Surgical Procedure Board - Tenwek, Kenya
It was a day like many others at Tenwek Hospital(2/2012) when during rounds it was announced that two term pregnant patients arrived with seizures. Both patients were diagnosed with eclampsia, both delivered. The first patient’s baby was an early neonatal death, the other patient’s (JR) baby was small but survived. The first mother improved quickly, but JR had evidence of renal failure, liver changes and the most obvious was her altered level of consciousness and subsequent hallucinations. These symptoms required treatment with anti-psychotic medication. Two weeks after presentation, JR suddenly became engaged with her baby, smiled and interacted appropriately with her family and providers. Her renal failure and liver failure resolved. She remained in the hospital to continue to care for her baby.
The reasons for resolution of this life threatening complication of pregnancy are only partially explained by her care. What is most amazing is the long list of possible etiologies and mechanisms of injuries. The patient and her family believe that she was healed. Physicians and nurses use longer explanations about mechanisms and the sources of the dramatic change.
These cases are a source of encouragement for those who work in very difficult settings with limited resources. I believe that this case is a wonderful lesson in ”Let the living, teach the living” and another example of the “mystery of healing”!
Marvin
See previous blogs:
The Awe of Healing - January 15, 2012
A Right Mind - September 5, 2011
The Mystery of Healing - April 17, 2011
Thackeray EM. Tielborg MC. Posterior reversible encephalopathy syndrome in a patient with severe preeclampsia. Anesthesia & Analgesia. 105(1):184-6, 2007 Jul.
Belogolovkin V. Levine SR. Fields MC. Stone JL. Postpartum eclampsia complicated by reversible cerebral herniation. Obstetrics & Gynecology. 107(2 Pt 2):442-5, 2006 Feb.
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