166 Days: My Journey Through The Darkness by Jennifer Clark Page B

if she did not get treatment. We had IV equipment, but not small enough catheters for a baby. I searched and found a 25 gauge needle and managed to get venous access and got some fluid in, but since I didn’t have a catheter, any movement could potentially rupture the vessel. As I tried to secure the needle, that is exactly what happened; the needle was moved and it punctured the wall of the vein. Just like that, I lost the venous access. I tried again on her other arm, and was unsuccessful. I gave her the rest of the fluid bolus through her rectum and arranged for a medevac to get the baby and her mother to a hospital where she could get more definitive care. As I explained the plan to the mother via my interpreter, I saw a look of fear come over her face as she shook her head. She explained if she went without notifying her husband, he would kill her. I could not believe what I was hearing. I tried to explain to her that if she didn’t take her baby to the hospital, she would surely die within the next day or two. She nodded her understanding, but insisted on talking with her husband before doing anything. She promised to come back after talking to him. She never did, and I never saw her again.
    After realizing the woman would not go on the medevac, I went down to tell the Captain the news. As soon as I walked back into the compound I saw the excitement was far from over. Apparently while I was making the arrangements for the baby, one of the Afghan soldiers came running up to Megan carrying a girl over his shoulder, no more than fourteen years old, who was gasping for each breath and moaning in pain. Her husband had hit her over the head with a shovel and pushed her off of the roof in anger, resulting in her falling over twenty feet. Thankfully the Afghanistan National Police (ANP) already had him in custody when they brought her to us.
    By the time I came back to the exam room, she was unconscious and unresponsive lying on the litter soaked in urine, indicating she had lost control of her bladder; a bad sign in a fall victim. After a quick assessment, Don and I quickly determined her status to be critical. We intubated her and applied a c-collar. We established two IV lines and called for a medevac; we did not have the means to do much for her in that environment and our supply of sedative drugs was very limited. It took about thirty minutes for the bird to land, and by that time her medications were wearing off and she began to aspirate. Her spontaneous respirations were causing me to be unsuccessful in ventilating her. She vomited, forcing me to extubate her (pull the breathing tube out of her throat) to prevent her from choking to death. As we carried her on the liter up the hill I realized the adrenaline was starting to wear off and my body’s fatigue was settling in. Thankfully the medevac arrived when it did and I relayed the information to the accepting medic informing him that he would need to re-intubate her. As we watched them load her into the helicopter I felt overwhelming sadness for the young girl. I later found out that she was the niece of the head of the ANP, which was a huge deal. We were reassured that her husband was dealt with “the Afghan way.” Several days later I was informed of the diagnosis of a severe intracranial hemorrhage and she was brain dead, being kept alive by a ventilator. The staff waited for her family to arrive and then eventually they discontinued life support. This was the first patient under my care who had died.
    By the end of the day I was exhausted, mentally and physically. We had a meal, waited for the sun to go down, and loaded the trucks again to travel to the site of the following day’s MedCap. We traveled for about an hour and a half, which seemed like eternity. Every several feet along the way there was a detail that walked alongside our vehicles scanning the sides of the road with metal detectors and bomb dogs in search of IEDs. It seemed that we would never