I was taking care of a middle-aged patient recently who was experiencing a recurrent bout of diverticulitis this time severe and with a small abscess. It’s at a stage where surgery to remove part of the colon is necessary but the surgeon wants to let things “cool down” for a few weeks. So my role is to select a good course of antibiotics to hasten the “cool down” period and hopefully prevent recurrence before the scheduled operation. I decided the best choice for the patient was about a ten-day course of intravenous antibiotics to be administered through an indwelling catheter. Patient had failed oral regimens and in fact did not tolerate the side effects well. So imagine my surprise with the patient’s indignant response of “so you are going to ruin my whole summer? I can’t even use my pass for the swimming pool!” I was stupefied.
Here I am, a physician, a specialist in America delivering my expertise to an ungrateful patient. A patient who will be in and out of the hospital in a matter of days because surgeons, medical specialists, social workers, nurses and pharmacists have worked seamlessly to provide coordinated care. Meanwhile, my own family members in Ghana could only dream of this luxury.
Recently, a relative was to be discharged from the hospital on oxygen and the somber discussion among family members on different continents was “so, how are we going to get oxygen? Will we have a reliable supply with all the dumsor?” The reality is that my relative could die an unnecessary death. Stories came flooding to my head. I recalled a patient I attended to at Korle-Bu Teaching Hospital in Ghana who I watched die, choking for air in part because there was not a single oxygen tank available let alone a mechanical ventilator for her respiratory failure. I recalled a relative several years ago presenting to a hospital apparently in congestive heart failure who died in the waiting room as the person accompanying them had to pay up front, then take the prescription for the emergency drug written, presumably furosemide, to the closest pharmacy to fill so that the doctor could administer it.
These were the thoughts in my mind as the patient in front of me continued to berate me for ruining what was left of the summer. But I said nothing. I let them finish. Then I walked away to attend to the next patient.
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