first day the hospital! woo! this is what we came here for! up bright and early for some bfast (they make us egg white fried eggs each morning. im sure they save the yoke for something, and I prefer the egg white anyway, but I still think it’s strange that our morning eggs never have the yellow). we left the hospital with so much stuff zipped in our pant pockets I had to keep one hand on my belt – BRASIL SCORES!! – to keep my pants from falling down as we walked to the hospital... did I mention im blogging while watching the brasil v chile game in a bar a few blocks from our hostel? so please excuse the interruptions with the goal updates : ) ha, no joke, as im typing this, BRASIL SCORES AGAIN!!! wow, way to start the game off right boys.
so what exactly does one fill their pockets with for a day at the hospital? this’ll give you an idea:
-gloves, lots of gloves, like a dozen gloves (that looks funny bulging out a pocket)
-hand sanitizer (contemplating just drinking this stuff and hoping it oozes out my pores)
-masks (of all shapes and size, importantly a TB mask because the TB ward is HUGE!)
-stethoscope
-notepad
-power bar (lunch)
-pen light
-swahili medical dictionary
-cell phone
-key to the apartement
-some Tz shillings in different pockets
-a copy of our passports and travel insurance cards and immunization records
…you get the idea, way more than is meant to be stuffed in normal pant pockets, especially for pants I maybe bought a size too big - good thing they’ve got a built in belt. If we usually look cool, today we looked extra cool with our overflowing pockets and white coats. mimi si daktari, mimi ni daktari mwanafunzi (I am not a doctor, I am a medical student) – see, im rocking the swahili already : ) really though, we are getting better, it’s such a cool language and the locals love when you speak to them in swahili and they know you’re making an effort to learn it, this is how we make friends.
we got to the hospital around 8:30, so pretty much before everyone else (things here move a bit more slowly than in america). we arrived feeling confused, a bit overwhelmed, and pretty much everything in between… fortunately we were approached, as we consistently are, by a curious african wanting to ask us where we come from and why we are here. turns out he is a pastor and him and his pastor friend ask us to follow them into one of the hospital buildings… pause, im going on a tangent so you can get an idea of what the hospital is like… it’s just off one of the main roads in arusha and literally in the shadow of mt meru, a towering mountain that we saw for the first time today as it is usually engulfed in the winter clouds here. you enter through the front gate and go down a short dirt road and then bam! hospital. except it doesn’t really have that effect… in fact, it doesn’t look much like a hospital so much as it resembles an abandoned warehouse. all one-story buildings scattered between cement and dirt walkways. tropical plants grow up to the open windows and you can see mosquito nets inside, behind the bars that imprison the patients. the signs to identify the different buildings are hand painted and hanging in front of them, some in english, others in swahili, and many a combination of both languages. they also typically have an arrow on them, directing you, but we’ve found that the arrows usually point to random cement walls, or in directions you do not want to go. it is infinitely simpler than OHSU’s campus, known for being a labyrinth, and yet we are definitely more lost here.
an hour or two later the deserted feeling was quickly disappearing as people, sick and not, began to overwhelm the hospital. it gets very crowded and part of me thinks people might just show up to pass the time, though I know most are here seeking much needed medical care. ok, back to the pastor. so we’re led into this large room, each wall lined with beds, almost edge to edge. we gathered around one bed with a young woman curled under a wool blanket and wearing a fleece and beanie (I was sweating in a t-shirt and my white coat, people here bundle in this weather, oregonian’s would be ready to whip out their bikinis). the pastor tells us, and im aware this doesn’t make much sense, “her sugar is high, she faints, they knew before why she fainted, she had a baby, now they don’t know why, she has water in her belly”… I mean, it was something along those lines… all we could think was a hyperglycemic woman with ascites and unexplained loss of consciousness – House episode anyone? the pastor asked us to pray and we extended our hands, hovered them over her body, bowed our heads and closed our eyes as he performed a feverish monologue I didn’t understand a word of. it was awesome. using prayer to heal, not the first experience I was expecting to have at this hospital but it seemed to do well for her, the patient, and that is what matters… offer what you can when you’re in a place like this.
at this point, after surrendering our email addresses to this man, dr. lee came to our rescue. we shadowed him the rest… BRASIL SCORES AGAIN?!!! DOMINATION!!... of the day. clinic day. saw some interesting patients. here’s a summary of the highlights:
**warning to those with weak stomachs, you might want to just skip this next part… to my classmates who might be reading this, enjoy!
-a man who was beaten when his car was stolen came in with back problems. dr. lee taught us quite a bit about that. quiz question: what muscle goes from the iliac crest to the ribs?
-a man with a huge keloid on his head after trauma and surgery to that area. quiz question: what is something that commonly causes keloid formation?
-a woman with a crooked finger called a swan neck deformity. quiz question: what are the seven criteria you use to diagnose RA and how many of those need to be present to make a diagnose?
-a younger guy who had a tib-fib open fracture and it wasn’t healing so there was this crazy gaping wound on the medial side of his ankle and all I could think was “if you can probe bone, it’s infected”
-another crazy leg wound on this guy who had been hit by a car – peds vs auto is never good. The epidermis on his leg was pretty much all dead and he had this huge, black and infected granulation-like tissue… it looked bad. quiz question: what are the layers of the epidermis (thick skin and thin skin?)
-another young boy who had lost his four fingers to a machine. dr. lee peeled off all of the dead tissue, looked sooo painful! And then squeezed the infected pus/blood out of the wounds, that was intense.
-a girl with skin webbing her pinky finger to the medial side of her hand, who was ready to miss the first month of school to have the aesthetic surgery to repair it. dr. lee said no way.
-a baby, only a day or two old, with crazy double joints. dr. lee could actually bend his knee totally backwards (not normal) and press the dorsum of his foot to his shin (apparently can be normal in infants).
-old lady with a hip fracture. quiz question: what are the two most common places hip fractures occur.
-an elbow fracture in a young boy and dr. lee handed us the xray, like he had been with all of the patients, saying “what’s the diagnosis?” and amy, thu and I would stare at it and debate and question what was normal and what we thought was wrong. it was a fun game : )
…annnndd the computer is dying, we have no converter here, and I’d like to watch the rest of the game so im out for now!
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