Soddo Special Delivery    From Dr. Mark and Allison Karnes

28/6/03

This past week has been filled with joy and sadness. I would just like one week not to have a major catastrophe. With that opening statement, let me say that we had a marvelous time in Addis last weekend. We said good-bye to the Solfelts from Madison, Wisconsin. They came to Soddo to fill in for the Andersons who are on leave in the U.S. Dave had about seven orthopedic cases a day and Barb taught in Jackie Anderson’s school here on our compound.

It was great seeing our Ethiopian family again in Addis and getting caught up on the latest news from their family. We stayed in Asle and Kari Arseland’s apartment with Kari on the Norwegian compound. Asle, our anesthesiologist, is in Norway attending classes while Kari stayed behind. Our time was filled with grocery shopping, shopping for our home, going to a medical supply company, enjoying a few restaurants and picking up our guests, Alberta Brown and Dr. Will and Agnes DeBraber. Dr. DeBraber is an urologist, who upon arriving in Soddo got busy seeing urological patients as well as teaching and training our PAACS surgical residents in basic urological procedures and principles.

On Thursday night disaster struck. A 35 year old mother of five came to our hospital with third degree uterine prolapse on Wednesday in preparation for surgery on Thursday. Her internal female organs were literally hanging outside of her body, making it very uncomfortable for her to walk, sit, work and carry on her daily activities. This is a VERY common occurrence here. It occurs usually in women who have had many children and from hours of pushing and straining as well as having poor nutritional factors. The muscles and ligaments that hold everything in place get pulled and stretched and in many cases actually can disintegrate so that there are no supporting structures remaining and literally everything falls out. The surgical resident and I performed a vaginal hysterectomy on her as well as vaginal reconstructive surgery. Everything was going well but near the end of one aspect of the surgery we noticed increased vaginal bleeding. We had difficulty visualizing where the bleeding was coming from. I asked for assistance from Dr. John Foor, a visiting vascular surgeon from Indiana. The source could not be located so we decided to open her and we quickly located the source of bleeding. It was taken care of and while Dr. John closed her abdomen, Dr. Dejanae and I went below and completed her surgery. I suggested that she receive a unit of her husband’s blood. She went to the recovery room in good condition and everything seemed to be fine. We completed her case by the early afternoon and I went to the clinic to see more patients. The next morning as I was leaving the house I received a call from Dr. Paul Gray, the residency program director, who informed me that our patient had died the night before. I was totally devastated. No one bothered to call me. The resident had been called at 9 P.M. the night before and stated that her blood pressure had dropped and her heart rate had increased. He started an extra IV line, ordered blood and she expired. He did not call me. The nurses did not call me. No one called me to let me know that she was in trouble, even though we live less than two football fields from the hospital. I had no opportunity to evaluate her, to talk to her family and express my sympathy to them.

Both Paul and I talked to the resident and explained how important it is to notify the attending physician when things are happening to our patients. Also, the nursing care here at times can be so lackadaisical. Their ability to recognize when patients are getting into trouble goes unnoticed and their failure to act upon the critical situation means the difference between life and death. I have been so thankful for our OB, surgical, and recovery room nurses back at Mercy Hospital in Muskegon because they have been able to recognize these types of problems and take the proper steps. In my 25 years of OB/GYN surgical practice, I had never lost a patient. I owe a lot of credit to the nurses who were taking care of my patients. Nursing care is vital. The proper training of nurses is critical.

I discussed this case with Dr. John Foor afterwards and he reassured me that her pelvis was dry before her abdomen was closed. He felt that the most likely cause of her death was a pulmonary embolus (a blood clot went to her lungs). We will never know. An autopsy was not done. When I found out the news, her body and family were gone. The only thing that is known is that a young woman that was laughing and joking with us before her surgery will not be able to raise her five children. This is the reality that her children have to live with. This is the reality that I’m living with.

On a more positive note, this past week we received notification from Global Outreach of those who contributed to our work in February. We are overwhelmed with your generosity and praying how best to use the resources God is sending to our ministry. The needs are great. Thank you so much for your prayers, words of encouragement and partnering with us in this kingdom ministry.

One Response to “Missing My Great Nurses”

  1. Harry says:

    Mark, Thank you for sharing the loss of your patient. I know this will bother you for some time to come. I just want to reaffirm to you that you are a great surgeon and that God has a purpose for you there and he also has plans in mind for the children of your patient. Praying for you, Harry

You must be logged in to post a comment.