Another day at the hospital.....

Becky and I experienced another heartwrenching story this morning........A father showed up at the emergency check-in area with his 10 year daughter looking very, very ill. He had been out of town several days apparently and arrived home to find his daughter sick. The girl's name was "Rachael"........she had a seizure while they were checking her in to be seen by the medical staff. Apparently she had been seen by a local clinic in Gambaga just 3 days ago for similar symptoms but we were unclear as to what treatment had been rendered. She was lethargic, not eating, and very weak by the father's report. She was rushed down to the Theatre area where we all hang out on Tuesdays and Thursdays. She looked very ill, curled up in a ball on the cart, foaming from her mouth, wimpering. Becky and I looked her over and Dr. Faile wanted us to proceed with a lumbar puncture to rule out meningitis. After what we have seen over and over here, we were apprehensive to say the least. With the help of the tech and father, we rolled her to her side and Becky was able to get a very cloudy, slightly bloody spinal fluid from her back. Initially the fluid came quickly, the it slowed. We sent it for immediate gram stain and cell count and took her to the isolation ward. Becky ordered stat antibiotics, labs, treated her for seizures, and started IV fluids. Things were not looking so good as the next few minutes passed. When I gazed over where her father stood at the end of the bed, Rachael started to have agonal breathing - a labored breathing pattern that can mean herniation of the brain and increased pressure on the brain. Becky and I watched over the next several minutes, and we knew in our hearts it was going to be over soon - Rachael would need a miracle to survive the infection we believed she had. We called for the chaplain, and then met with the father to tell him of the impending death of his 10 year old daughter. Our hearts just sank, as we sat and watched her for the next 45 minutes succumb to her overwhelming infection of the brain. Throughout our time with Rachal, the father stood at the end of the bed, coming in and out of the ward, never once holding his daughter, touching her or speaking to her......a woman came in shortly later, we assumed it was her mother, but we didn't know for sure....she also stood at the end of the bed, watching patiently to see what was going to happen. The father then picked up a small metal basin, filled it with cool water and sponged his daughter to try and cool her. Her temperature was well over 104 degrees.......as he sponged her so gently, with the mother standing at the end of the bed, Rachael took her last breath. The woman cried for just an instant........Becky listened and could hear no heart beat.....her battle was over................it's overwhelming at times to see all this......a few hours later we checked on her spinal fluid results. She had Neisseria Meningititis on gram stain in large amounts. Despite our efforts, Rachael was going to die......even in the US children and adults may not survive an infection of this magnitude. And I say again, this happens all over this hospital and others like it in Africa all day long.......

There are many miracles here at BMC too......many that we do save with meningitis, and in fact the woman who was in the bed next to Rachael, had severe mengititis on admission and is doing great and will go home soon........she sat and watched, as did all the other patients and families in the isolation ward, as we did our best to care for Rachael.........

Good night from Ghana........we leave at 4:30 am for Tamale then onto Accra for some rest and relaxation. We should have wireless in the hotel to keep blogging for everybody. This experience has changed us all - I can't speak for all the others, but I don't think any of us will leave the same person that we came......a better appreciation for life and death, and how others live in this world. So long from BMC. All is well as we pack for our trip home.