Tough little kids

October 1 

There came into the x-ray department a little 8 year old girl today. She was with her mom and sitting on her mothers lap, sort of moaning. She was with it, mentally, but seemed to be in a lot of pain. I took the requisition form from her mom and it was uncertain to me what needed to be x-rayed, as doctors’ handwriting is poor in Uganda also. I went out to ask her mom, and fairly soon it was very obvious that her femur was broken. And broken so much that it was substantially shortened, indicative of not only a break but an overlap of the broken pieces within her leg. The requisition said a leg and chest x-ray, so I prepared the room and had her mother bring the girl in. Before I even had her on the table, the girl was crying, and it only intensified when we placed her on the table. Instead of crying it turned to screaming. I can’t say that I blame her much, as her left leg was virtually hanging limp next to her right. No, I don’t blame her for screaming at all. I attempted to speak in English to the mother but she didn’t understand at all. By this time I had the young girl’s head and shoulders cradled in my arm to try to alleviate some of the pain and pressure on her leg. But I needed the mother to do the same thing so that i could position and I couldn’t let her know that. Luckily, Atim was close by so I called for her (over the screams of the girl) and implored her to please explain to the mother that I needed her to hold the girl. Finally the words were communicated and we got going. The next challenge, however, was that I needed to move the film under the girl and she was scared, screaming and kicking with her good leg. I finally maneuvered the girl (after attempting to calm her down in a language she doesn't understand) and we were ready to shoot the x-ray. I exposed and then grabbed another film for the chest. We lifted the girl and repositioned for the chest. In between her screams, I took the picture and we were done. I asked the mother to please stay so that I could develop her films. “They need to go to the doctor today with these films. This is a bad break,” I was thinking. I had Atim ask when the injury occurred, fully expecting to hear a day of so ago. “Three months ago.” I couldn’t believe my ear just heard that. I pressed a little more, questioning the answer but three months was what the mother said. All I could think was “How is it still this bad?”

I developed the films, and sure enough, the femur was broken, and in a couple of places. It sort of spiral fractured twice, once near the hip and once again near the knee. I could hardly believe it and was really upset as I realized the pain that girl was in. 

It was overcast so I had to dry the films in the room, and it took a while. In that time Charles came to work. We greeted one another and I realized how much I appreciate him being at work. He knows the department and knows what to do in many situations, which is helpful for me. I showed him the films of the girl’s leg and he said “that is an old fracture.” I told him what the mother had said and he asked as well. The answer came back again, three months. I asked him how that was possible. The medical care is good enough here that they would be able to cast this girl’s leg. What had happened? We talked and it seemed as though they went to surgery to fix her leg and something happened in the bone. Whether it was infection or what was uncertain to me, but somehow the bone is deteriorating inside her body. There was also an effect happening on her shoulder, and it seemed that maybe they were thinking the problem was spreading. This got Charles and I to talking.

We were talking about why this would happen and he simply said, “Maybe God is tired. Many people don’t fear God here and maybe He’s just tired of it.” He explained how many more diseases and illnesses can be found in the villages than ten years ago and how it doesn't make sense but that he thinks that might be the case. I was really shocked and taken aback by his statement, but at the same time, as I contemplated his words I began to wonder at that. I have a hard time understanding how my friend could say those words, and yet, at the same time I come from a place where physical illness and brokenness can be easily fixed. I rarely see 8 year olds with three month old femur fractures that are still unhealed. Let alone full of some sort of infection. That would not happen in the US, so in a way I can understand how what he has seen here makes him think that way. And its not that Charles is saying God isn’t good, but he was saying that the absence of fear and the irreverence is having an effect. Interesting.

Today also seemed to be the little kid broken bone day. I think I x-rayed at least four patients under the age of ten with visibly deformed fractures on their limbs. One of these was a 3 year old with a swollen left elbow. She had fallen and when her films came back it was obvious she had fractured her humerus. However, you never would have know that when I was x-raying her. She quietly complied with my requests for positioning and never made a sound. Instead she just watched me. I wonder, in those moments, if the curiosity and fear of my white skin makes the pain take a back seat, or if its just because these are tough little kids? Maybe I’ll never know the answer, but its interesting, nonetheless.

To go along with these tough little kids, a girl came in with a splinted but still broken left ankle. She was a little more vocal about her pain but rightfully so. Her ankle was at least 3 times the normal size and obviously infected. I had to take an AP and lateral, but just getting her on the table was excruciating for her. So I did a cross table lateral after the AP and tried to hurry as much as possible. I may not be able to ease everyone’s pain, but I will do the best I can where I can. In this case, I think that what happened after was more disturbing than her condition. 

Her wound began to ooze, so we put some gauze on it and then because she needed to wait for her results, she remained seated on the concrete floor for the duration. Here she is, filled with pain, with an already infected leg, sitting on a dirty floor. I suppose the pain of sitting on the bench was worse than the floor, so I can’t blame her for choosing that spot, but it just bothered me to see. Seems like that happens a lot these days...

Thursday evening is Trivia Night at Fugley’s, a restaurant and pub in Gulu, so Alli, Jessie and I headed over this evening. It was really fun for me to be doing something with the girls and to be out of the house was great. I was able to meet some of the Gulu Muzungu crew, Shawn, Jared and John. John works for Restore Int’l, Jared for Invisible Children and Shawn for Krochet Kids. They are all really interesting, fun and easy to get along with, so as Alli and Jessie led trivia night, I participated with the guys. I had a great time, and even won a 31bits bracelet! I won it because I knew that the song playing was Circus by Brittney Spears, which I’m not sure how I feel about that, but I got a sweet bracelet anyway...