I can't explain it except to say there are weird things in the world and forces of evil that try and mess with people's minds...
It started innocently enough. David gave sign-out to the team about what happened overnight. A few patients had fevers but overall all the hospitalized patients were doing well. Furthermore, he received no outside cases and had no deliveries until a woman showed up 20 minutes before we started morning report.
The woman had apparently been out walking in the dark to relieve her self and then fell after stepping in a small hole. The family found her several hours later and brought her in as soon as possible.
We finish by assigning posts to the staff for the day and praying. I grab my "doctor's bag" (an old army tan shoulder bag) and head off on rounds. We go to see the new patient first.
She's lying in bed on her back with coarse breathing. She appears semi-comatose with some drool coming out her mouth and a pool of urine under her. She moans and barely moves her extremities but otherwise is unconscious. Both pupils are normal and reactive. She has no evidence of trauma and on further questioning the family says she apparently fell beside the hole but it wasn't the hole that caused her to fall. Her vital signs and heart, lung and abdomen exams are normal.
I order a malaria smear and some other tests. I continue my work for the day while waiting for results.
Awhile later I get the malaria results back which are positive; all other tests are unremarkable. I order a quinine drip and go back to work.
At 1pm I go into the OR to repair a hernia on an elderly gentleman. As I am gowned up and about to start Zachary walks in to tell me that the woman has died. No one is surprised, apparently. Now the true story comes out.
The man I am currently operating on is the woman's brother. When he sold a cow to pay for the operation, she protested and said she wouldn't go and see him in the hospital if he used the money for the surgery. He left his village to come to B�r� yesterday in order to be at the hospital early. She had regrets later and went outside to follow him and be with him after the surgery. That's when, to no one's surprise she fell down and, shortly afterwards, died. That is what the people here expect to happen if you do something that you later regret...you'll die.
So, of course, the solution is to never regret anything. That's why I never hear apologies because it doesn't really matter what you do as long as your not sorry for it you won't be struck down by whoever it is you believe does the striking!
I'm slowly learning little by little why I feel frustrated...I'm in a serious culture clash...not just American-Tchadian, but my own personal cultural differences. If I do something I like to be thanked. I will stay up all night, be totally wasted, work while sick with Malaria, do whatever it takes if you'll only appreciate it. But the Nangjere language doesn't even have the word "thanks"...they've borrowed "merci" from the French but still rarely say it. And now I've discovered that while I easily forgive and forget, and will often apologize myself when wrong in an effort to reconciliate...here, that is not only culturally not done, but considered dangerous as one could die if he has regrets, apologizes or tries to make things up or reconciliate!
As they say in Nangjere, "Kai, Kai, Kai" or in French "�a, �a, �a"...or in English, "dude, what's up wid dat?"...
I somberly return to the dead woman's brother lying on the operating table, covered with a green drape, and continue the surgery, find the hernia sac, tie it off, close up the defect, suture the layers closed and clean up...will I never cease to be surprised by this place...?
James
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