This will be a short post, because I’ve been staring at a computer all day and my eyeballs might explode if I stare at it much longer.
Got up at the butt-crack of dawn (that’s for you, Daddy :D) to go to morning report today. Apparently Monday report is usually pretty long, because we go over all the admissions from the weekend – Friday evening through Monday morning. Two kids in the regular ward died, and another three babies in the NNU passed away. Great way to start off the week, eh?
Talked with Dr. Kung about my new assignment, which is basically going through the paper charts from the A&E (the ER, here), picking out the pediatric patients, and entering their names, medical record numbers, demographics, diagnosis, and disposition into an Excel sheet, for May – July 2009. SO stimulating. Seriously though, when she showed me how the charts are stored, I instantaneously developed an infinitely greater appreciation for US health systems and their endless red tape – there are literally old boxes piled on older boxes filled with carbon copies, organized in no particular order other than that all the patients from one day are bound together with a string. I repeat, A STRING. I’ll take a picture tomorrow, so you can all empathize with the horror that echoed through my impeccably methodical and well-organized brain when I realized that I was up against (OK, dramatic, but whatever, hyperbole gets the point across).
Worked on the charts till lunch, then back to Pie City (tried the Chicken Curry this time, YUM). Finally went into the infamous SPAR store – since I may not have blogged on this before, let me explain. The first few days we were here, literally every time we went to a store at Riverwalk and we couldn’t find something, they told us SPAR would have it. But we could never find SPAR. And then once we figured out where it was, we never had a chance to go in. But today, I DID.
Yeah, it wasn’t that great. It’s basically just a grocery store.
BUT. I did manage to find crayons for my little friend in the pedes ward, which I promptly delivered when I got back from lunch. I had been worrying about finding crayons all weekend, as well as how I was going to give them to him without all of the other kids begging me for something (which was Dr. Kung’s response when I told her I had promised to get him crayons). It ended up working out perfectly – he had gone for a bath, according to his grandmother, so I gave his present to her. She said, “I’ll tell him Aunty left him something very important.” I didn’t realize that they called non-family members Aunty here, but it made me feel kind of warm and fuzzy. And VERY RELIEVED that I had actually kept my promise.
Spent the rest of the afternoon going through the same charts that I had done in the morning, because Dr. Kung wanted me to record information for all of the pediatric patients that came through the A&E, not just the respiratory ones. I have a sneaking suspicion that she told me to do that in the first place, and I just misinterpreted her instructions. Doh!
Still, I managed to get through 539 charts today, according to my tally. That’s right, cause I’m a champ ;) Also, Kat and I made an important discovery: the reason doctors write so that you can’t read their notes, is because you can’t accuse them of doing something wrong if you can’t tell what the hell they did. Pretty solid theory, huh?
Came home and went for a run with Julia and Olivia. It was really nice, until a BUG FLEW RIGHT INTO MY EYE. I’ve swallowed bugs before while running, but this was particularly startling. It resumed being a nice run once I got it out though!
Dinner, watched The Hangover. My life is complete.
Monday, 30 May 2011
Sunday, 29 May 2011
Day 13 – 29 May 2011
The day started out in a bit of a panic, because we had been planning for days to go back to Kgale Hill for another hike, but we had never verified with Boitumelo what time we would be leaving. Olivia and I set our alarms for 9, and the first 10 minutes of my morning went something like this: stumble out into the common room. Greet Olivia, ask if we’ve heard from Boitumelo. Go to the bathroom. Come out of the bathroom. Phone rings, Boitumelo calling. Asks if we still want to go on the hike. Informs me that everyone else is already ready to go. Chaos ensues.
But typical African style, after we rush to get ready in the 15 minutes that I told Boitumelo we’d need, we find out that she hasn’t called the combi to come and get us yet. So we ended up sitting, drinking coffee, wasting time. Sigh.
Had a very nice climb though, once we made it out to the hill. Last time we only had time to climb the smaller hill, but the day hadn’t gotten too hot yet, and we were fresh and vigorous, so we climbed the first hill and moved on to a bigger one. The views were GORGEOUS (see pictures). The hill is next to a big quarry, which is super highly secured, because they mine diamonds here. Apparently we would need visas just to get into the grounds. I felt kind of like a spy taking pictures of it. The group splintered a bit towards the top of the hill, but we got some good pictures together. Boitumelo went off and meditated on a rock for a bit, and we creeped on her and took a couple pictures.
Uneventful trek back down, until we RAN INTO SOME BABOONS!! THEY WERE SO COOL! At first we just saw one, so we were trying to be quiet and stealthy, but then as we made it back into the parking lot we realized that there was a whole herd of them (OK, I’m sure herd isn’t the right term, but you get the idea). There was one in a tree that got pretty close to us, and was a total diva. After we piled into the van, a female went by whom we guessed was in heat, because her… rear… looked vaguely cancerous? Kim said that she thinks their butts get swollen so the males know that they’re ready for mating. It was kind of gross looking, actually.
