Today:There was a gecko skin shed into my briefcase.
There was a round worm curled in my shoe.
There was a small cockroach rampant in my hospital footlocker.
There was the return to Kigali after a fabulous 2 weeks away on spring break vacation.
There was the return to work, the return to school, the return to the home we have made here. There has been a return to the mental state that we are far away, that we are challenged, that we are privileged, that we are so fortunate.
There was the realization that my time here is now half over. I've hit the arc and am now running down the back half. So much to do. Exciting, intimidating and a little relentless at times...
There has been the acceptance of blog radio-silence. There is no way to catch up on what has been felt and thought and completed. There never is. Just have to re-start. Just have to keep going - take it in and appreciate the process, the path and the light. So goes the work and the writing!
There was the team of gum-booted hospital cleaners in the ED on arrival. Splashing water on the floor, mopping and squeegeeing. Puddles of bandages, blood and syringes. Floating caps, wraps, and tubes. There was the trail of my dirty footprints across the ED floor towards room 9.
There was a ride earlier. There is still a single-speed in play. The rear derailleur remains wrecked. Twisted beyond resuscitation by an errant branch almost a month ago. There are no XT derailleurs to buy in East Africa, let alone Rwanda.There was a man selling high-heeled shoes though.
He was walking the road carrying several pairs in his hands. Red ones with a cork heel - Just in case there was someone else walking and needing such an accessory this morning. There was another man carrying blazers for sale - One in brown suede and another with purple velour. They didn't look my size. Such walking selling wouldn't be done if it didn't work. If the sellers couldn't sell, they wouldn't walk. I marvel at the ability to buy and sell party shoes and formal clothes while walking through the muddy paths of the rural outskirts of Kigali. Testament to a hopeful nation on the move. On the up. It hopes.
For a new derailleur, I am hopeful. There is a riding friend with access to a diplomatic pouch. He believes that a derailleur can come from the UK in the pouch. It has been done before.There were kids racing to school on the ride. They smiled and waved and yelled greetings and questions at me. Incessantly. They chased after me and called me muzungo. They ask for money, but I think really they are only asking to be noticed, to be greeted, and to share in a slice of the wider world that is riding by. More than any of their family before them, they will do.
There was a comatose child in room 9 today. He had fallen from a tree picking mangos. His family did not have insurance. On my shift, his brain herniated through his right ear. A horrible sight and an inevitable declaration of his clinical outcome. There was his mother. Stoic and reserved. There was a conversation about futility of intervention and the merits of comfort care. There was her look of understanding, her look of acceptance about her child's imminent death that made it obvious that she has been in this situation before. This will not be the first of her children she has buried.There was an attempt to teach the resident and the nurse in room 9 that these conversations about death in the ED are also what we need to do as emergency care providers. The concept of providing acute ED comfort care is slowly gaining traction. Thankfully so, for there is much of it.
Returning towards home, there was a discussion with my regular taxi driver about the woes of Manchester United, the increasing cost of school fees for his child and how he collected drinking water from embassy swimming pools while surviving the genocide.
Once home for the evening, there were some happy games of tag and some living room skateboarding action. Then a little homework before the power went off. After that it started raining. Then the stars came out.
There is another day tomorrow.
Thanks for reading.
