Catching Up

Well, we've been awfully quiet through this part of our trip. This has been for 2 reasons - the first, I'm not convinced you all really want to hear about the vacation part of our trip, and the second is that we've been so busy! I guess we've been too busy for almost 10 weeks now, but I feel that we've barely scratched the surface of Cape Town. Before I get to that, though, I'm going to go back in time to finish up a couple of stories from the past. I'm at the beginning of an 11 hr flight, so I guess I finally have some time!

First I'm going to go all the way back to Karanda. I promised the story of one crazy day that lasted well past the end of my shift. In fact, to make it seem even longer, this was day 9, the last day of the longest stretch of shifts I've ever worked. While I was there, we had only one white patient. This man was a rough, tough bushman who's lead somewhat of an interesting life. He smokes regularly (this was a battle in the strictly non-smoking hospital compoud) he drinks, and does who knows what else. He had, many months ago, burned his foot quite severely and it had never been treated properly. Now he was here, and we were trying to get his foot healthy enough to try and skin graft it. The other option was amputation. Neither the Shona nurses or this man quite trusted the other, but by the 4th day he was there, both sides were warming up and we actually were all having fun joking around and teasing. The next day, though, things started to fall apart.

The first indication came early, when he decided to take his dressing off his foot. This is a huge no-no, especially in a place with very little ability for proper infection control in the building. By afternoon, he was quite confused, sweating, and starting to get aggressive. The poor Shona nurses had no idea what was going on - they've never seen it, but I figured it out fairly quickly and ran up to OPD to get orders. This man was very quickly going into alcohol withdrawl. This was tough, as we did not have the proper drugs to treat him with, and no security to help deal with the behaviour which was spiralling out of control at a rate I have never seen. How he ever made it to day 5 without incident I am not sure.

We began to hit him with everything we had, with about 10 mins of impressive (if I do say so myself) sweet-talking, I was able to start an IV on him. This was also after he attempted to drink my jar of alcohol swabs because it smelled right, but was not able to figure out why no liquid touched his lips, just fluffy cotton balls! I have never sweat so hard starting an IV before, as his behaviour now was quite unpredicable and I didn't know what was going to send him into a rage, or for how long he would remember that he was allowing me to do this. We also had no HIV status on him, and you can't help but contemplate the ramifications of him getting angry enough to stab me with his dirty needle... Thankfully it all went well. Well, for the approx. 5-10 mins he left it in before pulling it out and bleeding all over half the hospital compound. By this point, there was no more convincing him on the merits of an IV. The problem then was that we were giving him everything via shot in the arm, and he was none too pleased about becoming a pin cushion. He pulled the IV while walking up the long walkway up from male ward to the courtyard, and because the courtyard is always full of people, we were drawing quite a crowd.

I was one of only 2 white nurses at the hospital, and somehow the colour of my skin made me the one qualified to be his babysitter until we could finally sedate him enough to get him back down to his bed on male ward. For those who want to know, we were trying to give him mag sulph IV when he pulled it, managed to find a B complex to give him, and we were hitting him with the only benzo we had, diazepam. Due to said behavioural issues, we were alternating that with my personal favourite, "Vitamin H" (haldol). The combo did not take as quickly as I might have liked, though eventually he started to get sleepy. Basically, I stood by him for almost 3 hrs in the courtyard, occassionally sticking his arms with happy drugs while ensuring he didn't either beat someone up, escape out the gate (as he was quite determined to do) or finally get drugged enough to fall out of the wheelchair and bash his face on the concrete (an option that occassionally sounded the best - don't judge me, it was my 9th day in a row!)

At last, to make a very long story far shorter than it seemed at the time, he got sleepy enough. This came after several attempts to smoke his cell phone, unable to figure out why it didn't work, many tries at escaping out the gate (which thankfully locks) and a lot of nonsensical conversation with me (his side being the most nonsensical). The one doctor that was supposed to be looking after him (little dig!) finally came out of surgery to find me standing there by him, in the middle of the courtyard, completely exasperated, and started laughing at me. For me, it was one of those times that's only funny later. Much later. She and another doctor who had helped me out a lot with him (many thanks again!) came over and managed to convince/strong arm him back down to his bed. Ahhhhh, at last!! The moral of the story? Don't drink!! I was lecturing everyone around. This is what happens! And yes, it is funny now. ;)



Next story

We'll fast forward to Kruger Park, where we had an amazing time, but one story really stands out. As you may know, we were unable to locate any big cats, which was really too bad, but we had one experience that really helped make up for it. One of the lesser known predators in Africa is the wild dog. They are endangered, and sightings of them are rare. We were driving down this one road, all was calm, when up ahead our guide spotted them coming up the road towards us. This was cause for immediate excitement as they are so rare. As they came closer to our vehicle, which was now stopped for the event, something changed. Suddenly there was an explosion of action, and we realized we were smack in the middle of a hunt! The fleeing impala raced by at top speed, nearly hitting the side of the vehicle in the process. Wild dogs flowed in hot pursuit around the truck, disappearing into the African bush. A couple of young dogs lost the pursuit due to vehicle interference, and hung around waiting for the main pack to come back, posing nicely for pictures. It took a moment, but then "Oh WOW, oh WOW, oh WOW!!!" That was totally amazing!! I cannot express to you the thrill of being in the middle of the hunt with wild animals. Totally a national geographic moment.