Typhoid Girl

The general atmosphere and attitude of the people here towards the sick is so frustrating!  They've come to accept death as part of daily life, so when people do die, sure the mother and female direct relatives might wail, but the rest of the community just goes on living their lives as if nothing happened.  Even at the scene of death, you see these nurses just sauntering about as if there's nothing going on.  It's so frustrating!

And the reason I say that is because I recently found out that the girl we did the paracentesis on and prayed her had passed away - probably on the day I had left for the training!  I was pretty angry and disappointed when I heard that because I had really thought she had a good chance of improving.  At the same time, I knew she was really doing poorly, and I thought she needed a bowel washout and repair and probably a pleural drain for her all the pus that I thought was in her lungs, and I kept on saying all that to the doctor, but he just ignored me.  Well, not exactly ignore, but he would say he's at the outpatient, or I would just not round on her properly in the mornings, or refuse to take her to the OR because it's the night time/afternoon or the weekend, or not a theater day, or there's construction going on in the main OR.  I had even warned him that I'm pretty sure she had pleural fluid and maybe an empyema, and to drain her on Monday because I was leaving, but I doubt he actually did.  Ugh, I had too much a false sense of security after she improved a little symptomatically after the paracentesis - she even passed stool.  I felt so guilty knowing that I could have done something earlier, but didn't push enough to get them done.  I felt guilty leaving for a training session and not finishing caring for her.  Given my lack of clinical experience, I have a hard time knowing when I should push for something to be done or not, especially when other people who are more experienced clinically than me choose not to do it because of their laziness or apathy.  And most of the time, I only know afterwards that it was too late.  

When I had spoken to the UK doctor, he comforted me slightly by saying that a perforated abdomen was a really poor prognosis anyways for typhoid (which I think she had given the gross fluid from the paracentesis), but I still wish I had pushed for the paracentesis/lung drianage/empiric sepsis antibiotics earlier.  

:(