Some of us really wanted to go to a farmer’s market that Nikki (one of the BUP staff and basically a native Motswana, because she more or less grew up here) had told us about. The driver wasn’t sure where it was, but we stumbled on a coffee house/market where (mostly) ex-pats sold random kitschy stuff and live musicians did acoustic renditions of popular songs like “Oh my God.” Probably the classiest version of that song that’s ever been made. We were a little disappointed that it wasn’t actually a farmer’s market.
Schlepped back to the UB campus, because we all were pretty exhausted from the hike. Showered and stuffed our faces because we were also all STARVING. The post-hike exhaustion and food coma meant that we spent the rest of the afternoon lazing around and napping. Such a stimulating life we lead here.
Dinner, movie, sleep. Click on the picture at the top to see my pictures for today!
Day 12 – 28 May 2011
We all passed out last night after we got home, and slept in, which was GLORIOUS. I read in bed for a while after I woke up, migrated to the couch in the living room, and ended up finishing my book.
Went for a run with Julia and Olivia around campus, but I think the dust and the dry air got to me, because my chest got really tight and I had to stop. Only the second time I’ve run since I’ve been here, because it gets dark at 6, and the combination of getting home from work after 5 and not being allowed out after dark severely limits our ability to exercise. Clearly, I need to find a better solution to this situation before I turn into a huffing and puffing blob, as evidenced by this morning.
Sat around chatting after breakfast. We got around to showering eventually. Also, tried my first passion fruit! – They look like alien guts or something on the inside, but they have really good flavor. We finally managed to drag ourselves over to the News Café to access the supposedly free wireless. Instead, we were informed that they were out of codes for the month, so we ended up buying coffee and feeling slightly jipped. Oh well. It was still glorious to have a cup of REAL coffee. Clearly I have let my coffee addiction get more out of hand than I realized.
Came home and had left-overs and fruit with peanut butter and pralinutella (it’s a combination of nutella and praline flavors, SO delicious) for dinner. New discovery of the day: German candy store names must be pronounced with a Sean Connery-esque “sch” sound (just imagine it, you’ll think it’s as funny as we did). Watched When Harry Met Sally, because somehow Julia and Olivia had made it this far in life without seeing it (not sure how that’s possible). Planned weekend trips for the rest of our time here – itinerary TBA.
Basically, we accomplished nothing particularly monumental today, but we had a lot of fun just sitting around talking. I guess that’s what the weekend is for, after all.
Went for a run with Julia and Olivia around campus, but I think the dust and the dry air got to me, because my chest got really tight and I had to stop. Only the second time I’ve run since I’ve been here, because it gets dark at 6, and the combination of getting home from work after 5 and not being allowed out after dark severely limits our ability to exercise. Clearly, I need to find a better solution to this situation before I turn into a huffing and puffing blob, as evidenced by this morning.
Sat around chatting after breakfast. We got around to showering eventually. Also, tried my first passion fruit! – They look like alien guts or something on the inside, but they have really good flavor. We finally managed to drag ourselves over to the News Café to access the supposedly free wireless. Instead, we were informed that they were out of codes for the month, so we ended up buying coffee and feeling slightly jipped. Oh well. It was still glorious to have a cup of REAL coffee. Clearly I have let my coffee addiction get more out of hand than I realized.
Came home and had left-overs and fruit with peanut butter and pralinutella (it’s a combination of nutella and praline flavors, SO delicious) for dinner. New discovery of the day: German candy store names must be pronounced with a Sean Connery-esque “sch” sound (just imagine it, you’ll think it’s as funny as we did). Watched When Harry Met Sally, because somehow Julia and Olivia had made it this far in life without seeing it (not sure how that’s possible). Planned weekend trips for the rest of our time here – itinerary TBA.
Basically, we accomplished nothing particularly monumental today, but we had a lot of fun just sitting around talking. I guess that’s what the weekend is for, after all.
Saturday, 28 May 2011
Day 11 – 27 May 11
An early day, because I wanted to go to morning report with Dr. Kung. First time walking to work on my own, since Kat didn’t need to be up as early as me. I made it to the hospital, but got a little lost trying to find the conference room.
