Sunday, May 24, 2009
Yes! Just like the real ones.
The swimming hole where we got attacked by the fouroux, tiny insects (so tiny you can barely tell they're not specs of dirt on your arm) that are not, to my great distress, deterred by any amount of DEET.
So…what do I actually do here? Ok, a brief rundown of the day, if you’re interested:
1. Get up, thrash out of mosquito netting
2. Wait for shower (four people who all start work at the same time share one bathroom)
3. Have cereal (fake cornflakes…that’s all we’ve been able to locate) and instant coffee out on the porch (heaven…I’m telling you)
4. Go to the medicine ward, or the Kopp, as it’s known, which is maybe a 5 minute walk from here, depending on how hot it is outside, to start rounds at 7:30. (Actually on Wednesdays and Fridays there’s a grand rounds type of meeting/presentation, where someone presents a topic or case to the staff, which starts at 7:30, so then rounds are after that.)
5. Round with the team, which consists of two doctors, 1-3 nurses, and me. There’s a little cart that we drag around that houses all the charts (really, cards the size of half a sheet of paper in plastic covers that have seen better days) and order sheets (for labs and x-rays and such) and a bottle of alcohol for hand washing and a trash bin and even a little vase of plastic pink and flowers. Next to every bed there’s a wooden board hanging on the wall with a spreadsheet that includes the patient’s vital signs (with the temperature graphed, so you can see its trend with a quick glance) and medications. It’s so simple. Patients get taken care of, medications get ordered and given, vital signs get taken and recorded, and there’s none of the triplicate record keeping that keeps rounds at home dragging on till 1pm.
6. Off to the Polyclinique, which is a giant waiting room with small exam rooms off of it. It is normally anywhere from 90-110 degrees in the waiting room, but, blissfully, the exam rooms have window air conditioners. See patients until noon or 1.
7. Have lunch from 12-1, then a break from 1-2:30
8. See patients from 2:30 to anywhere from 3:30 to 5:30, basically until they’re all seen. (Top reasons for coming seem to be: hypertension, AIDS, fever and headache and/or body aches [treated as malaria, even if the blood test for malaria is negative], and tuberculosis)
9. Go back to the Kopp, where it is now approximately 95 degrees after the day’s sunlight has run its course, and record all the lab values that came back during the day, as well as see any new patients who were admitted.
10. Either do yoga, or run, or sit in a tired and hot heap on the chair in my room directly under the fan.
11. Dinner is at 7 exactly. If you’re not done by 8 there’s a stern talking-to from the ladies who work in the dining hall (who are, I must add, all very nice).
12. Putter around until bed, either watching 30 Rock (a favorite pasttime around here), or going to the lab to use the internet, or going to the nearest town to have a beer, or removing large bugs from one’s room, or duct-taping the screens down, or hand-washing clothes, or…you get the idea…there’s always stuff to do.
13. Go to bed, rinse, repeat…
Tuesday, May 12, 2009
1. There is an entire country off the coast of Gabon. It’s called São Tomé and Príncipe, and it’s the second-smalled country in Africa (after the Seychelles). It’s an archipelago of 12 or so islands, the two largest being São Tomé and Príncipe. According to my guidebook (the only one ever published on Gabon, as far as I can tell), the islands were formed from volcanoes, and were unsettled when the Portuguese came in 1470. All the islands comprise 386 square miles and have about 165,000 people, and they speak Portuguese.
2. There are a lot of Chinese people in Gabon. According to an article from the nytimes, Gabon is running out of oil, and to compensate for its lost income it’s allowing Chinese logging companies into protected forest. Not good. But anyway, the hospital has anywhere from 3-6 Chinese men out of 26 beds, all with malaria, none speaking any French. There’s a lot of charades going on on rounding.
3. There are many things I like so far about Africa, but hand-washing, line-drying, and then ironing all my clothes (botflies get killed by the heat) isn’t one of them. I think I’m going to take my chances and put most of my clothes in the hospital’s industrial-sized washers (with notoriously hot water).
AH! A bug just fell down my shirt. Ok, zen with the bugs, zen with the bugs, zen with the bugs…
Sunday, May 10, 2009
Wednesday, May 6, 2009
Thus begins our rotations here in Lambaréné. I am doing adult medicine, and the other American medical student (also a white girl named Elizabeth, to maximize confusion) is doing pediatrics. This week so far I’ve been in the inpatient wards in the morning (rounding on 26 patients in as many minutes) and the clinic in the late morning and afternoon (today: 2:30 to 4:30, hardly the schedule we're used to keeping at home, though it is oppressively hot, effectively limiting how many hours one can actually work during the day). On my current to-do list: 1. Learn French, 2. Learn medicine, 3. Learn to understand Gabonese French, 4. Learn names of medicines in French (Esidrex?? Never heard of it. Oh, wait, it’s hydrochlorothiazide? Riiiight, I have heard of that). The doctor I was working with actually left to go get something yesterday and said, “Ok, you can see this next patient while I’m gone,” and I was like, ummmmmm thanksbutnothanks. It takes me 10 minutes just to read the notes from their previous visit, because they’re all in illegible French with abbreviations I can’t figure out. Oy. Adventure! (Ça va aller...at least I hope.) :)
I’m already a little bummed out (for lack of a more eloquent phrase) by the sick people. Not that sick people in the US don’t bum me out, because they do, but I’ve already seen a few people this week who are sick. Like, I look at them and wonder how it is they’re even still alive. I saw literally the most cachectic girl I have ever seen in my life yesterday. She was 22 and weighed maybe 65 pounds. Good lord. AIDS is a scary thing. She'd been sick for a year but hadn't come to the hospital until now. I just think of millions of dollars being spent in the US chasing incidentalomas (translation for non-medical people: incidentalomas are little shadows and blips that are discovered incidentally on CT's and MRI's done for other things, and usually turn out to be absolutely nothing) and it makes me crazy.
Ok, off to bed. Under my recently re-strung mosquito netting. Now hopefully it won't fall on my face in the middle of the night, causing me to brush it off my face in a panic cause my half-asleep brain is concerned it's an ant colony, or a hungry mosquito family, or a bat. Or a spider the size of a yorkshire terrier that we calmly (ahem) removed from my roommate's room the other day. (Picture to follow)
This is a very interesting place, for reasons I didn’t expect. Dinner every night is a veritable melting pot of nations. Some of the faces around the table: A couple from the Ukraine (internist and surgeon), a nurse from Switzerland (the German-speaking part), a man from Switzerland (the French-speaking part), a nurse from Spain (who retired from a career as a lawyer and then became a nurse), two Gabonese students, and a doctor from France (who is on sabbatical from a 20-year career as an internist in the French Antilles and drove here from France). On the way back from dinner the other night in town, we were piled into the back of a big van, and we picked up a German student on the way, and suddenly everyone in the back (except the Americans) started speaking German. (As Other Elizabeth said, “This conversation has taken a turn for the German.”) And I kind of enjoy conversing with someone when neither of your first languages is the one you’re speaking in. There’s no self-consciousness about grammar or pronunciation when the person you’re talking to probably won’t notice anyway.