the $200,000 patient

Sometimes working in the hospital is like pulling a string out from my
grandmother's crocheted afghan (which I'm missing with the cold weather
right now): you think you're just picking out a loose thread and all of
a sudden whole sections are coming unraveled. Part of the problem of
constantly being underbudgeted (our budget for all the drugs, lab
supplies, X-ray films, and medical stores like IV's, tape, gauze etc. is
$500 this month) is that things are deferred until they can't wait
anymore and then are patched together with whatever solution you can
afford. But later when you try to solve problems, you find that the
problem was actually part of a solution to another problem, so then you
have to fix that one as well, etc.

Case in point: we have trouble keeping our oxygen concentrators working
properly (if anyone knows of a biomedical servicing company that would
be willing to come or that we could send someone to train at, the info
would be appreciated), so back in February I tried to buy three more for
the hospital. One of the nurses that works here, Liz, got her church to
donate another one and pay for the transport. Unfortunately, the
customs clearing house here has a backlog of around two years of
packages that had been sent to the hospital, the local girls school, and
the now-defunct services department, all of which were lumped together
in the same boxes and we owed them around 360 pounds (there's a way to
do the fancy pound sign but I don't know it). So we had to sort out the
different things people owed, much like sorting out a restaurant check
with a bunch of cheapskates who are divving out their 10% for the waitress.

At the same time, we had to get the hospital truck working again so
that we could pick up the boxes; it has two bad tires so we created a
income-generating project to use the truck to raise money for the
tires. At the same time, the battery has gone dead for the truck so
that was borrowed from the generator, but we've had power outages
because the local grass fires have been burning some of the electrical
line poles, so we've needed to use the generator some recently. And of
course, you can't run an oxygen concentrator without electricity, so
we've made it full circle in trying to get the oxygen concentrators here.

Tracing through those threads is difficult even when you've been part of
the decisions to make them; trying to trace through someone else's
decision-making process is nearly impossible. Needless to say, trying
to take care of a small need for one patient often ends up costing much
more and taking a lot longer than you hoped -- I ordered the
concentrators in February, and we will hopefully get them this weekend.