What struck me again as a participant on a Village team is the value there is in simply paying careful attention to someone for a few minutes. The Guatemalans waited in line for a long time before we ever arrived. Then they would have 3 to 5 minutes with a triage person, followed by a visit to a doctor, dentist or nurse practitioner. That visit could last from as little as 5 minutes to somewhat longer. However short the visit, we tried to give our complete attention to the person seeking our help. Even if they were just suffering from arthritis or pain from doing hard physical labor and were simply going to get some aspirin and vitamins, they were validated by another person.
I really enjoy doing triage as it allows me to practice my Spanish intensively. I have to listen carefully within the noise of triage. Although there is some repetition, you hear and see new things too. The two patients that stick in my mind from triage are the following. In Guadalupe a beautifully-dressed women came up to me late in the day. After complimenting her on her huipil (blouse) and finding out she came from the Peten, I asked her why she was needing to be seen. She said that her child had died at 20 days of age the night before. I told her how sorry I was and put my arm on her shoulder. She also revealed that another child had died a year earlier at the age of one month and some days. She wanted a gynecology exam to be sure there was nothing wrong with her that was causing these babies to die. I asked her whether she would like to talk to our pastor. I took her over to Barb Anderson, who was working in the pharmacy, and then took her to the front of the gynecology line to be examined by John Neeld. He confirmed that there was nothing wrong with her, but advised her to have her future babies in a hospital. I wonder if that is even possible. He also told her husband that the deaths were not caused by anything she did or didn’t do. She never cried, although I guess she was in shock.
The second patient was a beautiful young woman with a baby girl. She said the girl didn’t urinate or poop very often. When I looked at the child, she seemed to have a very odd head. I called Leslie Pierce (a translator who is also a neonatologist) and Andrew Trout (the radiologist) over to look at the baby. She was microsephalic (small head), blind, had seizures and had flacid muscles. Despite all these problems, she was beautiful and well cared for. I sent her to the pediatricians who referred her to a center which will help train her in what kind of exercises and other things can be done to improve the girl’s life. These kinds of birth defects happen, I am sure, in the US too, but at least we could refer her to a place which would help her care for her baby girl.
