Dammit!

My last pair of work shoes broke this morning... I am now faced with the choice of going to work in
a) broken shoes
b) rubber slippers
c) hooker heels

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I'm sorry my last post came out all whiny and self pitying. I'm not the first or the only one to go through this... everyone does it. My Colleague M went home to Mathara today after 5 weeks (and was entirely cheerful about handing over her ward to me).

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So I'm now handling the female ward. Slightly lesser number of patients but full of old achchi's suffering from APR (athe-paye rudha/ anga-patha ridenawa) . Since I've been suffering from APR. meself, I'm a bit more sympathetic than I would have been otherwise. The ward also has Kala*.

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Kala is a 19 year old with a 43% kerosene oil burn - accidental, she claims but the pattern of the burn injury makes us question that. She has a 2 year old daughter and was pregnant with her second child when she was admitted. Her husband Janaka is in my old ward with a "rescue burn"... he has essentially burnt the skin off both hands trying to save her.

Janaka looks a real rasthiyaadu type... dirty teeth, silver earling, breath smelling of stale ciagarettes. He drives a three-wheeler and lives near the place Kala was boarded at a couple of years ago while working at a garment factory. Romance blossommed between the brash sinhala youth and the shy tamil girl. His family was ok with the match... hers opposed it. So they eloped and in true Sri Lankan style, all differences were settled when little Tharushi was born. Kala's family came from Trinco and were living in a house paid for by Janaka.

Janaka had tears in his eyes when he told me how Kala made him tea and stroked his hair untill he fell asleep that fateful night. He was woken up by her screams of agony and had rushed to the kitchen to find her blazing like a torch. He carried Kala with his burnt hands into the threewheeler and then to the Accident Service.

Two days ago Kala developed labour pains and was rushed to DMH where she prematurely gave birth to their second child. She's back in NHSL while the kid is in the PBU.

In Sri Lanka, anything more than a 30% burn injury carried a pretty poor prognosis... i.e. 99% die. Kala has an inhalational injury as well... her lungs have been burn from inside by the kerosene fumes. We're pumping in fluids and plasma and high protien food... but the truth is that she can die any minute.

She scares the daylights out of me.

She's conscious and rational.... her breathing pattern sucks and she knows it. She asks me if she's going to die. Janaka asks me if she's going to die. Her mother asks me if she's going to die. I don't have much to say.

Everytime I leave the ward, I leave in grim anticipation of the call "Doctor, Kala has become bad".

Would appreciate any positive energy you guys can spare to be sent her way.