Day 149: ICU Cases

One of the hardest things to see in the practice of medicine, is really sick kids. Luckily, most kids are resilient and their illnesses are short lived and rarely serious. However, it is always sad to see a really sick child or even worse, watch as one passes away. Over the past several days, I have been helping out at the local Afghan Army Hospital. During this time I have been helping provide care for a nine year old boy who was hit by a car. He has some sort of brain injury. His exact injury is still unknown because we can't image his brain with a CT scanner, as we would in the US. Consequently, we have to use findings on physical exam to guess what is going on with his brain. It definitely requires the use of different skills to practice medicine in this kind of environment. Initially, this child was unconscious and only minimally responsive. However, over the past several days, he has made great improvement. He responds to his name, moves all four of his extremities, and even sipped some juice this morning. He still is basically asleep most of the time. However, there is now some hope that he might make some kind of meaningful recovery. As they say here in Afghanistan, "inshallah" (God willing) he will get better.


Another interesting case came up this afternoon. One of the physicians on staff at the hospital, started complaining of chest pain. Sure enough, we did an EKG on him and wouldn't you know it, he was having a heart attack right in front of our eyes. I was impressed with one of the Afghan doctors who had a pretty good handle on what steps were appropriate to take. Again, it is difficult here because the treatments and diagnostic procedures we would normally have available in the US, are not present here. Consequently, we have to treat him the best that we can and then hope (inshallah) that he will recover.