Blood, Sweat, and Tears - Literally
So I wrote about Hanouk's aggressive cancer and pending amputation two days ago. The post I would have written yesterday would have gone something like this:
Hanouk visited Black Lion this morning and his doctor again told him that "bone grafting" is an option as opposed to amputation. I spent 2+ hrs trying to convince him that it is not a real option and that amputation is the only possibility for saving his life but to no avail. The remote ("10-15%") hope of saving his leg is enough for Hanouk to ignore the experts' advice and sign his own death warrant. I am meeting him tomorrow morning @ Black Lion to talk with this Dr. Biruk and show him Rick's letter from the experts. On a side note: Of course as I ran to print out copies of the letter and 50+ pages of uptodate information, the power cut off in all of Sidist Kilo and Piazza. Maybe this was punishment for having 3+ days of electricity in a row? Power came back on an hour later, but too late to print and get back to the mission.
My talk with Hanouk yesterday left me dismayed, downtrodden, and depressed. I was in absolutely no mood to converse with anyone and of course it was at this time that I met Emmanuel on my walk to the Pizza Corner. For those who weren't reading last summer, Emmanuel is a 20 year-old street kid who works around the Taitu, trying to move marijuana and guide tourists although he is not licensed. He speaks the best English of anyone outside of Rick's kids and is a good guy at heart. Jake, Zev, and I spent a lot of time with him last summer and I saw him the other day for the first time this summer.
Anyways, he asked if he could come to dinner and I agreed. We went to the Pizza Corner and caught up from last year. Here is what I know about Emmanuel: Born in Gonder, Mother still lives there doing laundry for a living, will be 21 in september, shares a room w/2 older hustlers, each pay 200 birrh/month, the last money he made was 250 birrh 3 wks ago when he took some tourists around the city, is going into the 10th grade and is 7th in his class (the top 4 are out reach but the 2 above him are smarter, not harder workers), english is his best subject followed by history, he has tried to get jobs but can't get hired during the summer b/c everyone is looking and he has no formal experience, he has been arrested 3 times with stays of 2 months, 3 wks, and 3 days in jail. I told him to go research summer schools and the licensing process for becoming a guide and then to get back to me - if it's reasonable and sounds legit, i will go to the school and pay for some classes during the summer. We'll see what happens.
But back to today...
Stu and I arrived at Black Lion @ 7:30 and met Hanouk on his way into the mission at 8:15. He already had plans to be admitted for the "bone graft" procedure and we agreed yesterday to talk with his MD before anything happened today. Stu and I met with Dr. Birku, a nice man who may be the head of the Ortho department (?), and showed him Rick's letter citing 3 US experts' recommendation of amputation. He quickly told Hanouk that amputation is the only option and despite his tears, Hanouk quietly accepted his fate. Hanouk is on the operation roster for tomorrow morning and the rest of the day was spent preparing for the impeding procedure. Stu and I sat with the patient for a bit until Mesfin, Rick's 15 year-old son showed up (at my request...on my payroll). I went for coffee and Mesfin spent 30+ minutes talking with Hanouk about the procedure, trying to convince him that all is not lost and life will still be worth living with only 1 leg. Hanouk's major concerns are how people will look at him in the street, whether he will ever be able to help his father on his farm again, and the obvious fear of losing his limb. But to Mesfin's credit, when I saw Hanouk again, he was a different person and while far from upbeat, no longer in tears.
We waited until 11 for the nurses to find him a bed, then took care of a blood test for Hanouk, and then hit a hurdle when the nurse informed us that we needed to secure 2 pints of blood from the blood bank. The policy at Black Lion, and one I strongly endorse, is the "give one to get one" model. We had to find two people willing to donate a pint of blood (of any blood type) in order to receive two pints. I was chosen/volunteered along with Samuel, Hanouk's one friend in Addis, a radiation technologist-in-training. When we got to the Red Cross Blood Bank fifteen minutes down the road, they were closed for lunch. We grabbed a soda next door and returned half an hour later. Samuel was disqualified because he is currently taking anti-TB medication but I was welcomed to open a vein. I found out that I have lost 7 pounds, my blood pressure is acceptable, and finger pricks still hurt like hell.
Despite my own apprehensions, the blood drawing process was completely normal (and sanitary) and I demolished the lady beside me (unbeknownst to her) during our heated "who can donate a pint of blood faster?" race. I paid the price with nausea, a cold sweat, and stars/birds circling my head, but I still emerged victorious. And to top it off, I got a free coke afterwards! (didn't compare to the free pint of ice cream I got during the 2005 GDS blood drive, but I am in Africa, so I guess it'll do).
We went back to the hospital where we filled in Hanouk and the nurses on what had transpired. Luckily a man for the mission was at the hospital checking on Hanouk and we were able to arrange for the mission to take care of getting the second pint of blood (they are exempt from the "give one to get one" rule). As it stands now: Stu and I will be at Black Lion at 7:30 AM tomorrow to wish Hanouk luck and then to scrub-in and watch the surgery. As harrowing as this whole situation has been, I relish being in this position and it simply reinforces my desire to be a doctor where patient care is in my hands every day.
We wished Hanouk well and left for the afternoon. Mesfin and I grabbed lunch @ a popular eat near the hospital and I am now back in Piazza. And it is now time for a nap - I'm not used to an 8 hr work day, much less starting work @ 7:30. Tomorrow is a big day (hoping all is set with the blood) and I hope it goes off without a hitch (not to mention I'm giving a tour of the mission to a group of US students followed by a senior concert at the music college across the road, and then dinner with a family friend).
