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No Headaches
I’m (Jason) sitting in casualty (an emergency room) at the desk writing orders for a routine medicine admission when I hear a motorcycle speed up and stop at the door behind me. A mother jumps of the bike carrying a small, limp child in her arms. She rushes into the room and lays him on one of the exam beds.
He lies motionless on the bed, eyes shut tightly. I feel a pulse and I see his chest rising. Thank God he’s not dead! I think to myself. But I can’t wake him. Even when applying pain over his breast bone, he just slightly moves his head to one side. I see a large swelling on his forehead and learn that he has fallen from a second story building and became unconscious soon after the fall. His breathing begins to change. At times he takes quick gasps and at other times deep breaths like sighs. Then he begins to vomit, a bad sign that could indicate that the pressure in his head is increasing, most likely from bleeding within his skull.
I call the neurosurgeon from the teaching hospital nearby. He advises that we intubate (put a breathing tube in) the seven-year-old boy and put him on a ventilator so that we can help him breath regularly and decrease the pressure in his head. The nurse anesthetist comes for the intubation and does it quickly and successfully. The neurosurgeon also arrives. The child urgently needs a CT scan of the head but doubt his family can afford it never mind the cost of transporting him to the teaching hospital to get it done.After the intubation, I see the boy. His chest rises each time the machine pushes air into his lungs. He moves slightly each time this happens, but he’s still deeply unconscious. I shout his name into his ear. No response. I wonder what could be happening inside his brain. Even if we get a CT scan, will we enter his skull to remove the blood? Even with surgery, most of our head injury patients die. Even in the best hospitals in the world these injuries commonly end in death. When medicine is not enough, what can we do? I pray for this little boy. I ask God to give him life. I feel a peace and I know that God is in control.
Less than one hour later, I’m admitting another patient from the casualty. I’m met by our nurse anesthetist. “Guess what?” he asks. “I removed the breathing tube from that boy and he’s awake and talking.”
"What?” I ask. “Which boy? The one who fell from the second story?” I’m trying to confirm that we’re talking about the same patient because I can’t believe what I’m hearing.
"Yes,” he replies, “the boy that fell. He’s awake, sitting up in bed, and talking with his mother.”
I still can’t believe it. I finish the admission and head to the ward. Sure enough, he’s awake, communicating. I look at his forehead. The swelling that was there before is gone. I look again, I examine the area, I can’t find any swelling. How strange! How could it disappear so quickly? The swelling was from a collection of blood under the skin. Blood doesn’t reabsorb that quickly. It’s just not medically possible.
I think to myself, he must have a headache after his fall. I ask the mother, “Does his head hurt?” She asks him in the local language and he shakes his head “no”.
"What? Ask him again,” I tell the mother, thinking maybe he didn’t understand the question. She asks him again, same reply. I ask him, using the little Yoruba that I know. Again, the same reply.
I think of all the medical possibilities that could explain his improvement, but there are none. This boy is awake, talking. The swelling from his forehead is gone and he doesn’t even have a headache.
I tell the boy and his mother that what has happened is from God. That there is no other explanation. “Oluwaseun!” the mother shouts, “All gratitude to God!”
I just saw Tosin, the little seven-year-old boy who fell from the second story of his home, for a hospital follow-up visit.
He and his mommy came into the office with huge smiles on their faces, still thanking God for what happened.
And yes, in case you were wondering, he still doesn't have a headache!
~Jason
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