Sailing through choppy seas

A skeleton crew: I never understood the meaning of it until a couple of days ago.

The number of interns in our unit was suddenly cut in half. The half that cut away had finished their 12 months of training. We, on the other hand were left aboard to man the ship.

The hardest part was that with only the three of us we were spending far more time in the wards than was healthy or effective. The few off days would be spent catching up on lost sleep or watching a movie. It was still a long way for us when we could like our seniors yell, ‘land ahoy’. The weather wasn’t fine either.

There was suddenly a so-called double casualty on the horizon; two consecutive days of admission to our unit only.

The first day was interesting. Patients kept coming in throughout the night (not a wink of sleep for the poor intern and registrar). And then comes along a one-month-old with a heart rate of 350 beats per minute. The young mother was confused at the fuss that everyone was making over her child. She had brought the child to hospital because she didn’t seem to be feeding well and was breathing a bit fast. She didn’t know that all the while her child’s life had been hanging on a thin thin line.

After pumping in all the recommended medications the heart was still going too fast. The baby was already becoming blue and cold. Finally an ICU bed was available and the child was rushed upstairs for an electric shock that brought the heart back to its normal rate and rhythm.

The next night seemed to pass by without much hassle compared to the previous one.

But luck was definitely not on our side. Three hours into my sleep the dreaded call comes in, I am to help with an exchange transfusion. A child, a couple of days old is to have his blood removed from his body and replaced with a similar blood type to save his life. Although I was only called in to help, when the whole thing was over, the next day had already begun.

Thus the weekend was over and I had had only three hours of sleep! But the ship had to sail on. It was turning out to be a real Titanic job; there were so many patients onboard. The staff it seemed was at their limits. Tempers were fraying and it seemed we were in for a rough, rough time. But we had not it seemed accounted for that amazing thing humans possess – adaptability. In a few days the seas, it seemed had become calmer and we were sailing on even with a skeleton crew.

It was also crazy in a sense that there were so many patients who should never have been in this hospital. Some had bypassed many big hospitals to come here, sometimes with minor illnesses. It was a system that was bound to collapse some time. Money and resources were being wasted: both the patient’s and the government’s.

Some parents it seemed preferred to go to private practioners rather than go to the local government hospital. And thus, while for a small illness it would have been ideal to spend a couple of days restfully in a local hospital they in their concern were spending money and energy to come to a crowded foreign place.

Life had changed in another way in our ward. Everyone was busy. Our ward accommodated medical students and their white coated frames were suddenly everywhere. Sometimes frantically looking for the patient allocated to them, writing histories, making notes… they were doing it all. In a sense, they knew much more of the patients than us, some were enjoying the process of learning. It was a wonderful thing to have time to learn. They were also helpful, and the ship sailed on with their help.