Dianne Drake - The Doctor's Courageous Bride

“We’re divided into several large wards, accommodating sixteen beds maximum in each one. Plus, as you’re noticing, we’ve got patients in the halls.” Bed after bed lining the walls. “With any luck, we’ll be starting a building project in a few months to add on two more patient wards and a children’s ward.”

Times like this, when he needed so much more, gave Paul the overwhelming urge to get back out there and find the support. “Right now we’re over the maximum capacity, and we’re beginning to feel it because, like the rest of the medical world, we’re short-staffed.”

“Did you anticipate this kind of need when you set up here?”

“I anticipated a few patients straggling in every day, and I’ll be the first one to admit that I was wrong.” He shook his head. “It’s frustrating at times, but we don’t turn anybody away.” Paul stepped aside to allow Solange her first good look into one of the men’s wards. “It’s not modern by any standards, but it works quite nicely,” he explained.

“Modern?” Solange exclaimed, stepping up to look through the glass in the door. “This is wonderful, Paul. Even my clinic in Miami wasn’t this nice.” Of course, Mauricio had cut corners every time he’d found one to cut, saving that money for his upscale move. Their upscale move. Only she hadn’t known it at the time. “And, believe me, if I could ever come anywhere close to something like this, I’d think I’d died and gone to heaven.”

It was a bare-essentials set-up. A bed, a bedside stand, a patient—sixteen of them lined up in two well-kept rows of eight each. There wasn’t much room in the ward, but it was tidy. “Thanks to Frère Léon?” she asked.

“In part, yes. He supplied the craftsmen to get it built. Locals who wanted a hospital nearby. He had an army of them, and it went up much like an Amish barn-raising. The men working, the women feeding the men, the children playing around the area.” He chuckled. “I think Frère Léon told them if they didn’t get it done quickly, Joanna and I might change our minds and leave.”

“The tricky devil,” Solange laughed.

“And you said you’re in an old mission chapel?”

Solange nodded. “Ayida and Keskeya—my nurses—and I actually live in the chapel, and the infirmary is in a brand-new building separate from it.” It was a nice, comfortable set-up and she loved it. “The whole compound was a cloister a century ago, but the monks moved to the other side of the mountains about seventy years ago to be closer to the major throughways.” She smiled, thinking about how glad she was they’d left the old compound behind. It was the perfect place, where several roads led in and out. The villagers were using them now to come to The Mission, as it was called, for clinic days, where medical services were offered at the infirmary instead of out in the villages. “How many people work here, at your hospital?” she asked.

“Right now I have three physicians, all specializing in infectious diseases, besides myself, although I don’t really count myself as a physician. And I have twice that many nurses and nurse aides. We also have a lab technician and an X-ray technician. Like I said, we’re short-staffed according to our patient load, but we make do.” He smiled uncomfortably. “Of course, we’re doing much better on staff than you are, aren’t we?”

A young woman dressed in khaki shorts and a T-shirt scurried to the bedside of an older man to change an IV bag, and Solange watched the interchange between nurse and patient. Pleasant, efficient. Paul had a nice concern here. “Actually, we’re quite satisfactory in numbers. I’m out a good bit of the time, and Ayida and Keskeya take care of the infirmary while I’m away. And if I need to be there as a doctor, I’m there. People don’t get all fussy and bothered over schedules and appointments out where we are, so it works out splendidly for us.”

Paul led Solange to a door marked “TB”, and they stood outside, looking in through the window. “Do you treat a lot of TB?” she asked.

“About half our patient beds are devoted to it. Not enough to call us a TB hospital, but enough that we keep busy with it. The wards I’m going to add will be much larger than our normal wards, and they’ll be specifically for people with TB. I’m actually going to build a separate building for it, so the patients won’t have to be quite so confined.

“But the good thing about our TB program is that we actually have good luck with the treatment and cure rate when the patients get to us in time, then continue to take their medicines for that interminably long year after diagnosis. Which many of them do, now that they know there’s help available. We try to dose them here in the mornings, if they’ll come here…It’s the easiest way to keep on top of things. And we do some education on TB symptoms, making it more likely that if people recognize the symptoms they’ll come to us in the early stages rather than later on. Care to join me inside?”

Paul strolled through the doorway into the ward, with Solange following. “One of the biggest problems we have is that so many of the people quit once their treatment is started and they feel better. We get a lot of recurrences, and every single one of the men in this ward fall into that category. They took their INH, felt better, stopped it, and now they’re back. Only most of them have some form of drug resistance going now, which is what usually happens when you stop treatment in mid-course. And the next time around TB is so much harder to treat.

“So to lessen our workload, we hunt our patients down when we can, just to make sure we don’t get them back in here in another few months in the condition most of these men are in.” He gestured to the men in the ward and most of them responded with a friendly wave.

“Sometimes the condition doesn’t recur, though,” Solange said. “Sometimes TB doesn’t come back.”

“Sometimes, but rarely. If we could keep them here the whole time…” He shrugged. “But you don’t treat TB that way any more.”

“Dr Paul!” a middle-aged woman shouted as she ran down the short hallway toward them. “She came in with the baby already on the way out. And it’s not waiting to get born, except the cord’s coming first.”

“What?” Paul snapped, spinning around to Gigon Giroir, one of his trained nurses.

“The baby is not waiting, but the cord is beatin’ it out. She’s prolapsing, Doctor, and it’s not looking good ’cos she’s having some hard, fast contractions.”

Paul and Solange exchanged knowing glances before they ran down the hall, following Gigon, who ran so fast she looked like a sprinter heading for the finish line. “Start an IV,” Paul shouted after her. “Get set up for a Caesarean section and go find Dr Mordecai.”

“Do you deliver babies often?” Solange called.

“No, they go to the village midwife if it’s a normal delivery. We just get the bad ones.”

Solange followed Paul into the small procedure room, where a very pregnant woman was moaning on the examination table. Gigon was already slipping an IV catheter into the mother-to-be, whispering soothing words…words that seemed to have some effect since the mother wasn’t screaming at the top of her lungs.

A nursing aide cracked the valve of a green oxygen cylinder to blow off any settling dust, then hooked rubber tubing to it in preparation of placing a mask over the patient’s face.

The initial hiss of the oxygen blast startled the patient, who struggled tried to sit up, but Solange stepped up to her side and laid a reassuring hand on her shoulder to keep her down while the aide fastened the mask over her face then scurried around the bed to pile pillows under the pregnant woman’s bottom. That made it easier to keep the umbilicus from tangling around the baby’s neck.