What’s Up, Doc? July 9, 2012

Rocky said, “Doc, it’s only a scratch.”–Paul McCartney

“I cut my leg, and I think it might be infected.” These words would make anyone nervous in any environment. But in a muddy, muggy, buggy, tropical environment, they carry a bit more weight. And that weight came crashing in last week when one of the other visiting teachers showed me her leg.  A thin scratch lined  a red, inflamed and swollen calf. “It’s hot to the touch. What do you think?”

Now this woman is one of the more well-travelled people I know.  I often like to play a game where I try to think of remote and exotic locales, and ask her if she’s ever been there.  Uganda?  Guatemala?  Damascus? Mongolia? Yes, yes, yes, and yes– she’s been there and done that.  So when she asked me what I thought about the scratch on her leg, I didn’t know what to say.  I see her as the one who’s seen it all.  Um, how does it feel?  Do you think you should go to a doctor? I think there’s some Neosporin around here somewhere…..I got nothing.

“Well it doesn’t hurt that much. I don’t think I need a doctor. I’ll clean it out and clean it up.”

Sounds good to me.  The one piece of advice I did have was, “Draw a circle around it with a sharpie, and see if it gets bigger.”  Dr. Horace Mayo I am not.

Bell rings—Dash off to class—See you at lunch—Get on with the day.

Lunch rolls around-white rice and fill in the blank–my favorite. One person is noticeably absent from the table.  I ask the others if they’ve seen her.  A chorus of nos (no’s…nose?) is only countered with someone saying that her leg was bothering her, and she went to lay down.  Sounds good to me.

Bell rings–Study hall–Run off to bang my head against the language barrier and try to explain split infinitives to Chuukese children. I can barely explain them to American children.

Dinner rolls around-white rice and fill in  the other blank-my other favorite.  But someone is still missing.  This is no longer sounding good so a couple of us go out and knock on her door.  She doesn’t answer, concern rises as we walk into her house.  She’s not there.  We try to mask our worry with “Well, she must be feeling better and gotten gotten up.” Sure enough, when we return to the dining room, there she is, albeit looking somewhat wan.

“How are you feeling?”s are met with “Not so hot.”  She had to leave class early.  Apparently all of a sudden a wave of nausea and dizziness came crashing onto her shore and washed her out of the classroom and into her bedroom for the rest of the day until just now.  The afternoon had been a back and forth battle with throwing up and heavy crashing in bed.  She had come over to the dining room because, even though she wasn’t hungry, she hadn’t eaten all day and knew she should have something.  “I’m feeling better though, and should be fine after a good night’s sleep.”

Cut to: the next morning in our office.  “I think the infection looks better.  I think it’s smaller.  Take a look. What do you think?”  We’ve established by now that all my accumulated medical knowledge smaller the Higs-boson “god” particle. But even without a sharpie circle, it’s clear that the infection is not smaller but larger. Her leg is swollen and beginning to resemble an appendage from a Macy’s Thanksgiving Parade balloon.  “What’s that coming down Fifth Avenue?  Is it Snoopy?  Bullwinkle? No, it’s a big red, nasty, puffy leg.” It’s time to go to the hospital and see a real doctor.  This refrain is echoed by everyone on campus.  The call is made to Dr. Felix, a physician with whom the school works, and the appointment is set.  While the calls are being made, the patient tells me, “I just don’t want to ride on that road.”  Well suck it up, buttercup, a bouncy trouncy ride to the doctor or more vomiting and the probability of the infection worsening–you choose.  To be fair, she is also one of the most humble people I know, and I’m sure much of her reluctance to go stemmed from a desire not to impose on anyone.  But hey, it’s down the road for her, and the rest of us teach and carry on with the

tasks at hand.

Father Rich, the school director, returned from the hospital several hours later saying that her leg was indeed badly infected. The infection had gotten into her blood, and she had developed cellulitis.  Not good.  The prognosis was upbeat though.  She had been put on an I.V. drip of antibiotics.  She would have to spend a night in the hospital, and would most likely be given a heavy regimen of heavy antibiotics and discharged in the morning.  Preparations would be made here and supplies would be driven down to her this afternoon.

Wait a second!  Preparations?  Supplies?  I hear you asking, “What does she need?  She’s in the hospital.”  Let me tell you something, Bub.  This ain’t your fancy pants private hospital.  This ain’t your overcrowded public city hospital.  This ain’t even your Obamacare government-run nightmare socialist gulag hospital as painted by the tea party.  Haven’t you been reading.  This is Micronesia.  This is the third world to the tenth power.

Hanging sheets serve as doors to the ward rooms at the Weno hospital.

Preparations and supplies–no, not a book and reading glasses.  How about dinner?  There’s no food in the hospital here on Weno.  The school cook starts preparing some soup and (you guessed it) white rice.  How about water?  There’s no drinking water in the hospital here on Weno. Father Rich can pick some up on his way to see her this afternoon.  How about some sheets and a maybe a pillow?  There’s no linen service in the hospital here on Weno.  School staff can start gathering these up. How about someone to watch over her and make sure she’s okay during the night?  There is no nurse call button in the hospital here on Weno.  Ruffina and Artis, two women who work here at school will go down and sleep on the floor beside her bed.  Huh?  Yes, in an extension of the whole Chuukese extended family paragon, guests are not shooed out after visiting hours. There’s no visiting hours in the….Rather people, family and friends, sleep on the floor of the hospital room with a patient.

