Waiting for a CT

Rounding on the children's ward today, I was struck by my limits as a physician. One of my young patients continues to vomit and lose weight despite multiple interventions, and a recent head ultrasound shows significant hydrocephalus. Without a head CT, I cannot know what is causing the hydrocephalus. The surgeons may be able to place a shunt to drain the fluid, but I know I have reached the end of my abilities as a pediatrician. I stood helplessly in front of the mother today, watching her tend to the twins... one fat and healthy, the other one wasting away. I longed to transfer her to the nonexistent pediatric neurosurgical service, but I knew many life-altering decisions were in my hands alone.

In traveling to Cameroon, I have made several goals for myself. First, I want to support Kara Beth in a difficult, grueling, and isolating field. Secondly, I want to teach the Cameroonian residents about caring for children, especially with regard to treatment of infectious diseases. Thirdly, I want to help the hospital staff intervene effectively in the first few minutes and days of life to prevent neonatal mortality. I cannot do any of these things alone, but I hope that the residents will remember one small point about lumbar punctures, fevers, or ventilation when I leave.

After the frustration of seeing the little girl with hydrocephalus, I came upon another infant girl with high fevers. This time, I discovered that the residents had followed the advice of my recent lecture and obtained a lumbar puncture at admission. They also looked in the patient's ears and found an ear infection, saving this baby from unnecessary IV antibiotics and hospitalization. Watching this baby improve and prepare for discharge, I was again hopeful for Cameroon. With each improvement in practice and newly trained resident, the dream of advanced medical care is further realized.