Saturday, October 29, 2011

Family Tree.

An impish smile sprouted across Halena's face when she walked in the room for her first prenatal. She was due any day from the look of her waistband. What made her come so late?

I gathered her obstetrical history, measured and palpated, then set her up with a file since she said she wanted to deliver with us.

However as I went over her complaints, I was surprised she didn’t mention the very large rash-like growths on her body. Some were massive.

Were they pregnancy related? I couldn’t tell. So I asked her about it.

-- “This rash you have on your body, does it give you any trouble?”
-- “No. I’ve had it a long time.”
-- “Really? How long has it been?” The larger ones looked like extinct volcanos on the surface of the moon; the smaller ones bubbled up like molten lava.
-- “They started growing when I was a child. It’s because I’m related to the Rual tree.”
My health worker smiled sheepishly when he translated, anticipating my confusion.
-- “What? You are related to a tree?”
-- “Yes. That is why I have this growth. My family is a descendant of the Rual tree.”
-- “Oh... and this is your bark,” I half asked, half stated.

I could see the family resemblance.

The Rual tree & its fruit.
Other patients have come in with similar stories. Apparently among the Dinka, several families are related to the lion, the alligator, and the fish. But this is the first time I’ve met anyone related to a plant.

What was conception like? Was it cross pollination?

Reigning my brain back in, I finished her prenatal by noting in her book: “Patient says skin condition runs in the family because she is a distant relative to the tree.”

The next time I saw her was for her birth. She arrived fully and ready to push. And since her baby was showing signs of compromise, I called Margaret in as back-up.

Soon after, her water broke and a brown, gelatinous gook spilled out --Exxon Valdez in consistency and potential devastation.

With such murky fluids the risk of meconium aspiration (the baby breathing in the stained fluid and developing an infection) is high. So we prepared for the worse. But once he was born, there was little we could do to avoid it.

He came out ashen and limp. His rapid, shallow breaths told us everything we needed to know. He had aspirated. So we started him on oxygen and immediate antibiotics.

Although he didn’t breastfeed for many hours, we were able to stabilize him with time. His mother worried and fussed but by the following morning he was on the mend. I happily discharged them both this morning. Praise God for antibiotics!

I wonder what kind of tree he’ll become.