We currently have two patients admitted with malnutrition.
The patient pictured here also has Trisomy 21 and congenital heart defects that have not been repaired. The other has Kwashiorkor, which is a severe protein deficiency that we all learn about in medical school but, I imagine, very few in the US have ever seen. It is truly humbling to see all of the stigmata of this condition. No one exactly knows how this patient got so malnourished - it may be lack of resources, pure neglect, or a combination of both if there are too many children in the house. This patient was admitted over the weekend and was not able to receive adequate therapy because there was no albumin (protein) in the hospital. We also could not correct his low platelets because there were none. The combination of no resources at home and none in the hospital is amazing to me. At Duke, we admit patients for "failure to thrive" when they fail to grow as we expect all healthy newborns to grow. This child is 19 months old and weight 4.5 kg, which is far below all of the curves that we plot our infants on. We rarely have shortages of medicines and even then we have many other options. Impresionante.
Ellie, this is so sad. I can't even begin to understand how you must feel admitting this kid and not being able to give him the treatment he needs. His mom looks so tired in that picture, I wonder who is taking care of her other kids while they're in the hospital. Miss you, friend, and proud of you. You're doing great work. -Jenny
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