A Rookie Mistake

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It is the last day in Kaberamaido. I am busy triaging patients, performing basic wound care, and filling hastily written prescriptions. Dr. Bill is taking a break for a change, and enjoying the company of the children. Apparently, myself and the other EMTs have proven ourselves competent and capable healthcare providers, and he has entrusted with us the medical care today. Any serious cases, we are to refer to him, but all Basic Life Support and First Aid type cases we are allowed to take care of on our own.

I am thrilled, as are my fellow pre-medical colleagues. Finally, we get to play Doctor for real.

I am performing an exam on a child from the orphanage. She is a quiet and shy 11 year old, but she speaks English fluently, which is a pleasant and welcomed surprise. She presents with a headache, slight fever, and sore throat. Her vitals are stable, lungs are clear, and seems to be in otherwise relatively good health. I give her two chewable tylenol. I instruct her to stay hydrated, to take a tylenol to bring down the fever and take the other later on that day, to stay out of the sun, and to generally take it easy.

Easy enough, I think to myself.

We triage more patients. We hand out more medication. We write prescriptions. We fill prescriptions. We work until daylight ends, feeling like "real" Doctors.

"I got this," I think to myself.

We are packing up to leave when one of the Matrons motions to us. "Very sick child," she says as she pulls a little girl towards us. It is the patient I handed tylenol to earlier.

I am confused. I could have sworn this was just a headcold. I feel her forehead, and immediately am alarmed. "She is burning up," I think to myself. I grab another tylenol and hand it to her, with water. "Take this." I call over another EMT. "Get Doctor Bill," I said as calmly as I can manage.

Doctor Oscar, the local physician on the ground, arrives. He feels our young patients head. "Too hot!" He exclaims surprised. I agree. Doctor Oscar transports our patient on his motorcycle to his clinic, to watch her overnight. I walk with the other EMTs back to our house.

We later learn that our patient was having an acute malaria attack. She also was HIV/AIDs positive. I feel awful. We missed a huge, gigantic, enormous part of the patient's history, and almost put her in a life-threatening situation. If we had left the orphanage for the day and the patient was overlooked, our mistake could have cost her her life.

But a lesson learned is a lesson learned. No half-hearted medicine. Thorough, patient histories are just as important as filling prescriptions and "active" medicine. We visit our patient the next morning. She is smiling, and sitting up on her own. Her fever went down. She will be okay.

I feel relief. Relief, and guilt. I vow to never let a patient of mine down like that ever again.