pericarditis, progress

Odile Marie.

I could come hear just to hear the names.

She’s 19 years old, came in with a big heart and a big belly, ready to test our progress with 19th century ailments.

Nathalie Colas is the GI understudy, calm and getting pretty solid. GI isn’t all that hard, and we’re had some repetitions by now. I can’t get her board certified, and the ACG blew off our abstract- bastardos! We submitted a simple review of an unusual experience, with a Haitian woman doctor as the lead author- where is political correctness when you really need it? So our visit to Pierre in sin city is off. And that avenue toward a scope maintenance arrangement- my Achilles heel, is postponed. I may go alone and beg, though a fat old white guy just doesn’t have the same panache.

Well, nobody wants whining- we’ll expand it and try again with the AGA in the Spring.

But I digress.

Odile Marie is from Jacmel, Haiti’s version of New Hope, a rarified little arts community on the South coast. She lives in a one room house with a family of 7. Not unusual, but it is quite a crowd.

Not fat people, Bloomberg could let them supersize anything- the contrasts have people rolling their eyes.

And Odile Marie is skinnier than most, a pretty girl. So when she got the big belly, they figured they were going to need another pallet.

But that wasn’t it.

When she got so short of breath she couldn’t carry water, they brought her in by circuitous route, and Nathalie Colas admitted her.

Her chest X ray looked bad, with a big round heart, and fluid in the chest:

And her echocardiogram looked bad, too:

I’m having trouble uploading the movie, but this shows a pretty normal heart and a huge pericardial effusion- all the black stuff surrounding the heart.

We tapped another pericardial effusion over the summer, using the sonogram to guide us, after- I’m not making this up, as there are apparently no plaintiff attorneys in Haiti- reviewing the technique on youtube.

That went OK, he died soon enough of something else, but this girl had a big belly, so we made the diagnosis of TB by tapping that. No youtube necessary, paracentesis is already in my playbook.

Anyhow, she’s not pregnant, her parents are happy to know. But all 7 are going to require treatment.

And Nathalie, formerly leery of using the sonogram, has come a long way.

Which is fun to watch.

So after the battery tending at home:

And avoiding these:

And applying the Barkerized solar charger:

It was a pretty good run.

Well, it wasn’t all just mosquitos and tax deductions.

We did see this:

and this:

Scatter my ashes over the Exumas.

But not yet,

not yet.

Not yet is right. Some folks can use you for a while.

But that doesn’t mean you can’t sneak off for a visit to Sin City or Tahoe (or even the Bay Area for deep conversations and reflection). I hear that even the saints had their outlets.

As always, thanks for sharing; especially with us heathens.