Yapa was an old guy who was transferred in from Mathara somewhere in December last year. He had spent so much time in the ward that he used to joke that he had been added to the ward inventory. Always greeting me with a sweet smile, he would say, every morning without fail, "no need to check my blood pressure Nona, there's nothing wrong there... see if you can fix my lung".
And that was precisely what was bothering us. His left lung was virtually non existent as the left side of his thoracic cavity was filled with fluid. This had been drained 5 times in Mathara, only to fill back up again. We were reluctant to stick a needle in again - this type of collection usually meant either cancer or TB, both which need specific treatment but no matter how many tests we did, no diagnosis was reached. So poor Yapa was bounced around, from our ward, to the Medical Investigation Unit, to Chest Clinic Borella, to Chest Hospital Welisara and back to our ward and no one had a clue what was going on. X-rays, bronchoscopy, bronchial washout, CT scans etc. etc. Even Dr. House, MD would have been impressed by the thickness of this guy's file.
And every day he'd get a little more breathless. Each night, he'd have more difficulty in breathing. And each day I'd get more concerned at how little he was eating. Finally the decision was made to put in a tube and drain the fluid... and for a couple of weeks he was walking around carrying the tube and bottle as if it were a special kind of handbag and looking absurdly happy about it.
Then one day, he just deteriorated. Hands were cold and clammy, blood pressure was low and breathing was irregular. We pumped in saline and plasma, nebulised him with everything we vould think of, gave high dose oxygen and he pulled through. That evening as I did the round he told me, "Nona, I'm going to die in the night... the forms I have filled to donate my eyes (coreal transplant) are in this little bag under my pillow, don't forget". I pooh poohed at his statement, patting his arm and reassuring him that he was now on the mend.
Yapa survived the night... but he died at 8 am the following morning. His last words to me were once again, not to forget the forms. He sank into a stupor and then died peacefully a few minutes later. He died not screaming and begging to be saved, but convinced that his time on this earthly plane was over and his last wish to help someone in his death.
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May he attain Nibbana
And every day he'd get a little more breathless. Each night, he'd have more difficulty in breathing. And each day I'd get more concerned at how little he was eating. Finally the decision was made to put in a tube and drain the fluid... and for a couple of weeks he was walking around carrying the tube and bottle as if it were a special kind of handbag and looking absurdly happy about it.
Then one day, he just deteriorated. Hands were cold and clammy, blood pressure was low and breathing was irregular. We pumped in saline and plasma, nebulised him with everything we vould think of, gave high dose oxygen and he pulled through. That evening as I did the round he told me, "Nona, I'm going to die in the night... the forms I have filled to donate my eyes (coreal transplant) are in this little bag under my pillow, don't forget". I pooh poohed at his statement, patting his arm and reassuring him that he was now on the mend.
Yapa survived the night... but he died at 8 am the following morning. His last words to me were once again, not to forget the forms. He sank into a stupor and then died peacefully a few minutes later. He died not screaming and begging to be saved, but convinced that his time on this earthly plane was over and his last wish to help someone in his death.
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May he attain Nibbana
