Continuity

Today we had our second clinic at Pont Sonde. After a “grand opening” crowd of curious patients on our first day last week, I wasn’t sure what to expect after all the fuss and novelty wore off. I was happily relieved to find an equally full waiting room upon our arrival.

My favorite part of the day came with patients who returned for follow-up.

After months of missing the continuity, the relationships I nurtured in my residency clinic, the fact I recognized patients returning after only a week away gave me cause to celebrate. I saw a young boy following up for an ear re-check, an old woman letting me know her pain was better with the Tylenol I so brilliantly gave her (insert sarcasm here), and a young woman letting me know she couldn't afford to get the lab I sent her for. It may take this country clinic to make me feel like a family doctor again. And I’m thrilled for it.

The patient of the day was a woman coming back for a follow-up for an infection. Last week Dr. Charcot saw her and asked me to come over and lend a hand. At the time, she was clammy, feverish and looked to be suffering. She showed us a huge hot, hard and swollen area along the length of her groin and multiple oozing wounds and smaller abcesses on her back.

We advised her to go to the hospital, but she told us quite frankly she had been suffering for 8 days because she couldn’t afford to go to a hospital.

Last week we prepared as best we could a pseudo-sterile environment, and preformed a incision and drainage of the large abcess on her thigh, praying that we’d do more good than harm. The woman was already suffering systemic effects of the infection, and was on her way to becoming really sick. We had to do something. After draining as much of the infection as we could, we loaded her up with several antibiotics and strick instructions on how to take them. And we asked her to come back, not knowing if she’d trust us enough to follow through.

But today she sat waiting for us with a smile on her face, her forehead dry and cool.

Her swelling had gone down significantly, her fever had left, and she felt good enough to give us hugs.

We of course did more debridement which cut her celebration down a bit, but she seemed to tolerate it well, trusting us to have her best intention in mind.

Not every intervention we try works, not every piece of education sticks. But when it does, when we can care for someone with bare-bones equipment, with the simplest of resources and at minimal cost to the patient, I’m reminded EXACTLY why I’m here.

For her.