“Take a deep breath. Another one, and one more…”
Those were the last words I heard before I couldn’t fight the anesthetic anymore and I was fast asleep.
I recall questioning whether this was really happening. It was just a couple weeks prior that I began working on an article that explored the capacity of Malawian hospitals to accommodate serious illness and medical procedures. So far my findings had not been encouraging, so I had the worst of thoughts running through my head as I was being rolled into the operating room.
In one particular interview with a medical intern, I was told that it is not common for most hospitals to have back up generators. If a power outage occurs, there is a chance that patients who rely on the use of power-driven machinery may not be able to survive. Knowing this alongside my other worries, I was deeply afraid of how successful the surgery would be.
When I woke up, the pain in my torso hit me immediately, as the nurses told me it would. It was so widespread I couldn’t detect the precise location of the incision.
I knew one thing was for sure: my appendix was no longer inside me. It was sitting in a jar, in front of me, labeled “Mara Silvestri, Room 9A” as if it was considered just another body part by those who removed it. For me, it was monumental.
Just hours before, I learned I had appendicitis. Within a five hour span, I was diagnosed and under the knife, without much time to consider my health care options because appendicitis needs to be treated immediately in order to avoid a burst appendix.
As someone who squirms at the thought of blood or needles, I had faced my biggest fear by undergoing an emergency appendectomy. The appendix that sat in front of me symbolized a triumph.
Lying in the hospital bed with my expat crew surrounding me, the first thing I wanted to do was look down to see the size of my scar, but even with remnants of anesthesia clouding my judgment, I knew I wasn’t brave enough to see it.
I couldn’t help being curious. Despite the tears flowing down my face pre-surgery, the doctor was candid with me and refrained from sugar-coating the situation.
“If the appendix has perforated and caused internal problems, we will need to operate further. I’m going to make the scar below your belly button instead of to the side so we can expand it upward accordingly, in case we open you up and find internal problems,” he said as he motioned his hand up his chest and to his chin.
All I could imagine before surgery was coming out with a scar that spanned the length of my upper body.
I was lucky, I had the appendectomy before any serious complications occurred and the scar is only two inches long, I’m told (I still haven’t looked beneath the bandage).
Prior to that day I had met with multiple doctors who all told me the problem was my kidney. At that point, kidney complications seemed like a relief to liver, gall bladder or appendix complications. After asking around to gain knowledge of who the more experienced doctors in town were, I sought another medical opinion. I was told the problem was indeed my appendix, but by that point the diagnosis was becoming easier to make as the pain I was experiencing was increasing and I was in agony.
“Don’t worry, God is with you” I was told over and over again by doctors, radiologists and fellow patients.
How could I not be worried? My family was tens of thousands of miles away and I have a history of breaking into tears at the slightest of medical worries. I bawled when my dentist informed me I needed my wisdom teeth taken out- and that was at a clinic that was fully equipped, being performed by a doctor I had known since my adult teeth first grew in.
To sit in a hospital bed under a malaria net, with some of Malawi’s most common critters under the covers with me (cockroaches), being served a meal that I am sure consisted of chicken feet, caused me to be very concerned about how my recovery would progress. At one point, the nurse spotted the critter that was crawling about my bed and said “looks like you are not alone!” but this wasn’t the company I envisioned at my bed side.
Furthermore, the hospital I was in does not possess an internal communication system between rooms. There was no button for me to click in order to notify the nurses I needed their attention. The only thing remotely close to that was the radio behind my bed, which fell out of the wall when we tried to use it. This is one of the reasons I was so grateful to have friends I had made here by my bedside.
My stay in the hospital, and my experience with the Malawian health care system made me appreciate the access that patients in countries such as Canada have to a variety of specialists, surgeons, general practitioners and medical facilities.
The hospital I was at was a private hospital in Blantyre, yet it was still under staffed. There were times when I needed my IV changed, required assistance getting out of my bed, or needed another painkiller injection, but nurses told me they were busy with other patients.
I had a great support system to care for me in the days leading up to my dad’s arrival, but I was very happy to have a comfort of home at my bedside as my father walked into my recovery room and greeted me by telling me that he was there to care for me for the next week.
This experience marked an extreme moment in my internship that was already defined by extraordinary moments. Some may call me crazy for not racing back to the comforts of home at a time like this, but even in my post-op state, I’m eager to recover quicker so I can walk around Blantyre again and hear “hey sister” being yelled in my direction on my way to work. I’m also looking forward to once again hearing the sounds of my coworkers greeting me good morning at the beginning of another adventurous work day. It is all part of Malawi’s charm.
And with this, I can safely say that when in Malawi, expect the unexpected.