Mary's Blog

Mary's Blog: In Our Stories Live Love, Connection and Resiliency.

My amazing medical team partner Mary Zozoaya Monohan was working today with the health facilities assessment team at the CAP (essentially a small rural emergency department, obstetrical unit and clinic) in Chicaman while I was involved in the training the team at the Hospital in Uspantan. Here is her blog entry for today! Thanks Mary.

Today was filled with many of the things I most treasure in small moments in time. Being attentive to someone in need, problem solving when things don’t go as expected, family chipping in to help out and community with shared experiences.

I spent the day at the health center and will share stories from the day.

First, was a mother who came to the clinic with her young son and a niece. She had woken and found her undergarments were soiled with blood. She was 8 weeks pregnant. Despite the fear she must of felt she stayed calm and answered the multiple questions the obstetrician asked. It was determined she would need to travel to the hospital in Uspantan (about 30 minutes away in ambulance).  She was to be accompanied by someone. Her son and niece could not go with her but they were too young to go home alone. Her husband was working and her parents were not near. She called her mother-in-law, and although I could not hear the responses, the patients voice began to quiver, as every suggestion was not being met with a resounding yes. Family members were working and not available. Eventually, a distant relative was identified but it would take another 30 minutes before they arrived (1 person to accompany the children home and the other to accompany her to the hospital in another town). The fear was palpable, and she alone awaited transportation to the next level of care.

Secondly, was a grandmother, who was accompanying her pregnant daughter and grandson to the clinic. She was not coming for care but ended up needing to be seen. On their way, a dog had attacked them, she reported he was going for my grandson’s face, so she blocked the dog and had bites on both hands. They were penetrating and cleansed without any anesthetic and she simply grinned and grimaced and allowed the cleaning to occur. She was given antibiotics, some Tylenol and instructions for the wound care.

The third was a mother and grandmother we had observed sitting, waiting for test results. This 77 year old grandmother was having right upper quadrant abdominal pain. The tests were used to exclude appendicitis (looking for an elevated white blood cell count) but were incomplete in evaluating the liver disease some of the other tests alluded to. The health center had run out of the test strip and she had to go to the hospital to get the rest of the labs done. She was in extreme pain it was not till some of the labs came back that she was able to receive pain medicine. An injectable form of a pain medicine was given to her and oral medication as well, ‘to help with her suffering,’ the provider said.

As I review these stories, I think these seem like manageable issues. What isn’t included is the pot holes, and curves in the roads that this woman with abdominal pain would endure which would be difficult even with smooth roads. Having to travel to a place that is unknown, leaving your children and having to consider the possibility your pregnancy may not go on. Will the dogs that attacked the family on the way to the clinic be waiting on the return?

The strength, perseverance, humility I witnessed, reminded me that at our core we are united in our experience and human needs, community and connection is foundational and how important attentiveness, being fully present, is.

Mary Zozoaya Monohan FNP-BC/Nurse Coach - BC