The road goes on forever and the party never ends...
Hanouk visited Black Lion this morning and his doctor again told him that "bone grafting" is an option as opposed to amputation. I spent 2+ hrs trying to convince him that it is not a real option and that amputation is the only possibility for saving his life but to no avail. The remote ("10-15%") hope of saving his leg is enough for Hanouk to ignore the experts' advice and sign his own death warrant. I am meeting him tomorrow morning @ Black Lion to talk with this Dr. Biruk and show him Rick's letter from the experts. On a side note: Of course as I ran to print out copies of the letter and 50+ pages of uptodate information, the power cut off in all of Sidist Kilo and Piazza. Maybe this was punishment for having 3+ days of electricity in a row? Power came back on an hour later, but too late to print and get back to the mission.
My talk with Hanouk yesterday left me dismayed, downtrodden, and depressed. I was in absolutely no mood to converse with anyone and of course it was at this time that I met Emmanuel on my walk to the Pizza Corner. For those who weren't reading last summer, Emmanuel is a 20 year-old street kid who works around the Taitu, trying to move marijuana and guide tourists although he is not licensed. He speaks the best English of anyone outside of Rick's kids and is a good guy at heart. Jake, Zev, and I spent a lot of time with him last summer and I saw him the other day for the first time this summer.
Anyways, he asked if he could come to dinner and I agreed. We went to the Pizza Corner and caught up from last year. Here is what I know about Emmanuel: Born in Gonder, Mother still lives there doing laundry for a living, will be 21 in september, shares a room w/2 older hustlers, each pay 200 birrh/month, the last money he made was 250 birrh 3 wks ago when he took some tourists around the city, is going into the 10th grade and is 7th in his class (the top 4 are out reach but the 2 above him are smarter, not harder workers), english is his best subject followed by history, he has tried to get jobs but can't get hired during the summer b/c everyone is looking and he has no formal experience, he has been arrested 3 times with stays of 2 months, 3 wks, and 3 days in jail. I told him to go research summer schools and the licensing process for becoming a guide and then to get back to me - if it's reasonable and sounds legit, i will go to the school and pay for some classes during the summer. We'll see what happens.
But back to today...
Stu and I arrived at Black Lion @ 7:30 and met Hanouk on his way into the mission at 8:15. He already had plans to be admitted for the "bone graft" procedure and we agreed yesterday to talk with his MD before anything happened today. Stu and I met with Dr. Birku, a nice man who may be the head of the Ortho department (?), and showed him Rick's letter citing 3 US experts' recommendation of amputation. He quickly told Hanouk that amputation is the only option and despite his tears, Hanouk quietly accepted his fate. Hanouk is on the operation roster for tomorrow morning and the rest of the day was spent preparing for the impeding procedure. Stu and I sat with the patient for a bit until Mesfin, Rick's 15 year-old son showed up (at my request...on my payroll). I went for coffee and Mesfin spent 30+ minutes talking with Hanouk about the procedure, trying to convince him that all is not lost and life will still be worth living with only 1 leg. Hanouk's major concerns are how people will look at him in the street, whether he will ever be able to help his father on his farm again, and the obvious fear of losing his limb. But to Mesfin's credit, when I saw Hanouk again, he was a different person and while far from upbeat, no longer in tears.
We waited until 11 for the nurses to find him a bed, then took care of a blood test for Hanouk, and then hit a hurdle when the nurse informed us that we needed to secure 2 pints of blood from the blood bank. The policy at Black Lion, and one I strongly endorse, is the "give one to get one" model. We had to find two people willing to donate a pint of blood (of any blood type) in order to receive two pints. I was chosen/volunteered along with Samuel, Hanouk's one friend in Addis, a radiation technologist-in-training. When we got to the Red Cross Blood Bank fifteen minutes down the road, they were closed for lunch. We grabbed a soda next door and returned half an hour later. Samuel was disqualified because he is currently taking anti-TB medication but I was welcomed to open a vein. I found out that I have lost 7 pounds, my blood pressure is acceptable, and finger pricks still hurt like hell.
Despite my own apprehensions, the blood drawing process was completely normal (and sanitary) and I demolished the lady beside me (unbeknownst to her) during our heated "who can donate a pint of blood faster?" race. I paid the price with nausea, a cold sweat, and stars/birds circling my head, but I still emerged victorious. And to top it off, I got a free coke afterwards! (didn't compare to the free pint of ice cream I got during the 2005 GDS blood drive, but I am in Africa, so I guess it'll do).
We went back to the hospital where we filled in Hanouk and the nurses on what had transpired. Luckily a man for the mission was at the hospital checking on Hanouk and we were able to arrange for the mission to take care of getting the second pint of blood (they are exempt from the "give one to get one" rule). As it stands now: Stu and I will be at Black Lion at 7:30 AM tomorrow to wish Hanouk luck and then to scrub-in and watch the surgery. As harrowing as this whole situation has been, I relish being in this position and it simply reinforces my desire to be a doctor where patient care is in my hands every day.
We wished Hanouk well and left for the afternoon. Mesfin and I grabbed lunch @ a popular eat near the hospital and I am now back in Piazza. And it is now time for a nap - I'm not used to an 8 hr work day, much less starting work @ 7:30. Tomorrow is a big day (hoping all is set with the blood) and I hope it goes off without a hitch (not to mention I'm giving a tour of the mission to a group of US students followed by a senior concert at the music college across the road, and then dinner with a family friend).
The road goes on forever and the party never ends...
Comments