Report was super-interesting, again, but one of the patient’s situations was really sad. A baby with hydrocephalus (basically a condition where an excess amount of cerebrospinal fluid (CSF) builds up in the brain) had a shunt placed to drain the fluid off her brain into her abdomen the day before, but in the early evening, the resident responsible for the NNU (like the NICU) noticed that blood and CSF were leaking from the incision site, which is apparently not normal. She tried calling in the neurosurgeon who had performed the operation, but the surgeon said that she was too tired and told the resident to call the on-call pediatrician. All of the attendings were very upset and declared the attending’s behavior unprofessional. It was an interesting interaction to observe, but the worst part was that the baby had ended up deteriorating overnight and was placed on a ventilator. I can see both sides of the argument, because the neurosurgeon is the only one at PMH, so at a certain point you have to make hard decisions about allocating your time without getting burned out. At the same time, that’s someone’s child you’re responsible for, and, as the attendings put it, you shouldn’t take a patient in to surgery (“the theatre,” as they call it here) if you can’t follow up on the potential complications.
Dr. Kung stayed after for a meeting, so I went back to the pedes ward and ended up chatting with one of the interns. He went to medical school in Jamaica, and it was really interesting to hear about how the residency process works here. Basically, you do all four years of medical school, then become an intern for a year, followed by a year of work as a medical officer, then apply for residencies.
Dr. Kung came back and tried to show me how the computer system works here – apparently I misunderstood, and there are two computers for the pediatric ward, not for the whole hospital – but it has to connect to a remote server, which was down. I went back to my little office to do more work, and found two nurses taking a snack break. One of them left as soon as I came in (I guess she was shy, or maybe I smell), but the other one stayed and chatted with me for some time. I may have made a friend, yay!
My little friend from yesterday came back, this time with his own little friend. I let them color with my highlighters, which they seemed to enjoy. Then the little boy found a box in the corner with stuffed animals and a giant, unopened box of 120 crayons. Before I could do anything he ran off with them, and when I caught up he was showing them to his grandmother and she was telling him to “thank Aunty” for the gift. Awkward. I had to explain to her that they weren’t mine, so I couldn’t give them to him, but that I would bring him more tomorrow. I felt like such a horrible person. It only occurred to me later that I could have just replaced the box in the office. UGH, FML.
Lunch again at Pie City, which went much more smoothly than yesterday. Kat and I even got to our training 15 minutes early, and had to sit out on a curb waiting to be let in. In the meantime, we observed the Botswana version of the ice cream truck – a guy riding around on a bike, honking an exceptionally obnoxious little horn.
Got home late from the training, also feeling a little irritated because Dr. Kung told me that the IRB was taking too long to get back to us, so she is going to have to switch me onto Kat’s project for the time being. I had been feeling fairly neutral towards the strike thus far, but now I want it to end. Apparently the government offered a 5% increase, which they refused. Grrr.
Went to dinner at Embassy, a REALLY PHENOMENALLY TASTY YUMMY GOOD Indian restaurant at Riverwalk. Stuffed our faces. Was so, so happy. It actually turned into a really stressful experience, though, because there were 9 of us, and some of us were trying to pay by card while others were using cash. Paying the bill always takes a long time, but we were even more stressed than usual because we were trying to make an 8:15 movie. Julia and Becca went ahead to make sure there would still be seats available, but then the waitress came back twice because she was confused about how much to put on the cards, and then she told us that we didn’t have enough cash. She got really frustrated with us in the end, and muttered something about not getting a tip, which made us all feel alternately embarrassed and annoyed. As a side-note that may help you understand our feeling of disgruntle-ment (yeah, I know that’s not a word): they generally don’t give tips here. Only Westerners do, and usually not even then. But the entire clientele of this restaurant appeared to be ex-pats, so I think we may have misunderstood the conventions. Still, I had been planning to leave the waitress a tip, because it’s stressful serving our group, but after that I was feeling far less generous. Also, we were late to the movie.
Next, although we had thought the movie ticket was only 25 Pula, it turned out to be 40. We were flustered, and Julia and Becca were already inside, so we were even more flustered, but we had to go ahead and pay. The movie theaters here work like an actual theater, in that you have assigned seats that you select when you buy your ticket. We went through the ticket check together, but then we got separated by a crowd. Olivia and Kat went to the bathroom, which I didn’t notice until I went into the theater and almost talked to some people sitting in what I thought were our seats. I was super confused, so I just sat down randomly. The movie had already started, so the darkness added to my confusion. By the time the other two came in, two people had sat down on the other side of me, so we were separated. Just when I finally thought everything was settled, a guy and his girlfriend came in, and told me that I was in their seat. Feeling slightly panicked, I indicated that the people next to me were in my seat, to which the guy responded, “Tell him to move.” Not wanting to confront a total stranger who happened to be twice my size, I must have made the universally recognized “deer in the headlights” face, because the guy went and got an usher to sort it out. The couple next to me ended up being forced to move, and I sat down next to Olivia, feeling like the last thing in the world I wanted to do was watch the movie.
