Singing by the Morgue. Tetanus.

A toddler was brought to the clinic yesterday with severely labored breathing.  The child was critically ill with pneumonia. We had to act quickly to start oxygen and other treatments.   Within a few hours, the child looked much better and the child's oxygen  levels were rising.  The day began early today with a call to see a surgery ward patient who needed medical care before going to the operating room for a badly-broken leg.  Walking past the hospital morgue after seeing the surgical patient, a young woman could be seen in the early morning light, sitting by herself in front of  the morgue, rocking back and forth, and singing softly.   It was not until we went to make rounds on the pediatric ward and saw the clean, freshly-made bed where the ill toddler had been the evening before, that we realized the young woman  was that child's mother.   The woman was not at the morgue when we passed again. I spent the rest of the day thinking about the mother and about a missed opportunity for us to console her.

Dr. Eugene and I were at the hospital a few nights ago to see a young adult who had been admitted earlier in the day with difficulty opening the mouth.  As the evening wore on, it became evident that the diagnosis was tetanus.  We started such appropriate treatments as were available, but it will be a long and hard road for this young person.   Mission medicine often reminds us of the blessing of resources to treat illnesses.  It is less often that I think of the equal blessing of vaccinations, public health measures, clean water, etc.,  which help us to not become ill in the first place.