Malaria Attacks

Please click HERE before reading!

It is my first official day in Kaberamaido, Uganda, and the team has headed to the orphanage to meet the children. We arrive and are welcomed by a hundred or so faces, children lined up according to sex and age, all watching us with fascination laced with uncertainty.

We are introduced to the children's caretakers, formally called "matrons," and begin introducing ourselves to the children. We stumble a little, awkwardly speaking English to children we know cannot understand us, hoping for the slightest bit of connection and receiving none.

Regardless, we persevere. We take the children outside to play with the soccer balls some members of the team brought. I sing along and play a game when Jacquie, the medical teams leader comes out and requests an EMT. Stef follows Jacquie. I wait a few minutes to give them space, and then follow.

"Liz!" Jacquie declares as I enter the room. "Glad you're here, you can help Triage." I nod and grab some gloves. My heart pounds as I feel the eyes of the patients staring at me. Adrenaline courses through my veins. I get a piece of paper and a pen, and team up with Stef. Our translator is waiting for us to tell him what to do. The room is separated into three groups, Priority, Respiratory Distress, and Abdominal Pain. We decide to tackle the group closest to us, which happens to be Abdominal Pain.

I kneel down next to a young girl, and get the basics out of the way. Name, Age, Chief Complaint; severe abdominal pain. I get a set of lung sounds. Clear bilat. I ask if she's had a fever recently, she says yes. I ask if she has a fever now, she says yes. I ask if she's been coughing, she says yes. I ask her if she has to spit anything out when she coughs, she says yes. I ask what color is it? She says clear/whiteish. I make a mental note, "no blood." That means no TB. I ask her lie down so I can examine her. I unbutton her shirt and realize there's no need to palpate. I see a mass in the upper left quadrant of her abdomen, a huge swollen mountain erupting from her small body. I place a hand gently on it and test for rigidity, which of course is present. "Lit?" I ask, which means "Hurt?" in Kumahm. She nods yes. I tell her to button her shirt and let her sit up. I don't need to examine her further.

Stef finishes writing up the report and I bring it to Doctor F., the Emergency Physician we are traveling with. He stares in disbelief at the size of this young girls spleen, and sends her to the Priority group to wait for a van to the hospital with a tentative diagnosis of Malaria.

I move on to Triage the others. The questions are all the same. The answers vary, but I stay the same. I am a machine. Every patient is an equation, a question that can be answered through logic and a systematic algorithm of questions dictated by protocols that I have studied. I can feel the art of medicine and the logic pumping through my blood, as natural as the air I breathe. I am in control. In a world where HIV/AIDs runs rampant, where children are dying from treatable diseases like Malaria and Pneumonia, where diseases like Dysentery, diseases we eradicated in the USA decades ago, still exist, I am in control. I am focused and I am in charge. I am one with the universe and all who inhabit it. I am living, breathing, Medicine.

I am living, breathing, Art.