Thankfully, the movie (Pirates of the Carribean!) ended up being pretty entertaining, if bizarre in parts (one word for you: mermaids). Entertaining wait for the cab afterwards, although, in spite of calling for a cab specifically to avoid dealing with the sketchy Riverwalk cabs, we ended up squeezing five people into the backseat of a very, very sketch “Hello cab.” We checked our list of the official cabs when we got home, and they definitely weren’t on it. Whatever, 20 Pula for 5 people and we got a good story out of it.
Report was super-interesting, again, but one of the patient’s situations was really sad. A baby with hydrocephalus (basically a condition where an excess amount of cerebrospinal fluid (CSF) builds up in the brain) had a shunt placed to drain the fluid off her brain into her abdomen the day before, but in the early evening, the resident responsible for the NNU (like the NICU) noticed that blood and CSF were leaking from the incision site, which is apparently not normal. She tried calling in the neurosurgeon who had performed the operation, but the surgeon said that she was too tired and told the resident to call the on-call pediatrician. All of the attendings were very upset and declared the attending’s behavior unprofessional. It was an interesting interaction to observe, but the worst part was that the baby had ended up deteriorating overnight and was placed on a ventilator. I can see both sides of the argument, because the neurosurgeon is the only one at PMH, so at a certain point you have to make hard decisions about allocating your time without getting burned out. At the same time, that’s someone’s child you’re responsible for, and, as the attendings put it, you shouldn’t take a patient in to surgery (“the theatre,” as they call it here) if you can’t follow up on the potential complications.
Dr. Kung stayed after for a meeting, so I went back to the pedes ward and ended up chatting with one of the interns. He went to medical school in Jamaica, and it was really interesting to hear about how the residency process works here. Basically, you do all four years of medical school, then become an intern for a year, followed by a year of work as a medical officer, then apply for residencies.
Dr. Kung came back and tried to show me how the computer system works here – apparently I misunderstood, and there are two computers for the pediatric ward, not for the whole hospital – but it has to connect to a remote server, which was down. I went back to my little office to do more work, and found two nurses taking a snack break. One of them left as soon as I came in (I guess she was shy, or maybe I smell), but the other one stayed and chatted with me for some time. I may have made a friend, yay!
My little friend from yesterday came back, this time with his own little friend. I let them color with my highlighters, which they seemed to enjoy. Then the little boy found a box in the corner with stuffed animals and a giant, unopened box of 120 crayons. Before I could do anything he ran off with them, and when I caught up he was showing them to his grandmother and she was telling him to “thank Aunty” for the gift. Awkward. I had to explain to her that they weren’t mine, so I couldn’t give them to him, but that I would bring him more tomorrow. I felt like such a horrible person. It only occurred to me later that I could have just replaced the box in the office. UGH, FML.
Lunch again at Pie City, which went much more smoothly than yesterday. Kat and I even got to our training 15 minutes early, and had to sit out on a curb waiting to be let in. In the meantime, we observed the Botswana version of the ice cream truck – a guy riding around on a bike, honking an exceptionally obnoxious little horn.
Got home late from the training, also feeling a little irritated because Dr. Kung told me that the IRB was taking too long to get back to us, so she is going to have to switch me onto Kat’s project for the time being. I had been feeling fairly neutral towards the strike thus far, but now I want it to end. Apparently the government offered a 5% increase, which they refused. Grrr.
Went to dinner at Embassy, a REALLY PHENOMENALLY TASTY YUMMY GOOD Indian restaurant at Riverwalk. Stuffed our faces. Was so, so happy. It actually turned into a really stressful experience, though, because there were 9 of us, and some of us were trying to pay by card while others were using cash. Paying the bill always takes a long time, but we were even more stressed than usual because we were trying to make an 8:15 movie. Julia and Becca went ahead to make sure there would still be seats available, but then the waitress came back twice because she was confused about how much to put on the cards, and then she told us that we didn’t have enough cash. She got really frustrated with us in the end, and muttered something about not getting a tip, which made us all feel alternately embarrassed and annoyed. As a side-note that may help you understand our feeling of disgruntle-ment (yeah, I know that’s not a word): they generally don’t give tips here. Only Westerners do, and usually not even then. But the entire clientele of this restaurant appeared to be ex-pats, so I think we may have misunderstood the conventions. Still, I had been planning to leave the waitress a tip, because it’s stressful serving our group, but after that I was feeling far less generous. Also, we were late to the movie.
