I can't remember, and am too busy to review, all the previous posts and whether I related in this space about a guy who has been on the service since 4 July. He was a disagreeable type before he was admitted as he was a prideful alcoholic, HIV+ and just generally a parasite to those around him. I had tried to discharge him before only to have him bounce back because even though we would afford a cab ride for him he never could quite remember where he lived.
He embodies that blurry, poorly demarcated region between passive aggression-alcoholic dementia-personality disorder and the like. All who cared for him thought he was alone in the world as he was from Zimbabwe and was never visited. Well don't ya know today he was visited by five of the nicest women on the face of the planet. No they absolutely would NOT take him into their home, he was and is a jerk. But the were genuinely concerned for his welfare and wondered if they could pay for his mounting hospital bill, P10,000 and counting, and afford his ARVs. Since he is from Zim he will be billed, as if that will do any good, but to the credit of the hospital they haven't tossed him out on his ear.
After a long conversation at which time they were informed that he was deteriorating and that the most compassionate thing to do for him was to simply make him pain free and withdraw him from all meds aimed at Tb, AIDS, co-morbidities and the like, they concurred and we'll see how this goes.
It was admittedly refreshing to be able to do this, realizing the gravity with which we collectively made the decision, without the attendant fear of suit, legal reprisal, need for 2nd-3rd-4th opinion and so on. He will be free, and so will we; a break even day if there ever was one.
Midlife in Botswana; teaching, mentoring and learning medicine. And living the life.
Where are you?
Botswana
Where we live
About Me
- Mike
- It’s a little odd, being retired and all. So much so that many of my colleagues are now calling it “re-prioritizing”. The thinking here is that there will be less existential identity angst about whether, as retired physician, I can still call myself “physician”. Well…. I re-prioritized on the 27th of December 2019 and have not hung up my stethoscope. Through various degrees of separation, I have connected with an organization and am headed to Gidel in South-Central Sudan where I will be working at Mother of Mercy Hospital. 11°07'07.7"N 30°37'41.1"E for a 3-4 month gig. It will be back to doing what I love most about medicine; the nuts and bolts of history, physical, diagnosis in real time, creative approach to disease and no electronic health record. Perfect.
2 comments:
what an amazingly different experience than those you've had over here, no? i always remember you describing how death seems so much more dignified in africa, and i recall the same in my own experiences abroad. over here we'd call that much more than a break-even day. glad to hear things are settling into a pace and that you're keeping stride.
love ya.
eli
Your story reinforces how I sometimes mourn the 'death of common sense' in the U.S. health system. It's interesting just how much we focus on defeating death. As I have said many times, "perspective" is priceless and you are getting a healthy dose : )
LOVE,
Amber
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