He was frail having a shortness of breath, fever and diaphoresis.
Chest x-ray showed bilateral infiltrates and Lt. pleural effusion. Our working diagnosis was Tuberculosis. In spite of antibiotics and anti-TB medications his fever hasn’t been improved for 3 weeks even after chest tube insertion. We keep on assure ourselves that he must get better since his HIV antibody is negative. He said every morning that he is better when I made round even he looks very ill. His mother stayed with him 24 hours. She slept under his bed, she fed him and she transported him to different places for testing or to toilette.
Samuel looked sad at times. He said that he is worrying about hospital bills. But his mother was always thankful and had warm smile on her. She is one of many people who were gentle, kind and appreciative at Shisong. There were many very sick patients as Samuel or worse in the hospital with variety of ailments, military Tuberculosis, septic joints, meningitis, marked ascitis with portal hypertension. Some of the patient’s spleen was reaching iliac crest and she was febrile.” What is wrong with them?” that is the question we have to answer under the limited diagnostic studies and limited funds. So our team of 3 medical students and myself worked hard on clinical based medicine. We had history and physical findings, some of the basic labs and x-rays if we are lucky.
Often times we treated patients empirically. It is our daily decision to make whether we should treat patients with clinical diagnosis or order any tests since the most of the cases the down payment that patients put in was so low that fund will be dried out very soon. There was no sophisticated medical records or diagnostic tool but it was fascinating to see patients with Burkitts Lymphoma, Tetanus, Ludwig Angina , septic joints and Filariasis of conjunctiva as a first time in my medical career. At least 20 % of inpatients in the female ward were HIV + cases. Most of Malaria patients got better and was discharged from the hospital. That’s why I was confidant that I also will be recovered when I realized that I have Malaria when I returned to State.
The patients were always appreciative and persevere. The church was filled with villagers who so sincerely praising the Lord with their unique hymns and dances which last 1&1/2 to 2 hours on each Mass. My spirit is lifted and my heart is warmed by people of Shisong. Yes, I too must be gentle, kind and happy because those are the gifts I received from them, the Camaroonians.