It was a cold day in Durban. Sixteen degrees Celsius is cold for us on the East Coast of sub-tropical Africa.
I had made a trip through the suburbs to drop something off for my theatre scrub sister. The roadblocks are manned by community commandos, most of who are my patients and it’s easy to pass through.
On the way back to the hospital I passed a que of cars more than two kilometres long. They were on the road to the Galleria Mall or maybe just the filling station. There was an air of dejection and desperation hanging over the cars waiting. Ordinary South Africans waiting to get food or petrol. I was disheartened to see lone drivers trying to push into the que of orderly people.
I parked at the hospital. The doctors parking area was at about 30% full today. The last few days it has been at 10%. The faster cars don’t seem to be able to make it to the hospital.
I walked from the parkade toward the tunnel that goes under the medical centre to the hospital. I hate wearing only scrubs in winter. It is way too cold for sleeveless bravery. A striking young woman caught my eye as I laboured through messages on my phone. She was bald, well dressed and made up. Vibrant. No hair.
She was clutching a form and stopped me.
“Excuse me, is Ampath closed?”
Trying to wrestle my attention away from the little screen, I stopped to talk to her. “Yes, we didn’t have any lab service yesterday, and today we have one technician for the whole hospital. I am sorry” the famous South African refrain. “The lab is closed. Why?”
I glanced at the laboratory request form in her hand. In orthopaedics we keep it simple and don’t really ask for all the tests after which Elon Musk might name his children. This list was for things that scared me. Cancer markers.
“I need to have these tests before my chemotherapy tomorrow…”
I felt like crying and giving her a hug. Neither were an option. So I excused myself while I scrolled through my messages looking for something about laboratory closures and openings. In the end I called one of the doctors who knew how to work the system. In seconds my unknown patient took a photo of my screen and left to get her blood tests done in the nearby industrial area.
I went into my office. It is a safe place that is more of an art gallery than a doctors room. That’s the way I like it. We have been closed to the public all week. I am not sure I like that. I had the tedious job of completing a report of a patient whose lawyer was suing the province for negligence. In this case there was no negligence. She just had bad luck.
Instead of going home I went and did rounds in the hospital. Not the surgeon rounds where I check a patient’s limb and movement. A round where I chatted to nurses and tried to understand their issues.
I ended up in the trauma unit. Luckily the first patient I saw had an undisplaced fracture of the wrist and I knew what to do. I showed a keen student how to apply a cast and explained the care to the patient, the father of a neurologist in another city.
Then they called me to see another patient. I am not an experienced general doctor. I decided soon in my training, after realising internal medicine was not for me, that I would concentrate my energies on the simple and straightforward subject related to bones. This lady was bleeding from her flank. I could see the bump on her tummy that meant she was pregnant. She was stable, fortunately. Her abdomen was soft and it seemed she and the five month old foetus had escaped major injury. I numbed the bullet wound with local anaesthetic to relieve her pain. The student put up a drip. I called the obstetrician and general surgeon. Their movements were hampered by riots. The patient was admitted to the maternity ward where the loving maternity nurses would care for her.
My day ended with humanising visits to friends to feed me and charge my emotional batteries.
I am very blessed to have such friends and to be associated with a medical team that cares so much. But we are all at breaking point. Remember that.