Bad news

Today is Sunday. I'm off duty but still I performed three operations in the hospital while John was making the ward rounds. We received very bad news once we arrived at the hospital. The young man with snakebite died suddenly last night. We really don't know what happened. We had changed the dressing for him yesterday morning. The wound looked fine. His blood pressure was low right after the operation, but he responded well with the fluid resuscitation and was back to the ward in the afternoon. I remembered I saw him the last time in the evening before I was off. He was talking and having dinner with his family. He died so suddenly. He might have died of toxaemia from the snakebite but normally it should happen right after the accident, not five days later. The muscle necrosis was not bad at all compared with cases I had seen before in Kenya. After the fasciotomy, he could move his fingers very well. He should not have died of the muscle necrosis. I could remember his family was very concerned for him. His sister had asked me several times about his condition. I met her this morning when she came to the ward and found him missing. I told her that her brother had passed away suddenly last night. She immediately cried out and burst into tears, then ran out of the hospital. I could not find her again. I'm really sorry for her and the family. The problem is that we really don't know what happened. We could not do any tests or a post-mortem examination to find the cause of his death so we could learn from that. This is the reality and constraint we have to face. People's life here is so fragile. What we can do is just so little. Au Yiu Kai