My First Call

Things to keep in mind are:
• 1. Everything is in Spanish
• 2. Each patient in Emergency (ER) and In-patients is my responsibility.

I manage to survive the morning cases in the ER and decide to go for lunch near the hospital. Just as I finish, I get a cell phone call at the exact time I hear the helicopter and it starts pouring with rain. I run for the hospital where I find a snakebite patient and a pregnant lady, with suspected placenta previa and in labor. I find she does NOT have placenta previa but she IS in labor with her sixth child so I admit her. Then I start attending the snakebite with the help of another doctor, as I know nothing about snakebites. I get the patient’s pain under control with morphine and admit him, as surgery is impossible until his blood starts clotting. Then I get another urgent ER call to a child with burns. Yesterday the father was putting a mixture of gasoline and diesel into a lamp when it exploded. We sedate the child so we can clean him up. I then admit him and order liters of intravenous fluid to re-hydrate him. His burns cover his face, front, back and arms. I decide to induce the pregnant lady, as she is not progressing. While there, I’m advised that Mission Aviation Fellowship (MAF) has a child in a serious condition and that the ambulance is bringing him from the airstrip. His condition is very serious. It is possible that he is going to stop breathing. I admit him, give him oxygen, medicine for his lungs, antibiotics for the pneumonia he has, steroids to help him breathe better. I go to see if the pregnant lady needs a C-section but she has a contraction and holds her breath. I decide to look under the sheet and there is the baby. Of course, this is my first delivery here, I don't know where anything is, and I am alone with the door closed. Everything turned out okay and I go back to the child with breathing difficulties. The anesthesiologist has the ventilator ready, but the child is doing a bit better and we decide to wait before intubating him. At this point it is only 8:30 PM but the ER is empty so I go home to eat and shower. I call the hospital at 10:30 PM, still nothing, so I go to bed and sleep until a call at 7am this morning for another delivery. Everyone is still alive and I’m promised that all my calls won't be like this one.