I don’t know exactly why I haven’t written about work. I can come up
with lot’s of excuses – too personal, too sad, too hokey, too
voyeuristic, too unbelievable, or the inability to capture the moment
and do it justice with my poor writing skills. All of the above...
But yesterday there were a couple of scenes I wanted to share – funny, sad and inspiring. I’ll finish with funny.
So
I called the next patient, #83. A young child walked up to me looking
timid but resolved. “Who is with you today?” I asked not seeing a
caregiver approaching. “I am alone,” he responded. This is not an
unusual case – there are many orphans, teens and some younger, who
manage their own care, but this one struck me because he looked very
young.
Once we were in the consultation room I discovered
that he was actually 12 years old and was extremely stunted, looking
about 7 years old. He is an orphan; both parents died a few years
ago. He had been living with his Gogo (grandmother) in S. Africa until
about a month ago when she passed away after a stroke. He was now back
in Swaziland, living with an older brother. There wasn’t enough money
for bus fare for two, so he came alone.
I asked if he knew
his HIV status, looking at the positive results of the rapid test that
was done a few minutes before I called him in. He said he was tested
in S. Africa and was told he was HIV negative; he didn’t know the
results of the test that was just performed. The counselor wanted him
to return with his brother for disclosure of the results.
So
should I disclose his status? If I were him I would want to know, but
he is a minor with a guardian. He probably has an idea anyway since we
are asking him to return with his brother. I didn't tell him.
He
came to clinic because he had been coughing for seven months and it
hurt to breath. He most likely has TB and needs 6 months of multi-drug
therapy.
We gave him some money to get a chest xray and bus
fare for him and his brother to come back today. I was afraid I would
never see him again.
He came back today, chest xray in hand,
and his brother at his side. He listened to the positive HIV test
result and didn’t flinch. He was started on the TB medicines and was
set up to come back for counseling to start ARVs. Handled it all with
poise – like a 30-year-old in a 7-year-old’s body.
The other
story is about another young man, 10 years old who came with his aunt.
His parents were both deceased as well; his aunt is his mother’s twin
sister. She took him in and now he is like her own she told me.
She
is a talker… typically my Swazi patients are quiet around me – stoic
and guarded around a strange umlungu (white/foreigner). But this aunty
was chatty-chatty.
“He was dead when I brought him to this clinic.”
“Pardon me?” I say.
“
He was dead when I brought him here and Doctor Anouk and Doctor
Michelle saved his life. Now look at him. Now he doesn’t listen and is
always causing trouble.”
The description didn’t quite fit with
the meek looking little guy sitting quietly next to her, flat warts
covering his entire body. But he did have a sparkle in his eye and I
saw him running around the clinic with a couple of other boys.
(
One might think it a bother to have kids running the halls in a clinic
– but it is like balm to see healthy playful kids laughing and running
in this clinic).
Then she says, “ Show the doctor what’s in
your bag.” I am thinking a toy, maybe one of those miraculous wire
motorcycles with moving parts perhaps he made himself.
Out comes a dead pigeon he gleefully waves flopping its broken neck back and forth, a huge smile across his face.
OK. I look at her puzzled, “Ah, it’s a dead bird,” I stated the obvious.
“It flew into the window outside and killed itself. “
“I see. And what are you going to do with it?”
“I am going to take it home and fry it.”
Pause.
“Well… it’s good it’s not going to waste. Good source of protein too. “
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