My TB buddy

Bad evening for my 17 y friend. I talked with a local doctor today (actually a Haitian who trained in the US) who runs a tuberculosis sanitorium (yes, believe it or not, those still exist, just like leeches for blood-letting and Roy Williams' ability to coach). He agreed to take him as long as he's fairly healthy (which he had been).

This evening he became very short of breath, his oxygen level came down a little, and he had worse pain where his infection had been. But now, you can see a boggy fluid collection protruding from his chest wall. He has a complication of tuberculosis called empyema necessitatis; basically, the infection has spread out of his lung and through to the chest wall.

In the US, the treatment is not that difficult: 1) surgical removal of the fluid and 2) treatment of his TB. Obviously not the case here.

1) As I mentioned before, we don't have any XRays or CT scans to evaluate the infection. We don't have an operating room that could handle a major surgery. And our chief of surgery is a plastic surgeon. And, given that he has diffuse TB in his lungs, and spread throught his right side, and he's built like Karen Carpenter, its gonna be tough for him to fight through any major surgery even IF it could happen.

2) I found out today that the nurses have been refusing to bring him his meds or his meals. So I've taken on all responsibilities as his doctor, his nurse, his dietician, and, really, the only guy that talks to him during the day.