I WAS sleeping this morning when I got a call on the two-way radio. I was glad to wake up because I was having a weird dream. The dream was stopped by the call, but it continued to echo.
The story began a year ago when a 13 year old girl was admitted feeling tired and weak. She had experienced weight loss and fever and was thin. She sat there very quietly and didn't utter a word.
At a loss for a diagnosis, I started her on treatment for sputum negative tuberculosis. Within a week she had improved and regained strength.
On a hunch we did a TSH test to check her thyroid gland. It showed she had hypothyroidism. I was assisting a mum deliver a baby when Dr Sharon popped by to give me the results.
The laboratory test had been done in Cairns and the results came back four weeks later. As the girl was into her second month of TB treatment, this was continued.
She remained quiet and shy through this process but her health improved and she was discharged.
Last week I was called to OPD to review a sick patient. There was a young woman sitting on a wooden block with her a shirt over her head.
She was in desperate pain and discomfort but not complaining.
I asked for her name. When I heard it, and all the memories came back and continued to echo. A Papua New Guinea echo.
She had pulmonary oedema and renal failure as well as a corneal ulcer.
Initially she improved but her creatinine showed she wouldn't make it.
She had been brought in by neighbours who said she was neglected. Mum and dad got up early to go the gardens and came back late at night to cook, eat and sleep.
The neighbour saw she was very unwell and he and his wife brought her to hospital. When I said she would be admitted, they said they would go back and let the parents know.
The parents came. She remained in hospital in bed; sleeping and with no energy. She was still very quiet, not uttering a word. An echo of her former self.
I woke up thankfully from my nightmare and went to the ward to review her; not willing to give an inch in the defence of her right to life.
When I saw her, I knew it was a lost cause. Community health workers Rita and Sammy did an excellent job. Sammy assisted to put in an NGT [nasogastric tube]. Awesome staff members.
Whilst positioning her in the coma position and splinting her arms I ran out of gauge bandage. Her mum sat down and I asked her to assist me hold the girl’s hand.
All through this I was automatically going through the motions I’d been trained to do for someone in a coma. I felt no emotion. The soldier in me turned on and I automatically commenced the drill.
My only thought was why was the mum was not helping me properly. I put it down to her not being a trained medical person.
Then the mum stifled a cry.
Only then did I realise this was a mother watching her child die. I asked if she was the mum. She said she was the adoptive mum. The biological mum, the first wife, had died.
I saw her distress behind that tough face that Papua New Guineans have when they've been through a lot and have arrived at yet another tough situation.
Walking back to my house, I was crossing the bridge when I was affected by what had just happened.
An hour later, the family members were at the hospital and I explained the dire situation. In these sad scenarios, I advise the relatives to take the patient home before they die as transporting a live person is easier then transporting a deceased person.
The dad asked for the hospital ambulance to take them home. Due to cuts in the Christian Health Service budget this had to be paid for. The dad said he had only 10 kina.
It was another reminder that, for subsistence farmers, the modern world has left no safeguard.
There was a hospital vehicle going to town, so they were able to go back with the young girl without payment - bittersweet consolation that it was.
I was called into the ward at lunch time to review another patient recovering from a pig bite and when I turned around and saw the empty bed, I started with a shock.
Then I remembered what had happened to the young girl from the first time she came here to this morning. It was all an echo. A Papua New Guinea echo.
This young woman lost her life, but through it all she never uttered a word or complained. She accepted that this was her lot in her short time on earth. A precious soul.
She may have gone, but there's a doctor in Rumginae who’s half the man he used to be.