First call - done!

My first call night is over and now I am onto my second.  Thank you for your prayers! There is never a dull moment.  I had my first in the middle of the night c/s (cesarean section).  I also had a post-partum seizing HELLP syndrome patient come through the door.  HELLP is a disease of pregnancy that we see occasionally in the States, but rarely do we ever see those patients actually have seizures.  Severe forms of HELLP can be life threatening and in Africa it seems that you never see anything less than the severe form of any disease.  This patient’s overall presentation was a little bit unusual, hypotension instead of hypertension, normal urine protein instead of high urine protein, normal hematocrit instead of being hemoconcentrated.  I prayed about it asking for wisdom as I waited for the labs to come back and when they did the Lord made it obvious.  At home eclampsia or HELLP syndrome might be top on your list, but here malaria, parasite infections, electrolyte abnormalities from dehydration, epilepsy all must be considered.  The differential diagnosis is just so different.  Often with the lack of patient education and the language barrier getting a good history out of the patient is almost impossible.  I put her on IV magnesium to stop the seizures and she has done great since her arrival though and will likely be going home soon!  Praise God!

Something I have been thinking about since coming here is how little my medicine matters compared to the Lord.  We can do everything known to medicine, everything the lastest and greatest research tells us to do and still not be able to save a patient or be able to improve their lives.  That control ultimately doesn’t belong to me, or any other doctor.  It belongs solely to the Lord.  I think He has been teaching me about how little control I have and how great of control He has.  So humbling and yet also sort of a relief.  God calls us to give everything our best effort, to work with such conviction as if our every act was for the Lord directly.  He demands high quality work, but the ultimate result is never taken out of His hands no matter how seemingly perfect our efforts appear.  There is a popular worship song that has a line that goes “I want more of You and less of me.”  I sort of think it should be changed to “I want all of You and none of me.”  Take me out of the equation.  Apart from Him nothing matters.  Mother Theresa talks about her attitude when it comes to working for the Lord in this quote which I love, “I am simply a pencil in the hand of God.” That totally sums it up.  I am now coming up on my second call night – such a great thing to keep in mind.

It is mid-afternoon as I write this and the temperature is rising.  The pattern seems to be that the heat builds throughout the day until the daily afternoon storm.  The storm seems to last for less than an hour, but the amount of rain dumped in that time is probably more than California could hope for in 2 years.  It is always important to keep track of the time and the clouds so that you don’t get caught out in it!  The humidity here has made every book and piece of paper I brought with me buckle.  I guess it is living proof that things here are always wet.  This might be too much information, but I have been sweating so much that my sweat is no longer salty! So weird!

As today is Sunday I had the chance to go to one of the local churches.  The service was all in French, but it didn’t really matter.  Church services are a full body worship experience.  There is singing, dancing, cheering, clapping and just about everything in between.  It makes us Amercians look so boring!  The pastors seem to think that the louder and more animated they are the better they are at reaching their audience.  Watching a grown man jump around on stage, shouting into a microphone in a language you don’t understand is actually pretty funny.  I love their enthusiasm.  I almost wonder if that is how God intended worship to be….so overwhelming that you almost want to explode with joy! Tonight there is going to be a worship service on the compound in English.  I am really looking forward to this, but I am sure it won’t be nearly as animated!