Grant day, and TB madness

Here is the "tearoom", AKA doctors lounge. Female doctors won't let you take pictures of their faces...

Rainer, another medical student from Germany who is doing surgery

Post-op recovery, nice and warm.

"DOKTER" the doctors tearoom sign

Sebastian from Namibia, specializing in family medicine. Interesting scrubs here!

Today at the hospital I wandered into the high risk pregnancy clinic. I found a flustered doctor with a huge pile of files. I tried to help out by taking blood for those being admitted. Luckily some interns wandered in… Haha. This hospital is so random. We saw all different kinds of mothers, white Afrikaans, xhosa speakers, teens to older moms, fancy dressed and some with holes in their shirts. Everyone gets the same care. If you speak Afrikaans or English, it definitely makes things easier to sort out… Here, the interns kinda run their own show. If they have questions they ask, otherwise they just decide the plan… follow up, admit, transfer to tygerberg.

Went around with the Sanet, a senior medical officer, for afternoon rounds. There were some interesting cases (speaking from a pathology perspective), and some interesting people (speaking from a human perspective). Tomorrow is disability grant day, but in order to collect you have to be home with your family. So many patients were feeling much better today =).

-One guy in his 40s presented with delirium and headaches. Dx with TB meningitis. But when he became lucid they discovered his legs were paralyzed. Spinal shock from TB tubuculoma compromising his lower spinal cord. His wheelchair was next to his bed. We updated his medications, and moved to the next patient. He did not say very much, just that he felt “fine” when asked. I can’t help but wonder how he was coping with his new paralysis and dependency on a wheelchair… Emotions are not frequently addressed or brought to the surface in the hospital. This is sad, because some of the most powerful experiences I have had with patients is when we talk about how one copes and processes being in a sick role. I still need to process this a bit more. Internal medicine in the states frequently only focuses on physical disease… To be continues.

- Few stroke patients. One patient does not communicate, can’t move arms or legs. Whenever we say hello to her she just smiles, eyes closed. Patient was not a candidate for a MRI or CT scan (which involves a transfer to tygerberg). No neurology consult... not sure if its needed. They think she had a intracerebral bleed. The most important thing is planning where to transfer her. Plan is to transfer her to Helderberg Hospice, a community supported facility. Usually people go there for about 2 weeks, either for hospice to die, or in transitioning to home. They work with families to train them how to be caregivers. Interesting how this is community and not governmentally funded… This patient has family that are going to take her, otherwise she could be stuck in the hospital for a long time waiting for a rehab center bed.

That’s all for now. I’ll do my best to get more pictures. Time to recover in bed. Cough cough sputter.