I arrived in Eldoret today, unpacked, had my first swahili lesson, and then joined the medical students and residents for clinical diagnosis on the wards.
In an hour we examined 5 patients and the following are their diagnoses: (Sorry in advance to the non medical people reading this...I just really need to share this)
1) 11 yo boy w/ malaria and splenomegaly that was visible by visual inspection (interesting because malaria is not as common in Eldoret)
2) 8 yo boy w/ rheumatic fever...polyarthritis and a systolic murmur at the apex fulfilled his Jones criteria
3) 17 yo girl w/ nasopharyngeal carcinoma and an associated ~5cm diameter abscess on her neck
4) 46 yo HIV + male w/ visceral Kaposi's sarcoma
5) Male w/ catatonic schizophrenia who was not one of the patients we were seeing but we had to physically move him limb by limb to get to another patient.
I saw more 'zebra' cases in an hour today than I have seen during my entire third year. We read about these conditions constantly, however, seeing so many preventable and treatable diseases at one time has left me a bit emotionally overwhelmed.
Tomorrow I will actually get to have 1-2 of my own patients and basically I am allowed/encouraged to do whatever I am comfortable with - by the end of my 2 weeks on the wards I've been told that this will probably include blood draws, spinal taps, abdominal paracentesis, and orders for labs, meds and imaging. You might guess that I'm a bit nervous!
Hi Darchiu, what a great beginning to this trip for you. I can identify with your feeling of allure towards east Africa because when I looked at he picture of your taxi ride, it reminded me of the Caribbean islands, and they are certainly alluring.
ReplyDeleteWhat an unfortunate situation you are faced there with the illnesses. Yes, you're right, when you see preventable illnesses, you feel helpless. My goodness, the 17 y/o with H&N ca is awful. May God Bless you for the work you are doing to help the people there.
We saw your uncle's friend today, Lyonya Dumbrowsky ( we call him Dumbo) and he's going to make sure your uncle doesn't work too hard. But he seems to be doing very well and full of energy.
We're (Pani Nusia and I) going with mama to Sloatsburg this Saturday. I enjoy going there, very spiritual , very beautiful.
Darchiu, keep writing and posting pictures (and I don't want to sound morbid), and please also post the types of patients you see. Being in healthcare, I find it interesting. Is the hospital well-stocked with appropriate medications (antibiotics, cytotoxics, supplies..)?
All the best, looking forward to subsequent posts.
Pan Oleh
PS: Is Haba na haba, hujaza kibaba anything like Hamana hamana hamana?