Christina

I want to tell you about my patient Christina. She came to the hospital over a month ago barely conscious, incoherent, in respiratory distress. Her blood sugar was 600. She had diabetic ketoacidosis: DKA.  It is cases like this when I remind myself I worked urgent care for a reason in the States! This patient would have ended up in the ER, then admitted to the ICU with a battery of labs performed, her electrolytes closely monitored and an insulin drip started. Well, now I am a hospitalist who relies heavily on UpToDate without access to electrolyte monitoring or insulin drips. We managed to get her blood sugar back to a more manageable range with only fast acting insulin injections and IV fluids. She improved. She left the hospital on the only oral medications we have for diabetes. She needed insulin, but she does not have electricity, therefore no refrigerator, so she would be unable to keep the medicine from spoiling. 

Patients here are surprisingly good at keeping their follow up appointments. When I saw her again in my wonderfully air conditioned office at 75F, her blood sugar was still too high and I discussed how I could only increase her oral medications so much and that she really needs insulin. We talked about far-fetched ideas like her coming to the hospital every morning for an insulin injection. Instead, she decided she would work on lifestyle. 

Next time I saw her she had bought a long sleeve shirt on the way to the clinic because the AC in my office was too cold. Since her last visit she felt like a virus was coming on and she blamed by AC. The cold causing illness myths are everywhere! About diabetes, she had lost some weight, had been exercising daily, and eating healthy foods. Her fasting blood sugars were within normal range! I was ecstatic. This is a lofty feat for an American who has ample access to places to exercise safely and a wide variety of foods. Here in Africa, the roads are dangerous to walk on due to traffic and the vegetables in the market are limited and expensive for locals. This is a HUGE achievement. She is going to school to be a seamstress so she can have a business, save up money, and hopefully get a visa to visit her two sisters that immigrated to the US. 

She let me take a picture with her. She’s the first patient I’ve connected with in this way and it was truly encouraging. Sometimes I feel like I’ve moved all the way out here just to spend all my time figuring out how to eat and survive, read UpToDate, struggle with hospital finances and politics when supposedly we came to do ministry. I’m not sure when we will start to feel like we are actually doing ministry, but this patient certainly ministered to me.  She didn’t pray with me or preach to me but my heart felt lighter after my visit with her. I think God can use interactions that don’t fit the cookie-cutter “ministry” to glorify Himself and to bless those around us. I’m looking forward to seeing Christina again, and I’ll be sure to turn my AC off when she comes.