Nathan’s Notes – Mr. J

 

On my first day rounding for internal medicine service I met Mr. J.  Mr. J had an ascending paralysis.  This left him unable to move his arms or legs and he could only sit up with the help of his watchman (a family member who comes to the hospital and helps the patient with their needs while in the hospital).  Dr. Bill and I are pretty sure he has GBS.  It is thought that GBS is a rare side effect of some viruses.  The problem is that if the paralysis extends to the muscles of the chest the patient will not be able to breath and then would require a ventilator.  Kudjip does not have a ventilator.  We were quite concerned.   Despite Mr. J’s dire situation he always has had a huge infectious smile.

After 5 days rounding with no change we stopped to talk with Mr. J.  He could move his little finger and raise his hand off the bed.  There is no easy way in Pidgin to explain such a complex illness.  Dr. Bill began to share our earlier fears, that his lungs would stop working.  That it was as if God had drawn a line across his body and told the paralysis to stop there and go no further.  The smile on Mr. J’s face grew bigger as he more deeply grasped the situation and the goodness of God.

This weekend I had the opportunity to see Mr. J again.  He smiled as I walked onto the ward and showed me he could lift a foot and his hand.  There is no mediation to treat GBS.  All you can do is support, provide oxygen, and pray.  We serve a big God.  Please pray for Mr. J that he will continue to regain his strength and be able to walk out of the hospital soon.

Nathan’s Notes – Day 1

It was a beautiful March morning in 2017 as I entered B ward of Kudjip Nazarene Hospital.  The sun was softly streaming through giant windows.  The walls were a clean white.  On the nurses station was a sign “We treat, Jesus Heals.”  Thirty some patients were patiently waiting to see one of the two teams of doctors.  Today was my first day on the ward and I was working with Dr. Bill, a long time physician at Kudjip.  We began examining patients and talking about their treatment plans and progress.

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Our first patient had altered mental status with episodic fevers.  His presumed diagnosis is Typhoid with improving encephalopathy (infection of the brain).  We are encouraged as family has noticed he is acting more like himself.  My mind is racing.  “Typhoid?  I think the last time I read much on this was medical school 11 years ago.”

The 2nd patient has a diabetic foot ulcer after stepping on a nail.  Looks like he needs further surgical detriment to remove the dead tissue around the wound.   Okay, I’ve seen a lot of this in rural Oregon, but how do I counsel a low sugar diet in a country that is totally carb based?

The 3rd patient has fever of unknown origin.  We think typhoid but the test we have to confirm this is very unreliable, only slightly better than a flip of a coin.  She is possibly improving.  We will check a blood test and get a follow up chest X-ray and reevaluate later.

Forth, another possible typhoid and, no, typhoid is not an epidemic, this is typical life in the highlands.

Fifth, liver cancer.  We are trying to make him comfortable and get him home.  We will talk with the chaplain later today.

The sixth patient has ascending weakness.  We think post viral.  Could be Tb of the brain but we have no CT machine to evaluate this.

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In spite of challenges, he greets Nathan with a smile every morning

Next, the seventh patient has HIV and dysentery (bloody diarrhea).  Presumed opportunistic infection.  Symptoms slowly improving.  Hopefully we can get her well enough to get on some meds for her HIV.

The eighth patient has TB  and seizures.  Unclear if the seizures are from his TB or his medications or both.  Seems to be doing better on his new anti seizure medicine so we will monitor a little longer.

And the ninth has weight loss, with presumed adrenal insufficiency and TB.

I glance at my watch its only 9:30AM.  Most of the problems I’ve seen are rare in the USA and would not cross my mind in evaluating a sick person in Oregon.  And so the day went, one new problem after another.  “We Treat, Jesus Heals.”  We do our best to help each patient and share the love and hope we have in Jesus Christ.  Some patients will get physically better and others won’t.  We pray all learn of and see the love of Jesus.  Only in Him can we hope to truly heal the broken.