Dressed in my clothes

Tomorrow morning, Elita will be dressed in my clothes when she takes the body of her dead baby back to Puerto Alegre.

Claudia, one of the ténicas,  asked me this morning, “Doctora, you wouldn’t happen to have an extra pair of shorts and a shirt to lend to this baby’s mother?  And some underwear?  She has been here for four days and she has not changed her clothes.”

Elita hadn’t bought a change of clothes when she came from her village; she had just brought her baby in for shots.  But in Programas the nurses knew that the baby was sick, and they brought Elias over to the hospital.   He was eleven months old and malnourished.  And he had a fever, which was not getting better with antibiotics.  His parents thought he was tocado del aire, and they wanted to bring him to the brujo to ventear, to blow on him.  I was not on call yesterday, so at 4 PM, Declan and I took a walk to meet Dayana at the Plaza Municipal.  I saw baby Elias sitting on his mom’s lap, on the chairs outside the hospital.   The patients often sit outside in the afternoon, because there is no electricity until six PM.  My colorful Boden tank and running shorts fit Elita well.   Elias looked sick, but not much sicker than this morning.  His IV had fallen out, and the family would not let us put in another IV.  “Then he needs to drink something,” I told them.  “He has fever and diarrhea and he needs some oral intake if he does not have an IV.”  Neli agreed to mix up some oral suero.

Coming back to the hospital, Dr. Williams was standing at the desk, writing.  I started to tell him the updates on two of our patients who had been transferred to Iquitos.  He did not seem interested.  “I am filling out the death certificate for this baby,” he told me.  “The parents took the baby down to the brujo and when they brought him back, he was dead; he had choked on his own vomit.”   I peeked into the hospital and saw the parents, in tears, sitting in front of a baby-sized bundle wrapped up on the table. Should I bring the hermano? I asked.  They nodded.  Jens set up some candles in front of the bundle, and Hermano Pedro came to say some prayers.  Linorio, the night watchman, came up to me, asking about their passage back to Puerto Alegre.  Yes, of course I could buy the tickets if Linorio could go and reserve the seats.

I hadn’t considered a budget to help families bring their deceased family members home, but of course it is not the first time that I have helped a family bring their deceased home.  I hadn’t thought about some of the practicalities of death in the Napo River community.  For me, Santa Clotilde seems isolated, but it is a big town, a referral center for people in outlying villages.  They will travel many hours here to get help; by the time they arrive, they may already be quite sick.

Another woman left the hospital dressed in my clothes; hers was a happier story. Alba had come in with abdominal pain and an early pregnancy. Her pain got worse over the course of a couple of hours, and her blood pressure began to drop. She had arrived with a hematocrit of 39; it dropped to 31 and then to 21. We suspected a ruptured ectopic pregnancy; the whole Centro de Salud worked together to get her transferred via air ambulance to Iquitos. It was Saturday afternoon; many staff were away at a barbecue and the cell service was mostly down. We needed our lab tech to draw the labs for emergency blood transfusion, and we needed Christian to unlock the pharmacy to get some equipment. Jackson rode back and forth to the barbecue on his motorcycle, bringing our staff back to help out. Zenith rounded up several friends to give blood, Dr. Williams was coordinating with Iquitos but the calls kept dropping. I stayed with the patient, helping the nurses. Alba’s pain was increasing; we gave her some morphine and put in a foley catheter to prepare her for surgery in Iquitos. She could not put on her tight pants after the foley catheter. “Do you have some loose shorts you could give her?” Leynis asked me. I brought down some of my scrubs and we made them into loose cutoff shorts.

It all worked out fine; the airplane came, and once again the whole village gathered at the dock to see the patient transferred. Declan was aghast, especially after our experience of bringing the dying patient down to the dock after the elections. “Don’t these people have anything better to do?”

It was super-great to have Padre Jack here for a few days. He and Padre Mauricio worked down here for thirty years. I have been hearing about him for years from Toni, but this was my first time meeting him. Very inspirational!

Rosemary, the mother of Declan’s friend Dayana, took us to the house of a friend of hers who owns a pet monkey. Very cute little pet monkey; he climbed all over Declan!