The hospital was a maze. Maybe this feeling of fighting to survive had caused my sense of direction to shrivel up, the same way your body knows how to send blood to the only the vital organs when it thinks its dying. Maybe my mind thought it was dying. I had passed that baby sleeping on the stairs at least twice, yet I was no closer to understanding where I was. Perhaps it should have concerned me that there was no one nearby who appeared to be taking responsibility for the little dreamer, but my mind was on other things. One thing, actually. Acetaminophen. My eight year old, Jorge, was in pain and as I had come to find out from the more seasoned inhabitants of this cold, dark maze, the only way to get medicine was to venture out into the city and find it yourself. Of course, upon returning to the small room that Jorge was sharing with six other little boys, I was sure to bring enough to go around. Some of these boys had not seen their parents in days or weeks. Many of them were waiting for their parents to earn enough money to pay for that next test, round of treatment, or surgery. In the meantime, they were at the hospital’s mercy, which was in short supply. I looked across the room at the youngest member of our little hospital family. He spent most of his time propped up in one corner of his crib, arms hanging off each side and wide eyes staring blankly around the still room. He almost never cried, but some instinct in me felt that he needed to be touched. He looked so fragile and I was afraid to pick him up, so I just walked over to rub his back and talk to him. He was hot. Too hot. I wondered to myself how much he weighed. Maybe ten kilograms? I could probably give him about a teaspoon of Tylenol. No nurse had been in to see him for at least eight hours. His mother was hours away in a village working to pay for his treatments and no one wanted to waste time on a baby who offered no assurance of reimbursement.
“Did you bring my food?”
As usual, Joshua had given me a few Lempiras before I left so that I could bring him back some dinner. The hospital provided one meal a day and it was anything but edible. He had been born with tiny legs that never grew. They stuck out from his eight year old body like chicken feet. What he lacked in leg power, he made up in upper body strength. I set his box of cold Chinese on his bed and watched his little wheels spin in that direction. He swung himself up like a monkey and inhaled his meal.
Hospital Escuela is the teaching hospital of Honduras. That fact in itself made me nervous, as anyone who learned to practice medicine in such an environment could not reasonably be faulted for any future lack of competence, conscience, or integrity. The first time I entered the ten story building in the middle of bustling downtown Tegucigalpa, I was shocked by the filth, the emptiness, and the amount of people sitting on the floors. It occurred to me that we were in a very poor city and perhaps waiting room chairs had been deemed a luxury in the presence of such basic needs as water and electricity and armed guards. As the days before and after Jorge’s surgery passed, however, I began to develop an odd familiarity with the faces sitting on the floor. Some of them never changed. Then one day, I sat down on the floor with them and found out why they were waiting. Some of them had already been diagnosed, but they were too sick to go home and too poor to pay for their tests. So they waited. Others had formed a line, maybe days ago, and were still waiting for a consult, a prescription, a medical file. Still more were sleeping on the floor outside of a loved one’s room. On any given night, the floor of the waiting room outside of the unit where Jorge was would be covered with piles of clothes, people underneath them, too tired to even swat at the cockroaches that scuttled from room to room.
I never understood why I was allowed to stay with Jorge. Perhaps the nurses had some sense of protection for the young, blue-eyed, American girl who would probably not be safe sleeping among the crowds outside.
After I got Joshua settled with his food and dispersed pain medicine to the motherless boys, I began the evening search for linens. The hospital laundry service provided gainful employment to several kind Honduran ladies, but somehow there never seemed to be any sheets or towels. Ever since my roommate and I had become the mothers to Jorge and nine other children months before, we were now expert hospital survivors and had discovered that if we waited until the small shipment of laundry arrived on the unit each night, we could sneak enough sheets to at least take care of “our boys”.
Sheets, medicines, and food dispersed, I slumped into the plastic chair next to Jorge’s bed. As usual, the running water to the unit had been turned off for the day and the one toilet was almost overflowing.
“Are you OK?”, I asked him, knowing full well he was not.
A tube from his side had been draining bright red blood ever since his surgery and his Foley bag was getting uncomfortably full. No doctor or nurse had been to see him yet and I was sure the acetaminophen had only put a dent in his pain. He turned his back to me and I tried to let him be a man by pretending not to hear his sniffles. The other boys were beginning to calm down, too. One other mother had appeared to stake a claim under her toddler’s crib. She crawled under there after nursing him, no blanket, no pillow. Two other boys, who had been best friends that day, lay in their beds and kicked their little feet up in the air, laughing at each other. I followed their IV lines with my eyes and realized why they had been together all day. They were connected to the same pole.
During the day, the room was lit by one functional bulb of fluorescent light that hung precariously from a wire twelve feet above. It flickered sometimes just to remind us to be grateful for its presence. When the sun was out, a warm spot of light would travel across the floor, spilling in from a bedpan shaped hole in the window. and providing one wheelchair bound child, who amused himself by following its path, with his daily dose of Vitamin D. Now that it was night, the only light seeped in from the nurses station down the hall. I didn’t mind the darkness. We all took refuge in the opportunity to close our eyes to the unpleasant realities around us. Tomorrow the fight would begin again.
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