First Patient

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It is the first morning in Kaberamaido. I have barely woken up when Jacquie walks into our room with a stethoscope around her neck. The EMS nerd in my wakes up, and I remember why we are here. I grab my stethoscope and pull on some scrubs, and I am ready.

I walk outside and greet the women who have congregated. There are the leaders of our trip and some new faces, women that live in the village and have just stopped by to say hello. The rest of the team begins to wake up and come outside, and everyone seems to be chatting about the rest of the day except for an older woman. It is beginning to get hot out, and I wonder why this woman is here, as it soon becomes clear that she is not part of our team.

Dr. Bill wakes up and comes outside. I walk inside to see what's for breakfast, and remember that I left my backpack on the porch. I go to retrieve it, and see Dr. Bill examining the mystery woman. Apparently, our first patient had arrived.

Dr. Bill and Jacquie brought her inside to examine her on the couch. The rest of us waited outside. Jacquie emerged and announced that this woman most likely had TB, and that her left lung was filled with fluid. She said that this would be a good teaching case, and all the EMTs should come inside and listen to her lungs.

And so, we did.

I walk up to the patient, who is now laying on our couch, chest exposed, surrounded by 6 or so collegiate EMTs. It strikes me as how awkward teaching hospitals must be for the patients, and I realize what a great sacrifice patients at teaching hospitals make in order to train the Doctors of tomorrow. Jacquie hands me her stethoscope and I take four-point lung sounds. The difference is clear, and amazing, if only from a clinical standpoint. It is unlike anything I've ever heard in the States, or anything I could have even thought possible.

I want to spend more time listening. I want to examine every second acoustically, to internalize it, to understand it, but the others are waiting for a turn and I feel badly for the patient, so I hand the scope back to Jacquie and go wash my hands.

It strikes me as odd, how casual this encounter has been. TB is so stigmatized in the States, especially to us healthcare providers. (With good reason, I suppose.) And here we were, first thing in the morning, with a TB patient worse then any one in the States for the last few decades, sitting on our couch. "She has a few months to live, if that." I think, while I turn the faucet and wait for the water to flow.

I wash my hands thoroughly. It's all I can do.