Next, although we had thought the movie ticket was only 25 Pula, it turned out to be 40. We were flustered, and Julia and Becca were already inside, so we were even more flustered, but we had to go ahead and pay. The movie theaters here work like an actual theater, in that you have assigned seats that you select when you buy your ticket. We went through the ticket check together, but then we got separated by a crowd. Olivia and Kat went to the bathroom, which I didn’t notice until I went into the theater and almost talked to some people sitting in what I thought were our seats. I was super confused, so I just sat down randomly. The movie had already started, so the darkness added to my confusion. By the time the other two came in, two people had sat down on the other side of me, so we were separated. Just when I finally thought everything was settled, a guy and his girlfriend came in, and told me that I was in their seat. Feeling slightly panicked, I indicated that the people next to me were in my seat, to which the guy responded, “Tell him to move.” Not wanting to confront a total stranger who happened to be twice my size, I must have made the universally recognized “deer in the headlights” face, because the guy went and got an usher to sort it out. The couple next to me ended up being forced to move, and I sat down next to Olivia, feeling like the last thing in the world I wanted to do was watch the movie.
Thankfully, the movie (Pirates of the Carribean!) ended up being pretty entertaining, if bizarre in parts (one word for you: mermaids). Entertaining wait for the cab afterwards, although, in spite of calling for a cab specifically to avoid dealing with the sketchy Riverwalk cabs, we ended up squeezing five people into the backseat of a very, very sketch “Hello cab.” We checked our list of the official cabs when we got home, and they definitely weren’t on it. Whatever, 20 Pula for 5 people and we got a good story out of it.
Day 10 – 26 May 11
Lots of pros and cons to this day. Pro: free in the morning, because we didn’t have clinic and Dr. Kung was checking out schools for her son. I sat in an office off the peds medical ward and continued working on the log book through the morning. Initially pretty discouraging, because I had a whole page of names that I couldn’t even find in the book (usually I can find the name, but there’s no medical record number recorded). Also, some of the “names” that I’m supposed to find are initials and an admission date. Even if the records were as complete as the U.S. and/or electronic, what can I do with that?! It got better once I finished that page though.
A little boy wandered down the hall around 11 and we looked at each other as he passed the open door, so I greeted him in Setswana. He apparently took this as an invitation to come in, and within 2 minutes he was jumping around on the couch in the corner and having a grand ol’ time. SO. CUTE. I wasn’t 100% sure he was supposed to be in there, but it was a nice break from work to play with him. He was very precocious too – he told me that he was four, but he understood my English perfectly, which is a rarity here. From what I’ve read (and experienced a bit), children here are taught in Setswana up until the equivalent of 5th grade, and take English as a foreign language. Then, after 5th grade, it switches, and kids are taught in English, with Setswana as a foreign language. But this little guy was too young to even be in school, so I was doubly impressed. Also, I showed him the little icons on my phone for a cat and dog, just to see if he knew the English words, and he ended up figuring out how to play a game on it all by himself. Basically, he was too cute for words, and I was sorry when I had to leave for lunch.
Pro/con for lunch: Walked to main mall with Kat, because she had been to a popular lunch spot there, Pie City, and was raving about it. We were supposed to meet Julia, but she got called into a last minute meeting, and we had to be at a training session with Dr. Kung around 2, so we left without her. We got our food (basically like a popover, DELICIOUS), and sat outside to wait for Julia to find us. She got lost, then a guy came up and asked us for food, and Kat and I ended up leaving late and being late to our training, all of which made the whole experience frustrating.
Dr. Kung also was not very pleased with us for being late. Also, she asked in the car whether I had gone to morning report (I had asked her the day before whether I was allowed to go, since she wasn’t planning on being there), which I hadn’t, and I felt even worse.
Pro: the training we had WAS SO COOL! They were teaching us how to use Microsoft Access, a database program that is apparently a part of the Office Suite. Mostly, Dr. Kung wanted us to get it for Kat’s project, but I can see so much potential for data entry for my project too. I went home full of ideas, which is always a good feeling ☺ I felt like such a computer nerd.
At home, we had planned to go to an internet café nearby, but since Kat and I got back late, it was starting to get dark. We eventually decided to scrap that plan till the weekend, and started making dinner. Talked to Mommy and Daddy on the phone, while we roasted some butternut squash/pumpkin/potato mixture that we bought yesterday. It ended up taking over an hour to cook – long enough for us to watch the Glee! season finale!! (it’s about time Rachel and Finn got it together, but honestly, WHY DO THEY KEEP LOSING AT COMPETITIONS?!?!) – but it was DELICIOUS. Aimee, get ready, because squash is going to be a staple when we get back to school!
