Max and I are in disbelief that this will be our second to last update, but it's been a wonderful past few months and we still have a week left, so we can't get too sad yet.
I had an interesting week in the hospital with Jenn and a social service doctor who is taking over for Dr. Charles as he takes two weeks of vacation time. The new social service doctor is not very communicative, so hasn't been all that helpful with special cases and such, but he's nice enough. It has really emphasized for me how important the Honduran fellow is to provide some kind of continuity and local knowledge to the clinic. Pediatricians coming for a month at a time just really can't do it on their own.
I was happy to see the Global Healing ultrasound put to good use this week. The ultrasound is huge and was donated a couple of months ago. It's been sitting in the corner of the clinic for that time without much use, as no one in the hospital is trained in reading ultrasounds. Additionally, we don't want to move it out of the clinic in case parts (or all) of it get stolen, as happened with the last one, apparently. Howard has been organizing a visit for a couple of radiologists and an ultrasound tech to come down in February and teach local doctors how to use it, which I think will be great. Hopefully then it will be put to good work! Anyway, the surgeon did come by to use it once this week on a woman she believed had gall stones, but she couldn't actually find any in the ultrasound. Jenn also used it twice - once on a boy she wanted to check for an inflamed kidney and another time on a boy's brain.
The second case was pretty interesting. It was a premature baby (born at about 7 months and 1600 grams) who had been in the clinic for weight checks every week since he was born. He was growing very slowly (was 1900 grams this past week), but Jenn was the first doctor to feel his head and realize that his sutures were completely open and his posterior fontanelle was also very large. He presented with a fever of 101.6 degrees, so Jenn wanted to put him on antibiotics and admit him for the fever before we worried about the sutures. She sent him to the ER and went back after about an hour to check on him, only to realize that the ER had not even started the antibiotics because they were "waiting for a bed to free up." She was very angry and frustrated that there seemed to be no thinking outside the box, especially since it should be fairly obvious that the baby needed to be on antibitics asap and could really be put on any surface to do so. Additionally, when the did finally clear out a bed from him, they didn't change the sheets in between patients.
After the antibiotics were administered, we brought the baby back into the clinic and did an ultrasound on the brain. He seems to have pretty severe hydrocephalus, and Jenn was able to send pictures we took of the screen to a neurologist in the US for a consult, which was great. I cannot even imagine how much more difficult international work like this was before the internet...
The hardest part for me of the whole encounter was having to explain to the mom what it was we were doing and that her son would not develop normally, resulting in lower intelligence, decreased motor function, etc. It just all came out of nowhere, since she'd been coming to check-ups with the clinic for a few weeks and no one had caught the hydrocephalus before.
Also this week, I started tutoring a local high school graduate to prepare her for the SAT, as she's hoping to go to the US for college next year. I had taken her to the test in La Ceiba about a month ago, but her scores were not as high as she had hoped, so she'll take it again in January. She's fun to work with and I'm hoping someone else will be able to take over after next week, although I doubt that will be a problem with all the volunteers that come through Peggy's house.
