Yom al Sabit (the seventh day)

Its Sunday morning 8 am and I am lying in bed relaxing, It's difficult to doze as although the sky is blue there is a persistent roar of not too distant thunder. Military jets are exercising, probably French as they are the noisiest, circling  over the city. You would think they would take one day off each week and why not the Sabbath?

In fact  Yom al Sabit ( Chadian Arabic ) was yesterday, its timing in the week, and the words themselves make clear  the Semitic roots  of the language. Sabit is so close to Sabbath  and when you hear Yom Kippur ( the Day of Atonement)  do you think of warplanes , always butting in as above or goats? Google it and see what you get.

So if today Sunday is not my Sabbath rest, (I am on call and have to  do a ward round), what did I do with the actual Sabbath yesterday? 

At 7:30 Andrea woke me to let me know that she couldn't contact the anaesthetist, his telephone was clearly resting and not available.  The wife of one of our guards needed a caesarean  and I stood in to put her to sleep. The  4 kg baby boy was delivered and by 10 o'clock  I was back at the house having a quick breakfast and coffee before getting on with the day's work.

On the mens  ward there was only one man with heart failure ready to go home, he left and was replaced by  semi conscious  man with malaria from the Emergency Room. Another man who had a definitive  amputation of his hand a week ago came in for a dressing ( he was trying to prise open an old hand grenade with a knife, don't ask why, he initially claimed it was an exploding cigarette lighter). There were  five  empty beds, the sixth bed had been put on the children's  ward.

There were  three women on their  ward, one with heart failure due to rapid atrial fibrillation , a second with liver disease (cirrhosis and bleeding  varices) needing a blood transfusion, and the last after a mastectomy for breast cancer.  There  should  have  four empty beds ,  but there was  only one. Another  had been taken into the children's ward,  and once that room really was  full  the children's ward  overflowed  into the women with the presence of a   new child with malnutrition and one who was getting better quickly from her severe malaria.

 This  month children's health is at more serious risk than ever,  and this year we are prepared for it. Last year's autumn harvest is a long time ago and the next one is keenly awaited, the rains fall a source of  benediction. in the meantime food is short and malnutrition common in the under 5's. But the same rain makes the puddles  and the   mosquitoes flourish in the puddles stagnant water becomes  a curse. 

There were five more severely malnourished children on the children's ward, some wasted and stick like, others bloated with retained water and peeling skin. All are on the  intensive feeding program, and if the families can spare the time they can be cured.   An older girl who had been profoundly unconscious for 5 days with cerebral malaria had  amazingly opened her eyes and said a word to her mother. Another 7 year old clearly had tetanus, all his muscles have gone stiff,  it wasn't obvious the day before. So he was  immediately transferred to a single room for ant tetanus serum, antibiotics and sedatives. Finally there were two surgical cases from earlier in the week a girl with a perforated gall bladder and peritonitis  which I presume occurred during the convalescent phase of typhoid, she was doing well:  and the other another with a bowel obstruction due to an internal hernia through the small bowel mesentery.

It's an  unusual and interesting mix of cases for one  doctor and it is great to see so many getting better.

By 2:30 I was home for lunch and I got a bit of rest between calls to the Emergency room and checks on the sickest patients. . The evening was calm and we sat down as a family to watch the current favourite ,Call the Midwife, on the computer. I am not sure if it  counts as  recreation or continuing medical education after all the day had  that started with 'Call the Anaesthetist'.  So the Sabbath was a quieter  day with no non essential work  but not exactly a day of rest.  It was our  6th consecutive   days of 24 hour on call,  only six more to go until next Saturday which really will be a day of rest , Yom al Sabit.

PS  A little time for Arabic, I think I'll learn the days of the week