Working Together

Although our relationship got off to a rocky start, today I think Lipi and I became friends.

You see, when I had first seen this eleven-year-old girl, she was absolutely screaming in fear when I approached her bed. Two days earlier she had had a large piece of bone and tissue removed from her right leg, damaged by chronic infection. In order for the open area of her leg to heal better, she was put in a cast from just below her buttocks to her toes, with a little window cut out where the open area could be regularly dressed. It was that dressing change that she so dreaded when we doctors visited her.

The only kids I see have had some sort of painful injury or surgery (most often either burns or incision and drainage of abscesses). We have no oral narcotic drugs whatsoever, and our injectable ones are frequently in short supply. We sometimes use a little IV sedation – and believe me, I wished wholeheartedly that I had used some when I first changed Lipi’s dressing.

Today, she was much calmer when I came to her bed; there was less pain day by day, thankfully, because her wound was healing. ‘Couldn’t I do it myself?’, she asked plaintively. Since it actually isn’t technically difficult to remove the old dressing (gauze coated with sterile Vaseline so that it doesn’t stick to the tissue), that seemed like a very reasonable option. So I got out a much-too-large pair of sterile gloves, carefully told her not to touch it with her other hand, and put one on her. I put the other one on me (we don’t have a large supply of gloves, so I didn’t want to open another pair).

A new colleague First, Lipi grasped the old gauze and gently lifted it out of the wound – a procedure which before was accompanied by much emotional, if not actual physical, agony. After being cautioned again not to allow it to touch the surrounding less-clean cast, she was handed the new sterile gauze into her gloved hand. With great care, she slowly placed the gauze (with me holding one end) into the wound. I had the nurse hand her a hemostat, which she was able to grasp like a pro and oh so gently push the gauze into the wound. After a bit of poking, she passed the instrument to me, and said, ‘You do it.’ I filled the wound of my new medical colleague, covered it with dry gauze, and a nurse then applied a roll bandage to keep it all in place. Lipi gave a shy little half-smile as we all applauded her new skill.

If only all my attempts at collaboration with my Bengali friends, colleagues, neighbours and trainees had such a gentleness to them, and such a sense of accomplishment at goals achieved! I could say the same for collaborative efforts with foreign colleagues, for that matter. My deep, burning soul-desire is to become more patient in my work – whether in efforts to persuade others to a new way of looking at something, or in trying to teach a skill that I feel I have tried to teach five times, or when I am frustrated because I can’t figure out how to articulate what it is I am trying to teach (like ‘prioritisation’, in a language and culture with no word for it!).