My phone rings this morning at 8:30. It's one of the ID attendings, asking if I know where JC is. The radiology department had just called her to try and track down JC, and they couldn't locate him (doubtful they even tried, but I wouldn't want to be the one spending an hour searching wards for a patient, just rather call the person who ordered the test). So she asks me if I have seen him. And wouldn't you know it, I get to be the one to try and track him down...
So I head to the most likely place. The ward he was originally admitted to last week. That was ward 38. Though he was never technically in ward 38. He was admitted to ward H1. And then on Thursday he was bumped to ward 22. It took me half an hour to find him on Thursday. So I show up at 38, no sign of him. Perhaps he just hasn't returned from his weekend pass yet. But I'm slightly paranoid about what radiology wants, and I'm a bit worried that they have bumped him from a CT scan which has been arranged for tomorrow, to a study today. And if they want to do it now, and we can't find him, it's possible he will lose his spot, and then god knows when it will happen.
I depart ward 38 and decide to head off to ward 22. As I'm stepping into the ward, the attending calls me again to explain that what radiology wants is to confirm, again, the details for tomorrow. The CT scans are so backed up at Bara (do keep in mind there are 2 CT scanners, for 2,000 plus beds) that on Tuesdays they send patients to a nearish by hospital do have scans done there. They depart in the morning, and return in the afternoon. Everything has to be arranged for the trip. A functioning IV has to be working, the consent has to be signed, and food has to be arranged.
As I walk into the ward, verifying the details with the attending, I hear my name called out, "Doctor Brian." My surname is too confusing to pronounce, and in fact, I've grown to prefer Dr Brian.
JC is back. We chat about the weekend. He had a nice time home with his wife and daughter (who I keep referring to as his son, and only half the time does he correct me, so I am perpetually confused if he has a son or a daughter). I write a brief note in his chart for the ward team, again laying out what needs to happen for him to get his CT scan tomorrow. While this may not give all the answers, it'll hopefully shed some insight into the mass that is easily palpable in his abdomen. I finish my note, and tell him later I'll see him on rounds.
A few hours later the attending and I go visit him. It really is more if a visit than to evaluate him.
"Here, I'm done reading these," he says as he hands me back some magazines I left him.
"Pass them around, I've already read them." It's a bit of a lie. Last week when he was admitted, he forgot to bring something to read, so when I was at the bookstore I picked up some magazines. As an aside, I actually found it quite tough to figure out what he would want to read, and I didn't want to pick something insensitive, like Home and Garden or Men's Health. I figured current affairs are always safe, so I grabbed a Time and some other local current affairs type magazine. I honestly can't recall what was on the cover of time, but on the cover of the other one was an anti-genetically modified article. This cover is showing as he hands it back.
"GM foods are evil. More attempts by the US to make profit on the hungry in the developing world."
I love it. Just love it. The comment is from one of the ward docs who passes and sees the magazine.
"Actually, we're just trying to save the world from starvation," I add.
"But don't you think that modifying the genome of foods will possibly have some consequences that we don't know about," asks JC.
I confess to him, "I don't know anything about GM foods, I just like to play devil's advocate when US affairs are mentioned in a negative context."
JC goes on to tell me his concerns with GM foods. I will never be able to explain how bizarre this is. I don't have these conversations with patients here at Bara. In fact, as he is talking it dawns on me that he have such little interaction on a personal level here. I have a flashback to talking about Moby with a 50 year old patient when I was on the CCU service as an intern.
But there is more to it than just having a conversation, it is the fact that we are having a fairly cerebral conversation. I am not sure how to word this in the most appropriate context, so let me preface by saying that if what I write seems offensive, or insensitive, then it reflect my desire to type this out quickly so I can get back to the hours of work I still have to get done tonight. The population that accesses health care in Bara are not persons who are employed in careers which have required higher education. Which is not to say that the people aren't in-tune with current affairs etc, but to be discussing the science of GM foods is a rare at Bara.
"So, you're calling my bluff."
"Eh doc, it's no problem. I studied biochemistry before."
Before. Before he ended up as a refugee in South Africa. There is more to his story, but I don't know it, yet.
BPB