A little boy wandered down the hall around 11 and we looked at each other as he passed the open door, so I greeted him in Setswana. He apparently took this as an invitation to come in, and within 2 minutes he was jumping around on the couch in the corner and having a grand ol’ time. SO. CUTE. I wasn’t 100% sure he was supposed to be in there, but it was a nice break from work to play with him. He was very precocious too – he told me that he was four, but he understood my English perfectly, which is a rarity here. From what I’ve read (and experienced a bit), children here are taught in Setswana up until the equivalent of 5th grade, and take English as a foreign language. Then, after 5th grade, it switches, and kids are taught in English, with Setswana as a foreign language. But this little guy was too young to even be in school, so I was doubly impressed. Also, I showed him the little icons on my phone for a cat and dog, just to see if he knew the English words, and he ended up figuring out how to play a game on it all by himself. Basically, he was too cute for words, and I was sorry when I had to leave for lunch.
Pro/con for lunch: Walked to main mall with Kat, because she had been to a popular lunch spot there, Pie City, and was raving about it. We were supposed to meet Julia, but she got called into a last minute meeting, and we had to be at a training session with Dr. Kung around 2, so we left without her. We got our food (basically like a popover, DELICIOUS), and sat outside to wait for Julia to find us. She got lost, then a guy came up and asked us for food, and Kat and I ended up leaving late and being late to our training, all of which made the whole experience frustrating.
Dr. Kung also was not very pleased with us for being late. Also, she asked in the car whether I had gone to morning report (I had asked her the day before whether I was allowed to go, since she wasn’t planning on being there), which I hadn’t, and I felt even worse.
Pro: the training we had WAS SO COOL! They were teaching us how to use Microsoft Access, a database program that is apparently a part of the Office Suite. Mostly, Dr. Kung wanted us to get it for Kat’s project, but I can see so much potential for data entry for my project too. I went home full of ideas, which is always a good feeling ☺ I felt like such a computer nerd.
At home, we had planned to go to an internet café nearby, but since Kat and I got back late, it was starting to get dark. We eventually decided to scrap that plan till the weekend, and started making dinner. Talked to Mommy and Daddy on the phone, while we roasted some butternut squash/pumpkin/potato mixture that we bought yesterday. It ended up taking over an hour to cook – long enough for us to watch the Glee! season finale!! (it’s about time Rachel and Finn got it together, but honestly, WHY DO THEY KEEP LOSING AT COMPETITIONS?!?!) – but it was DELICIOUS. Aimee, get ready, because squash is going to be a staple when we get back to school!
Day 9 – 25 May 2011
Dragged myself out of bed at 6:10, because Kat had to be back at the hospital for a meeting at 7:15, and I wanted to go to morning rounds with Dr. Kung at 7:30. Ugh. Also, forgot that I was planning to wear sandals to walk to work, then change to heels, so my feet were already a mess by the time we got there. Double ugh.
We were a little late to rounds because Dr. Kung and Kat were still trying to work out a glitch in the database program. Residents were giving presentations on the patients they admitted from the night before, which was super interesting. The diagnoses were not particularly different from what you’d see at home – a bunch of pneumonias, an obstructive jaundice, and a few more complex ones that the attendings GRILLED the residents about. I felt kind of bad for one of them. Almost.
After presenting their patients (each one had four), an intern gave a presentation about “fevers without known source/fever of unknown origin” (aren’t those the same thing?). Let’s just say that reading off of their Powerpoint slides is a weakness among presenters everywhere.
Things finished up around 9, and then Dr. Kung gave me free reign until the clinic opened at 11. I went back to the peds ward to start working on the patient list she had given me, and woah buddy, do I have my work cut out for me! I mentioned the logs yesterday, but let’s backtrack a bit here – there are two computers here, for the entire hospital. Charts are all handwritten. So when a child comes onto the ward, the only record that they’ve been admitted here is this logbook. All of the entries for a given month fit on two to three pages, but somehow they’re not actually in chronological order. My guess is that kids aren’t always entered right when they get admitted, so things get pretty jumbled when they finally do get entered. Which makes my job, finding a specific admission date and trying to decipher handwriting spelling names that I can’t even pronounce, pretty difficult. I made it through about a third of the list, then headed to clinic. Being my usual directionally challenged self, I had assured Dr. Kung that I would be able to find my way to the clinic on my own, but as soon as I walked out of the ward I realized that I had no idea which of the buildings it was in. I walked in circles a few times, but I generally followed the signs to “Clinic” and actually made it there before Dr. Kung. Go me!
I already knew that today would be busier, because I had seen the list of patients the day before. To put it in perspective, yesterday we saw 5 patients; today, we planned to see 9. We started off a bit late, but then got even further behind because we were being super-thorough on one of the new patients. There was a brother-sister pair that both had pretty bad asthma, which wasn’t helped by the fact that the mom wasn’t giving their medications like she should. Dr. Kung performed a lung function test on them, which was very fancy and computerized, but she had brought all the equipment from home and had to lug it all back with her at the end of the day. It was interesting, because the program uses a graphic of the Big Bad Wolf from the Three Little Pigs, to tell kids to “blow the little pig’s house down” for the test. Unfortunately, none of these kids knew that story. Needless to say, the makers of that program are not culturally sensitive.
