Orthopedics was called to evaluate a 20 year old patient in Casualty with multiple fractures. When Tommy, a visiting medical student from the University of Cincinnati, went to evaluate the patient, he noticed he was not breathing well. A pulse-oximeter (which measures the percent oxygen saturation of hemoglobin) was applied and found to be 50%, a very low value. Getting more of the history, we found that two days prior, he was riding a bike when he was struck by a high speed vehicle, and was originally “treated” in a nearby government hospital. He was referred to Tenwek only after his condition “worsened.” When I came into the room, our anesthesiologist was working, with difficulty, on intubating the patient, straining to see the opening into his trachea through blood and pus. Amazingly, Joel was able to intubate the patient, and his oxygen saturation improved somewhat. An orthopedic review showed an open femur fracture on the right, a closed femur fracture on the left, and a near complete traumatic amputation of his left foot which was conveniently neglected at the outside hospital, and now smelling rancid. Because of the injury to his lungs and overlying pneumonia, we had to perform “damage control orthopedics,” in order to avoid further pulmonary injury. A quick amputation of the necrotic leg, and two tibial traction pins were applied until we could “nail” his femurs at a later time. However, the next day, the patient passed away in the ICU because of pulmonary failure…
Later that afternoon, we were called to evaluate a 43 year old man who was assaulted by some friends, struck in the back of his neck with a “rungu” (large wooden club). He was not moving his extremities, and was noted to have a dislocation of his cervical spine. On review of the x-rays with a visiting radiologist from the University of Louisville, the patient was found to have bilateral jumped facets (similar to the young woman told of previously). However, in this case, the patient was completely quadriplegic. Attempting to reduce the dislocation with tongs and traction, we were successful with relocating one facet, but the other side remained dislocated because a fracture completely sheared the facet from the rest of the vertebrae. The chance of recovery, apart from a miracle, is very slim…
Please keep our patients in your prayers, that God would give us, as their providers and advocates, wisdom and skill in their treatment, and that God’s healing power would be present, especially when the outcomes are well beyond our human ability or resources. We remain so dependent upon God for grace to persevere, for wisdom, for strength, for love, and care...for the benefit of our patients. We do our part, believing, in faith, that all is according to the plans of a sovereign God, who holds our patients' lives in his hands, and determines the number of their days, so that we may confidently say that nothing happens, whether good or bad, outside of His loving and perfect will.
1 Peter 4:19: So then, those who suffer according to God's will should commit themselves to their faithful Creator and continue to do good.
Hi Guys, I am praying for you today!
OK, I'm going to have to stop reading your blog. You absolutely break me up just about every time. Twice I have shared your entries with my faculty at our morning devotions. Our teachers feel like they know you. We are standing with you, holding your patients before our sovereign and holy God. Tom
I look forward to reading your blog..every time. It is such an encouragement to witness what GOD is doing thru you, in you, around you. Its such an honor to be a small part of the amazing work there as we pray for you and experience vicariously what is happening. We love you..keep pressing on..keep writing! I think your next career is in formation now.
ruthie and family
Thanks for sharing your experiences, Dan. It encourages us to keep pressing on with our studies and training when we are feeling tired. Who knows how God might use an experience or a piece of knowledge in the future? We're praying for wisdom and grace for you and those you work with. Hugs to Heather and the kids!
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