Thursday, February 13, 2020

Candlelight

Candlelight

When I think of candlelight, I think of a nice dinner with my husband.  No children.  A pretty white tablecloth.  A table with a view, overlooking water or city lights.  A wonderful aromatic hot dinner set before us.  Quiet.  Romantic.  

Or…

A very calming evening after a stressful day.  Tranquil classical music.  A hot bath drawn and soft warmth lighting the bathroom.  Relaxing.  

Candlelight.  That’s what I think of.  

But not this…

This is far from usual.  Surgery, albeit basic, by candlelight.  Not something I often think about, or quite frankly, ever want to think about again!  This is insane!  

If you’ve been reading our blog, you know that we’ve been having generator problems for a week and a half already.  This has been getting serious.  Our batteries are dying on our headlamps.  My cell phone is dead.  It gets charged up every now and then when we send it down to Bendele, but for the moment it has been dead.  

Staci and I joked that we would eventually be doing surgery by candlelight.  And now that time had come!  

A lady came in bleeding heavily with a term pregnancy.  She had stopped bleeding somewhat, but I went to help Staci in case we decided to do a c-section.  Staci is perfectly competent to do a c-section, but I am happy to help in the dark if need be.  Everything is harder in the dark!  We have already done several emergency abdominal cases this past week with just a headlamp in the operating room!  Everything is harder, trust me!  

I held the candle up to the woman’s clothes to see how much blood had leaked onto her clothes.  

Staci examined the woman, who was 4cm and not bleeding heavily anymore.  No heartbeat on doppler, but we needed to confirm it with an ultrasound.  

Hmm….how are we going to do this as the machine doesn’t hold a charge?  And the only small working generator is being used to try to repair the other big generators.  Finally a mechanic has come!  

Well, we’ll have to make do!  I quickly blew out the candle so that we could approach the generators and fuel source.  We made the rest of the way by moonlight.  

We brought the patient outside and had her lay on a piece of plastic, near where all of the men were working on the generators.  We carried the ultrasound cart out to be plugged into the working small generator.  OUTSIDE!  In the DARK!  

It fired up once being plugged in to the small generator.  

Sadly the baby had already died.  I always try to get these cases delivered vaginally.  The key is augmentation and early transfusions.  As the woman’s mother spoke French, but the patient didn’t, I regretfully had to use her own mother to inform the patient of the terrible news.

With a plan underway for this woman, we then stopped by urgence as a nurse had informed Staci that there was a trauma for her to see.  

We entered the room in urgence, dimly lit by a few people’s cell phones.  A young 20’s male was lying on the bed with no sheet, no shirt, blood covering his entire head.  It ran down his chest and saturated the bed. A student nurse was holding three compresses over the wound, but it clearly was still bleeding.

I held up my candle to see a little better. 

Staci went to the operating room to grab a razor, a couple sutures, and a staple gun.  Andrew soon arrived as he had been helping the men with the generators.  

There was no water, as there was no electricity, so Andrew ran to his house to get some more water so to irrigate the 5cm scalp laceration.  I got some more of the story while waiting and holding pressure on the bleeding wound.  I explained to the student nurse to fold your fingers up so they can put more direct pressure on the wound and not with a flat hand as the pressure was not directly over the wound.  We chatted about what had happened.  Someone had hit the patient’s head with a machete.  Who knows why. 

Staci and Andrew quickly made it back and we irrigated his wound.  We found a significant arterial bleeder and sutured both sides of it.  Irrigation again, and then Andrew stapled the skin shut.  Pressure dressing.  Done.  

The candle was still burning.  Thank goodness as it took quite a bit of scrubbing to get this man clean again!  

And then back home.  To candlelight.  And quietness.  It is actually quite nice to not have all of the stimulation of the cellphones and computer.   We even have the kids sleeping. 


And since I am writing this, we have electricity again.  But that’s for another story.  

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