Nightmare

I don't know why, but for the last few nights I have been dreaming I'm at work -- either at the hospital or the clinic. Last night I had a nightmare. I was in a small ER somewhere and my patient was a 1 month old baby that was not doing well. I was doing a spinal tap and the CSF (cerebrospinal fluid) was turbid like dishwater. This child had bacterial meningitis and was dying! I began barking out orders and trying to get this child to the intensive care unit in Marshfield. It was chaos and a race against time.

The situation changed and I was on Isla Bastimentos in Panama, back among the Ngobe. This time I was tapping an older infant with improvised equipment in a barebones clinic and getting the same dishwater CSF. I began to cry because children were dying on meningitis and I could not save them. I managed to save 6 kids by giving them antibiotics in time, but one kid died. We did not have enough ceftriaxone, we did not have enough spinal tap kits or needles or syringes or IV start kits. I woke up crying. It is really hard to know what to do and watch helplessly as a patient dies because you do not have the tools you need. Wow, it took me quite a while to shake that off. It was so vivid. Brrrrrr!