18/05/2022
“Mom, don’t return me to the other room near the lavatory”: the horrors and mishaps of Tetanus dark rooms.
Are tetanus side rooms supposed to be so horrible? Fortunately, or unfortunately, I have participated in the managing of several tetanus patients both pediatric and adults who by the way where all of the male gender.
In my experience of managing these patients, all patients who survived tetanus had vivid memories and horrifying stories of these isolation rooms. Of course, no body forgets the excruciating pain of the spasms and the locked jaw that made them starve in silence, everyone narrates how the ordeal of the broad day darkness, deafening silence, the worrying loneliness and the chocking pungent smell augmented their tetanus torments. One of my patients reported that the experience was so disorienting that he couldn’t differentiate between day and night, he barely recognized the faces of is caretakers, he only differentiated them by their voices when they where so careless to speak loud enough for him to hear. Besides the torments of tetanus, there is also a feeling of being neglected, when doctors take days minus reviewing your health condition and missing treatment because the nurses forgot about you. I think, this is why most of the patients requested to be transferred to the general wards as soon as the spasms where bearable.
Throughout history there is a disturbing pattern of managing Tetanus even when there was a general understanding that the disease came from something infecting an open wound. tetanus has been regarded in history all through time, with documents noting tetanus symptoms found from 5th century BC in Ancient Egypt, even though there was an understanding that the disease came from something infecting a wound, many ideas for treatment were horrible and not beneficial , such as early Chinese physicians needling patients above the ears around 300 BC, Hippocrates’ ideas in Ancient Greece of promoting sweating through drinking strong wines and being wrapped in oil soaked cloths, and ideas in the Renaissance of covering the patient with manure. Well as our use of dark rooms is backed by science and is promoted has helpful in resource limited settings, the dent they put on the patient’s mental health is not desirable.
I won’t forget one day after a very hectic ward round, I decided to pass by and check on one of the tetanus patients I had admitted, a young boy 11 years. When I reached the room, I found the care takers outside and the doorway was closed, when I pushed the door to open, my eyes meet a blinding darkness that I couldn’t see anything inside. when I pushed the door wider to allow in more light, I saw the patient laying on the floor, crawling to reach the opposite end which had a flask and food containers, when he saw me, he said, “I feel very hungry and I want something to eat”. I couldn’t tell how some one so stiff and rigid managed to get off the bed, perhaps the only explanation is that he had just fallen off the bed. This is simply negligence, but worse things can happen in a locked, isolated dark room.
In my community, being isolated from people during sickness is associated with fear and stigma, the dark rooms and spasms make it all more confusing and suspicious, community members start wondering what could be going on or whether evil spirits are involved. This comes with an unwanted implication for patient care, one time a father escaped with his son from the hospital side room and hired spiritual healers to pray for the son from home. Definitely, he brought the son back when the condition deteriorated but the point is that, some medical interventions will be misunderstood and /or misused in certain communities if social cultural issues aren’t put into contexts beforehand.
I assume that you could be having a more or less similar story in which medical interventions had unwanted/unintended consequences on the patient or a story in which medical interventions didn’t sit well with the members of the community and ended up being misused or misunderstood, feel free to share, I can’t wait to learn from your story.
I Originally created this post for a medscape blog