I offer to drive down in the afternoon with Father Rich to help out, to visit my friend, and to check out the hospital first hand.  After driving an hour down a path that could be used as a set piece for “Indiana Jones and the Road to Hell” and stopping at the store for water and soda crackers, we head into the hospital.  The outside looks like a double wide trailer, but once inside, I can see that it’s much larger as it extends back from the facade. We walk down the hall to her room which she shares with several others.

She is asleep, still in her clothes from the morning on a bed which is covered in graffiti, but she wakes up as we enter.  Of course her first response is, “What are you doing here?  You din’t have to go out of your way and come down. I’m so sorry….” But we tell her it’s no problem.  I ask if I should contact her sons back in the States. “No.  There’s nothing they can do but worry.  I’ll let them know when I get out.” (She has.)

I must admit I was taken aback with the conditions.  First, it’s hot.  Not just a little.  The air is still  and humid in the room.  Several other people are on beds in the room.  One guy looks like he’s just a worker on break lying down.  A large woman is sitting on the floor beside a bed occupied by a family member. She is leaning on a cooler of food and eating something.  My friend, hooked up to an I.V., is looking washed out to say the least. I’m a little embarrassed because I had a hard time taking it all in, and I know my original conversation was stiff, stilted, and awkward.

After a short time, a nurse came in to move her to the Intensive Care Unit.  The irony is not lost on us as the program she teaches in is called the I.C.U.  A bed in the unit opened up because a patient who had been admitted earlier that morning was now being discharged.  If this quick turn around sounds strange, I can explain.  The I.C.U. in the hospital is air conditioned.  The original occupant comes from a prominent clan.  He is somehow related to the president of Micronesia so he was placed in the unit, not because his condition was serious, but so he might be more comfortable.  Upon leaving he told the staff he wanted the bed to go to the teacher–a most generous offer, unorthodox by American standards, but just another beat in the rhythm of life here. Clan carries more than some weight.

The room is basically the same as the other one.  It’s a little smaller-three beds total as opposed to eight, and of course the air conditioning made a world a difference.  The other beds hold two older women.  They each have blankets on, but in looking at them, I can tell they are missing legs.  The shape under the blanket drops off at the knees of one, and the other has her covers off to reveal a stump of a thigh.  The diabetes epidemic rears its ugly head.  The elephant in the room of course is that our friend has an infection on her leg, and we have wheeled her into a room where the other two patients are amputees.  The inappropriate jokes hang in the air, but are never said. ( It’s only writing this now that I can even bring them up  since the worst of the situation is far behind us.)

In the room, the relatives of the other patients are present as well.  They recognize Father Rich and start chatting, and I continue talking to our patient. Less awkward now, but my face still stings where it was originally slapped by my first impressions of the place.  She tells me about the doctor.  A friend of the high school, he moved her ahead of all the other people in the waiting room. The wide hallway lined with people because the bench in the middle for sitting was already filled when they arrived this morning. But, “…nothing like a doctor in the U.S.  You know that whole thing of asking your doctor questions and conversing about what’s wrong?  Not so much.”

We need to get back to school, so we drop off the food, water, and linens and let her know that two women from the school will be down to spend the night.  Of course this is met with protests, but Father explains that these objections on her part are not culturally competent.  “It’s how we do things here.  The family stays and sleeps on the floor, and right now you’re our family.”  The idea of the women not coming isn’t in the schema at all; it’s just what is done.  As Ruffina says when I ask her about anything I find confusing about Chuukese culture, “It’s just what is.”

We left the hospital, our patient dozing in her bed, a plastic grocery bag with bottled water and soup and rice and soda crackers hanging from the bedrail.  Artis and Ruffina make it down and spend the night.  The next afternoon the patient is released with a bundle of antibiotics and a look of dismay that all her treatment and meds cost nothing.  Micronesia has free health care.  “It wasn’t as bad as I thought.  It could’ve been a lot worse.” Her world travels have obviously placed her bar for what a hospital should be at a different level than my own.

Days later, all is well.  I’m typing this; she is at the desk working across the office from me.  She’s still in the middle of a course of antibiotics, but worlds better than where she was.  But she told me, “It came on so fast.  One second I was fine, and the next–Whoom!  I’ve never had that.  I even wondered if this is what it’s like when you die.  You just get sick and down you go.” There you have it.

Um, all’s well that ends well, I guess. I gotta go wash my hands….again.

Categories: Uncategorized | 4 Comments

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4 thoughts on “What’s Up, Doc? July 9, 2012

  1. Joel Young

    Chris, how is our friend now? Joel

  2. Up and at ’em and a-ok.

  3. Anne Paine

    My heart sunk, but I’ll believe you that things are better. Terrifying; thank God you were there for all the support needed. I’ll want an update in a few – OK?

  4. I really didn’t do much. It was all her and the folks here at Xavier.

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