Last week in Vanuatu: Part II

So this post is picking up from where the previous one left off about our last week in Vanuatu. If you’re feeling confused, try reading the last one, might put things into context 😀

With Dr. S

After dinner on Tuesday night with Dr.L, we took a quick siesta back at Mangos before heading back to the hospital for a night shift on call. Nothing had happened on my previous on call, but this time Aaron and I split up in the hospital to cover more ground. He slept in maternity and I slept in peds, and we wrote our names on the medical and surgical wards to be called if anything came through. At 10pm I crawled into my tiny peds cot, and slept under the furiously spinning fan. I thought it was going to be another silent night as nothing happened in the first few hours.

It was 5am when I heard a knock on the door and the lights flashed on blinding me momentarily. It was Dr. S, he said there was some complications with a newborn up in Maternity. I chased him up there and woke up Aaron along the way. We took our shoes off and entered the NICU where the baby was in obvious distress.

The baby had been born during the day, but was in intensive care because of meconium aspiration. Now the child was in acute distress. Dr. S went into action with newborn CPR, we stood behind still getting out of our haze. As Dr.S was performing CPR I was flashing back to earlier today. It was really a weird situation, calmer than before without all the crowd but I didn’t have the optimism I had that afternoon. I didn’t know what to expect but I didn’t see it coming when Dr. S stopped performing CPR. The child had passed away, in only 24 hours we had witnessed two of the most shocking moments of our careers so far. It was nearly 6 am when the Dr. S left the room to talk with the mother and we heard the cry through the door. At that moment I thought it was going to be on of those days, when nothing would go right and no matter what we did we would fail on every front. It was especially weird when Dr. S asked us to examine the newborn for sign’s of life and try newborn resuscitation techniques. It was a strange and fearful experience learning in that situation, but we couldn’t see an alternative and appreciated the opportunity to gain experience without risking further damage. Sometimes, like this, medical education seems very weird and barbaric, at the time it’s easy to justify it with the idea of helping out in the future but I’m not fully sure it appropriate.

Feeling right at home 😀

 

Our Maternity friends 😀

When we we’re feeling our lowest one of the nurses from maternity came to get us. There was a new birth in the ward and we were invited to go watch. Seeing a successful birth was a great change of events and got us energized and excited again for rounds in the morning.

After a quick break to shower and eat breakfast we headed back to the medical ward for rounds. Some of the new patients were one’s that we had admitted from Clinic the day before so it was interesting to present cases during rounds and know a lot of the details. There was one patient with advanced Cirrhosis with ascites and an extremely distended stomach with a inverted belly button. The patient was terminal but we had admitted him for a palliative drainage of the fluid in his belly (paracentesis).

Our medical ward friends

It was my turn to do this and I had spent some of our time the night before reading up about the details of how to do it. It seemed pretty straight forward, follow sterile procedures and stick a needle in to drain the fluid.  As Dr. L looked on, I began the procedure and slowly setting up my tray and prepping the patient. The whole thing was very straightforward, but I still felt a big sense of relief when I saw the backflow of yellow fluid through the needle.  I connected the draining tube and collecting bag and the golden fluid slowly flowed out.

We packed up all the supplies and went back to dispose the sharps. In the 10 minutes we were away, the draining bag had filled up (nearly 2 litres). In the next 24 hours, the nurses drained the bag another 5 times removing almost 12 liters of fluid. It was still obvious the patient had fluid remaining in his belly but we were worried about the patient’s blood pressure so we stopped the drainage. I felt pretty good about doing so well on the drainage, it felt weird to stop it since it was so successful. I really wanted to see the final number of liters drained but I also didn’t want any harm to come to the patient. It’s an odd thing being a medical student, wanting to learn and see interesting presentations but also fearing what that means for the patient.

Our almost unstoppable trivia night team 😀

When our rounds finally ended we went back to mangos to crash. It wasn’t till 6pm that we woke up, it was nearly time for trivia night with all our baby doc friends. We headed to Coconut Palms, a nearby hostel to defend our trivia night victory from the week before. Our group was well balanced, 2 Kiwis, 2 Brits, 1 Ni-van (Dr.S) and us two Canucks. James, the Ni-van trivia night master, read the clues in his usual incomprehensible yet hilarious way. It was our fourth week, so it was easy to decipher his clues, and our group managed to squeak out an early lead. A few stumbles in the music round with our limited knowledge of Madonna singles and Nickleback history dropped us back into second late in the night. That’s where we finished when it was all over, but the night was just getting started as we reflected on the past 48 hours.

I won’t go into any more detail on our night, the photos tell enough of the story. Part III covers our last weekend in Vanuatu when we hiked a volcano in Ambrym. It was by far our best non-medical experience so far, so stay tuned (if you can) :D!

Ambrym, read part III for more details 😀

Thanks for reading!