Christmas Eve

The hospital feels deserted. The hallways are empty of stretchers. There are empty beds in the wards.

Disease does not take time off for any holiday but the inpatient census goes down over Christmas all over the Christian world. The walking wounded return home to their families.

I did my share and discharged three children this morning. The three infants were all improved and ready to go even if this were not Christmas Eve. Some of the children live a long distance away and there is no efficient transportation. Sending a sick child home prematurely might be a disaster.

The mother of the sickest child that I follow, a 2.5 year-old girl with very serious pneumonia, told me her husband is coming and they want to take the child home. This is her right, but I suggested she should keep her in the hospital. Today, for the first time, her fever is down and a blood test showed modest improvement. She is still very weak. Apart from treating children with cystic fibrosis, I do not recollect a sicker child with pneumonia. I am happy her temperature is down but the x-ray shows that her right lung is not contributing much at all to her breathing. She needs oxygen. She cannot tolerate oral feedings. She is on three intravenous antibiotics. If the parents stop the oxygen and antibiotics, I do not think she will survive long. The Mom is very discouraged. She has been in the hospital a week. The little girl is modestly malnourished. She was sick but looked better during the first two days in hospital and then she got much worse. The antibiotics were changed twice and the last change seems to have made a difference. Over the last 36 or so hours she has started to slowly improve. I hope they don't take her home.

Since the clinic is closed today I went with Renold, my interpreter, to the market. I asked if I could purchase something for his three children. He picked out three pairs of shoes, which don't look like much, but Renold was very happy about this gift. His wife died from hypertension seven years ago and his mother has also passed on. His 80 year-old father was formerly a cook for the hospital and he still lives with them.