Sabid

Sabid is a patient who was admitted the day we arrived to Bagram.  She was diagnosed with 47% of her body burned.  I believe this to be an underestimation.  The only parts of her not burned are her face, chest, upper arms, hands and feet.  People who are classified at 50% burn have a 100% mortality here.  Right now, she is on room air with sats at 98%, her white count today was 24, down from 48 and I had the most amazing day with her! 

Most of the folks are getting a little burned out, I am one of them.  I wish the docs would quit torturing her and make her comfortable.  Every other day she goes to the OR and her body (no skin) is debrided (scrubbed and cauterized).  She has of course grown very depressed over the last month and you can't go into her room without her constant fearful crying.  She is anticipating the pain before it even starts.  I can't really blame her, she's a 14 year old bride of four months in an arranged marriage.  Her husband has never come to see her because his brother says he is too young.  The brother-in-law is with her constantly and he feeds her, moves her limbs so she doesn't contract and encourages her to get better.  Who says these Afghan men think women are less than dirt?

Anyway, today Sabid defacated on herself.  There is no best way to clean her.  I thought of her room and there is a shower in there.  After investigating the possiblity of using this water without causing some sort of infection to bathe her, we walked her into the bathroom.  It was painful for her but once we ran the warm water on her, she seemed to calm down and enjoyed her shower.  We washed her hair, french braided it and really spiffed her up!  She looked beautiful.  Once we got her back to bed, we tucked her in and started to warm her up.  Since she hasn't any skin, she has no way to keep her body temperature.  Sabid also doesn't eat because she hates our food (so do we by the way) so without nutrition, she isn't going to be able to heal the skin she does have.  After the shower, she told her guardian she wanted an apple, orange, rice and meat.  There was no way she was going without!  I found an apple and fed her, and she looked at me with her beautiful eyes and smiled.  That was the most amazing feeling I've ever had with a patient.  She then fell into the most peaceful sleep I've seen her in.  After work, I found the rice and meat and brought it to her.  I hope she eats it and I pray she is a miracle.