At the bedside

So I am on call this Sunday, and while doing rounds we saw a lady I have been looking after who has had a lot of difficulty recently. She had a placenta previa, and had bled at home. By the time she got to the hospital her baby had died. She was bleeding heavily and delivered, but then had problems with her blood pressure and her pulse. There was also some concern that she might have AIDs and that she could have a blood infection. Needless to say she has been a concern of mine for a while, and she is very slow to get better. Another part of the problem is that she has a rare blood type, and we needed her family to donate so that we could transfuse her. This came very slowly. I had asked the Midwives to give her another unit of blood yesterday, and today on rounds the blood was there, but not running. The Midwives said she had terrible shaking yesterday when they gave her the blood, so they thought she had a transfusion reaction and stopped it. The thing is 1) She was getting O negative blood which is the universal donor, basically nobody should have a reaction to that type of blood (except in rare circumstances), and 2) what they were describing didn't sound like a typical

transfusion reaction. So ... I asked them to start it again and I would come back in an hour to see how she was doing. When I came back the transfusion was stopped again! Asked at the front desk, and they said the patient had the same reaction and they stopped it. I talked to the other doctor on call, and he said they could check the blood to make sure they had determined the blood type correctly, but that the lab tech was not back for an hour or 2. The other alternative was to sit at the bed side and start the transfusion again and see how the patient reacted. I decided on the second option, and I sat at her bed side for the next half hour and just watched her. Her breathing is somewhat laboured from the anemia, and she is very frail looking. She had her eyes closed most of the time and was quietly lying there for the whole time. After half an hour with no reaction I talked to the Midwife again and asked her to continue the transfusion and call me before stopping it if there was any more shaking. I do not know

what was going on, and I am still very worried about the patient, but perhaps she will improve now. Some times all you have to give is your time. And sometimes that is enough.

This evening is Church and I played the flute again. We had an infant dedication after church. It was wonderful, with the whole community committing to help the parents raise their child. The sense of community here is strong, and I think it is what makes this place work as well as it does.

Galatians 6:9

And let us not grow weary of doing good, for in due season we will reap, if we do not give up.