This picture was taken by a friend here in Kijabe. (Ansley Kynes for those who wish to know). She timed it just right! The Abyssinian black-and-white colubus is my favorite local monkey. They don’t break into the house like the small monkeys, and they are not mean like the baboons. But what I love most about them is how they leap from tree to tree and how they welcome the dawn with their low pitched cry.
It can hit you hard sometimes, especially on a bike. I have only been on my bike a few times since I returned to Kenya from our Christmas in the US. Each time I go home I gain a few pounds (maybe a lot of pounds). I cannot resist Mexican food and hamburgers. But usually when I get back I drop 10 pounds just because of the setting. I had accomplished the weight gain in the last trip, but for some reason the weight loss was not following our arrival to Kijabe. I did not want to ride my bike because it is so much harder to pull this weight up the long hills. If I could just lose a few, then the bike ride would be more fun. And so I kept delaying. But last weekend a friend sent out a text saying they were going to ride Awesome Sauce, probably my favorite ride in Kijabe. I could not resist the invitation. I joined them at the local dukas, and we headed up the first steep hill by the waterfall. I began in the front, but ended the climb at the rear. I quickly came to the front in the next two downhills, but then came the next very steep climb. My heart began to beat out of my chest, the sweat of my head turned icy, and the world became smaller and less stable. I couldn’t do it. I hopped off my bike to push up the hill as I soberly realized I was not going to be able to make the ride. I called ahead to my friend who was already out of sight and said I was turning back. David graciously accompanied me on a return trip with some great downhills, but with none of the excitement of Awesome Sauce. Getting older can be great in some ways, but physically it can hit hard. There is a lesson in here somewhere. It probably is that you should exercise regularly and watch your weight.
Chai time with my friend Abigail left me something to ponder. She said,
“Here in Africa, we just live by the grace of God.”
Happy to be on the medicine service with learners from the US, Kenya, and Vietnam.
The best part of the job is working with residents, medical officer interns, clinical officer interns and other consultants in the hospital. I am feeling especially pleasant this week because I am working on the internal medicine service. Last week I was in the ICU which is definitely intense. There is a definite lightening of the load when one gets to move away from the care of the deathly ill patients. The worst of last week was a young mother who came in at the young age of 32 years. Four weeks ago she delivered a baby premature. Something happened at her delivery, and she ended up needing four units of blood in transfusion. This happened in a hospital a in a different district. She was discharged and slowly became weaker and weaker with more and more trouble breathing. She presented to our hospital, and she was found to have a very weak heart. This is called peripartum cardiomyopathy. Hers was so bad that she had developed multiple organ failure. Her kidneys, lungs, liver, and heart were all failing. On top of that she had a big blood clot in her heart as well as a problem with the ability to clot her bood. We admitted her and began the fight for her life. Initially she responded to our treatment, and I was hopeful that she would get better. However after 3 days she quit improving. On day 4 she began vomiting blood. I had the sinking feeling during morning rounds that although she had improved and was better than when I first met her, that there was nothing more I could do to improve her more. Unfortunately that afternoon her heart stopped during an investigation to determine why she was vomiting blood, and after about 4 hours of trying to rescue her she passed. It will not be easy to get over. This week my patients are less sick, and I find myself almost skipping through the hospital, enjoying the people I work with and enjoying the patients who are getting better.