What I really need to do right now is go for a nice run to let some thoughts settle, but dusk is approaching, and I have a lot of stuff to read tonight, so Instead I've decided to sit on the back porch and jot down a few thoughts.
My schedule: Talked to Prof this am, and looks like I'll be spending 2 months on wards, then a month in the HIV clinic, and then a month in neonatology (I'm going to justify this in a later post because many remember the lack of love I felt for NICU back in January), and then back on wards for the final 2 months. I'm working on setting up some vacation for those final 2 months, and think that will the the trip to Kilimanjaro--for those who want to join.
Today: I rounded with one of the ward teams, which won't be the team I'm working with starting tomorrow Ward Teams consist of 2 Interns (these are second year interns-internship is 2 years of 4 month rotations in core disciplines), 2 MOs (medical officers, akin to SHOs) and 2 registrars (Senior residents specializing in pediatrics), and then there are 3 Consultant attendings to a ward. Intake/Call is q 4 nights. So today I rounded with a team post-call/intake. The consultant saw all the new patients from intake, and I was just awe-struck by the thoroughness on rounds. Fantastic teaching (give me a second and I'll tell more about the kids on the ward). After ward round w/ the attending, the post-call reg left, and then the registrar and the intern and MO who weren't on call rounded on all the old patients and made a list of things to do. When that was done we grabbed a bite to eat, then went back to the ward to complete those chores--which consisted mostly of blood draws, restarting IVs etc.
Blood Draws: I've made it know that this is a skill which isn't something we do well. Although, I figured give me a butterfly needle and I may be able to hold my own. Alas, no butterfly. Also, routine phlebotomy from arterial sticks rather than veins. Also from external jugular veins. Going to take some getting use to this practice. And for those back home, certainly no child life..
Kids we're taking care of: First off, pediatrics is defined as up to age 14. That's a little bit different. I want to avoid the gross-guess what I saw statements that often come across in writing...
As expected, lots of kids are HIV+ and lots of problems related to this as well. I did see a pretty routine bronchiolitic kiddo, and one or two with gastro. But the others have issues such as Potts Disease (TB of the spine), Reyes Syndrome (Traditional healers crushing up aspirin, acetaminophen, motrin, and using in traditional medicine preparations), multiple kids with meningitis-including one with a strep species. There are sick kids right now on the ward who would be in the PICU back home. Sadly, though, getting into the ICU is limited here.
I kind of hesitate to write more at this point, because I don't want to lose sight of the big picture which is that I'm uber-impressed by how smart the docs are, and in the context, I think the care is really good. I'm not sure how to write without making my point seem more of "look at this suffering." And since blogs are in a public domain, I don't want things to be portrayed unfairly. SO I'm going to leave it at this for now.
Cheers.
