The little guy with the case of severe malaria was sitting up in bed this morning, awake and alert to his surroundings. It looks like he’s made it. It's pretty amazing. There were times on Monday when we thought we were watching him take his last breath.
The ward rounds continue to bring us interesting and
challenging cases. We diagnosed a teenager who had been coughing up blood for a
few months with pulmonary tuberculosis. An adult patient with bad headache,
body aches, and fever was diagnosed with a serious case of malaria, but was
also newly diagnosed with AIDS. We’ve had two patients this week with advanced
esophageal cancer, one of which has a stent that had been placed in her esophagus and is on
liquid morphine for palliative care. In Africa, unlike the US where you are never more
than a stone’s throw away from a narcotic pain pill, it is very difficult to come
by morphine and its derivatives. I was quite happy to see that this woman with
terminal cancer had appropriately been prescribed a medicine that would help
ease the pain of a very debilitating disease. The medical team had a good discussion
on end-of-life care at her bedside, covering some of the many issues that are
involved in trying to facilitate a dignified death. She has a difficult road ahead.