just that great.

Fried Pork

It´s the Easter Season and along with the religious aspects of this time of year, there is also a culinary component to it. In Paraguay the traditional fare is Chipa, a manioc and cheese bread formed into the shape of a ring. Depending on how religious you are, BBQs are also quite popular. By the extent of your religious inclination, I mean that those who are firm Catholics in this country do not eat any meat during the Holy Days. Even more conservatives don't eat any meat throughout the entire Lenten season (!). Regardless of your spirituality, Easter is a 4-day holiday filled with time for family, friends and… food.

On shift at the hospital I hear a car pulling up to the front, meaning that we are receiving a patient for First Aid Care. A large man gets out of the vehicle and I patiently wait for him to make his way into the foyer. All the while he is soothingly stroking his protruding belly in circular motion. He waddles to a stop in front of me and groans. I smile inwardly, already guessing at the reason for his being here.

"Good afternoon, Sir. How can I help you?" I ask.

"Ugh… I have awful colic," he groans as he winces in pain.

Shrewdly I ask him, "What did you eat?"

With his head down in apparent shame, he hesitantly raises only his eyelids and answers, "Fried pork."

I can´t help but smile, finding the situation quite hilarious.

"FRIED Pork, Sir?"

He nods.

I give him a look of compassion and have him follow me in to our examining room.

After the doctor has come in, checked him, and left us alone, I prepare his IV meds and resume our conversation.

"Was it at least worth it?" I questioningly tease.

He turns his head to look at me and replies without pause, "YES!"

Turns out he and his wife had slaughtered a pig the previous day and not only did they have just a kilo or two of pork meat, but more than 100kgs of it!

I couldn´t help but giggle thinking that this man had so expectantly prepared himself for a 4-day holiday of binge eating, to find himself confined to a light diet for the next 7 days after only one delicious meal. Must be Karma :)