A big day in pediatrics.

Hi, this is Hailey.
So today is Wednesday. I expected to spend the morning at what is called the CTC clinic, where outpatients with HIV come to get checked up and refill their medications. But for some reason there were about 50 people crammed into the small CTC room, and all the goings-on were in kiswahili so I decided it wasn't worthwhile to stay. I wandered back toward the larger pediatric ward in hopes of finding something to do, when I found Brad, a medical assistant from Salem, OR who happens to be here with a Salem pediatrician for the week (amazing coincidence, eh?) who was walking over to meet Dr. Temple (said pediatrician) for rounds. The first few patients were quite typical for Mt. Meru, a child with fever is treated for malaria. A child with diarrhea and vomiting are treated for gastroenteritis. A child with a cough and trouble breathing is treated for pneumonia. The cost-effectiveness of testing for these maladies is poor, it is better in general just to treat. The next patient had a congenital hydroencephalus, and I got to see my first trans-fontanelle brain ultrasound. The child was sent to a nearby city to have a shunt placed to drain the fluid off the brain, as they can't currently do it at Mt. Meru. The next patient had cerebral palsy and suspected pneumonia, in general he was in good health which was good to see as it can be quite difficult to manage with limited resources. The next thing I know, there is a lot of ruckus coming from the ward next door. We ran over to find that two infants we had been following the last several days, both with HIV and pneumocystis pneumonia, were both coding at the same time. We started rescuscitation, and one, the sicker of the two, revived and started breathing on his own after only a minute or so of ventilation. The other, we started CPR. I have never done chest compressions on an infant before, the feeling was overwhelming. We tried for several minutes with CPR and epinephrine but were unable to revive her. It was very sad. We had watched her since Monday breathe with increasing difficulty, and the doctors had been saying that she would tire out eventually. I thought that she would hang on longer than the little boy, but no. Her mom, also HIV positive, was distraught.

We came to Tanzania to experience a breadth of human suffering unlike what we would see in the States, and certainly we have had such experiences in only two short weeks. Though it is often difficult, it is always worthwhile. We are learning so much and feeling so much every day. It is nice, after months of book labor and studying, to be so vividly reminded of why we chose to come to medical school.