Unique Patient Encounters
I’ve been caring for patients in creative ways during the past weeks, as I finalize logistics to start working in Lilongwe again. I follow up with patient questions via e-mail, like usual, but having time on my hands for the first time since we moved to Malawi has opened up some opportunities for care that were not possible before. One day I had a 1-hour zoom conversation with a patient suffering some unusual pains. I know telemedicine is pretty common for doctors worldwide these days, but a face-to-face visit with a patient on the other side of the country was new for me. Earlier that day, a family came to visit us at our house. The wife is a talented tailor who came dancing in wearing a colored dress cut from the same cloth of the curtains she just delivered. Then she brought her daughter from the car and laid her on our couch. The seventeen-year-old had been in pain for some time; she had a long-term problem that I knew about and a few other problems that I diagnosed and advised about in our living room. She was dehydrated and had a slight fever, so I pushed into her hands a cup of water mixed with electrolytes for her to sip. Since I had the thermometer out, I checked her father as well, and found that he had a high fever of 103. I exchanged my cloth mask for an n95 and dug up some rapid malaria tests from my hallway cabinet (I had them leftover from our travels, never leave home without them if I’m leaving Malawi and going to a country where malaria might be hard to test for.) It turns out that both father and daughter had malaria. The treatment medications in my cabinet were expired, so I instructed the mother to stop by a pharmacy on her way getting those two home.
The next week, my patient was referred for a 3 AM emergency surgery in a hospital one hour away. I communicated with her mother through a series of confusing messages, then finally drove out to the hospital to look through the operative reports, ultrasounds, and lab tests. Only by making the 4-hour trip could I understand the full condition myself, which allowed me to better explain things, answer questions, give counseling, and provide tips for further clarification.
I know this time is a blessing. I haven’t informed most of my patients that I am back to work yet, I haven’t started working full days, and I have left flexibility in my schedule. I have time to contact the patients who have been waiting for me to return and see them first in luxuriously long appointments dealing with all their pent-up concerns. I have time to go to Malawi’s refugee camp and see the situation there with my own eyes, something I’ve been wanting to do for years and never managed. And I have time to think through new protocols and ways to assist families with preventive medicine, plans to collaborate and carry on in areas that others will soon be leaving behind. After Easter, I tell myself, I’ll get back into a regular routine. But will I slip back into old comfortable habits, working in the clinic most days of the week, seeing mostly traditional appointments who book ahead. Or will I be able to keep time open in my day for these unexpected opportunities to serve in unique ways? After 2 years focused primarily on administrative and systems-based work, I’m excited to get back to caring for patients and those relationships that mean so much to me. I’m looking forward to the ways my ministry with patients will form itself. How it will form me in the process.