Ready for a day off....

The dinner party went smashingly! Great food, great company, great conversation. Paul, grew up here and he is so well informed about local, nationals and international politics. I learned so much about Cameroon listening to him talk. My take away is that I really don't want to be here when they have elections again (this fall) or when the current president dies, which ever comes first. Paul does not think this will be pretty. Tomorrow is National Youth Day, but Paul explained that Feb 11th was originally a day of mourning for the country of Cameroon as the country was split on that day. It has been sort of bushwacked to take the attention off the real issue and focus on the kids. I might go to the stadium to watch some of the festivities. Or I might go shopping for this tunic I've had my eye on. Jacqueline introduced me to the guy who does the design and embroidery and they are gorgeous.

Updates on a few patients:

This is one of the original palliative care patients seen almost 3 years ago after he had a stroke. His wife (one of 3) explained he finished his hypertension medicines and then they either had to buy the medicine or food.
His BP was 185/113. 

These are some of the man's 12 children and 30 grandchildren. The little girl in the front was so cute, so engaging, just stood in the doorway to her grandfather's room and smiled and waved. 

The family of the paralyzed man finally agreed to bring him to the hospital today. I got to ride along on the ambulance ride to get him. Don't be picturing those nice, sleek, fully equipped things we have at Allina or HCMC. Picture something maybe left over from WWII. I spoke with the orthopedic surgeon, Falker Roth, visiting here from Germany and he will be seeing him in the OR tomorrow, but is not hopeful that this man will recover and survive from the extent of the wound. He referred to the tough choices they have to make here, and I said, "What choices? They have nothing." His point was that this is the setting where people on the ground, docs and nurses and hospital administrators need to look at their human and material resources and make choices about who should get what based on who has the best chance to survive. If this young man is not going to make it, then you don't put a bunch of resources into his treatment, because in this country, it isn't a philosophical debate. There will literally people who will not get medicines or tests or immunizations because they spent an inordinate amount on this man. Falker said, the best thing to do is provide best supportive care.

I've been asked to speak with the large staff meeting after chapel on Monday to impress upon them the importance of supporting Palliative Care in their hospital. I have so many stories and examples just from my few days shadowing Remi and William that demonstrate the excellent care they provide and the impact on the patients and families. It's the long term planning and sustainability that I see as the challenges they face.