ICU revisited

The air is thick with the ash of trash fires and old engine emissions. It is like breathing gravy and my lungs stretch themselves to capacity to keep me conscious. Walking up the hill to mulago hospital’s other entrance, because the guard wouldn’t let me through the gate, my backpack pulling each step back a little, I could feel my lungs straining, feel the wheeze in my chest.

I was angry by the time I made it the entrance and half-heartedly directed by a guard past a malaria research building funded by University of California San Francisco, down crumbling concrete steps, beyond the stench of an old pit toilet or a long-broken flush one, only to end up a few meters from the original entrance.

Sigh.

But this mission was about H so I swallowed the irritation and walked into the massive complex. Floors upon floors with no one offering information or directions. I walked to a pair of metal doors at the end of the hall, women on woven mats sat quietly with their legs tucked under them or to the side, waiting patiently – for what, I’m not sure. The man behind the door, guarding the occupants beyond it, directed me down a floor.

3D. I was looking for the ICU on 3D. and in short order I found it. The door with multiple “do not enter” signs of various wording. I started to walk in but the second pair of swinging doors had “no man’s land” above the door. All I could think was infection. This was the ICU. I hesitated and backed out.

Scanning the people walking by, I stopped someone in a uniform and she laughed and directed me through the doors, assuring me it was fine. Shoes cluttered the doorway- fading red tape the demarcation line for outside shoes vs ICU ward slippers. I stood indecisively, waiting to be yelled at. Two nurses approached.

“who are you looking for?”

I stated H’s name. They both shrugged, perhaps my accent mangled it making it more foreign sounding than it should be. I began to explain.

“he was transferred from IHK yesterday. He has severe head trauma.”

One nurse’s face lit up and she turned to the other and reminded him of H’s arrival the previous day. suddenly they were pointing down the hall; I walked into a bright room with one bed in each corner. H was in the far corner on the right, by the huge window.

He looked like I imagine he does when he’s sleeping, except for the large tube in his mouth breathing for him. But his eyes were closed. His skin clear and unmarked. Even the place on his scalp where his wound was sewed with dark green stitches was discreet. He looked like he could open his eyes at any moment. But he didn’t.

Instead he lay unmoving, his roasted coffee colored complexion in stark contrast to the white sheet around him. His frame looking tiny in the giant bed.

Machines clicked and whirred, the ventilator inhaled and exhaled and I cried silently.

Around the corner from the ICU entrance in an open air alcove like the one I’d seen the women in earlier, I leaned my back against the wall and slid to the ground breathing as deeply as my lungs would allow. I watched a gurney with a man laid out on it get pushed down the hall, wheels wobbling like a supermarket basket.

There were three family clusters with their belongings stacked neatly beside them. Colored mats rolled out with people sitting on them, buckets filled with cooking utensils, blankets folded, fruit being cut and handed out as people spoke softly to each other. They were there for the long haul. Indefinite diagnosis and recovery, they set up temporary lodging tucked away in the nooks and crannies of the hospital.

A nurse came out to request a straw for a patient, he was Ethiopian and didn’t speak luganda and so the need was pantomimed instead. I wonder how he pantomimes diagnosis. What happens then?

I walked back up the stairs, into the lobby, and out the door. I passed other gurneys in transit, crisscrossing my path headed who knows where. But all I could see was H. all I could hear was his ventilator. All I could wonder was his fate.

The street in front of mulago hospital is lined with tropical plants and flowering foliage, yellow roses and pink hibiscus, tiny other flowers in blue and red; a beautiful, if misplaced splendor in the shadow of and ICU visit.

Tags: friends, health, uganda, work