In the Life of a Fickle Intern

March 18, 2014

Hospital Life

Filed under: Daily Lowdown — dailymedicine @ 11:23

A little more than two weeks in and I have already seen more sick patients than probably all of my residency years! Ok, maybe I’m exaggerating some, but the patients here are sick. They come to the ED only when they’re on the brink of death, literally. The people here are very resilient! Because patients wait so long, the pathology that they come in with are really interesting. I’ve seen patients with cerebral malaria, metastatic tuberculous, and the list goes on. Moreover, they don’t complain; they don’t yell; and they are all very pleasant…if they’re awake enough to be pleasant.

The ED experience is similar in many ways to the ED at home, but it’s very different in basic function. They have less resources and their practice is different due to this. When I say less resources, I mean, VERY little resources. Patients’ families are sometimes given a prescription for a medication to take the pharmacy to buy to bring back to the ED for the patient.  And this is a tertiary referral teaching hospital for the country! I wonder what it’s like in the rural parts of the country.

It took a few days for me to determine what my role here was since I don’t speak very much swahili, but now, I think I have established my role as an observer/consultant. Now that the residents know me a little more, they are pulling me into the rooms when they have questions about the patients to get a second opinion. They’re asking a lot of questions which is great. Even though I can’t communicate to the patients, all the doctors and nurses speak in English to each other so I can actively participate. They’re also pulling me into rooms just to see an interesting case.

Patients who come to the ED in Tanzania must pay for all the services provided. This definitely plays a part in the delay of getting medical treatment, but it is kind of nice only to see sick patients. There are very few alcoholics or drug seekers here. It’s a great change of pace. The ED has a total of 9 rooms, but 4 of those rooms can fit up to 5 beds. It definitely can get a little crowded at times. There are only 4 cardiac monitors in the whole department and only two ventilators so they have to be careful who they intubate. They don’t intubate anyone who has a low chance of surviving – HIV patients, TB patients, Hepatitis patients. That would include at least half of my patients in Baltimore!

One of the Peace Corps personnel took us on a tour of the rest of the hospital today. The “ward” consists of a single large room filled with beds that are about 2-3 feet apart. There were 27 beds in one room that was slightly bigger than my living room! There is no separation, no privacy, no anything. There were patients laying on mattresses on the ground. This was a bit overwhelming, but a nice reality check. Americans are so spoiled and the majority of the people don’t realize it. The next time a patient in the ED ask me why they don’t have a TV in their room for their cold and cough, I’m going to show them pictures of the wards in Tanzania! Maybe not, but I would be tempted. 

I am learning so much here, medically and culturally. It is making me realize how little i know of the world outside of work. I just need to remind myself to always keep things in perspective. This has been such a great opportunity and I am so glad to be here. I am already planning my next visit back to Tanzania, but at that time, maybe I’ll just come vacation and climb Kilimanjaro and do more safaris!

March 11, 2014

Selous Game Reserve

Filed under: Daily Lowdown — dailymedicine @ 01:25

My friend and I ventured on our first safari this last weekend. Hands down, it was one of the coolest and most amazing things that I’ve ever done in my life! The animals were everywhere! We saw hippos, lions, monkeys, giraffes, zebras, buffalos, and the list goes on, and all from dangerously close distances. Because we are expected to work Monday through Friday, we only had two days to spare. Luckily, the camp we stayedat squeezed in as many safaris as possible in that time. It was such an incredible experience and I would recommend it to everyone and anyone.ImageImage

March 3, 2014

Adventures Abroad Begin

Filed under: Daily Lowdown — dailymedicine @ 20:26

Hello from Dar Es Salaam! With internet! I am in Tanzania this month for an elective international medicine month. The months leading up to March were really busy, balancing life and work and life all over again. This trip abroad was exactly what I needed to maintain some sanity from my undeniable senioritis. Now that I have a little more free time, I can blog!

Nineteen hours and some odd minutes later, my friend (and classmate) and I land in Dar Es Salaam. The initial heat hit us like an oven. Coming from the East Coast where there is almost a foot of snow on the ground, this was a bit of a shock. The drive to the apartment was…dark. Apart from the main roads, there are very few street lights. There were people just walking and hanging out on the streets in the dark all along the way. I have no idea what to expect from this trip. This is my first time to Africa. My initial impression is that it feels like any other developing country…a little crowded, a little dusty, a little congested with a lot of culture and hospitality.

Today was supposed to be our orientation day, but our tour guide, an attending from our home hospital who has been working here for a few months, got stuck in another country due to a flight cancellation. Because we were banking on having someone show us around, we were left moneyless (Tanzanian schilling), foodless, and internet less with no resources and no maps. With only granola bars to hold us over, we got antsy pretty fast. Luckily, an old copy of Tanzania Lonely Planet was in the apartment. After some perusing, we ventured out of the hospital campus (where our apartment is conveniently located) to find an exchange bureau which lead to a grocery store and ultimately a vodafone kiosk where we got a sim card for internet. Though that sounds simple enough, it took us the good part of the afternoon navigating the city without useable money, a map, or even Swahili. All in a day’s worth! And it totally played out in our favor because now we are once connected via cyberspace to everything we are used to, aka Google Maps and Tripadvisor.

As always, I am a bit jetlagged. At 3’o clock AM, I am ready to get the day started. If only other people were awake!

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