Tuesday, October 02, 2007

The boy from Africa

Edward is 9, and when he first came in to he ER he was in terrible shape. His dad was with him, and both were falling asleep they was so exhausted. Edward has two siblings and he's the oldest. They all speak French, because that's spoken along the Ivory Coast. I have been thinking of going for two months to Africa during the spring of my 4th year, and this really made me want to even more.

Edward was rather depressed and rather in pain for most of the first of the week he stayed with us. He had his knees retapped and his hip tapped to draw off some of the fluid of the effusion that was causing the pain and swelling. That helped with some pain, and we eventually had him on opiate painkillers as well as super high strength NSAIDs. We drew blood for so many labs, and the anemia he already had got worse and we transfused him by the time he left. We did a chest x-ray to screen him for Tb and that resulted in his getting a CT that found a big lung cyst we feared was an infection called pneumocystis, that would indicate he had AIDS. He got a bronchoscopy of his lungs that I got to assist on as his 'doctor', and it was hard when he came out of anesthesia because he was screaming and terrified.

After almost a week we had Edward on IV fluids part time and his pain was a whole lot better, but he was still not too happy. He hadn't been outside since arriving, and had been wheeled around the hospital only a little. Mostly he was confined to his room, and the shades were almost always draw. So, one afternoon when I was free of work, I had the intern, my friend David, write an order to allow him a 1 hour leave to go outside and have a break. Edward told the translator that she and his mom were not allowed to go; he just wanted it to be me and him. His student nurse had to go though to keep an eye on him. We had a syringe squirt gun fight and I got soaked. I raced him down the hospital lobby hallway in his wheelchair. We went outside and did some off road wheelchairing, then played catch, soccer, stickball, and dodgeball in the grass. I worked real hard and eventually got Edward throwing his hands up and giving a big man yell as loud as he could. That was one of the most awesome things I've ever seen. Then we went and bought a chocolate bar and some juice. Later that evening he was voluntarily leaving his bed to show one of the peds residents he could use his walker and take a few steps (he had been getting PT and OT to help him increase his range of motion and his strength). That resident, Kelly, was one of the first to notice what a change he had taken.

The next couple days he was so much happier. He was chatty, and even a little pouty in a little kid way. The former somberness was mostly all gone. We had a wrestling match where he tried to break my arm and a game of catch with the whole care team of doctors with him after that. He also had really caught on to the secret hand shake I had been working on teaching him. I had an action figure named after me.

I never really learned any French beyond "bonjour" and "Salut" and "Sefe fe mal?" (supposed to be "does it hurt?", though I'm sure I wrote that wrong). We didn't need to speak the same language though. We spoke boy.