This day was unforgettably sad and left a profound imprint on me.
It wasn't that another child died, or another two children infact, it was the emotions that trailed the sequence of events.
On this day, two children died almost simultaneously within the space of a few minutes. It happened in the daytime on a normal round that consists of generally malnourished, disease ridden children.
The first child rather unexpectedly passed away, without mother really noticing let alone the staff and when she did, the shriek reverberated through to the other wards. When i got to the bedside, Mother 1 was wailing and flaying her arms and the crowd watched (student nurses, nurses, other mothers and their kiddies). I stood in disbelief and dismay and requested the nearest nurse to comfort her and usher her to a private area, while i tried to assess the situation. The assessment was: dead child.
Not long after I am rapidly called to child 2, she is now Cheyne-Stoking (not unexpected, i had tried my luck to see if she could be referred) and mother 2 picks up on her imminent death and keels over to cry and wail.
The ward round begun with two deaths, two inconsolable mothers who were contained in the linen room to overcome their acute grief.
I don’t think I can yet formulate how incredible awful those moments moving to hours were. It was torturing on many levels; that two deaths should occur together; that i felt quite helpless; that the language and culture barrier held me back from offering some sort sympathy; that HIV and malnutrition is a rife problem.
One of the difficult aspects to this day was my inability to emphasise. I felt as well as not having the language skills i couldn't comprehend the form of expression of grief. So I consulted ward sister. The grieving is a form of utter break down, the griever cries intensely and audibly, they will physically melt down and do not hear or register others, hence why everyone watched them and didn't intervene. They will remain in such a state till they tire and then will be responsive to others.
Your role as the doctor should be to finish the cycle of care and though i dreaded it very much i went with sister to speak to the two mothers. I offered my sincerest apologizes and listened to sister speak in Zulu for what felt like ages. I looked down and tried to not look awkward but eventually just asked what was going on. The mums were saying they were what happened was inevitable and they felt that we had done all we could. I was relieved in one way to know that the ultimate acute emotion wasn’t aimed at me. At this moment i couldn't hold back a surge of overwhelming tears. I spontaneously reached out and gave them each a hug, they were a taken by surprise but clearly quite moved, all three of us the shed silent tears and sister led a prayer in Zulu.
A medicinal hug should be introduced to the grieving process here, its got to be healthier than the solitary soul crying in the linen cupboard. A final note to end on: though death in childhood is a common phenomenon and accepted as common place, its not easy to get used to no matter now unattached you may think you are.
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...even just reading this I feel emotional, but for me it's not the griveing that makes me emotional...but that you got over the awkwardness of the situation and all that society teaches you over here and listened to your human heart and reached out to these women and gave them a hug. That fills me with emotion. But isn't it amazing that even after all this no-one 'demands' to speak to the person in charge and wants a pen and paper to sue? How invaluable life is when that is all you have to hold on to....
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