1/11/16 - We are the same on the inside

Today was another day of working on the wards around the hospital and enjoying learning from each other from both clinical and personal experiences. The common theme that I seem to notice, is that we are all pretty similar. It might be that I have a bias because I tend to look for the things that make us the same rather than what makes us different, but today was full of examples.

We have started as a morning routine, those that wish have been going down into the valley for a run or walk to start the day as the sun is coming up at 6 am. It is fairly easy to be awake and alert (and to fall asleep by 8:00 if you don't keep busy) when the sun rises and sets at 6:30 AM and 6:30 PM. Today we decided to take it easy and walk since most of us didn't feel as well rested thanks to the roosters and a couple of really aggressive dogs last night. It was amazing to enjoy the scenery of mountains all around, the sun shiny through the clouds, and a thick fog drifting in the distant valley. Since w have arrived, there has been rain every day which has made the gardens grow and turns the entire valley from brown and gold to green lush growth.

We split off into our respective groups, with one going to the outpatient HIV clinic, another to inpatient rounds, and a small group to hospice rounds, visiting people in their homes. It was really great to hear the stories of the team doing hospice as they had a chance to see the places that people live and feel the real appreciation for the work that those who have come before us have started and we are privileged to be a part of carrying on. It seems that these patients, with chronic illnesses with little hope of ending their suffering with complete healing, just needed to feel that people remember them by coming to visit and bringing very small gifts such as clean towels, Vaseline, soap and personal care items. No matter if you are suffering through illness at the fanciest care facility back home or in a mud hut in Tanzania, you just need to find comfort in knowing you are not alone.

My experience today was on the equivalent of a maternity care ward with managing patients who are pregnant and may have some complications, those that are in labor, and those that are getting ready to go home after their delivery. Because of some complications in labor, we decided that two women needed cesarean sections. No matter if you are white, black, yellow, or some other color on the outside, when the scalpel comes out, we are the same on the inside. Cutting through layers of different tissues, the end result is a crying infant, ready to face a whole new world with the help of its mother and family. Not all stories are happy endings, though. Yesterday, there was a baby who did not survive due to a prolonged labor and today the mom had to go home. She was discharged with a group of women from the day before. The rest of the moms and her lined up at the nurses station waiting for their papers. This women waited with tears streaming down her face as she responded to the nurse to explain her baby had died, with the nurse softly patting her shoulder saying, "pole sana", I am very sorry. I wished I had the ability to communicate to her that she had suffered a great loss and she will be  sad - this was supposed to be the day after her first baby was born and instead she would be taking a tiny body home for burial. Even in English, I have no words. I know many patients and friends that have suffered  the loss of a baby and even in a luxurious birthing suite somewhere in Minnesota, the grief is unbearable and I have no words that could take it away. Again, we are all the same on the inside.

Finally, with no graceful or smooth transition, I will talk about the happy ending to our night. We decided to go to the local watering hole which used to be called The Peace Garden, but has changed many times over the years but is where the team always goes to grab a drink. We made a short walk and just barely got in before the start of a tremendous downpour. We grabbed our drinks and sat to listen to rain beating on the tin roof. One of the workers had brought her baby with and we marveled at how adorable she was. The mother smiled and untied the baby off her back and gave her to us to hold. All of us smiled and laughed as the little girl examined our faces, glasses, jewelry and clothing with small giggles and smiles. As we were marveling, one group member said how wonderful it is that babies are the same wherever you go - "curious and getting to know the world", and "they are all cute and happy.". Well said, and fitting for the thoughts that had already been in my head.