The cow next door wakes me. I’ve somehow managed to sleep through Pastor and Wife going to play early morning golf in the half light; through Cook preparing bread for the morning, through the chickens fighting for an insect and birds asking the sun what time it is. In my sleep scrambled brain, I panic that I’ve slept in rudely, but a quick glance at my travel clock tells me it’s only 6:17 and I have three more minutes before my self appointed rising time. Most of the house will get to nap this afternoon, and so rise early and stay up late, but I’ll be trying not to nod off on the purse bench at the hospital, so bed at 9:30 and up at 6:20 for me, even though that’s early and late.
I pull on the green scrubs that I’ve worn all this week and knot my hair on my head, then wedge open my door and pad down to the bathroom. The water here isn’t safe, but I brush my teeth with it anyway, tempting fate every morning, and, thus far, winning. Opening the cold oven, I remove two slices of toast, spread them with stiff butter, and eat by myself at the big, plasticine table.
The schoolchildren smile past on the road outside, and I glance at the clock, loathe to be late even if no one notices when I’m on time. Red and cream goes by the window, then pink and grey, then brown and white.
Grabbing my heavy shoulder bag from Hounduras, I slip into thongs and slide out the gate, past Nemo, the dreadlocked and sometimes fierce house-dog. The walk up to the hospital starts cool and I wander the side of the road, trying to stay out of the topsy-turvy traffic and appreciating the wealth of flowers. Kids are still heading to school, and they alternately smile shyly, grin or offer me a cheerful “morning…malo!” Halfway up the hill, I brave the traffic to the other side and the walk starts getting hot.
Nearly to the hospital, I stop at the grocery store and ponder a mince pie, a sausage roll or a cheese bun. The bun, today, and a bottle of water. Maybe a second bun. The store is small but well stocked, with rows of fresh bread, shelves of instant noodles, a few vegetables – mostly bok choy – and some cuts of a cow that was probably chased to its machete-caused death in a taro field last week.
I’m a sight in my green scrubs and an elderly greets me. “Hello doctor!” Not yet, but soon!
The hospital is already crowded and I walk up the long, outdoor ramps, passing families and a few nuns (who came from where?) as I head towards Obs and Gynae. Inside the small building, most of the wards have six beds and patients supply their own sheets and pillows. At least one family member, and usually five, are staying with the patient. The nurses, in their white dresses which accentuate the hips, laugh and offer me a game on the computer, which I smilingly decline. The charts are all paper and I’m lucky if I can make my way through one before the handwriting stumps me. Sometime between 8:07 and 8:34, rounds will probably start. Today, we start with just head of ward, and by the time we’re done, we’ve collected one fellow and one resident. That’s it. We four (one attending, one fellow, one resident, one useless med student) for this 42 bed ward. The doctors here are some of the best I’ve seen and the nurses could probably run any hospital in the world, but they’re trying to spoon a river backwards, stemming the huge rush of patients with limited supplies, little equipment and rare sleep. Rounds are finished inside two hours, and one doctor is off to the labor ward (another four delivery rooms and eight waiting beds) and two to the clinic, to see perhaps 45 more patients. When an emergency ceasar is called just before lunch, clinic is down to one doctor and the labor ward is left in the hands of the midwives as two head to the theatre to try to save a baby’s life.
At lunch, we sit in a small kitchen and eat off ice cream carton lids. Today is taro and flour soup. A little salt would help things greatly, but there are vegetables in the soup, so that’s good. Also, I have my cheese bun. A giant cockroach wings his way down the wall. At home, I’d probably do something silly and scream like a girl. Here, I put my hand over my ice cream lid until he’s flitted elsewhere.
There’s another ceasar after lunch, and I walk back down the ramps to the OT, probably 300 yards away. The patient will be wheeled down this same concrete, hiding behind her hands and a few ie lava lavas. Another med student and I change, tucking our hair into puffy blue caps and wandering down the sterile hallways to await the surgery. The anesthesiologist is from China and her broken English, compounded by the patient’s mostly Samoan-dialect, make communication difficult. Still, the spinal happens quickly and inside four minutes, a squalling infant is handing to the paediatrician. Momma’s tummy is quickly repaired and I smile goodbye to her, knowing I’ll see her on rounds in the morning.
It’s back up to labor now, and as I walk through the short hallway, I’m quickly ushered into a room where a girl is in the process of giving birth. A midwife and I help her delivery and I smile. The other med student comments that seeing new life never gets old, and she’s right.
By now, it’s pushing 5:30 and most of the staff changed over at 4. I hurry to leave so I’m not caught in the dark on the way home. Now there are no school children, but appreciative taxi drivers honk as they whiz by on the road. It’s much hotter this afternoon than it was this morning and by the time I slink past Nemo again I’m grateful to find dinner under the net on the table. Cook offers me a nuu and I gratefully accept. After food, I spend most of the evening sprawled on the bed, flipping through a textbook. Tomorrow, I know I’ll be asked questions I can’t answer, but whatever I read tonight might help. Rugby is on TV and I watch for perhaps half an hour, then grin when Samoa Idolz comes on. I’ve never seen the American version. Back in the room, I spend an hour calculating if it’s late enough for me to politely go to sleep, then decide it doesn’t matter, call good night and pull my door.
The bed reminds me just how much I was on my feet today and it’s several minutes before my back relaxes enough for me to pull up the sheet. Surgery rotation in the States might drive me to a nightly hot-water bottle. Still, it’s not long before I’m staring at the glowing stars on the ceiling.
I can hear crickets tonight, and cars on the road, and if I listen very close, the television next door. Tomorrow, it will be the cow.