Start It Up.
Snooze. Snooze. Snooze. Okay! time for my run. Out the bedroom door and the sun is backlighting the clouds for a third gorgeous sunrise in a row. Into the second bedroom for my costume change. Contacts in, running clothes on, and daily back pain grimace as I put on my socks. Back outside. Broken GPS watch is on, drink some water, and tie what are barely laces on what barely remains of my shoes (a simplicity challenge). Walk past the patients going about their morning while I do strange things like high knees and core warm ups. The 4 dogs are play wrestling as usual.
I'm late, which means it is already hot and humid, but no worries. I am injury free and feeling good. I take my usual route which goes through a few villages and there is always a let of "Hello," "Run. Run. Run," "Very Good," and the like in mixtures of Thai, English, or Both.
Arriving home, I make my breakfast, cool down, and shower. Susan talked business to me for about 5 minutes, and then we read across from each other as we sip our coffee and eat our breakfasts. I had 2 thoughts this morning, "this is really nice," and "we are old people."
- Thankful for calm. Thankful for quiet. Thankful for a relaxed morning.
Outreach.
It is a Thursday and I am headed on outreach with Phermsach. Susan joins us this week; nice that we get to spend Thanksgiving Day together. Koon Maew is coming too, which means we will visit some children. We leave the Care Center at 8:30, and grab gas and snacks at 7-11.
After 45 minutes of driving, we are in an area I know, but more remote than I have been. I cringe as the car precariously ducks power lines as we turn a corner on a narrow dirt road. We arrive at the first stop. The 7-month old son of a 17 year-old woman. There were complications of labor which we could not figure out, but without seeing him I know by his inconsolable, high-pitched, but weak cry that he had a neurological injury.
After about 20 minutes of his crying, I am having a hard time. He was recommended to get physical therapy 5 days a week, but the hospital is over an hour a way, so the best they can do for him is once per week. I try to explain swaddling, which seems to be something they are familiar with, but even this seems questionable in such hot weather.
His mother does wonderfully with him. In our 45 minutes with them, he literally does not stop crying for more than 2 minutes. She shows patience, resolve, love, and attentiveness. We deliver milk, they exchange phone numbers, and will keep track of his progress and support her as much as they can.
- I am thankful to witness her care and maturity. I am thankful for her.
Visit 2
A 9 year-old girl with Down Syndrome who will have heart surgery next year. She acts shy to begin with; then proves anything but. She is happy and has a wonderful play imagination as she puts on face face powder and drinks from empty cups. She performs for us the whole time we are there. It’s difficult to imagine limiting fluid intake in a 9 year-old to protect her heart. The sponsorship program appears to financially help those who have unexpected medical expenses as well.
- Thankful to still be learning new ways Sisters of Good Shepherd are helping Thai people.
Visit 3
A patient I know well; in fact I saw him last week. HIs family is earning necessary income harvesting rice, so he is left alone for the entire day. A man in his mid-30's with a neurological disorder that renders him without the use of his arms or legs, though the feeling in them remains. His only method of moving is to use his head and neck; he has worn the hair off the back of his head.
I am a little dismayed when I see him. HIs mother is there, but his diaper is fully saturated and his skin is pruned. She explains he is moaning to be moved every 2 hours through the night and she is so exhausted from the harvesting that she has not had energy to bathe him. It is sad and frustrating to see someone helpless in poor condition, but who is more helpless? I try to withhold judgment.
A cold bath, shave, and a piece of cake boost his spirits even before Susan’s massage. Then I cut his finger and toe nails which must be 2-3 months long. I ask in Thai “what color do you want?” No one understands the joke, but I still laugh. As I trim his toe nails, there is a moment I look up at him and recognize strange amusement in his eyes. The sight of me cutting his toes nails may seem a little surreal for someone who spends his days lying on wood plank looking at 3 thatch walls tin ceiling.
- Thankful for his amusement and smile.
- Thankful his mother still works hard to help take care of him.
- Thankful he had a shower and company today.
Visit 4
A 30 year-old man who was electrocuted 3 years ago. He can speak a few words, move his left hand, and has had a wound on the right leg that has not healed. Our visit is short, but I clean and dress the wound. His sister and mother are his main caretakers: I am thankful for them. He seems to be in good spirits and generally healthy. At first he refuses Susan’s offer of a mini-massage, but then he relents.
- Thankful for his families love and care.
- Thankful for the joy his sister gets from their 2 puppies.
Nap.
Back at 3:00 pm and home for a rest before night duty. I get a 30 minute nap, Susan gets an hour. And then we settle in for night duty.
Night duty has become a busy, separate time. The patients I take care of are gaining independence, but still need a lot of help. I spend the night:
- serving dinner
- handing out medications at 5:30, 6, 7, and 8
- making trips to their personal food baskets in the kitchen.
Challenge.
Tonight, our patient trying to recover from TB meningitis decided to refuse his medications. He is having a hard time lately. Sometimes he vomits them. Sometimes he tries to refuse them. He cannot swallow them whole and I am sure they are absolutely disgusting when chewed.
At 6pm he has 8.5 pills to eat. We give snacks, try tricks, but he is on to us. Tonight he was not having it and it started to become a scene. I took him to his room and proceeded to beg, bargain, and explain with all my ability and might. I worked with him for 50 minutes before he took the last one.
Each time this happens, I literally feel like I am fighting for his life. And that is not untrue. Tuberculosis is a nasty bug notorious for becoming antibiotic resistant when medications are not taken consistently or to completion. Today, we won and he still smiled at me when I said “good night and sweet dreams”.
I am thankful. I am thankful. I am thankful.
- Thankful to be working on Thanksgiving Day, because it is exactly what I needed.
- Thankful for having some time with my wife on an otherwise busy day.
- Thankful for a day of presence with people and patients; a day I avoided distraction.
- Thankful for family, health, GSV, and so much more.
