Just Like Someone Without Mental Illness Only More So_ A Memoir - Mark Vonnegut [51]
“Speak English, Max. Use the translators. Your Spanish scares people.”
Our baby-blue paper scrubs didn’t hold up well in the heat and humidity. By noon they were falling apart. Bellies and underwear were flashing. Someone was dispatched to go back to the compound to get more. Cloth shorts would have had advantages. Our money belt was plainly visible wrapped around Max’s glistening belly.
“Be careful, Max. I think they can see our valuables.”
While I was over on the adult side, someone asked me if I’d help hold down a twelve-year-old boy while they were draining an abscess, so I grabbed a leg and helped out, wondering if the kids with something wrong with them were ending up being seen on the adult side and I was the “baby no eat–bones ache–cough” specialist. They got about five cubic centimeters of pus out of a not-very-swollen lymph node. Wouldn’t antibiotics and hot compresses be just as likely to work? What did we know about abscesses in the tropics and the risks of making a surgical incision in someone you might or might not see again? What if we slipped and nicked a big vessel or nerve? We put a draining wick in, gave his mother a prescription for Keflex, and told them in Spanish to come back at the end of the week. What if we had run across this kid on the last day of the clinic? Would we still have gone after that node?
In my regular job, many of the children I see for ear-infection follow-up couldn’t possibly have had ear infections. The eardrum has no thickening, no redness, no fluid. There’s nothing but a thin, translucent, perfectly normal eardrum. The antibiotics these children were put on couldn’t possibly have worked so quickly. Doctors and patients and parents are so eager for the resolution a diagnosis of ear infection brings that phantoms appear and are welcomed. The doctor finds something wrong, thus doing his job. The parents’ decision to seek medical attention is validated. The visit is over. Everyone gets to move on.
Now, in Honduras, where I was expecting a stream of severely ill children, I’m suddenly in the same position as the ER doctors back home. I’ll never see these people again. A few hours into the first day I see a bulging, bright red eardrum and feel warm all over. The little girl probably had ear infections before and had gotten over them on her own. She would have ear infections again and get over them without a doctor or antibiotics, but I was a happy guy.
“Ear infection,” I said to my translator, who passed it on like a great gift to the parent who had brought the child and stood in line for hours.
“Amoxicillin,” I said generously as I wrote out the prescription for the parent to take to the pharmacy.
“Should be better in forty-eight hours,” I added expansively.
I now know and suspected then that antibiotics have very little effect on ear infections, but it takes longer to explain that than to give out prescriptions.
After seeing another two hundred or so patients on day two, I was a dishrag, dazed and barely able to walk. I wedged myself into a window seat on the bus and waited for it to take me back to the compound. I had promised myself that I was going to swim at least a little every day. There were three doughnut-ring formations of coral twenty yards from the beach. Each ring was about thirty feet across and contained its own little world. There were lots of bright-colored fish riding the swells in and out of the giant doughnuts. There was also a menacing barracuda about seven inches long. I just wanted to fit in and tried sliding in and out of the coral doughnuts with the fish. My legs got cut up pretty badly.
When Max asked what had happened and I tried to explain about being playful, he said it was lucky I didn’t attract any playful sharks.
Every day the lines got longer. The charter buses from La Cieba east along the coast started to arrive. Ten of me couldn’t have put much of a dent