Clinic seemed to go on FOREVER, because we had so many more patients. Dr. Kung kicked me out around 2 to get lunch. I only missed one patient though. The last patient of the day was THE cutest kid I have ever seen. The poor baby has been sick since age 3 mos. Part of the right lung collapsed because the illness was so bad, and it still hasn’t reinflated properly. An invasive procedure would let us look inside and see what’s wrong, but there’s neither the equipment nor the pulmonologist to perform it here. The family would have to go down to South Africa to get it. Boo.
Earlier in the day, I mentioned to Dr. Kung that with the medical record numbers I had found in the morning, I was thinking of submitting a request to medical records to start pulling the patients’ charts. We were anticipating that it would take a while for our request to be processed, so I thought it would be good to get the ball rolling. She told me that she was still waiting for IRB approval, even though she submitted the paperwork at the beginning of April! This is beyond normal Africa time delays – there has been a strike going on here since Easter, with almost all of the teachers and government employees asking for a 16% salary increase. A few other interns’ projects have been affected, but this is the first time that I’ve encountered a problem personally. Ugh.
After the last patient, Dr. Kung, a nurse and I cleaned up, then she gave me a ride home again, which was nice because I was really tired. In spite of that, we decided to go to Riverwalk when I got back, because the Rice girls hadn’t been there yet, and we needed groceries for dinner. Between the three of us who are splitting groceries, we somehow managed to spend over 600 Pula. That food better last us a few weeks.
We knew before we left that we would have to take a taxi back, because it was after dark, but we realized as we got ready to go that we had 5 people, and taxis here are only allowed to carry 4 people. We tried calling a few of the numbers for reliable taxi drivers that we had in our phones, but they were all too far away, so we grit our teeth and decided to negotiate with the rando taxi drivers that hang out in front of Riverwalk. We ended up having to split up into two taxis, but we bargained the price down to 20 Pula (normally it’s 25). Lina and I made it back before the other two, and we had time to pull a splinter out of Lina’s finger (received from one of the lovely roadside bushes on the way there), put away all of our groceries and boil a pot of water, and the others STILL weren’t back. Minor panic moment, but it turned out that they had just gotten dropped off at the South gate and got lost trying to find the dorm. Whew.
Made pasta for dinner, yum yum! We had bought kumquats at the grocery store, because we were intrigued that the label said you could eat the skin. Basically it’s like a bite-sized orange. But Julia bit into one, and it was black on the inside, so now we’re all terrified to eat them. At least we tried.
Also, Lina managed to load the Grey’s season finale on her laptop while she was at work, so we all crowded around her computer to watch it. IT WAS AWESOME. But it meant that I stayed up later than I meant to, which does not bode well for tomorrow morning…
Life Lessons Learned in Africa, Part III:
1. Interns/residents are terrified of attendings no matter where you go.
2. It is a bad idea to become addicted to any TV show before going abroad, let alone three shows (DON’T TELL ME WHAT HAPPENS IN THE GLEE SEASON FINALE).
3. Instant coffee does not provide anything near the same level of caffeination as regular coffee.
4. If you don’t put away your food, bugs will crawl in it. In fact, bugs will crawl in/on anything. Including your bed. If you don’t like squashing them, you are SOL in Africa.
5. Grocery shopping while hungry is not advisable – even when bread only costs $1, all that crap you put in your cart adds up.
We were a little late to rounds because Dr. Kung and Kat were still trying to work out a glitch in the database program. Residents were giving presentations on the patients they admitted from the night before, which was super interesting. The diagnoses were not particularly different from what you’d see at home – a bunch of pneumonias, an obstructive jaundice, and a few more complex ones that the attendings GRILLED the residents about. I felt kind of bad for one of them. Almost.
After presenting their patients (each one had four), an intern gave a presentation about “fevers without known source/fever of unknown origin” (aren’t those the same thing?). Let’s just say that reading off of their Powerpoint slides is a weakness among presenters everywhere.
Things finished up around 9, and then Dr. Kung gave me free reign until the clinic opened at 11. I went back to the peds ward to start working on the patient list she had given me, and woah buddy, do I have my work cut out for me! I mentioned the logs yesterday, but let’s backtrack a bit here – there are two computers here, for the entire hospital. Charts are all handwritten. So when a child comes onto the ward, the only record that they’ve been admitted here is this logbook. All of the entries for a given month fit on two to three pages, but somehow they’re not actually in chronological order. My guess is that kids aren’t always entered right when they get admitted, so things get pretty jumbled when they finally do get entered. Which makes my job, finding a specific admission date and trying to decipher handwriting spelling names that I can’t even pronounce, pretty difficult. I made it through about a third of the list, then headed to clinic. Being my usual directionally challenged self, I had assured Dr. Kung that I would be able to find my way to the clinic on my own, but as soon as I walked out of the ward I realized that I had no idea which of the buildings it was in. I walked in circles a few times, but I generally followed the signs to “Clinic” and actually made it there before Dr. Kung. Go me!
