The clinic day was drawing to a close, as our OB/Gyn was finishing up his last few patients. Two nurses were still hanging around, talking and laughing with a few of our check-in staff. The generator had been turned off and locked up until the next day. The common sound of a motorcycle grew louder as the driver and his passenger stopped in front of the hospital.
A 20-something young man, who looked pretty “street tough” quickly got off of the motorcycle and approached me. “My child took a whole bunch of his mom’s pills and won’t stop crying!!” he quickly and breathlessly shared. “Where is the child?” I asked. “Can you bring the child here? And any information about what medicine he took?” I asked as he turned toward the awaiting motorcycle, got on and said “I will be right back!” I started looking at our inventory of what we had for such an event and realized we were dreadfully unprepared, but nonetheless, we were the only facility near to where the child lived.
After several minutes, the young man, the child and the child’s mother returned on the same motorcycle. The sound of the child’s moaning and wailing echoed throughout the hospital. I carried the child into the hospital, and placed him into the arms of one of our nurses and asked her to take vitals and monitor him. I then started quizzing the parents:
· “When did he take the pills?”: About 10:00-10:30 (4-5 hours prior)
· “What kind of pills?: We think they are called <a brand name I did not know>
· “How many did he take?”: We think he took 10
· “What are his symptoms up to this point?”: Crying without stopping, writhing, not able to focus
…and the questions continued, vomiting? Diarrhea? Fever? Etc etc.
So as I recalled back to my days in the ER in the US, what would we do? Among other things we would contact the Poison Control Center and get their advice. I was afraid to induce vomiting because of the time since the ingestion and the risk of aspiration. Maybe the Poison Control Center would know. So off I went to find the number. I grabbed my phone, and, the internet was not working. I kept trying but to no avail. I finally found the number on a drug pamphlet in the pharmacy and dialed the number.
“Poison Control Center. You realize you are calling New York?” “Yes, Ma’am, I really don’t care where you are if you could give me some advice.”
By this time, I had contacted a Haitian pharmacist friend who had given me the generic for the med, and wished me good luck.
“Sir, what is your situation?” With as much brevity as I could muster, I explained the situation medically. “According to our toxicologist, here is what we suggest.” She began with a list of things for us to do, and to most things she suggested, I responded with, “we can’t do that here.” “Oh! Well let me have you talk to someone else.”
After another conversation the second MD finally said, “well, what do you have there?” I gave him the short list, he muttered some expletive and said, “Well, what you have done and not done so far is good. At this point, I would monitor and if things get worse, then move onto more aggressive emergency measures. Good luck!” That was the second “good luck” I had received. I think they are like strikes: 3 and you’re out!
So, we waited. Time crept slowly as the child screamed. We continued monitoring, and watching,…… and waiting. Finally, the wailing subsided. The writhing slowed, and monitored sleep crept over him. I put my arm around his father, who had been sobbing, and he slowly smiled, as if hope had once again found him.
We waited some more and the little one asked for a drink of water. Some sips were given and we watched some more. Eventually, we had just a sleepy, normal 3-year-old with us, and mom and dad asked if they could return home. After a little longer, we dismissed them, adding that they should bring him back immediately if anything changed. I am not sure what we would have done, but at least we had a few options. Dad asked our security guard at the hospital to call a motorcycle to pick them up. As they left the building, the dad gave me a hug and said two things in broken English: “thank you!” and “God bless you!”
I am still not sure what I had done. I really offered no real solution. I had only made several calls and confirmed that we were doing the right things and not the wrong things. Our staff and I had done our best with what we had but still felt woefully inadequate. This had a happy ending but, what about the next child? The next patient? We knew we had some work to do so we could be prepared for whatever came the next time.
The Poison control center was wonderful! Not only were they attentive and offered help when I called, but they called again a couple of hours after the initial call and then again the next day. They, like me, felt helpless, but wanted to offer me some hope and encouragement.
It is in situations like this that all of the medical training in the world can’t help, especially if all of the resources are not at your disposal. It is especially frustrating because you know what to do, you are advised what to do, but you don’t have what you need to accomplish it.
|Photo Credit: maternalmedia.com|
Hope. It is so important! Sometimes even if we don’t know what to do, or what to say, just caring and being there can offer that modicum of hope.
We as Christians are lucky! We realize that so often we don’t know what to do or what to say, the feeling that we don’t have what we need to fix the problem. If we simply ask, there is someone always around to buoy us and give us hope. May we never forget that hope can be found if we just look for it. Jesus guaranteed it!
“….for I am with you always…..”