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A post-op septic man, two very very sick babies on oxygen, and a five-year-old girl seizing and comatose probably as a result of meningitis. Genuinely one of the most frightening things I have ever been around.

In retrospect, one of the most dominant emotions during that whole experience was not what I expected. Fear? Yes. Concern? Check. Sympathy? Tick... But revulsion?

It took over 24 hours and three more trips to the ICU during the course of the next day to sift through that one. The revulsion was not at the fitting child itself - who would do that? But at the full frontal experience at the barefaced wrongness that is a system, a country, a world, where a child could be this sick and not have more done for it. In any western country that child would have been sedated, ventilated, monitored, have a central line, a feeding tube, a catheter, a BIS neuro monitor taped to the tiny forehead to catch low grade seizure activity...

But here, the only way for us to gauge seizure activity is to test the arms for rigidity, or lift the eyelid and look for the faint flickering movement that betrays an electrical storm going on inside the brain. I watched and learnt to stay calm, use the protocol in the book, base your fluid boluses and IV diazepam on their vital signs, monitor regularly. Too much diazepam and you depress the effort of breathing, making it shallow and ineffective. Too much and the seizure continues unchecked...

Somehow they all made it through the night. And so did I. Albeit tense, tired and slightly tearful.

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