I already knew that today would be busier, because I had seen the list of patients the day before. To put it in perspective, yesterday we saw 5 patients; today, we planned to see 9. We started off a bit late, but then got even further behind because we were being super-thorough on one of the new patients. There was a brother-sister pair that both had pretty bad asthma, which wasn’t helped by the fact that the mom wasn’t giving their medications like she should. Dr. Kung performed a lung function test on them, which was very fancy and computerized, but she had brought all the equipment from home and had to lug it all back with her at the end of the day. It was interesting, because the program uses a graphic of the Big Bad Wolf from the Three Little Pigs, to tell kids to “blow the little pig’s house down” for the test. Unfortunately, none of these kids knew that story. Needless to say, the makers of that program are not culturally sensitive.
Clinic seemed to go on FOREVER, because we had so many more patients. Dr. Kung kicked me out around 2 to get lunch. I only missed one patient though. The last patient of the day was THE cutest kid I have ever seen. The poor baby has been sick since age 3 mos. Part of the right lung collapsed because the illness was so bad, and it still hasn’t reinflated properly. An invasive procedure would let us look inside and see what’s wrong, but there’s neither the equipment nor the pulmonologist to perform it here. The family would have to go down to South Africa to get it. Boo.
Earlier in the day, I mentioned to Dr. Kung that with the medical record numbers I had found in the morning, I was thinking of submitting a request to medical records to start pulling the patients’ charts. We were anticipating that it would take a while for our request to be processed, so I thought it would be good to get the ball rolling. She told me that she was still waiting for IRB approval, even though she submitted the paperwork at the beginning of April! This is beyond normal Africa time delays – there has been a strike going on here since Easter, with almost all of the teachers and government employees asking for a 16% salary increase. A few other interns’ projects have been affected, but this is the first time that I’ve encountered a problem personally. Ugh.
After the last patient, Dr. Kung, a nurse and I cleaned up, then she gave me a ride home again, which was nice because I was really tired. In spite of that, we decided to go to Riverwalk when I got back, because the Rice girls hadn’t been there yet, and we needed groceries for dinner. Between the three of us who are splitting groceries, we somehow managed to spend over 600 Pula. That food better last us a few weeks.
We knew before we left that we would have to take a taxi back, because it was after dark, but we realized as we got ready to go that we had 5 people, and taxis here are only allowed to carry 4 people. We tried calling a few of the numbers for reliable taxi drivers that we had in our phones, but they were all too far away, so we grit our teeth and decided to negotiate with the rando taxi drivers that hang out in front of Riverwalk. We ended up having to split up into two taxis, but we bargained the price down to 20 Pula (normally it’s 25). Lina and I made it back before the other two, and we had time to pull a splinter out of Lina’s finger (received from one of the lovely roadside bushes on the way there), put away all of our groceries and boil a pot of water, and the others STILL weren’t back. Minor panic moment, but it turned out that they had just gotten dropped off at the South gate and got lost trying to find the dorm. Whew.
Made pasta for dinner, yum yum! We had bought kumquats at the grocery store, because we were intrigued that the label said you could eat the skin. Basically it’s like a bite-sized orange. But Julia bit into one, and it was black on the inside, so now we’re all terrified to eat them. At least we tried.
Also, Lina managed to load the Grey’s season finale on her laptop while she was at work, so we all crowded around her computer to watch it. IT WAS AWESOME. But it meant that I stayed up later than I meant to, which does not bode well for tomorrow morning…
Life Lessons Learned in Africa, Part III:
1. Interns/residents are terrified of attendings no matter where you go.
2. It is a bad idea to become addicted to any TV show before going abroad, let alone three shows (DON’T TELL ME WHAT HAPPENS IN THE GLEE SEASON FINALE).
3. Instant coffee does not provide anything near the same level of caffeination as regular coffee.
4. If you don’t put away your food, bugs will crawl in it. In fact, bugs will crawl in/on anything. Including your bed. If you don’t like squashing them, you are SOL in Africa.
5. Grocery shopping while hungry is not advisable – even when bread only costs $1, all that crap you put in your cart adds up.
Wednesday, 25 May 2011
Picture Sharing, Attempt #1
Mwha! If you click on the picture, you can go to the whole album :) Go me, and my lack of techno-savvy...
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