The day started out fairly normally – morning report, then to work in the wards. Dr. Kung had clinic in the morning, so I hung around with the residents helping with various labs and things. I placed another TB skin test, this time unsupervised! I also examined a baby that Dr. Kung admitted on Friday, whose exam I had missed the previous day. It was a pretty sick baby, probably HIV infected, and it had an enlarged liver and spleen in addition to a heart murmur, all of which I found on my own. I was pretty proud of myself ☺ The baby who needed surgery for an intestinal obstruction STILL hadn’t gone to theater – I overheard something about a problem with the lights in the operating room – which worried everyone, because the longer the obstructed segments of bowel go without oxygen/blood, the worse the prognosis and the greater the chance of infection. Sigh.
The CT scanner here is still broken, and two of the kids with TB meningitis need scans to show us whether they’re improving or worsening on treatment, so we have to refer them to a nearby private hospital. Since most people here have 90% of their health care costs paid for by the government, accomplishing a referral requires that we go through the hospital social worker to get approval. I helped Tiny fill out all of the paperwork (three forms for each child, talk about bureaucracy), then dropped them off in the social work office on the other side of the hospital campus. When I asked how soon they could be approved, they told me to come back on Thursday. Great. If someone in the States had to wait two days for a CT scan, they would sue the hospital. Here, one of these kids might have had a stroke from increased intracranial pressure, and there’s nothing we can do about it.
Once I was no longer useful on the ward, I joined Dr. Kung in the clinic. She was in the middle of assessing a new patient, and right after I sat down, she offered to let me do the skin allergy test on the patient. I was surprised, because I had watched her do quite a few and felt comfortable with the procedure, but I hadn’t expected to be performing one myself. I quickly agreed though, and despite having a little trouble mastering the art of leaving small drops of solution, I managed a passing job. Then Dr. Kung surprised me again by offering to do a skin test on me. I felt a little awkward doing it in front of the patient, but Dr. Kung said that it would help me understand what the patient was going through. Turns out that I’m apparently not allergic to anything in Botswana, and Dr. Kung made a joke that I should come and live here because it’s clearly the ideal environment for me. Hmmm…
The rest of the day went pretty quickly and uneventfully: lunch, entering charts in the afternoon, home. One funny story: I was sitting and working on the charts, listening to my iPod, and I heard a tap on the window next to me. The room I sit in has windows all along one wall, but they’re covered by curtains all the time, except one small part of the window in the corner. A little boy playing out on the playground had apparently spied this one small opening, and was looking in at me and waving. I waved back, and then he ran around the building and opened the door to the room I was sitting in, marching in with a couple of his friends. I laughed and said hi, but since the room I work in is the paediatrician’s office, I figured that they probably weren’t allowed in, so I led them back to the door and said bye. A little while later though, he repeated the process, except this time Dr. Kung had come back in the office, and was looking slightly worried that the little boy had come in so casually. I quickly led him back out, and he went willingly, but then held out his hand at the door. I tried to give him a high-five, but he just continued holding out his hand and then pointed at me. I thought he was pointing at my stethoscope, which was around my neck, or my name badge, but he shook is head and kept pointing. I realized that he was pointing at the pen I had clipped to the front of my shirt, and he nodded when I motioned to it and asked if he wanted it. I shrugged and gave it to him, and he ran away. It was so odd! It’s the second time I’ve had one of the kids want my pen – the other time a group of three or four kids surrounded me and one of them started digging in my pockets and took my pen. Whatever, I’ve got like a million of them. What’s so great about a pen though, is what I want to know.
Talked to Mom and Dad on Skype ☺ We made frozen mac’n’cheese for dinner that was DELICIOUS. Definitely going to be a repeat meal. Then we were all still kind of tired from staying up the night before, so we tried to go to bed early, but nature had other plans. It had gotten kind of cloudy in the late afternoon, and it was really windy, but around 8 it started thundering. By 9 it was pouring BUCKETS of rain, and we all rushed into the living room to look out the window. It was pretty dramatic, and huge bolts of lightening lit the whole sky. Very Lion King-esque, especially since it’s been kind of creepily perfect sunny, cloudless sky, Pleasantville weather since we arrived. Everything looked like it was flooding, and we all groaned at the thought of how muddy our walk to work would be in the morning.
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